Classification: Internal

HSSE Risk Assessment Form

RISK MATRIX HAZARDOUS SITUATIONS TO CONSIDER
Lookup details: User selects one CONSEQUENCE and one LIKELIHOOD (result is determined automatically) 1 Can anyone be struck by, or come into contact
CONSEQUENCE with anything?
1 2 3 4 5 2 Can anyone be caught in, on, under, against or
Minor Medium Serious Major Catastrophic between anything?
1st Aid MTI RWI LTI Fatality Can anyone slip, trip or fall?
3
First Aid Injury Medically Treated Restricted Work Lost Time Injury Can anyone be exposed to environmental
Injury Injury 4
Qr.1 - Qr10k Qr10K - Qr20k Qr20k – Qr50k Qr50k - Qr100k > Qr100k hazards (e.g.: fumes, lack of oxygen, noise,
A – Almost Certain temperature, extremes, dust, vibrations,
MODERATE HIGH EXTREME EXTREME EXTREME
> 1 per week radiation, chemical)?
11 16 20 23 25
(>25%) 5 Can anyone be exposed to physical limitations
B – Likely
1/week – 1/month
MODERATE HIGH HIGH EXTREME EXTREME (e.g.: not enough space, lack of access to tools
7 12 17 21 24 fit for purpose, uncomfortable work position)?
(10-25%)
LIKELIHOOD

C – Possible
LOW MODERATE HIGH HIGH EXTREME 6 Is anyone at risk from others working in close
1/month – 1/year
(1-10%)
4 8 13 18 22 proximity?
D – Unlikely 7 Could process energy be reduced?
LOW LOW MODERATE HIGH HIGH
1/year – 1/10 years
2 5 9 14 19 8 Is any environmental damage possible?
(0.1-1%)
E – Rare 9 Is any property or equipment damage likely?
LOW LOW LOW MODERATE HIGH
< 1/10 years
(0.1%)
1 3 6 10 15

RESIDUAL RISK RATING RESULT CONTROL LEVEL HEIRARCHY OF CONTROLS

(after controls in place) (Authority)
Priority Control
TOLERABILITY CRITERIA

EXTREME Unacceptable CEO / COO 1 ELIMINATION - complete elimination of the hazard /

removal of energy source
HIGH Undesirable Lusail Project Manager 2 SUBSTITUTION - use something less hazardous
Tolerable, but risk should be reduced if reasonably 3 ISOLATION / ENGINEERING - physical barriers, guarding
MODERATE Supervisory Staff
practical 4 ADMINISTRATIVE - procedures, training
5 PPE - last form of control to be implemented
LOW Broadly acceptable Procedural Control

Contractor: Al Aali International Date of Assessment: Assessor Name: IBRAHEEM K PARAMBIL

Classification: Internal

LREDC -PWC Plants at

Project: Seef Lusail – North & Date of Previous Assessment: Approved By:
Commercial Boulevard
Assessment No. 07 Scope of Work: Surveying of Chambers for PWC Measurement

Participants: CM/PM, QC, HSE, Site Engineer

Exposed Risk Level Risk Level

SI Activity Hazard Existing Controls Additional Controls Accountability
Group(s) P C RFN P C RRN
1 – General Awareness

Safety induction to all Verify the competency of

competent employees C 2 8 E 2 3
the crew.
from AAI.

Ensure a briefing about

Health surveillance the method statement
check to the workers B 1 7 related to this job. D 1 2
who fit to work. Issuances of PPE depends
General education Lack of on the activity
and training before knowledge
any activity starts. Personnel Competent supervision Project
(New employees, with Competent Engineer /
1.1 transferred workers, Incompetency Client operatives Construction
including Ensure a toolbox Manager /
Property Issuances of PPE (i.e.
subcontractors meeting conducted C 1 4 E 1 1 Supervisor /
Lack of Helmet, safety glass,
prior to any work Safety Officer
experience safety shoes visibility
vest)

Project security
procedure and Issuance of Gate Pass
regulation. C 1 4 /Site IDs Follow LREDC E 1 1
Security guidance

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Classification: Internal

2 - Planning
Valid and approved
Joint site visit to be Project
permit to work signed by
Lack of done prior to work C 2 8 D 2 5 Engineer /
all parties.
Coordination execution Construction
2.1 Planning Work Crew
Competent and Daily tool box talk and Manager /
Unfamiliar with Supervisor /
experience Supervisor B 1 7 task instruction at job C 1 4
work area Safety Officer
for site activities location.
3- Lifting of the Manhole Cover

Risk Assessment
Competent supervision
with Competent Project
Manual Safe method of lifting operatives Engineer /
Lifting of the Manhole Work Construction
3.1 Handling/Bad using two man lift C 1 4 Communication D 1 2
Cover Crew Manager /
Posture Lifting aids in place Trained First Aiders
Full PPE worn( Hard Hat, Supervisor /
Safety Boots, High Vis, Safety Officer
Gloves)
Competent supervision
with Competent
operatives
Project
Full PPE worn( Hard Hat,
Permit for Road closure Engineer /
Safety Boots, High Vis,
Struck By Moving Work Barricaded Area Construction
3.2 Death C 2 8 Gloves, TTM with TMA D 1 2
Vehicles Crew Signage Manager /
competent banks man
Supervisor /
Risk Assessment /
Safety Officer
Method Statement
Communication
Trained First Aiders
3.3 Falling Objects / men Physical Work Safe method of lifting C 5 22 Competent supervision D 2 5 Project
injuries/ fatality Crew using two man lift with Competent Engineer /
Lifting aids in place operatives Full PPE Construction
worn( Hard Hat, Safety Manager /
Boots, High Vis, Gloves, Supervisor /
FBH) Safety Officer

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Classification: Internal

Risk Assessment /
Method Statement
Communication
Trained First Aiders
4- Confined Space Entry
Safe access and egress,
Only confined space
third party trained
Confined space entry personnel from LREDC
permit must be secure approved training
prior to entry, vendor list shall enter
Atmospheric testing The confined space,
shall be conducted by Availability of third party
competent authorized trained and Project
gas tester prior to entry, competent confined Engineer /
Work Use of Tripod to attach A 5 25 space entry supervisor, Construction
4.1 Entering the Manhole Death C 1 4
Crew to harness for Availability of third party Manager /
emergency trained confined space Supervisor /
Barriers around the area attendant to maintain Safety Officer
Gas / Oxygen Monitor the entry and exit,
Confined space permit Sufficient illumination,
Confined Space Training Full PPE worn (Hard Hat,
Trained Safety Watch to Safety Boots, High Vis,
be present Gloves, FBH)
Exhaust Fan, Emergency
arrangements with
Trained First Aiders.
4.2
Fal Death Work Crew Permanen B 5 2 Risk 2 5 Proje
ls t Use of 4 Asse D ct
Fr Tripod for ssm Engin
o emergenc ent / eer /
m y Met Const
He Barriers hod ructio
igh around Stat n
t the area eme Mana
and nt ger /

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Classification: Internal

persons to Com Super

divert foot mun visor
traffic icati /
on Safet
Con y
fine Office
d r
Spac
e
Train
ing
WA
H
train
ing, ,
Solid
anch
orin
g
poin
t,
prop
er
acce
ss
and
aggr
ess
with
prop
er
illum
inati
on,
Com
pete
nt

Document No: QD-LUS-HSSE-FM-002, Revision 2, Date 02.01.2020 Page 5 of 11

Classification: Internal

supe
rvisi
on
Train
ed
First
Aide
rs,
sign
age’
s,
Full
PPE
wor
n( H
ard
Hat,
Safe
ty
Boot
s,
High
Vis,
Glov
es

Sufficient illumination Project

Risk Assessment /
will be provided in Engineer /
Method Statement
Work good working order Construction
4.3 Inadequate Lighting Trapping B 3 17 Communication, LUX C 1 4
Crew and checked prior to Manager /
Monitoring
entry that battery is full Supervisor /
Trained First Aiders
charge Safety Officer

4.4 Exposure To Fumes Asphyxiation Work Gas / Oxygen Monitor B 4 21 Risk Assessment / D 2 5 Project
due to oxygen Crew Confined space entry Method Statement Engineer /
enrichment/de training Communication, Construction
ficiency, egress Ventilation, Continues Manager /

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Classification: Internal

atmospheric monitoring
Exhaust Ventilation,
Supervisor /
of toxic gases Emergency rescue
Safety Officer
arrangements and
Trained First Aiders
Risk Assessment / Project
Confined Space Method Statement Engineer /
Work supervisor in place C 5 22 Communication Construction
4.5 Lone Working Death E 1 1
Crew Attached safety line to Hole watcher, Manager /
person in the chamber Continues monitoring Supervisor /
Trained First Aiders Safety Officer

Risk Assessment /
Project
Hydration/Fluid to be Method Statement
Engineer /
taken on board before Communication
Extreme weather Heat Stress / Work B 3 17 Construction
4.6 entry, Ventilation, whether D 1 2
Condition frigid Crew Manager /
limited exposure, client monitoring, Welfare
Supervisor /
approved suitable PPE facility,
Safety Officer
Trained First Aiders

5- Exiting the chamber

Risk Assessment /
Confined Space Method Statement,
supervisor in place. Communication. Project
Attached safety line to Sufficient illumination, Engineer /
Extreme weather Work person in the chamber Competent supervision, Construction
5.1 Entrapment C 2 8 D 1 2
hazards Crew using tripod and Competent hole watcher Manager /
harness. Trained First Aider with Supervisor /
Use of Trolley for Emergency rescue team Safety Officer
person to be pulled. Constant Control Room
communication.

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Classification: Internal

Barricaded Area,
In case of any
Flag Man, Signage
emergency all work will
Emergency
be stopped, shutdown Project
Management Team,
Work all running equipment Engineer /
Risk Assessment /
Struck By Moving Crew &machineries and A 5 25 E 2 3 Construction
5.2 Death Method Statement
Vehicles reported to muster Manager /
Communication
Visitors point Supervisor /
Trained First Aiders
All Workforces shall Safety Officer
Full PPE worn( Hard Hat,
aware about the
Safety Boots, High Vis,
muster Point location
Gloves)
6 – Emergency

In case of any With ERT (Emergency

emergency all work will Response Team)
be stopped, shutdown Emergency rescue Project
all running equipment B 2 12 equipment. D 1 2
Engineer /
Work Crew &machineries and AL AALI & LREDC
Emergency Poor- Construction
6.1 reported to muster Emergency Procedure to
procedure/ Response communication Manager /
Visitors point be followed Supervisor /
Safety Officer
Emergency contact
All Workforces shall
number should be aware
know the muster Point D 3 9 D 2 5
and displayed to all
location
personnel
7 - Weather Condition
Work All activity to be stopped
Crew Awareness on Heat and crew to report
7.1 Adverse Weather Heat Stress stress related risk B 3 17 facility area during C 1 4
Condition through TBT/Training Sandstorm/ rain /High
wind
Temperature Visitors Communicate heat C 2 8 Provide cool water in the D 1 2
related illness to local workplace and
emergency response encourage workers to Project
Humidity team drink it frequently (4.5 to Engineer /

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Classification: Internal

6 litres per day)

Utilize cool room
Radiant Heat available near working
Monitor and ensure the
and station and provide
LREDC Heat Index Flag B 2 12 D 2 5
electrolyte/ ORS powder
system at site regularly
to avoid body
Air velocity dehydration as required
Take periodic rest
breaks and rest
Heavy Protect skin from direct
facilities as per client
work/hard work D 3 9 sun exposure by covering C 1 4
flagging system or
and applying sun’s lotion
according to body
temperature
Strong Proper training has to
wind/Strom be provided to the
During summer, mid-day
workers about the risks
C 2 8 rules have to follow as D 2 5
of heat stress, safe
Rain or Hail per Qatar Law
working practices and
emergency procedures
Property Construction
Wear loose fitting
Poor visibility Never work alone Manager /
coveralls and other
always work in pair C 3 13 E 2 3 Supervisor /
personal protective
(buddy system) Safety Officer
equipment’s.
Monitor the weather
forecast and prepare
Avoid soft drinks, salt
for the emergency D 3 9 E 1 1
tablets and heavy meals
response

During Poor Visibility,

Mud or slurry or slippery
the work to be stopped
condition needs to be
and work shall be C 2 8 D 1 2
cleared site by site in
resumed once the
working platform.
visibility is clear
All electrical appliances
Keep rain suits for
must be covers and
B 2 12 emergency purpose at D 2 5
check before use after
site
rain get stopped

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Classification: Internal

8 - COVID – 19

Workers shall remain at

least 2 meters apart.
If this is not possible
owing to the nature of
the work, workers shall
wear a face mask and Frequent hand washing
gloves. with soap and water

However, requirements A 2 16 Awareness training an C 1 4

for COVID-19 related poster on effective
PPE should be defined handwash techniques
Work Crew
as part of the Permit to
Work process and be
Project
integrated with any
Clients Engineer /
other requirements
Construction
associated with the
Biological Manager /
Corona Virus (COVID- work area.
hazards Supervisor /
8.1 19) infection and
Visitors Be aware of the signs When coughing and Safety Officer
prevention. Cold & flu virus
and symptoms like B 2 12 sneezing, cover mouth C 1 4
fever, cough & and nose with flexed
shortness of breath elbow or tissue

Dispose-off the tissue

Make sure Flu
with responsibility in a
symptoms: fever, B 2 12 C 1 4
trash bin and
cough & shortness of
immediately wash your
breath
hands

Inform immediately
A 2 16 Avoid touching your C 1 4
your supervisor and
eyes, nose, and mouth
department

Maintain a clean
Wear a mask to limit A 1 16 C 1 4
environment & sanitize
the respiratory droplets
surface

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Classification: Internal

9 - Social Factors
Ensure Social Factor
topic to be discussed Ensure no horseplay at
D 3 9 D 2 5
with crew/workers site
during TBTs
Supervisor shall aware
Work Crew
and recognize any Proper delegation of Project
violence or bullying E 4 10 duties and job E 3 6 Engineer /
Violence, situation which is to be description Construction
9.1 Social Factors Visitors
Bullying, Stress prevented immediately Manager /
Ensure stress Ensure personal space is Supervisor /
Management maintained and report to Safety Officer
Clients C 2 8 C 1 4
awareness conducted your supervisor if any
for the crew violation
Report any incident The work to be carried
related to bullying or C 3 13 out under the D 2 5
violence immediately supervision

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