HAZARD IDENTIFICATION & RISK ASSESSMENT (HIRA)

OHS-PR-09-03-F02 (A) HIRA-Hazard ID and Risk Assessment Form and Register

Operating Area: Project Name:
Contractors: Project Type: Contract No.:
Risk Assessment (Baseline and full RA)
TASK/ACTIVITY/PROCESS NAME: Excavation work using equipment DEPARTMENT/AREA:
RA Number: DATE:
SEVERITY / CONSEQUENCE (Impact/Hazard Effect) (Where an event has more than one ' Loss Type ', choose the ' Consequence' with the highest rating)

Loss Type Additional "Loss Types" may exist for

an event: Identify & rate accordingly (1) Insignificant (2) Minor (3) Moderate (4) Major (5) Catastrophic

Loss Time Injury / Reversible Impact on

(S/H) Harm to People (Safety/Health) First Aid Case/Exposure to Minor Health Risk Medical Treatment Case/Exposure to Major Health Risk
Health Single Fatality or Loss of Quality of Life / Irreversible impact on Health Multiple Fatalities / Impact on health Ultimately Fatal

Material Environment harm (RST) Serious

(EI) Environmental Impact Minimal environment harm incident with workplace Material Environment harm (RST)
environmental harm incident (RMT)
Major environmental incident (RLT) Major environmental harm – Incident Irreversible

(BI/MD) Business Interruption / Material / Fire No disruption to operation / 1000 SR to Less than 10k SR Brief Disruption to Operation / 10k SR to Less Than 100k SR Partial Shutdown/100k SR to Less than 1M SR Partial Loss of Operation/1M SR to Less than10M SR Substantial or Total Loss of Operation / 10M SR and more
Damage & Other Consequential Losses
LIKELIHOOD Examples (Consider Near-Hits as well as actual events) RISK RATING / PROFILE
The unwanted event has occurred frequently : Occurs in order of (1) or more
(5) ALMOST CERTAIN per year & is likely to reoccur within 1 year 5 (M) 10 (H) 15 (Ex) 20 (Ex) 25 (Ex)
The unwanted event has occurred infrequently : Occurs in order of less than
(4) LIKELY once per year & is likely to reoccur within 5 yrs. 4 (M) 8 (H) 12 (H) 16 (Ex) 20 (Ex)
The unwanted event has occurred in the business at some time: or could
(3) POSSIBLE happen within 10 years. 3 (L) 6 (M) 9 (H) 12 (H) 15 (Ex)
The unwanted event has occurred in the business at some time: or could
(2) UNLIKELY happen within 20 years. 2 (L) 4 (M) 6 (M) 8 (H) 10 (H)
The unwanted event has never known to occur in the business or it is highly
(1) RARE unlikely to occur within 20 years. 1 (L) 2 (L) 3 (L) 4 (M) 5 (M)
RA TEAM (Names) DESIGNATION SIGNATURE RISK RATING RISK LEVEL GUIDELINES FOR RISK MATRIX
Stop operation and review controls- Eliminate, avoid risk & implement high
1. 15 to 25 (Ex) - Extreme priority action plans
Proactively manage & implement specific controls/action plans-Review after 7
2. 8 to 12 (H) - High days
Actively manage & monitor – Additional controls is advised & review after 14
3. 4 to 6 (M) - Medium days

4. 1 to 3 (L) - Low Risk acceptable – Monitor & manage as appropriate with frequent review

Review by: Signature: Date: APPROVED BY / MANAGER or SUPERVISOR: DATE: NEXT REVIEW DATE:
Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.
HAZARD IDENTIFICATION CONTROL RISK RISK REDUCTION ACTION PLAN
ASSESSMENT

Consequence

Consequence

Risk Ranking
Risk Issue

Likelihood

Likelihood
Controls

Ranking
(Improve Existing Controls/ Follow up By Whom (Name) Implemented
Item #

Work Activity Hazards (Possible Incident) (What can go wrong) Existing Controls
(Process, Equipment, Materials) (Accident/ Ill health to person, fire or property Implement new controls) & By When (Date) (Yes / No)
loss)
Site Manager
1 Obtain Permit to Work ⬧ Unauthorized work to be performed within ⬧ Accident resulting serious injury or death to
⬧ Permit to Work shall be obtained as a ⬧ Permit Receiver shall be trained and Site Manager
Site Engineer
3 2 6 3 1 3 YES
a defined location and boundary worker prerequisite Safety Engineer
⬧ Significant property and appurtenances ⬧ A safe worktopractice performshall work be implemented to 2 2 4
authorized
⬧ All workers byattending
the Manager the to receive
toolbox a
meeting 2 1 2
Site
Site Engineer
ManagerForeman.
Supervisor/ YES
damage ⬧ Workthe
reduce shallpossibilities
not be started until duly
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Work Safety Engineer
⬧ Uncontrolled Personnel entering a ⬧ Loss of production ⬧ Permit
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workers
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Site Engineer
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restricted location ⬧ Permit
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⬧ Significant cost due to damages Toolbox
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Receiver 3 1 3 Supervisor/ YES
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safety
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2 Mobilization of materials, protocol
⬧ Lack of safety awareness and knowledge ⬧ Physical injury and damage to property due ⬧ shall designate
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YES
manpower and equipment at site for the job/Incompetent Personnel
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Permit
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Supervisor/
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YES
⬧ Working without wearing appropriate ⬧ Physical injury
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Ensure will be
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⬧ All inspected tools and equipment will be 1 2 Site ManagerForeman.
Supervisor/
Safety Engineer
YES
Personnel Protective Equipment
⬧ Improper manual handling (PPE) due to lack
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its condition
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Supervisor/
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YES
⬧ Physical Injury from slip, trip and fall deployed
⬧ 20kg
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will Site Manager
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3 Checking and verification of any ⬧ Damage to underground utilities prior to ⬧ Damage to property ⬧
⬧ Locate
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Supervisor/ Foreman. YES
underground utilities excavation due to failure to perform pre- ⬧ Back injury
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removed from the site Safety Engineer
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⬧
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Engineer
Site Manager
Engineer
YES
4 Perform excavation using Excavator ⬧ Underground utilities ( unsecured ) ⬧ Damaged to existing plant / underground ⬧
⬧ Ensure
Area
underground thatbe
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Report accordingly any noticed 3 2 6 Site
Supervisor/ Foreman. YES
⬧ Fatality 
⬧ Cover
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banks
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Site Engineer
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⬧ Property damage
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Supervisor/
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⬧ Poor Access/Egress ⬧ Physical injury from slip, trips & fall materials
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access and egress
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Supervisor/
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⬧ Defective mechanical equipment Physical injury / Property damage
⬧ Fatality and Damage to property
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Engineer
YES
⬧ Provide
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Provide
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contact with dust ⬧
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lights ⬧ Any
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Warning signs and
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safety
of must
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Site Engineer
⬧ High ambient temperature ⬧ Heat Stress (stroke, cramps, skin rashes etc.) ⬧ underground
boundaries
buildup
⬧ Provide for
ofpathwaysservices.
unknown both
sufficient routes.
gas.
drinking water and ⬧ Follow existing traffic rules inside the area.
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repair.
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Safety Engineer
YES
⬧
⬧ Mechanical
breaks.
Provide
condition
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with ⬧ Supervisor/ Foreman.
1  HIRA-Hazard ID and Risk Assessment Form and Register
removed
⬧ No tools
banks
water
obstructions
man and
insideshall
equipment
/ spotters
excavation.
be
to assist
OHS-PR-09-03-F02 moved
to be thestored and kept
(A) closed to
machine orAll Personnel
removed immediately undergo in a Heat Stress
Rev. 0     Revision Date (May 2021)
direct exposure from the sunlight. Awareness Training.
 Site Manager
⬧ Ingress of water and mud ⬧ Biological hazards ⬧ Manually or using submersible pump to removed 3 ⬧ No work to be allowed in presence of water 3 Site Manager
Site Engineer
2 6 1 3 YES
⬧ Safety Engineer
5 Loading / transferring the ⬧ Traffic Hazards ⬧ collapse
Struck byofVehicles
excavation
and traffic collisions the accumulating
⬧ Provision of proper water inside
traffic the excavation
management suchdueas 3 2 6
in excavation.
⬧ All operators must be certified and Site
Site Engineer
ManagerForeman.
excavated materials to dump truck ⬧ Equipment without 3rd party certificate ⬧ to rain or leakage from some utilities damage ⬧ Continuous dewatering until the excavation 2 1 2 Supervisor/
Safety Engineer YES
⬧ Serious
PhysicalInjury
injury / Property damage designated
⬧ All equipment
throughout
routes
excavation.
for for
used vehicles / equipment
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3 2 6
authorized
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Site ManagerForeman.
Supervisor/ YES
⬧ Permanent disability pedestrian routes.
third-party certification to ensure safe operation. ⬧ Retraining
adequate banks of
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⬧ Incompetent operator Physical injury / Property damage
⬧ Fatality ⬧
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Site Engineer
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⬧
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Site Engineer
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⬧ Airborne dust ⬧
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Supervisor/ YES
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Site Manager
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certificate
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Supervisor/ Foreman. YES
⬧
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Site Manager
Engineer
6 Shifting and offloading of excavated ⬧ Other moving equipment in the area (such⬧ Struck by Vehicles and traffic collisions and
⬧
the driverstrained
Provide
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Supervisor/ Foreman. YES
soils into the designated area as dump truck, etc.) ⬧ capacity
/ isolate load for the
all unauthorized person Personnel away from the necessary Safety Engineer
⬧ Exposure to Dust ⬧ Serious Injury
Excess dust may lead to respiratory diseases and
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done around of the 3 2 6
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Site
Site Engineer
ManagerForeman.
Supervisor/ YES
⬧ Permanent disability area.
equipment. ⬧⬧Retraining illuminated
ofworkers
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7 Housekeeping ⬧ Unwanted materials that lay inside and Physical injury from slip, trips & fall excavated
⬧ Conduct area to
and Maintain control the dust flow
daily housekeeping ⬧ Rotation
Maintain of assignment
daily proper housekeeping to lessen Site
Site Engineer
ManagerForeman.
⬧ Fatality ⬧ Suitable
Appropriate traffic management
dust mask must plan
be shall be
use. 3 2 6 deem necessary
the exposure of Personnel in the related 3 1 3 Supervisor/ YES
outside Safety Engineer
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dust related 2 6 ⬧ Provision of two-way radio
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Site
Site Engineer
ManagerForeman.
Supervisor/ YES
walkway the walkway maintain
from
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access ways. necessary for clear communication of banks
necessary. Safety
Site Engineer
Engineer
8 Closing of Permit to Work ⬧ Poor housekeeping ⬧ Environmental complaint hazards
⬧
⬧ Permit
⬧ Separate,
Designated
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demarcated 2 4 ⬧
manSupervisor
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Supervisor/ YES
⬧ Undisposed waste materials ⬧ Governmental
⬧ Accident resulting serious injury or death to
violation in
⬧ done before,
walkways
Mobile with signs
equipment during andbe
posted.
shall after
properly
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and after theshall
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Safety
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Engineer
Site Manager
Engineer
worker obstruction
⬧ All waste materials generated fromshallthe bework 2 2 4 activity 1 1 1 Supervisor/ Foreman. YES
⬧ Governmental
Accident resulting serious injury or death to ⬧ Designated
designated offloadinglaydown
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toallthethe
proper materials
housekeeping to prevent
and Safety Engineer
Site Manager
Engineer
⬧ Unaccounted workers ⬧ violation ⬧ Security/guard
shall be disposed should
properly be mobilized
and shall as notandbe signs
left 3 2 6 ⬧ TBT for
Enough waste workers
bins and proper 3 1 3 Site YES
worker established
⬧ All materials with suitable
used at the demarcation
site such chemicals, spoils
storage from
of spilling
materials onatshall
the
the be
road provided
while
designated Supervisor/
Safety Foreman.
Engineer
⬧ Inadequate communication ⬧ Loss of production
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unattended atout theshould
worksite be implemented, belog book monitoring Site Engineer
⬧ Significant cost dueserious injury or death to
to damages ⬧ Regular
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and
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location dump communication
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pertaining 2 1 2 Site ManagerForeman.
Supervisor/ YES
⬧ All materials used at always siteavailable
thestorage such as chemicals, ⬧ security/guard Safety Engineer
⬧ Poor storage of chemical, flammable and worker
⬧ Significant property and appurtenances communication
stored
⬧ Permit at the
Receiver
Coordination
flammable
designated
shall ensure
between
and combustible
at
that
HR materials
and PMT the
proper
forend
shall
of
storage
newbe 2 2 4
PMT
⬧
⬧
to
Foreman
Site
Must Manager
log inhave
shall
and out
ensure
shall be that cover
responsible
chemical holder with proper is installed
on the 2 1 2 Site
Site Engineer
ManagerForeman.
Supervisor/ YES
combustible materials and etc. damage each
of day induction
chemical iscondition
doneshould
before, during properly.
effective implementation of the Permit to Safety Engineer
⬧ Unattended unsafe condition ⬧ Loss of production workers,
stored
⬧
⬧ All at the
unsafe
Electrical designated
equipment must
shall
be
storage
be atand
provided
be identified
properlytheafter
end
by ofthe
the
secured, 2 2 4
training
⬧
⬧ Site
TBT Manager
Work should beshall donebeand responsible
all pending onunsafe
the 2 1 2 Site
Site Engineer
ManagerForeman.
Supervisor/ YES
⬧ Accident
Governmental violation work
each day ⬧ SDS must
effective be available
implementation of the Log in logout Safety Engineer
⬧ Unsecured electrical equipment, energized ⬧ Significantresulting
property serious injury or death to
and appurtenances safety
⬧ Permitrep.
distribution and
Receiver must
board shall be
closed rectified right
and padlocked
ensure that away.
housekeeping condition
⬧ Permit must
Issuerand
Receiver be
shalldiscussed
visit
shall the work
account byall location to 2
worker Site Engineer
equipment
⬧ Environmental
worker
damage
complaint ⬧ All
⬧
in Areawaste
Permit
done with materials
un attended
Receiver
before, shall
during
generated
unsafe
account
and after
from
condition
all
the
the work
worker
work must
under be 3 2 6 Supervision
system
⬧ Supervising
verify
under good
his Engineermonitoring
housekeeping
Permit to Work and Foreman
was
and
the
conducted
ensure shall
all have
1 2 Supervisor/ Foreman.
Safety Engineer
YES
⬧ Accident resulting serious injury or death to shall be disposed properly and shall not be left 0 supervisor
Select must take place ###
⬧ Accident resulting serious injury or death to
worker
identified
hisElectrical
⬧ Permit toequipment
unattended atWork and shall
the worksite ensure be all have signed
properly secured, out beforeControl
adhere
signed to the
closing
out Method
proper rectification
the attendance
on the Permit to Work
sheet ofand
the clear
open 0 Supervisor/ Foreman.
worker on the attendance
distribution board closed sheet and
andto clear of the
padlocked area 0 observation
Select
of Control Method
the area 0 ###
⬧ Significant cost due to damages ⬧ Safety information on how handle chemical ⬧ Site Manager shall be responsible on the
⬧ LOTO procedure
materials must be posted should be available and ⬧ Site Manager shall be responsible on the
properly implemented effective
effective implementation
implementation of the Permit to
⬧ All materials used at the site such as chemicals,
flammable and combustible materials shall be Work
stored at the designated storage at the end of ⬧ Monthly inspection and color code should
each day be implemented
⬧ Electrical equipment checklist and registry
should be updated

2  HIRA-Hazard ID and Risk Assessment Form and Register OHS-PR-09-03-F02 (A) Rev. 0     Revision Date (May 2021)
 SEVERITY / CONSEQUENCE (Impact/Hazard Effect) (Where an event has more than one ' Loss Type ', choo
Loss Type Additional "Loss Types" may exist for
an event: Identify & rate accordingly (1) Insignificant (2) Minor
Medical Treatment Case
(S/H) Harm to People (Safety/Health)
First Aid Case/Exposure to Minor Exposure to Major Health Risk
Health Risk

(EI) Environmental Impact

Minimal environment harm incident Material Environment harm (RST)
with workplace

(BI/MD) Business Interruption / Material / Fire Damage & No disruption to operation / 1000 SR Brief Disruption to Operation / 10k
Other Consequential Losses to Less than 10k SR SR to Less Than 100k SR

LIKELIHOOD Examples (Consider Near-Hits as well as actual events)

(5) ALMOST CERTAIN The unwanted event has occurred frequently : Occurs in order of (1)
or more per year & is likely to reoccur within 1 year 5 (M)
(4) LIKELY The unwanted event has occurred infrequently : Occurs in order of
less than once per year & is likely to reoccur within 5 yrs. 4 (M)
(3) POSSIBLE The unwanted event has occurred in the business at some time: or
could happen within 10 years. 3 (L)
(2) UNLIKELY The unwanted event has occurred in the business at some time: or
could happen within 20 years. 2 (L)
(1) RARE The unwanted event has never known to occur in the business or it is
highly unlikely to occur within 20 years. 1 (L)

RISK RISK LEVEL GUIDELINES FOR RISK MATRIX

RATING
Stop operation and review controls- Eliminate, avoid risk &
15 to 25 (Ex) - Extreme implement high priority action plans

Proactively manage & implement specific controls/action

8 to 12 (H) - High plans-Review after 7 days
Actively manage & monitor – Additional controls is advised
4 to 6 (M) - Medium & review after 14 days
Risk acceptable – Monitor & manage as appropriate with
1 to 3 (L) - Low frequent review
than one ' Loss Type ', choose the ' Consequence' with the highest rating)

2) Minor (3) Moderate (4) Major (5) Catastrophic

Treatment Case Loss Time Injury / Single Fatality or
o Major Health Risk Reversible Impact on Loss of Quality of Multiple Fatalities / Impact on
Health Life / Irreversible health Ultimately Fatal
impact on Health
Material Environment
ironment harm (RST) harm (RST) Serious Major environmental Major environmental harm –
environmental harm incident (RLT) Incident Irreversible
incident (RMT)
Partial Loss of
Operation/1M SR
on to Operation / 10k Partial Shutdown/100k To Less than10M SR Substantial or Total Loss of
ss Than 100k SR SR to Less than 1M SR Operation / 10M SR and more

RISK RATING / PROFILE

5 (M) 10 (H) 15 (H) 20 (Ex) 25 (Ex)

4 (M) 8 (H) 12 (H) 16 (Ex) 20 (Ex)

3 (L) 6 (M) 9 (H) 12 (H) 15 (Ex)

2 (L) 4 (M) 6 (M) 8 (H) 10 (H)

1 (L) 2 (L) 3 (L) 4 (M) 5 (M)

Area/Department
Date Compiled Date Revised
Compiled by:
Management Action
Priority
Ref No. Description of Risk Risk Score Action Responsible person
Rating
 Target Action
Responsible person
date complete