126 OG Risk Assessment "5M" Worksheet

+---+-----------+----+---------+---+------------------------------------+
| T |           | D  |         |   |  Aircrew reviews all items during |
| C |           | at |         |   | mission planning                   |
| S |           | e: |         |   |                                    |
| : |           |    |         |   |  Check each box which applies to  |
|   |           |    |         |   | your sortie                        |
|   |           |    |         |   |                                    |
|   |           |    |         |   | **Σ** Total the associated "Risk   |
|   |           |    |         |   | Points" (RP)                       |
|   |           |    |         |   |                                    |
|   |           |    |         |   |  AC or Appropriate Supervisor     |
|   |           |    |         |   | signs sheet                        |
|   |           |    |         |   |                                    |
|   |           |    |         |   |  File sheet with Flight Plan,     |
|   |           |    |         |   | Form F, & Flight Orders            |
+---+-----------+----+---------+---+------------------------------------+
| A |           |    |         |   |                                    |
| C |           |    |         |   |                                    |
| : |           |    |         |   |                                    |
+---+-----------+----+---------+---+------------------------------------+
| C |           |    |         |   |                                    |
| P |           |    |         |   |                                    |
| : |           |    |         |   |                                    |
+---+-----------+----+---------+---+------------------------------------+
| B |           |    |         |   |                                    |
| O |           |    |         |   |                                    |
| : |           |    |         |   |                                    |
+---+-----------+----+---------+---+------------------------------------+
| N |           |    |         |   |                                    |
| : |           |    |         |   |                                    |
+---+-----------+----+---------+---+------------------------------------+

+---+---+-----------------------------+---+---+---+------------------------+
| # |   |                             |   | * |   |                        |
|   |   |                             |   | * |   |                        |
| M |   |                             |   | M |   |                        |
| I |   |                             |   | E |   |                        |
| S |   |                             |   | D |   |                        |
| S |   |                             |   | I |   |                        |
| I |   |                             |   | A |   |                        |
| O |   |                             |   | * |   |                        |
| N |   |                             |   | * |   |                        |
|   |   |                             |   | ( |   |                        |
|   |   |                             |   | W |   |                        |
|   |   |                             |   | X |   |                        |
|   |   |                             |   | a |   |                        |
|   |   |                             |   | n |   |                        |
|   |   |                             |   | d |   |                        |
|   |   |                             |   | E |   |                        |
|   |   |                             |   | n |   |                        |
|   |   |                             |   | v |   |                        |
|   |   |                             |   | i |   |                        |
|   |   |                             |   | r |   |                        |
|   |   |                             |   | o |   |                        |
|   |   |                             |   | n |   |                        |
|   |   |                             |   | m |   |                        |
|   |   |                             |   | e |   |                        |
|   |   |                             |   | n |   |                        |
|   |   |                             |   | t |   |                        |
|   |   |                             |   | ) |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 2 |   | High Priority (HHQ,         |   | 2 |   | Unfamiliar Airfield    |
|   |   | CORONET, ETC.)              |   |   |   | Operations             |
+---+---+-----------------------------+---+---+---+------------------------+
| 3 |   | Contingency (ONW, etc.)     |   | 1 |   | Obs                    |
|   |   |                             |   |   |   | tacles/Terrain/Hazards |
+---+---+-----------------------------+---+---+---+------------------------+
| 3 |   | Combat/Combat Support       |   | 4 |   | Security/Threats       |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Short-notice                |   | 1 |   | Bird Hazard Elevated   |
+---+---+-----------------------------+---+---+---+------------------------+
| 5 |   | FCF / OCF                   |   |   |   | ## WEATHER             |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Cell Formation (1); Large   |   | 1 |   | Departure: Low         |
| o |   | Cell (2)                    |   |   |   | Visibility/Ceilings    |
| r |   |                             |   |   |   |                        |
| 2 |   |                             |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Multiple Receivers          |   | 1 |   | Temperature Extremes   |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Non-DOD Receivers           |   | 2 |   | Thunderstorms          |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Multiple Refuelings         |   | 2 |   | Icing                  |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | EMCON 3 or 4                |   | 1 |   | Turbulence             |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Transition (M010,           |   | 2 |   | Arrival: Low           |
|   |   | Off-station, Night)         |   |   |   | Visibility/Ceilings    |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Duty Day (\>12 hrs-basic,   |   | 1 |   | Crosswinds / Windshear |
|   |   | \>16 augmented)             |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Odd Hours (Late Night,      |   | 1 |   | Alternate Required     |
|   |   | Early AM)                   |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 3 |   | HAZMAT/Cargo/Pax            |   | 1 |   | RCR (1) / RSC (2)      |
|   |   |                             |   | o |   |                        |
|   |   |                             |   | r |   |                        |
|   |   |                             |   | 2 |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
|   |   |                             |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| * |   |                             |   | * |   |                        |
| * |   |                             |   | * |   |                        |
| M |   |                             |   | M |   |                        |
| A |   |                             |   | A |   |                        |
| N |   |                             |   | N |   |                        |
| P |   |                             |   | A |   |                        |
| O |   |                             |   | G |   |                        |
| W |   |                             |   | E |   |                        |
| E |   |                             |   | M |   |                        |
| R |   |                             |   | E |   |                        |
| * |   |                             |   | N |   |                        |
| * |   |                             |   | T |   |                        |
| ( |   |                             |   | * |   |                        |
| H |   |                             |   | * |   |                        |
| u |   |                             |   | ( |   |                        |
| m |   |                             |   | O |   |                        |
| a |   |                             |   | u |   |                        |
| n |   |                             |   | t |   |                        |
| F |   |                             |   | s |   |                        |
| a |   |                             |   | i |   |                        |
| c |   |                             |   | d |   |                        |
| t |   |                             |   | e |   |                        |
| o |   |                             |   | I |   |                        |
| r |   |                             |   | n |   |                        |
| s |   |                             |   | f |   |                        |
| ) |   |                             |   | l |   |                        |
|   |   |                             |   | u |   |                        |
|   |   |                             |   | e |   |                        |
|   |   |                             |   | n |   |                        |
|   |   |                             |   | c |   |                        |
|   |   |                             |   | e |   |                        |
|   |   |                             |   | s |   |                        |
|   |   |                             |   | ) |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Tempo -- Fatigue, Stress    |   | 1 |   | Interruptions          |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Recency -- NMR, Non-current |   | 1 |   | Schedule Changes       |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Training -- Unqualified,    |   | 2 |   | IP/N/IBO Supervision   |
|   |   | Upgrade, Demos              |   |   |   | Required               |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | AC with \< 1500 KC-135      |   | 1 |   | Incomplete Guidance    |
|   |   | hours                       |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | CP/N/BO with \<500 KC-135   |   | 1 |   | Pressure to Complete   |
|   |   | Hours                       |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
|   |   |                             |   |   |   | #                      |
+---+---+-----------------------------+---+---+---+------------------------+
| * |   |                             |   | # |   |                        |
| * |   |                             |   |   |   |                        |
| M |   |                             |   | C |   |                        |
| A |   |                             |   | R |   |                        |
| C |   |                             |   | E |   |                        |
| H |   |                             |   | W |   |                        |
| I |   |                             |   | - |   |                        |
| N |   |                             |   | I |   |                        |
| E |   |                             |   | D |   |                        |
| * |   |                             |   | E |   |                        |
| * |   |                             |   | N |   |                        |
| ( |   |                             |   | T |   |                        |
| A |   |                             |   | I |   |                        |
| i |   |                             |   | F |   |                        |
| r |   |                             |   | I |   |                        |
| c |   |                             |   | E |   |                        |
| r |   |                             |   | D |   |                        |
| a |   |                             |   |   |   |                        |
| f |   |                             |   | F |   |                        |
| t |   |                             |   | A |   |                        |
| R |   |                             |   | C |   |                        |
| e |   |                             |   | T |   |                        |
| l |   |                             |   | O |   |                        |
| a |   |                             |   | R |   |                        |
| t |   |                             |   | S |   |                        |
| e |   |                             |   |   |   |                        |
| d |   |                             |   |   |   |                        |
| ) |   |                             |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Aircraft Status -- Waived   |   | ? |   |                        |
|   |   | to fly                      |   |   |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Tail Number Change          |   | ? |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | Delayed Release             |   | ? |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+
| 1 |   | De-icing                    |   | ? |   |                        |
+---+---+-----------------------------+---+---+---+------------------------+

<table style="width:100%;">
<colgroup>
<col style="width: 21%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 22%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 21%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><strong>Risk Points from Above</strong></td>
<td><h2 id="total-rp">Total RP</h2></td>
</tr>
<tr class="even">
<td><h2 id="left-side">Left Side</h2></td>
<td></td>
<td></td>
<td></td>
<td><strong>+</strong></td>
<td><strong>Right Side</strong></td>
<td></td>
<td></td>
<td></td>
<td><strong>=</strong></td>
<td></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 13%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 7%" />
<col style="width: 3%" />
<col style="width: 6%" />
<col style="width: 10%" />
<col style="width: 3%" />
<col style="width: 12%" />
<col style="width: 10%" />
<col style="width: 3%" />
<col style="width: 11%" />
<col style="width: 7%" />
</colgroup>
<tbody>
<tr class="odd">
<td><strong>Approved by:</strong></td>
<td></td>
<td><h2 id="ac">AC</h2></td>
<td><strong>RP<u>&lt;</u>10</strong></td>
<td></td>
<td><h2 id="sof">SOF</h2></td>
<td><strong>10&lt;RP<u>&lt;</u>20</strong></td>
<td></td>
<td><h2 id="sqog-cc">SQ/OG CC</h2></td>
<td><strong>20&lt;RP<u>&lt;</u>30</strong></td>
<td></td>
<td><h2 id="arwcc">ARW/CC</h2></td>
<td><strong>RP&gt;30</strong></td>
</tr>
<tr class="even">
<td><strong>Signature:</strong></td>
<td colspan="12"></td>
</tr>
</tbody>
</table>

> *Note: Items are not all-inclusive -- submit other factors for
> consideration to 126 ARW/SE (x5780). Crew-Identified Factors should
> include risk items not covered elsewhere*.
>
> If any sub-area contains multiple entries, consider applying risk
> mitigation efforts such as: Avoid, Delay, Transfer, Spread, Compensate
> or Reduce