DEPARTMENT:

PROCESS:
ACTIVITY LOCATION:
ORIGINAL ASSESMENT DATE:
LAST REVIEW DATE:
NEXT REVIEW DATE
HAZARD IDENTIFICATION
REF WORK ACTIVITY HAZARD

FALL FROM HEIGHT

1 WORK AT HEIGHT

FALLING OBJECT

HAND CUTTING

2 MACHINERIES FOR TRIM SHURBS

FLYING PARTICLES OF SHURBS

POSSIBLE TO CONTACT LIVE CABLES

 RISK ASSESMENT FORM
RA LEADER: APPROVED BY:
RA MEMBER 1: SIGNATURE:
RA MEMBER 2: NAME:
RA MEMBER 3: DESIGNATION:
RA MEMBER 4: DATE:
RA MEMBER 5:
N RISK EVALUATION
POSSIBLE INJURY/ILL- HEALTH EXISTING RISK CONTROLS S L RPN ADDITIONAL CONTROL

1.CONDUCT WAH TRAINING 1.CLOSE SUPERVISION 2.B

FATALITY 2.PROVIDE BANKS MAN 5 5 25 RA,SWP

1.CARDON OFF WORK AREA 1.USING LANYARD TOOLS

SERIOUS BODY INJURIES 4 3 12 PROVIDE BANKS MAN
2.BRIEFING WORK ACTIVITY

1.TRAINING PROVIDED 2.USE

BODY INJURIES 4 2 8 1.PROVIDE MACHINE GUARD
PROPER PPE

1.USE PROPER PPE (FACE

EYE INJURIES SHIELD,GOGGLES) 4 3 12 1.COMPETENT WORKERS ONL
1.USE INSULATED RUBBER GLOVES
ELECTROCUTION 2.CHECK THE MACHINERIES IF ANY 4 2 8 1.BRIEFING RA,SWP
DAMAGED
OVED BY:
ATURE:
E: REFERENCE NUMBER
GNATION:
:

RISK CONTROLS
ADDITIONAL CONTROLS S L RPN IMPLEMENT PIC DUE DATE REMARK

OSE SUPERVISION 2.BRIEFING

WP 5 1 5 SITE SUPERVISOR

NG LANYARD TOOLS 2.
4 1 4 SITE SUPERVISOR
VIDE BANKS MAN

OVIDE MACHINE GUARD 3 1 3 SITE SUPERVISOR

OMPETENT WORKERS ONLY ALLOW 4 1 4 SITE SUPERVISOR

EFING RA,SWP 3 1 3 SITE SUPERVISOR