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Risk Assessment Template

Department : Name of Work Activity :


Location : Name of Person Incharge :
Last Review Date : Next Review Date :
1. Hazard Identification 2. Risk Evaluation

SN Task Hazards Possible Existing Risk L S R Additional / New L S R Action By Deadline


Consequences Control (If any) Risk Control

Conducted by : (name) Approved by : (name)

Conducted by : (designation) Approved by :(designation)

Signature : Signature :
Date : Date :

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