Very Likely Hazard Lik

1 5
UNLIKELY Likely Hazard wil
4
2 LOW RISK Possibly some man
POSSIBLE 3
Unlikely Manifesta
3 MEDIUM RISK 2
LIKELY Very unlikely Manifesta
1
4 HIGH RISK
VERY LIKELY Low Risk Risk Level
Risk level t
5 Medium Risk
ALARP
High Risk Risk level i

SEVERITY HEALTH AND SAFETY ENVIRONMENT VESSEL / PROPERTY DAMAGE

Work Activity being assessed : If any hazard manifests itself even after effective control
Code : No. - Number, LKH - Likelihood, SVR - Severity, RF - Risk Factor, A.C - Additional controls measures were taken or develops unexpectedly, then work
EXTREME
5
Multiple or single fatality
Release to environment, long term
large impact on environment
complete Loss of vessel or
Financial loss >$ 1 million

should be stopped and office informed Major damage to vessel with long
Code for Risk Factor : HR - High risk, MR - Medium risk, LR - Low risk MAJOR
4
Injury requiring repatriation
Release to environment, large
impact on environment
lay up repairs. Financial loss $
100,000 - $ 1 million
For unusual jobs and work on critical equipment, copy of risk assessment to be sent to office For Office use : For standard risk assessments in SBM II MODERATE Loss time injuries excluding Release to environment, Small to
Damage which can be repaired
during voyage. Financial loss
Date of Risk Assessment Last Assessment: Current : Last : 3 repatriation medium impact on environment
$10,000 - $100,000
Minor damage to equipment or
SECTION 1 Please see below for the risk estimator Risk rating Residual Risk MINOR
2
Restricted work injury / medical
first aid cases
Spill contained on board vessel. Financial Loss $5,000 - $
10,000
No. Hazard Consequence LKH SVR RF Controls LKH SVR RF A.C NEGLIGIBLE Minor First aid injuries, e.g. cuts /
Inconsequential leak
Negligible damage to vessel.
1 wounds / bruises / sprains Financial Loss < $5000

2
SEVERITY
3 NEGLIGIBLE MINOR MODERATE MAJOR EXTREME
LIKELIHOOD
1 2 3 4 5
VERY UNLIKELY
4
1
UNLIKELY
5 2 LOW RISK
POSSIBLE
6
3 MEDIUM RISK
7 LIKELY
4 HIGH RISK
8
VERY LIKELY
9 5
Section 2 - Additional controls Acceptable/Intolerable If ALARP then fill Additional controls in section 2 DO JOB
No. Controls to ALARP ( As Low as reasonably practical) To Be completed prior commencement of work
SEVERITY HEALTH AND SAFETY ENVIRONMENT VESSEL / PROPERTY
Alternate method of work considered and found not applicable Yes No
1 EXTREME
Multiple or single fatality
Release to environment, long term complete Loss of
5 large impact on environment Financial loss >$
SEVERITY
NEGLIGIBLE MINOR MODERATE MAJOR Yes EXTREME Risk Rating = Severity X Likelihood Major damage to ves
Discussed hazards and controls
LIKELIHOOD with team No MAJOR
Injury requiring repatriation
Release to environment, large
lay up repairs. Fina
2 1 2 3 4 5 With
4 Controls, Severity (in most cases) will impact
not comeon environment
100,000 - $ 1 m
VERYwhen
UNLIKELY down but, Likelihood is brought down(in most cases )
MODERATE Loss time injuries excluding Release to environment, Small to
Damage which can
Date and time all controls are in place 3 Very Likely Hazard Likely to occurmedium impact on environment
repatriation
during voyage. Fin

3 1 5
$10,000 - $10
Minor damage to eq
MINOR Restricted work injury / medical
UNLIKELY 2
Likely Hazard will be experienced
first aid cases
Spillas only one
contained control
on board vessel. Financial Los
4 10,000
Shut down period for
2 this RA (For work on critical jobs only) From To
4 LOW RISK NEGLIGIBLE
Possibly Minor First aid injuries, e.g. cuts
some manifestation of Hazard / may occur
Inconsequential leak
Negligible damage
1 wounds / bruises / sprains Financial Loss <
POSSIBLE 3
5 Evaluation of Risk Assessment after completion of work Unlikely Manifestation of Hazard unlikely
3
Any new hazard or missed hazard ( If Yes, Mention in comments
MEDIUMand
RISKto be Yes No 2
6 considered when doing next risk assessment for the same job )
LIKELY Very unlikely Manifestation of Hazard very unlikely
1
4 HIGH RISK
7 Low Risk Risk Level is Acceptable
VERY LIKELY
8 Comments : Review dates Rank Risk level tolerable but needs additional control to
5 Medium Risk
ALARP
9 1
High Risk Risk level intolerable
2
DO JOB A risk assessment can be reviewed and then used within one month period
Prepared by: SEVERITY HEALTH AND SAFETY 3 ENVIRONMENT VESSEL / PROPERTY DAMAGE
basis no change in hazard or control measures - (NA for SMMS)
4
EXTREME Release to environment, long term complete Loss of vessel or
Multiple or single fatality
5 large impact on environment Financial loss >$ 1 million
Major damage to vessel with long
MAJOR Release to environment, large
Injury requiring repatriation lay up repairs. Financial loss $
4 impact on environment
100,000 - $ 1 million
Damage which can be repaired
MODERATE Loss time injuries excluding Release to environment, Small to
during voyage. Financial loss
3 repatriation medium impact on environment
$10,000 - $100,000
Minor damage to equipment or