/ Form 000.653.F0155
Plant Risk Assessment Checklist
HAZARD IDENTIFICATION CHECKLIST
A.Entanglement / Yes/No
Can anyone’s hair, clothing, gloves, necktie, jewelry, cleaning brushes, rags, or other materials become entangled with moving parts of the equipment, or materials in motion?
B.Crushing / Yes/No
Can anyone be crushed due to:
  1. Material falling?

  1. Uncontrolled or unexpected movement of the equipment?

  1. Lack of capacity for the equipment to be slowed, stopped, or immobilized?

  1. Equipment tipping or rolling over?

  1. Parts of equipment collapsing?

  1. Coming in contact with moving parts of equipment during testing, inspection, maintenance, cleaning, or repair?

  1. Being thrown off or under the equipment?

  1. Being trapped between equipment and materials or fixed structures?

  1. Other factors not previously mentioned?

C.Cutting, Stabbing,andPuncturing / Yes/No
Can anyone be cut, stabbed, or punctured due to:
  1. Coming in contact with sharp or flying objects?

  1. Coming in contact with moving parts of equipment during testing, inspection, operation, maintenance, cleaning, or repair of the equipment?

  1. Equipment, parts of the equipment, or work pieces disintegrating?

  1. Work pieces being ejected?

  1. The mobility of equipment?

  1. Uncontrolled or unexpected movement of equipment?

  1. Other factors not previously mentioned?

D.Shearing / Yes/No
Can anyone’s body parts be sheared between two parts of the equipmentt, or between a part of the plant and a work piece or structure?
E.Friction / Yes/No
Can anyone be burnt due to contact with moving parts or surfaces of the plant, or material handled by the equipment?
F.Striking / Yes/No
Can anyone be struck by moving objects due to:
  1. Uncontrolled or unexpected movement of equipment or material handled by the equipment?

  1. Equipment, parts of the equipment, or work pieces disintegrating?

  1. Work pieces being ejected?

  1. Mobility of equipment?

  1. Other factors not previously mentioned?

G.High-Pressure Fluid / Yes/No
Can anyone come into contact with fluids under high pressure, due to equipmentt failure or misuse of the equipment?
H.Electrical / Yes/No
Can anyone be injured by electrical shock or burnt due to:
  1. Equipment contacting live electrical conductors?

  1. Equipment working in close proximity to electrical conductors?

  1. Overload of electrical circuits?

  1. Damaged or poorly maintained electrical leads and cables?

  1. Damaged electrical switches?

  1. Water near electrical equipment?

  1. Lack of isolation procedures?

  1. Other factors not previously mentioned?

I.Explosion / Yes/No
Can anyone be injured by explosion of gases, vapors, liquids, dusts, or other substances triggered by the operation of the equipment, or by material handled by the equipment?
J.Slipping, Tripping , and Falling / Yes/No
Can anyone using the equipment, or in the vicinity of the equipment, slip, trip, or fall due to:
  1. Uneven or slippery work surfaces?

  1. Poor housekeeping such as spillage not cleaned?

  1. Obstacles being placed in the vicinity of the equipment?

  1. Other factors not previously mentioned?

Can anyone fall from a height due to:
  1. Lack of a proper work platform?

  1. Lack of proper stairs or ladders?

  1. Lack of guardrails or other suitable edge protection?

  1. Unprotected holes, penetrations, or gaps?

  1. Poor floor or walking surfaces such as the lack of a slip-resistant surface?

  1. Steep walking surfaces?

  1. Collapse of the supporting structure?

  1. Other factors not previously mentioned?

K.Suffocation / Yes/No
Can anyone be suffocated due to lack of oxygen or atmospheric contamination?
L.Temperature Extremes or Fire / Yes/No
Can anyone come into contact with objects at high or low temperatures?
Can anyone suffer ill-health due to exposure to high or low temperatures?
Can anyone be injured by fire?
M.Manual Handling / Yes/No
Can anyone be injured from manual handling due to the following factors:
  1. The force to be applied by the employee?

  1. The actions and movements involved in the manual handling?

  1. The range of weights handled?

  1. The duration and frequency of the manual handling?

  1. The time and distance over which an object is handled?

  1. The lack of mechanical aids?

  1. The layout and condition of the workplace environment?

  1. The way work is organized (such as availability of employees and materials, quotas, targets, and job rotation)?

  1. The postural requirements imposed by the manual handling?

  1. The age of the employee carrying out the manual handling?

  1. The skill and experience of the employee carrying out the manual handling?

  1. The nature of the object being handled (such as size, shape, structure, and material of load; sharp edges; slippery; difficult to grasp/hold; unstable; and live person or animal)?

  1. Other factors not previously mentioned?

N.Other Hazards / Yes/No
Can anyone be injured or suffer ill-health from exposure to:
  1. Chemicals?

  1. Toxic gases or vapors?

  1. Fumes?

  1. Dust?

  1. Noise?

  1. Vibration?

  1. Radiation?

  1. Other factors not previously mentioned?

O.General Ergonomic Factors / Yes/No
Can anyone be injured due to:
  1. Poorly designed seating?

  1. Repetitive body movement?

  1. Constrained body posture or the need for excessive effort?

  1. Design deficiency causing mental or physiological stress?

  1. Inadequate or poorly placed lighting?

  1. Lack of consideration given to human error or human behavior?

  1. Mismatch of equipment with human traits and natural limitations?

  1. Other factors not previously mentioned?

P.Product Ergonomics / Yes/No
Can anyone be injured due to product design factors:
  1. How does it work and is it an appropriate solution?

  1. Will the sequence of actions for use of the product result in a hazardous situation?

  1. Can it be misused and if so what are the consequences of misuse?

  1. Are there parts that can fall off, shake loose, or be removed through misuse?

  1. Is it prone to damage or excessive wear and tear?

  1. If maintenance is required, can it be carried out?

  1. Can it be easily and adequately cleaned?

  1. Does the product require any special aptitude, physical ability, or prior knowledge or experience

  1. Are the points of contact with the user likely to be uncomfortable, or create pressure points?

  1. Are there any special considerations that apply (such as does it suit left-handers) and/or can it be used by disabled persons?

  1. Does it need special storage requirements?

  1. Will transport during and between use be a problem?

  1. If it is to be used in conjunction with other products are there adequate provisions made for this interaction?

  1. Are the materials of manufacture and methods of fastening/joining/assembly appropriate?

  1. Are labels (instructions) liable to obliteration, (peeling) through use or maintenance?

  1. Other factors not previously mentioned?

Q.Environmental / Yes/No
During the use of the equipment or product is there any risk to the environment from:
  1. Spillage(such as fuel or other substance) from the equipment itself or above/below ground storage tanks?

  1. Leaking (such as fuel or other substance) from the equipment itself or above/below ground storage tanks?

  1. The generation of fumes, dusts, or vapors?

  1. The generation of excessive noise?

  1. The generation of any wastes (liquid or solid) that will need to be disposed?

  1. Will transport, handling, or storage of the equipment or product require any special consideration?

Note:This form is referenced in Practice000.653.1304.

Copyright © 2009, P2S. All Rights Reserved.
Form Date: 01May2009 / Page 1 of 4 / Health, Safety, and Environmental