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Risk Assessment

Assessor's Name Date


Time
Work Area
The task being evaluated

What is the Who How Existing risk Risk rating Additional controls New risk Action/ Action/
Hazard? might be might control rating monitored monitored
harmed? people be measures? (Residual) by whom? by when?
harmed? L C R L C R
What is the Who How Existing risk Risk rating Additional controls New risk Action/ Action/
Hazard? might be might control rating monitored monitored
harmed? people be measures? (Residual) by whom? by when?
harmed? L C R L C R

Review Date
Signature

Trainer's Name

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