Plant Hazard Identification & Risk Assessment Form

Company: Section/Area: Risk Assessor (s):

Section 1.
Mechanical hazards Machine parts or work pieces eg, shape, relative location, mass and stability Accumulation of energy inside machinery eg elastic elements (springs), liquids of gases under pressure, the effect of vacuum Crushing hazard Shearing hazard Cutting or severing hazard Entanglement hazards Drawing in or trapping hazard Impact hazard Stabbing puncture Friction or abrasion hazard High pressure Electrical Hazards Contact of persons with live parts (direct contact Contact of persons with Parts which have become live under faulty conditions (indirect contact) Approach to live parts under high voltage Electrostatic phenomena Thermal radiation or other phenomena such as projection of molten particles and chemical effects from short circuits, overloads Thermal hazards Burns, scalds and other injuries by possible contact with objects or materials (hot or cold) Damage to health by hot or cold working environment Noise Hearing Loss or other physiological disorders Interference with speech, acoustic signals

Assessment Date:
Hazards: Potential Damaging Energies
Radiation

Restoration of energy supply after Interuption

Low-frequency, radio frequency radiation; microwaves Infrared, visible and UV radiation

External influences on electrical equipment

Other external influences (gravity, wind etc.)

X-rays and gamma rays Lasers Alpha and beta rays, electron beams neutrons Materials and Substances Contact with or inhalation of harmful fluids, gases, mists, fumes and dusts Fire and explosion Biological or microbiological hazards Ergonomics Unhealthy postures or excessive effort Inadequate consideration of handarm or foot-leg anatomy

Errors in software Errors made by operator (human/machine mismatch) Relating to travelling function Movement when starting Engine

Movement without driver at driving position Movement without all parts in a safe position Excessive speed of pedestrian-controlled machinery Excessive oscillations when moving Insufficient ability of machinery to be slowed down, stopped and immobilised From handling of the machine (lack of stability) Mechanical hazard and hazardous events From load falls, collisions, machine tipping (lack of stability) Uncontrolled loading-oveloading-overturning moments exceeded Unexpected/unintended movement of loads Due to power source and to the transmission of power

Neglected use of PPE Inadequate lighting

Mental overload and underload, stress Human error, human behaviour Inadequate design, location or identification of manual controls

Inadequate design or location of visual display units Vibration

Hazards from engine and the batteries Hazards from transmission of power between machines

Use of hands held machines Whole body vibration Unexpected startup, Unexpected Overrun/OverSpeed Failure/Display of control system

Hazards from coupling and towing

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Section 2. - Summary of Identified Hazards 1. 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)
Hazards: Associated Risks:

Likelihood (tick one): Consequence (tick one): Risk Rating: Section 4. Risk Controls
Possible Controls:

Very Likely Life Threatening High

Likely Detrimental

Unlikely Harmful Medium

Highly Unlikely Negligible Low

Preferred Hierarchy of Controls

1. Elimination 2.Substitution 3. Engineering (Isolation, Guarding, Redesign) AS 4024:2006

Preferred Controls: 4. Administrative (SOPs,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

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Comments of Person carrying out the assessment:

Name: Line manager to endorse the assessment:

Signature:

Date:

Name:

Signature:

Date:

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