RISK / IMPACT ASSESSMENT

CONTROL SHEET
Contract No.  
Project Title  
RA Reference RA/Department/Contract No/000
RA Date  
RA Revision No. 00

SEVERITY RATING: MATRIX

Please Note
If the severity rating lies between 1 to 16, then corrective actions
People/Equipment/Production       needs to be taken by concerned persons with documentary evidence
provided in conjunction with WI HSE 09
Health Safety Loss & Environmental Impact
    Probability
    OH&S Environmental     1 2 3 4 5

1-3 Immediate Very High - VH Fatal / Permanent disability Major Incident 1 1 2 3 4 5

High - H Serious injury / illness Serious Incident 2 2 4 6 8 10

Severity
4-9 Before task commences
10-16 Before task commences Medium - M Moderate injury / Illness Moderate Incident 3 3 6 9 12 15
20-25 Acceptable Low - L Minor injury / Illness Minor Incident 4 4 8 12 16 20
>25 Very Low - VL Slight injury (No lost time). First Aid Case. Slight Incident 5 5 10 15 20 25
Working group Designation       Certain or
Very Likely Likely May Happen Unlikely
Imminent
           
   
    Fill in & enclosed herewith WI HSE 069
   
   
Approved by:
Verified by:
Client
Project Manager:
Name: ________________________ Signature: ______________ Date / /
________________________ Signature: ______________ Date / /

Construction Manager/Site Agent: Consultant Approval:

________________________ Signature: ______________ Date / / Name: ________________________ Signature: ______________ Date / /

Distribution: Original to Site HSE File Cc: HSE Department
Scope / Activity: Compressed Gas Cylinder - Handling
Page 1 of 3 WI HSE 001/ OCT 2007
 RISK / IMPACT ASSESSMENT
CONTROL SHEET

Rating (see Rating (see Sign.

Priority Existing Controls Existing Controls Priority
No. Hazard /Aspect Risk / Impact enclosed legend (*) VH,H,M,L (OH&S) (Environmental)
enclosed legend (*) VH,H,M,L
Resp.
page for details) page for details) Person

Hazard is anything with potential to Risk is the harm resulting from

OH&S E OH&S E OH&S E OH&S E
cause harm or loss. the hazard.
   
Not in confined spaces Or underground  

Untrained persons can Operator to be trained. Trained and competent

Property to damage. person is to operate          
1. cause unsafe act; fire or Appointment form and
Injury to employees. only.
explosion. certificate.
Store away from other Regular monthly checks.
flammable substances.
Store in a well ventilated
Damage to property Store in a well ventilated area.
2. Fire. and injuries to          
area.
employees. Extinguishers shall be
Regular monthly checks. provided and maintained
in the storage area.

Damage to property Plan flammable store Do not store cylinder

3. Fire or explosion. and injuries to properly. under direct sunlight or          
employees. near source of ignition.
Storeman to be induct.
Use trolley with chain to Proper storage to be
ensure upright at all times. made to avoid hazard or
Damage to property explosion.
4. Fire or explosion. and injuries to Induct storeman and          
employees. employees. Keep cylinders upright
and not to roll the
cylinders.
Use only specified Induct all employees.
5. Good conductor of heat. Injury to employees. connectors.          
Induct all employees.

Scope / Activity: Compressed Gas Cylinder - Handling

Rating (see Rating (see Sign.

Priority Existing Controls Existing Controls Priority
No. Hazard /Aspect Risk / Impact enclosed legend (*) VH,H,M,L (OH&S) (Environmental)
enclosed legend (*) VH,H,M,L
Resp.
page for details) page for details) Person

Page 2 of 3 WI HSE 001/ OCT 2007

 RISK / IMPACT ASSESSMENT
CONTROL SHEET
Hazard is anything with potential to Risk is the harm resulting from
OH&S E OH&S E OH&S E OH&S E
cause harm or loss. the hazard.
   
Keep all such equipment in Check operation of
good condition. Do regular safety valve.
Injury to employees and checks and do not allow
6. Fire or explosion. Secure hose properly to  
damage to property. employees to work with
unsafe equipment. avoid loose connections.

Supervisor to control.
Keel all such equipment in
good condition. Do regular
check and do not allow
Leak of gas or heat causes Injury to employees and employees to work with          
7.
fire or explosion. damage to property. unsafe equipment.
Supervisor to monitor that
this rule is complied with.
By separating the All containers shall be
cylinders, the gasses legibly and durably
Property damage; cannot interact. marked.          
8. Fire in area.
Injury to employees.
Induction of all employees.

Chain cylinders in place or Induction of all

9. Explosion. Damage to property. transport in trolley. employees.          
Induction of all employees.
Fibres inside cylinder Secure container after
Explosion. break away and form a use, place in area where
Damage to property.
10. pressure build up. Always it will not cause any          
Acetylene cylinders laying
Property damage. keep acetylene bottles hazard or obstruction.
flat
upright.

Page 3 of 3 WI HSE 001/ OCT 2007