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Manufacturer’s Letter Head

Risk Assessment Document

PRODUCT DETAILS
Product type: [specify the product –
Ex. Electrical insulating sleeves]
Product Name Manufacturer Details
PPE Category:
Fall Protection
Trademark/Brand Country of Origin

Model/Batch No.

PRODUCT RISK ASSESSMENT


Risk/Hazard Description Risk Classification Control Measures
Ergonomics High Moderate Low N/A
Mechanical
Falling/slipping High Moderate Low N/A
Falling objects High Moderate Low N/A
Abrasion High Moderate Low N/A
Impact High Moderate Low N/A

We hereby confirm that the risk analysis for above products have been carried out against the hazards it may present and meets
the relevant standard, and basic health and safety requirements.

Name and Designation of Authorized Representative Date and Signature

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