THE BAROSSA COUNCIL /
STATIC RISK ASSESSMENT FORM
Area: / Work Health and Safety / Document Number: / TBCFOR3333
Form Owner: / CEO Executive Services / Last Revised Date: / 06 March 2014
Document Control: / Risk Management Team / Entry TRIM Reference: / B1008 / /
Date Approved: / 13 June 2012 / Next Review Date: / 13 June 2015
Entry Date: / Entry Signature:
1. / Details
Plant/Equipment/Substance being assessed / Date of Risk Review
Site/Location / Compiled by / Date / //
Team / Reviewed by / Date / //
Can the plant/equipment/substance be eliminated? / Yes / No
2. / Risk Assessment Team
Name / Position / Signed / Date
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//
//
//
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3. / Assessment Grid
In accordance with The Barossa Council’s Risk Management Policy
Ref / The Hazard / Yes / Risk Identification
(Describe the issue in detail) / What existing controls are in place now / Photo
Trim Ref / Level of Consequence / Level of Likelihood / Level of Risk / Treatment Option (s)
Describe the controls put in place
to reduce the risk / Hierarchy of Controls
Eliminate
Substitute
Engineering
Administrative
PPE / Revised Level
of Consequence / Revised Level
of Likelihood / Revised Level
of Risk / The Risk
Accept?
Reduce?
Transfer?
Substitute?
Eliminate? / Person(s) Responsible / Date the control be implemented / When will the control be reviewed
ENTANGLEMENT
1. / Anyone’s hair, clothing, gloves, jewellery, cleaning materials becoming entangled in moving or spinning parts / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
2. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
CRUSHING
3. / Material falling off the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
4. / Uncontrolled or unexpected movement of the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
5. / Lack of capacity of the plant to be slowed, stopped or immobilized / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
6. / The plant tipping or rolling over / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
7. / Parts of the plant collapsing / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
8. / Coming into contact with moving parts during testing, inspection, operation, maintenance, cleaning or repair / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
9. / Being thrown off or under the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
10. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
CUTTING/STABBING/PUNCTURING
11. / Coming into contact with sharp or flying objects / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
12. / Coming into contact with moving parts of plant during testing, inspection, maintenance, cleaning or repair of the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
13. / The plant or work pieces disintegrating / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
14. / Work pieces or plant pieces being ejected / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
15. / The mobility of the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
16. / Uncontrolled or unexpected start-up or movement of the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
17. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
SHEARING
18. / Body parts being sheared between two parts of the plant or parts of the plant and a work piece or structure / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
FRICTION BURN
19. / Contact with friction heated moving parts/surfaces of plant or materials / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
MOVING OBJECTS
20. / Uncontrolled or unexpected movement of the plant or materials / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
21. / The plant, parts or work pieces disintegrating / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
22. / Work pieces being ejected / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
23. / Mobility or movement of the plant or plant parts / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
24. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
HARMFUL CONTACT (HIGH PRESSURE FLUID INJURY)
25. / Coming into contact with fluids under high pressure due to plant or hose failure or misuse of the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
SUFFOCATION
26. / Lack of oxygen or atmospheric contamination / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
BURN (HIGH TEMPERATURE INJURY)
27. / Coming into contact with objects at high temperatures / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
28. / Fire / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
HOT/COLD WORKING ENVIRONMENT (THERMAL DISCOMFORT)
29. / Exposure to high or low temperatures / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
ELECTRICAL SHOCK/BURN
30. / The plant contacting live electrical conductors / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
31. / The plant working in close proximity to electrical conductors / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
32. / Overload of electrical circuits / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
33. / Damaged or worn electrical cables, leads or switches / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
34. / Water near electrical equipment / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
35. / Inadequate isolation of electrical power supply / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
36. / Residual electrical energy / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
EXPLOSION
37. / Explosion of flammable or explosive gases, vapours, liquids, dust or other substances triggered by operation of the plant or material / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
38. / High pressure build-up / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
SLIP, TRIP, FALL
39. / Uneven or slippery surfaces / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
40. / Poor housekeeping, e.g. equipment, etc. not stored properly / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
41. / Obstacles being placed in the vicinity of the plant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
42. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
FALL FROM HEIGHT
43. / Lack of a proper work platform / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
44.. / Lack of proper stairs or ladder / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
45. / Lack of guardrails or suitable edge protection / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
46. / Unprotected holes, penetrations or gaps / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
47. / Poor floor or walking surfaces, not slip resistant / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
48. / Steep or sloping walking surfaces / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
49. / Collapse of the supporting structure / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
50. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
ERGONOMIC
51. / Poorly designed seating / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
52. / Repetitive body movements / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
53. / Constrained body posture or the need for excessive effort / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
54. / Design deficiency causing mental or psychological stress / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
55. / Inadequate or poorly placed lighting / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
56. / Lack of consideration given to human error or human behaviour / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
57. / Mismatch of the plant with human traits and natural limitations / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
58. / Other (specify): / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
OTHER HAZARDS
59. / Chemicals / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
60. / Dust / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
61. / Radiation / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
62. / Toxic gases / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
63. / Noise / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
64. / Fumes / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //
65. / Vibration / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectEliminateSubstituteEngineeringAdministrativePPE / Please SelectC1C2C3C4C5 / Please SelectL1L2L3L4L5 / Please SelectEHML / Please SelectAcceptReduceTransferSubstituteEliminate / // / //

The Barossa Council © 2014Form:Static Risk Assessment Form TRIM TEMPLATE REF: 13/23515 Page 1 of 13

The electronic version of this document is the controlled version. Printed copies are considered uncontrolled. Printed Copies are uncontrolled for 3 months from 25/01/2019 and then must be reprinted.

Appendix 1 – Examples of measures of consequence or impact
Measure / Financial Loss
$ / Business Impact / Damage to property / Injury to person (s) / Socio-Political & Community Issues / Environmental impact
C1 / Insignificant / Negative impact on operating/ capital results of less than $5,000 / Negligible loss of or damage to IT and communications. No loss of data. Small delays in undertaking routine needs or tasks for ½ day. / Negligible damage to or loss of assets. / No significant injuries or significant impact. / No adverse effect on public image.
Insignificant level of community concern.
Negligible adverse impact upon social health and well-being of the community which has little or no impact upon established community relationships and links. / Minor breach of legislation. Negligible impact on environment.
C2 / Minor / Negative impact on operating/ capital results between
$5,001 and $10,000 / Minor loss/damage to IT and communications. Some catch up required.
Minor impact in undertaking routine needs or tasks for 1 day. / Minor loss/damage. Some repairs may be required. / Small numbers of injuries; first aid or out patients treatment required. Minor inconvenience. / Minor adverse effect on public image.
Minor level of community concern.
Minor adverse impact upon social health and well-being of the community that may have a minor impact upon established community relationships & links. / Minor localized impact one off situation easily rectified.
C3 / Moderate / Negative impact on operating/ capital results between
$10,001 and $50,000 / Moderate to high loss/damage to IT and communications. Data lost.
Capability/production impaired, moderate impact on stakeholders & routine needs or tasks for 1 – 3 days.
Moderate legal issues, non-compliances and breaches of legislation. / Moderate to high damage requiring special/contractor equipment to repair or replace. / A number of injuries requiring hospitalisation and long term treatment. Moderate inconvenience. / Moderate adverse effect on public image.
Moderate level of community concern.
Social health and well-being of the community affected by moderately reduced opportunities for participation in community life and/or decision making, moderate incidences of increased isolation etc. / Moderate impact, no long term or irreversible damage, may incur cautionary notice or infringement.
C4 / Major / Negative impact on operating/ capital results between
$50,001 and $100,000 / High risk of loss, data, corrupt. Significant catch up required. Business continuity plan implemented.
Loss of capability, disruption to production, major impact on stakeholders & routine needs or tasks for 3-5 days. / Significant/permanent damage to assets and/or infrastructure. / Major disruption to work routines and practice. Additional resources required. Significant number of injuries requiring hospitalisation and long term treatment. Singular fatality. / Significant adverse effect on public image.
Significant level of community concern.
Serious breach of legislation with investigation or report to authority with prosecution and/or moderate fine possible. / Severe impact requiring remedial action& review of processes to prevent reoccurrence. Penalties &/or direction or compliance order incurred.
C5 / Catastrophic / Negative impact on operating/ capital results of above
$100,001 / Extensive loss/damage to IT and communications assets and infrastructure. Permanent loss of data. Widespread disruption to the business.
Loss of production/capability, failure to meet stakeholders needs for more than 5 days.
Projects & programs failure, inability to meet minimum acceptable standards, most objectives not met. / Widespread substantial permanent damage to assets and/or infrastructure. / Long term disruption to work practices and routines. Impact on wellbeing of personnel. Extensive life threatening impact. Potentially large numbers of serious injuries and fatalities. / Major adverse effect on public image.
Major level of community concern.
Major breaches of legislation, major litigation. / Long term, large scale damage. Serious/repeated breach. Significant prosecution.

The Barossa Council © 2014Form: Static Risk Assessment Form TRIM TEMPLATE REF: 13/23515 Page 1 of 12

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Appendix 2 – Analyse the Risks

Now that the risks have been identified the next step is to analyse the level of risk they present. Use Table 1 and Table 2 to determine the likelihood of it occurring and the consequence if it did. Then, use the consequence and likelihood ratings to determine the level of risk in Table 3.

Table 1 – Measures of consequences or impact

Level / Description / Example detail description
C1 / Insignificant / No injuries, low financial loss
C2 / Minor / First aid treatment, minor impact, medium financial loss
C3 / Moderate / Medical treatment required, moderate impact, high financial loss
C4 / Major / Single fatality, extensive injuries, loss of production capability, major impact, major financial loss
C5 / Catastrophic / Multiple serious injuries and fatalities, detrimental effect, extensive financial loss

Table 2 – Measures of Likelihood

Level / Description / Example detail description
L1 / Almost Certain / Is expected to occur in most circumstances
L2 / Likely / Will probably occur in most circumstances
L3 / Possible / Might occur at some time
L4 / Unlikely / Could occur at some time
L5 / Rarely / May occur only in exceptional circumstances

Table 3 – Risk Analysis Matrix – Level of Risk

Likelihood / Consequences
Insignificant
C1 / Minor
C2 / Moderate
C3 / Major
C4 / Catastrophic
C5
L1 (almost certain) / H / H / E / E / E
L2 (likely) / M / H / H / E / E
L3 (possible) / L / M / H / E / E
L4 (unlikely) / L / L / M / H / E
L5 (rare) / L / L / M / H / H

Legend

E / Extreme Risk; immediate action required
H / High risk; senior management attention needed
M / Moderate risk; management responsibility must be specified
L / Low risk; manage by routine processes

(Risk Management Standard AS/NZ 4360:2004)

The Barossa Council © 2014 Form: Static Risk Assessment Form TRIM TEMPLATE REF: 13/23515 Page 1 of 13

The electronic version of this document is the controlled version. Printed copies are considered uncontrolled. Before using a printed copy, verify that it is the current version