Plant Hazard Identification & Risk Assessment Form



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, |( |Low-frequency, radio frequency radiation; |( |External influences on electrical equipment |( |

|relative location, mass and stability | |microwaves | | | |

|Accumulation of energy inside machinery |( |Infrared, visible and UV radiation |( |Other external influences (gravity, wind etc.) |( |

|eg elastic elements (springs), liquids of| | | | | |

|gases under pressure, the effect of | | | | | |

|vacuum | | | | | |

|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 |( |Relating to travelling function | |

| | |neutrons | | | |

|Entanglement hazards |( |Materials and Substances | |Movement when starting Engine |( |

|Drawing in or trapping hazard |( |Contact with or inhalation of harmful |( |Movement without driver at driving position |( |

| | |fluids, gases, mists, fumes and dusts | | | |

|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 |( |From handling of the machine (lack of stability) |( |

| | |foot-leg anatomy | | | |

|Contact of persons with live parts |( |Neglected use of PPE |( |Mechanical hazard and hazardous events | |

|(direct contact | | | | | |

|Contact of persons with Parts which have |( |Inadequate lighting |( |From load falls, collisions, machine tipping (lack of |( |

|become live under faulty conditions | | | |stability) | |

|(indirect contact) | | | | | |

|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|( |Inadequate design, location or |( |Due to power source and to the transmission of power | |

|as projection of molten particles and | |identification of manual controls | | | |

|chemical effects from short circuits, | | | | | |

|overloads | | | | | |

|Thermal hazards |( |Inadequate design or location of visual |( |Hazards from engine and the batteries |( |

| | |display units | | | |

|Burns, scalds and other injuries by |( | | |Hazards from transmission of power between machines |( |

|possible contact with objects or | |Vibration | | | |

|materials (hot or cold) | | | | | |

|Damage to health by hot or cold working |( |Use of hands held machines |( |Hazards from coupling and towing |( |

|environment | | | | | |

|Noise |( |Whole body vibration |( | | |

|Hearing Loss or other physiological |( |Unexpected startup, Unexpected | | | |

|disorders | |Overrun/OverSpeed | | | |

|Interference with speech, acoustic |( |Failure/Display of control system |( | | |

|signals | | | | | |

|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 |

| | | | | |

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|Section 6 – Comments and Endorsements |

|Comments of Person carrying out the assessment: |

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| |

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|Name: Signature: Date: |

|Line manager to endorse the assessment: |

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|Name: Signature: Date: |

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