1

Compiled by:
No. Initials & Surname. Designation. Employee Number
1. R.P Sekoadi Safety Officer 20128889
2. N.C Ndwamato Contract manager 2085940
3. L.S Jele Construction supervisor 20125773
4. R.S Maumela Site manager 20090182
5.
6.
7.
8.
9.
10
11.
12.
13.
14.
15.

ADDENDUM G (v) - RISK ASSESSMENT PAGE: 1 OF

COMPANY: SUBJECT: REINFORING AND FORMWORK AND DOWELING OF EXISTING REV: EFFECTIVE DATE:
CONCRETE
Approved by: Reviewed by: Reviewed by: Reviewed by: Reviewed by: Reviewed by:
________________________ ________________________ ________________________ ________________________ ________________________
AME Exxaro Safety Officer Exxaro Specialist Environment Contractor Safety Officer Contractor 2.9.2 Appointee Exxaro Responsible 2.9.2 Appointee
________________________ ________________________ ________________________ ________________________ ________________________
Employee number Employee number Employee number Employee number Employee number Employee number

DT-CM-020
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DT-CM-020
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←Consequence Severity rating →
Loss Type 1 2 3 4 5
(Additional “Loss Types” may exist for an event, identify & rate
1 Insignificant 2 Minor 3 Moderate 4 Major 5 Catastrophic
accordingly)
Single fatality or Irreversible Loss of
Harm to People (Safety) (S) First aid case Medical treatment case Lost time injury
quality of life
Multiple fatalities
Loss of shift or hospitalization
Permanent disability resulting in Death occurred directly linked to an
Harm to People (Health) (H) Exposure to minor health risk
Exposure to major health risk however with reversible impact on
irreversible loss of quality of life occupational disease
health
Major environmental harm with long
Moderate environmental effect / Significant reportable environmental Extreme environmental harm
term irreversible ecological damage
short term reversible ecological harm with reversible ecological Irreversible ecological damage
Minimal environmental harm L2 incident
Environmental Impact (E) L1 incident
disturbance – damage
Remediable post LOM (Life of Mine)
L3 incident
L2 incident L2 incident Serious national public media outcry
Minor adverse local/public/ media
Remediable short term within LOM Remediable within LOM
attention and complaints.
Exposure between 10% and 50% of Exposure between 50% and 100% of
Hygiene (HY) Exposure ≥ 10% of OEL
OEL OEL
Exposure exceeding OEL Acute exposure ≥ double the OEL
Serious breach of law; investigation / Major breach of the law; Ver considerable penalties &
Minor legal issue. Non compliance
Legal & Regulatory (L & R) Low level legal issue
and breaches of the law
report to authority, prosecution considerable prosecution and prosecutions. Multiple law suits & jail
and/or moderate penalty possible penalties terms.
Negligible or minor or superficial Moderate damage / business
Business Interruption / Material Damage & Other damage / business interruption to interruption to facility resulting in
Major damage/ business interruption Future operations significantly Total loss of production / Future
to facility resulting in production affected by production losses for a operations untenable for a period of
Consequential Losses facility resulting in production losses production losses for a period of 1 to
losses for a period of 2 to 3 weeks period of 3 to 4 weeks more than a month.
of less than 1 week. 2 weeks at.

Major adverse attention and

Minor adverse attention and
Impact on Reputation / Social / Community (C) complaints from authorities, affected from authorities, affected and
and interested parties
complaints from authorities, affected Extreme adverse attention and
Significant adverse attention and
Adverse attention and complaints and interested parties that can lead complaints from authorities, affected
complaints from authorities, affected
and interested parties (district &
to revoking of mining right and/or and interested parties that lead to
interested parties (district level) negative JSE/SRI rating revoking of mining right and
regional level)
(National level) negative JSE/SRI rating

Examples (Consider near misses as Risk Rating

Likelihood ↕ well as actual events) 1 2 3 4 5
The unwanted event has occurred frequently; occurs in order of
5 (Almost Certain) one or more times per year & is likely to reoccur within 1 year 44 64 80 92 100
The unwanted event has occurred infrequently; occurs in order
4(Likely) of less than once per year & is likely to reoccur within5 years 28 48 68 84 96
The unwanted event has happened in the business at some
3(Possible) time; or could happen within 10 years 16 32 52 72 88
The unwanted event has happened in the business at some
2 (Unlikely) time; or could happen within 20 years 8 20 36 56 76
The unwanted event has never been known to occur in the
1 (Rare) business; or it is highly unlikely that it will occur within 20 years 4 12 24 40 60
Risk Rating Risk Level Guidelines for Risk Matrix
84 to 88 (Ex) – Extreme Eliminate, avoid, implement specific action plans/procedures to manage & monitor
52 to 80 (H) – High Proactively manage
28 to 48 (M) – Medium Actively manage
4 to 24 (L) – Low Monitor & manage as appropriate

DT-CM-020
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HAZARD IDENTIFICATION RISK ASSESSMENT RISK MANAGEMENT

Initial Risk Residual Risk
Risk Identification Risk Analysis Control
Evaluation Evaluation

Consequences

Consequences
Risk Rating

Risk Rating
Likelihood

Likelihood
Risk consequences
Geographical Risk
Hazard Identification (Matrix Detail/ Description
Area (Unwanted Event)
Description)

 Only trained,
competent and
authorised
operators to
operate.
 Ensure firm grip
Operator not trained for Lost time injury or
LDV Washbay Untrained operator 3 4 68 and footing when 3 2 36
the task hospitalisation
operating
equipment.
 Do not leave
equipment
unattended.

LDV Washbay Unauthorized Operator Assembling of shutter Lost time injury or 3 3 52  Competent, 3 2 36
boards and tables hospitalisation authorised and
trained Shutter
hand to do task.
 Correct PPE worn-
gloves, overalls,
 helmet, safety
boots, face shield
 Only shutter hands
required to erect,
 move or dismantle
formwork and
 support work
structures.
 Correct PPE worn-
DT-CM-020
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overalls, helmet,
 safety boots,
gloves, glasses.
 Correct lifting
methods practiced.

 All tools shall be on

a register and have
a serial number.
 Damaged or
homemade tools
will be discarded
off.
 Ensure that all
deviations on tools
Failure to provide and equipment are
LDV Washbay Equipment not inspected Lost time injury 3 3 52 recorded on the tool 3 2 36
appropriate equipment
register.
 Defective tools will
be removed from
site, isolated and
will be locked away.
 Continuous toolbox
talks about tools to
be discussed with
employees.
 All tools that are
damaged are to be
removed from the
Substandard/damaged Minimal environmental
LDV Washbay Hand Tool 2 3 32 site. 1 12
hand tools(scrap) harm
 All damaged tools 2
to be reported to
supervisor
LDV Washbay Rebar Incorrect Manual Lost time injury/ loss 3 4 68  The proper manual 3 2 36
handling of rebar of shift or lifting procedure
hospitalization must be adhered to
however with by lifting with legs
reversible loss of and not the back.
DT-CM-020
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 6

 Long rebar must be

properly carried by
quality life two employees
below shoulder
height.
 Rebar caps must
be used to cover all
ends.
 PPE to be worn
Leather gloves,
Overall, Safety
boots, Hard hat,
and Safety glasses.
Lost time injury/ loss
 Only authorized
Employees coming in of shift or
steel fixers to fix
contact with Sharp Edges hospitalization
3 3 52 rebar, 2 36
of rebar and binding wire. however with
 Trained, competent
reversible loss of
and authorized
quality life
employee to fix
rebar.
 Designated 3
laydown area for
rebar to be on site
 Rebar to be
stacked and stored
correctly
 Place Shutter board
or scaffolding board
on rebar to ensure
Lost time injury/ loss
no stepping threw
of shift or
Stepping through open areas.
hospitalization
uncovered openings in 3 3 52  Safety Boots to 2 36
however with
Rebar cage worn
reversible loss of
quality life  Employees to be
vigilant when 3
walking on or next
to rebar
Trip and fall over or Lost time injury/ loss 3 3 52  Ensure tools (Drive 3 2 36
DT-CM-020
REV 5

of shift or
hospitalization
Stepping into apertures however with
reversible loss of
quality life
LDV Washbay Grinder
Lost time injury/
Unauthorised use of
irreversible loss of 3 4
grinder for cutting Rebar
quality of life
Improper storage of Lost time injury/ 3 3
grinder or discs causing irreversible loss of
damage to discs and quality of life
subsequent disc failure
during use.
7
unit, vibrator, rakes,
and spades) are
placed in safe
positions not to
obstruct walkways
or create tripping
hazards to
employees on
rebar.
 Employees to be
vigilant when
walking on or next
to rebar.
 All aperture to be
clear identified /
mark to improve
visibility of location.
 Users of tools & equipment
must be inspected by
Exxaro 2.9.2 and approved
by the AME.
 Only trained, competent
and authorized people to
use tools.
68 2 36
 Tool registers to be signed
when taking tools from
stores.
 Supervisor to enforce.
 OS.2.10 Portable Tools 3
standard must be always
adhered to.
52  When on site, store discs 3 1 24
in a safe manner in the
toolbox to prevent being
stepped on or damaged in
anyway.
 Only trained and
DT-CM-020
REV 5
 8

competent people to use

tools
 Tool registers to be signed
when taking tools from
stores.
 Only Authorized people
must use tools.
 Supervisor to enforce
 Only trained,
competent and
authorized people
to use tools.
 Tool registers to be
signed when taking
tools from stores.
 Supervisor to
enforce
 Full overalls, double
Lost time injury/ eye protection
Incorrect use of grinder
irreversible loss of 3 3 52 (safety glasses and 2 36
for cutting Rebar
quality of life face shield),
welding apron, long
sleeve leather
gloves, safety
shoes and spats,
hearing protection. 3
 OS.2.2 Grinding,
Cutting, and drilling
machine standard
must be adhered to
at all times
Use of defective grinder Lost time injury/ 3 3 52  Grinder must be 3 2 36
for cutting Rebar irreversible loss of inspected by
quality of life Exxaro 2.9.2 and
approved by Exxaro
AME or his
delegate before
being used on site.

DT-CM-020
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 Authorized user to
inspect angle
grinder and record
all deviations
Defective / sub-
standard angle
grinder may not be
used.
 Only trained and
competent people
to use tools.
 Tool registers to be
signed when taking
tools from stores.
 Supervisor to
enforce OS 2.2 -
Grinding, Cutting
and Drilling
machines
LDV Washbay Grinder  Authorized user
must ensure that
the grinding disc
has stopped
spinning before
placing down.
Grinding disc still Lost time injury/  Only trained,
spinning when placed irreversible loss of 3 4 68 authorized and 3 36
down quality of life competent people
to use tools
 Tool registers to be
signed when taking 3
tools from stores.
 Supervisor to
enforce
Improper disposal of Soil pollution 1 3 16  Broken/used discs are 1 2 8
discs resulting in classified as hazardous
environmental harm. waste.
 These must be thrown into
the designated bin labelled
DT-CM-020
REV 5

Grinder used in wet
Single and/or Multiple
conditions causing 5 3
fatalities
electrical shock
Excessive Exposure to Lost time injury/ 3 4
Noise from Grinder irreversible loss of
quality of life.
10
and locked in this purpose.
 This waste will be
removed, recorded on
Waste disposal register
and disposed of at the
mine’s Hazardous Waste
Depo.
 Refer: SPI/GG/H03.005
Integrated Waste
Management Procedure
Supervisor to enforce
Grinder must not be used in
wet conditions.
The Authorized user must
not stand in water while
using the grinder.
Do not expose the grinder
to water or rain.
 Do not route extension
lead through water.
88 1 60
 Only trained and
competent people to use
tools.
 Tool registers to be signed 5
when taking tools from
stores.
 Only Authorized people
must use tools.
Supervisor to enforce
68  Only trained and 3 2 36
competent people to use
tools.
 Employees to wear
hearing protection
 All PPEt o be SABS
Approved
 Supervisor to ensure that
correct hearing protection
is available and used as
DT-CM-020
REV 5

Grinding sparks can Lost time injury/ loss
ignite Combustible
materials & chemicals.
11
required.
 Employee to warn
bystanders prior to
starting machine if
bystanders are in the
close work area of
grinding activities.
 Warning signs shall be
used to demarcate the
high noise zones in the
working area.
 dBA to be indicated on
Grinder.
Supervisor to enforce
3 3 52  Compliance with the 3 2 36
of shift Mandatory Code of
Practice for Prevention of
Fires at Mines
COP/GG/H06.101.
 All combustible materials
and chemicals must be
removed or protected from
the cutting/grinding area.
 Supervision to determine
the direction and fall
distance of the sparks and
plan accordingly to ensure
the sparks do not strike the
veld.
 When necessary, work
area to be protected by
welding screens & welding
blankets.
 Hot work permit must be
available and valid.
 Fire extinguisher must be
available and inspected.
 Only trained and
competent people to use
DT-CM-020
REV 5

LDV Washbay Formwork
Lost time injury/ loss
Improper lifting and of shift or
placing of formwork can hospitalization
3 4
result in back injuries or however with
hand and finger injuries reversible loss of
quality life
Formwork falling onto Lost time injury/ loss 3 3
persons foot or leg during of shift
handling and carrying it
12
tools
Supervisor to follow and
enforce Hot Work
SPI/GG/J03.002.
 Only trained and
competent people to erect
formwork.
 2 or more employees to
handle large formwork.
 Employees must use the
correct method for lifting
of formwork. (Use
legs/bend knees and not
your back to lift heavy
materials)
68 2 36
 Formwork must be
correctly placed on
dunnage or pallets to limit
the height to lift from.
 Placing formwork on
dunnage or pallets allows 3
hands and fingers to slide
under form work and not
be trapped in a nip point.
 Supervisor to
enforce.
52  No person can lift 3 2 36
more than 25kg
manually.
 Formwork heavier
than 25kg must be
clearly marked as
such.
 Persons handling the
formwork to ensure they
have a firm grip on the
formwork when lifting and
carrying it.
 More than one employee
DT-CM-020
REV 5

Fingers Caught between Medical treatment
2 4
formwork panels case
Nip and Pinch points Lost time injury/ loss 3 3
created between straight of shift or
edge and existing hospitalization
structures, formwork. however with
reversible loss of
quality life
13
to carry formwork if too
heavy.
Test the load by lifting
slightly as well, if the load
is too heavy the employee
must ask for assistance.
 PPE to be used Gloves,
Safety boots, overall.
 Only trained and
competent people to erect
formwork
 Supervisor to
enforce.
 Only trained,authorised
and competent persons to
work with formwork.
 VFL and PTO to
determine competency
and compliance with
procedure.
 More than one employee
to hold formwork while it is
48 3 32
being installed.
 Correct PPE must be
used: Gloves, Safety
glasses, Safety boots, 2
Overall and Hard hat.
 Keep hands and fingers
clear of pinch and nip
points.
 Supervisor to enforce
52  Only authorised and 3 2 36
competent persons to
work with formwork.
 Persons to take care when
coming close to the edges
of formwork not to get their
fingers caught between
formwork and the straight
DT-CM-020
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LDV Washbay Shutter Oil
Exposure to Shutter oil
Medical treatment
causing skin irritations or
splash into eyes.
Shutter oil spilled onto Minimal environmental
ground causing soil
pollution
Medical treatment
Employees Slip on oiled
shutters.
14
edge.
 Employees to stay clear of
existing structures to
minimize points of contact.
 Leather glove to be worn
 Keep hands and fingers
clear of pinch and nip
points.
 Good communications
between employees when
handling material or
equipment that can cause
nipping or pinching to be
maintained.
 Supervisor to enforce
 MSDS must be available,
communicated and proof
of communication to
employees be kept on site.
2 3 32 2 20
case  PVC glove and Glasses to 2
be worn.
 Supervisor to enforce
controls.
 Applying of formwork oil to
non-installed shutters must
be done in a bunded area
or on plastic.
 Spill kit to be available.
 Contaminated soil must be
harm 2 3 32 reported and cleaned 2 20
accordingly.
 Use a funnel when 2
decanting shutter oil.
 All decanting must be
done on a drip tray.

2 3 32  Do not walk on formwork 2 2 20
case after shutter oil is applied.
 Wipe off excessive oil.
DT-CM-020
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 Place shutters immediately

in place after oil is applied.
 Supervisor to enforce
controls
DOWELING ON EXISTING CONCRETE
 Only competent,
trained and
authorized operator
to operate the
drilling machine.
 Supervisor to
ensure that portable
drilling machine are
serviced, and
service proof is
provided.
 Use the correct
LDV Washbay Portable Drilling machine Unauthorized operator Lost time injury 3 4 68 drilling machine for 2 36
the task.
 Ensure the drilling
machine is
disconnected from
the power supply if
not in use and
disconnect the
power supply
before changing or
adjusting bit or
attachment.
3
LDV Washbay Hand drill Exposed to moving Lost time injury 3 4 68  Wear cut resistant 3 2 36
spindle and cutter gloves when
operating. Ensure
hole saw is in a
good condition,
inspected on a
monthly base. Do
not lean with your
body weight on the
DT-CM-020
REV 5
 16

machine when
drilling let the
machine do the
work. Ensure the
correct size hole
saw is used for the
specific cable.
 When working in
proximity the
employees must
wear their eye
protection with face
masks.
 All employees
must ensure 1.5m
physical distancing
at all times.
 All drills must be
Making use of defective
LDV Washbay Handrill Lost time injury 3 4 68 inspected before 2 36
Hand Drill
use to prevent 3
electric shock or
injury.
 Inspections
conducted on
monthly basis.
 The tools must be
inspected by an
Exxaro employee
and signed off for
approval by AME
 The operator must
wear cut resistant
Contact with flying metal Medical treatment safety gloves, long
LDV Wasbay Flying metal shavings 2 3 32 2 20
shavings case sleeve overalls and 2
safety glasses while
operating a drill.
LDV Washbay Noise from drill Person/s developing Lost time injury 3 4 68  Noise awareness 3 2 36
noise induced hearing training to be
loss due to excessive conducted. While
DT-CM-020
REV 5
 17

drill is in operation,
the operator and all
noise from equipment.
bystanders must
wear earplugs
 Where dust is
generated by the
LDV Washbay Dust from drill Inhalation of dust Lost time injury 3 4 68 2 36
drill, FFP2 dust 3
masks will be worn.
 Keep your hands
away from the
rotating parts of the
drill. Keep your
hands away from
the rotating parts of
Contact with rotating drill Medical treatment
LDV Washbay Rotating drill bit 2 4 48 the drill. Operator to 2 20
bit case
ensure when 2
operating that he
doesn’t lean with
his body weight
while drilling, let the
drill do the work.
 All sharp
edges/burrs should
be filed down after
drilling through
Physical contact with
3 3 52 materials. Always 2 36
sharp edges/ burr
wear cut resistant
LDV Washbay Material safety gloves while
handling materials
and hand tools. 3
 Wear cut resistant
safety gloves when
Hot surfaces 3 3 52 2 36
handling hot 3
materials
LDV Washbay Adverse weather Exposure to High Single and or multiple 5 3 88  Comply with mine 5 1 60
conditions temperatures fatalities OPI/GG H02.100
Measuring and
Managing thermal
stress (heat and

DT-CM-020
REV 5
 18

cold)
 Workers to take
regular water
breaks during
temperatures above
37.5 degrees to
ensure the body is
hydrated.
 Workers to know all water
drinking designated areas
in the work area
 Clean as the task
continue.
 Employees to
ensure that site is
left clean at the end
of each shift.
 All used papers,
bottles, PPE, etc is
to be removed from
Slip / Trip / Fall Loss of shift or site and thrown into
LDV Washbay Housekeeping 3 3 52 2 36
hospitalization the correct marked
dust bin. 3
 Supervisor to do
over inspection on
end of shift close-
out inspection to
ensure compliance.
 Safety gloves to be
worn when handling
waste material.

DT-CM-020
REV 5