Spreadsheet: 0c0b425c-b4e3-4638-bc9e-5976487b60ea
Sheet: Sheet1

RISK ASSESSMENT & CONTROL
Process / Activity / Area / Equipment
Business/Site Name |  |  |  |  |  |  |  |  |  |  |  |  | Date |  |  |  |  |  |  | Dep |  |  |  |  |  |  | RA Ref. |  |  |  |  |  |  |  |  |  |  |  |  |  | Issue
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1
Describe Process/Activity/Equipment being assessed:
Materials/Substances/Resources used
Are there clear work instructions/procedures:                  List document numbers below |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Is the process / activity included in the skills matrix: |  |  |  |  |  |  |  |  |  |  |  | Yes |  | No
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Yes |  | No |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 |  |  |  | High risk if activity not in skills matrix, and user is not confident in abilities
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 |  | 0 |  | Are you confident in your abilties |  |  |  |  |  |  |  |  |  |  |  | Yes |  | No
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 |  | 0
What is the operator's level of competency? |  |  |  |  |  |  |  | Highly skilled and experienced |  |  |  |  |  |  |  | 1 | Trained or highly experieced |  |  |  |  |  |  |  | 0 | No training / some experience / supervised |  |  |  |  |  |  |  | 0 | Novice / inexperienced / unsupervised |  |  |  |  |  |  |  | 0
TO INSERT RISK FIGURES FOR FREQUENCY PROBABILITY AND SEVERITY REFER TO THE TABLES BELOW
 |  | FREQUENCY |  |  |  |  |  |  |  |  |  |  |  |  | PROBABILITY |  |  |  |  |  |  |  | SEVERITY
 |  | FA - Freq. of Exposure |  |  |  |  |  | FB - Duration of Exp |  |  |  |  |  |  | PA - Likelihood of injury |  |  |  |  |  |  |  |  | SA-Number exposed |  |  |  |  |  | SB - Who's Exposed |  |  |  |  |  | SC - Severity
 |  | 1 | Yearly |  |  |  |  | 1 | < 10 min's |  |  |  |  |  |  | 1 | Improbable |  |  |  |  |  |  | 1 | 0 - 1 |  |  |  |  | 1 | Operator |  |  |  |  | 1 | Insignificant
 |  | 2 | Monthly |  |  |  |  | 2 | 10min - 1hr |  |  |  |  |  |  | 2 | Less likely |  |  |  |  |  |  | 2 | 2 - 5 |  |  |  |  | 2 | Contractor |  |  |  |  | 2 | Minor
 |  | 3 | Weekly |  |  |  |  | 3 | 1 - 4hrs |  |  |  |  |  |  | 3 | Possible |  |  |  |  |  |  | 3 | 6 - 20 |  |  |  |  | 3 | Visitor |  |  |  |  | 3 | 1-3 days off
 |  | 4 | Daily |  |  |  |  | 4 | 4 - 8 hrs |  |  |  |  |  |  | 4 | Likely |  |  |  |  |  |  | 4 | 21 - 100 |  |  |  |  | 4 | All in vicinity |  |  |  |  | 4 | +3 days off
 |  | 5 | Continuously |  |  |  |  | 5 | Continuously |  |  |  |  |  |  | 5 | Certainty |  |  |  |  |  |  | 5 | >100 |  |  |  |  | 5 | Public |  |  |  |  | 5 | Fatality
When choosing risk value for the 'F', 'P' or 'S' if you cannot distinguish between two values always choose the higher of the two.
 |  |  | Not necessary |  |  |  |  |  |  |  |  |  |  | Up to assessor |  |  |  |  |  |  |  |  |  |  | Assess further |  |  |  |  |  |  |  |  |  |  |  | Assess further
 |  |  | 1~11 | 10 | I |  |  |  |  |  |  |  |  | 11~21 | 20 | L |  |  |  |  |  |  |  |  | 21~60 |  | M |  |  |  |  |  |  |  |  |  | > 60 |  | H
No. | Hazard type |  |  |  |  |  |  |  |  | Control measures |  |  |  |  |  |  |  |  |  |  |  |  |  |  | (F) Frequency |  |  |  |  | (P) Probability |  |  |  |  | (S) Severity |  |  |  |  | Total risk=F.P.S
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | F-A |  | F-B | F |  |  | P-A |  | P |  | S-A | S-B | S-C | S |  | I | L | M | H
1 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
2 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
3
4
5 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
6 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
7 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
8 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
9 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
RISK ELIMINATION & CONTROL
Process / Activity / Area / Equipment
Business/Site Name |  |  |  |  |  |  |  |  |  |  |  |  | Date |  |  |  |  |  |  | Dep |  |  |  |  |  |  | RA Ref. No. |  |  |  |  |  |  |  |  |  |  |  |  |  | Issue
[NAME]
No. | Hazard type |  |  |  |  |  |  |  |  | Control measures |  |  |  |  |  |  |  |  |  |  |  |  |  |  | (F) Frequency |  |  |  |  | (P) Probability |  |  |  |  | (S) Severity |  |  |  |  | Total risk=F.P.S
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | F-A |  | F-B | F |  |  | P-A |  | P |  | S-A | S-B | S-C | S |  | I | L | M | H
1
2 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
3 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
4 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
5 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
EMERGENCY CONDITIONS
No. | Hazard type |  |  |  |  |  |  |  |  | Control measures |  |  |  |  |  |  |  |  |  |  |  |  |  |  | (F) Frequency |  |  |  |  | (P) Probability |  |  |  |  | (S) Severity |  |  |  |  | Total risk=F.P.S
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | F-A |  | F-B | F |  |  | P-A |  | P |  | S-A | S-B | S-C | S |  | I | L | M | H
1 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
2 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
3 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
4 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
5 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  |  | 0 |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |  |  | 0 |  | 0
NO further assessment required |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Further assessments required
Comments & Notes
 |  |  |  |  |  |  |  |  | Name |  |  |  |  |  |  |  |  |  |  |  |  | Signature |  |  |  |  |  |  |  |  |  |  |  |  | Date
Principal Investigator