Plant Hazard Identification & Risk Assessment Form
Company:Section/Area:
Risk Assessor (s): / Assessment Date: / / /
Section 1. / Hazards: Potential Damaging Energies
Mechanical hazards / Radiation / Restoration of energy supply after Interuption /
Machine parts or work pieces eg, shape, relative location, mass and stability / / Low-frequency, radio frequency radiation; microwaves / / External influences on electrical equipment /
Accumulation of energy inside machinery eg elastic elements (springs), liquids of gases under pressure, the effect of vacuum / / Infrared, visible and UV radiation / / Other external influences (gravity, wind etc.) /
Crushing hazard / / X-rays and gamma rays / / Errors in software /
Shearing hazard / / Lasers / / Errors made by operator (human/machine mismatch) /
Cutting or severing hazard / / Alpha and beta rays, electron beams neutrons / / Relating to travelling function
Entanglement hazards / / Materials and Substances / Movement when starting Engine /
Drawing in or trapping hazard / / Contact with or inhalation of harmful fluids, gases, mists, fumes and dusts / / Movement without driver at driving position /
Impact hazard / / Fire and explosion / / Movement without all parts in a safe position /
Stabbing puncture / / Biological or microbiological hazards / / Excessive speed of pedestrian-controlled machinery /
Friction or abrasion hazard / / Ergonomics / Excessive oscillations when moving /
High pressure / / Unhealthy postures or excessive effort / / Insufficient ability of machinery to be slowed down, stopped and immobilised /
Electrical Hazards / Inadequate consideration of hand-arm or foot-leg anatomy / / From handling of the machine (lack of stability) /
Contact of persons with live parts (direct contact / / Neglected use of PPE / / Mechanical hazard and hazardous events
Contact of persons with Parts which have become live under faulty conditions (indirect contact) / / Inadequate lighting / / From load falls, collisions, machine tipping (lack of stability) /
Approach to live parts under high voltage / / Mental overload and underload, stress / / Uncontrolled loading-oveloading-overturning moments exceeded /
Electrostatic phenomena / / Human error, human behaviour / / Unexpected/unintended movement of loads /
Thermal radiation or other phenomena such as projection of molten particles and chemical effects from short circuits, overloads / / Inadequate design, location or identification of manual controls / / Due to power source and to the transmission of power
Thermal hazards / / Inadequate design or location of visual display units / / Hazards from engine and the batteries /
Burns, scalds and other injuries by possible contact with objects or materials (hot or cold) / / Vibration / Hazards from transmission of power between machines /
Damage to health by hot or cold working environment / / Use of hands held machines / / Hazards from coupling and towing /
Noise / / Whole body vibration /
Hearing Loss or other physiological disorders / / Unexpected startup, Unexpected Overrun/OverSpeed
Interference with speech, acoustic signals / / Failure/Display of control system /
Section 2. - Summary of Identified Hazards
1. / Hazards: / Associated Risks:
2.
3.
Any specific circumstances:
Persons at Risks: (list)
Is the risk (Tick one)
Minimal risk exposure
Adequately controlled. No further action required
In adequately controlled. Further Action/Investigation Required. Proceed with Risk Assessment (Section 3)
Covered by Regulation/Standard/Code Specify:
Section 3. – Risk Assessment
Existing Controls (if any)
Likelihood (tick one): / Very Likely / Likely / Unlikely / Highly Unlikely
Consequence (tick one): / Life Threatening / Detrimental / Harmful / Negligible
Risk Rating: / High / Medium / Low
Section 4. – Risk Controls / Preferred Hierarchy of Controls
Possible Controls: / 1. Elimination
2.Substitution
3. Engineering (Isolation, Guarding, Redesign) AS 4024:2006
Preferred Controls: / 4. Administrative (SOP’s,Training)
5. Personal Protective Equipment
Section 5 – Implementation Plan
Control Option / Associated activities / Resources / Person (s) Responsible / Proposed Implementation date
Section 6 – Comments and Endorsements
Comments of Person carrying out the assessment:
Name: Signature: Date:
Line manager to endorse the assessment:
Name: Signature: Date:
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