Plant Hazard Identification & Risk Assessment Form

Company:
Section/Area:
Risk Assessor (s):
Section 1.

Assessment Date:

Hazards: Potential Damaging Energies

Mechanical hazards
Machine parts or work pieces eg,
shape, relative location, mass and
stability

Radiation

Restoration of energy supply after Interuption

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

Cutting or severing hazard

Alpha and beta rays, electron beams

neutrons

Relating to travelling function

Entanglement hazards

Materials and Substances

Drawing in or trapping hazard

Contact with or inhalation of harmful

fluids, gases, mists, fumes and dusts

Impact hazard

Fire and explosion

Stabbing puncture

Friction or abrasion hazard

Ergonomics

High pressure

Unhealthy postures or excessive

effort

Electrical Hazards

Lasers

Biological or microbiological hazards

Errors made by operator (human/machine

mismatch)

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

Inadequate consideration of handarm 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 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)

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

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

Vibration

Due to power source and to the transmission

of power

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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):

Consequence (tick one):

Very Likely

Likely

Unlikely

Highly Unlikely

Life Threatening

Detrimental

Harmful

Negligible

Risk Rating:

High

Medium

Section 4. Risk Controls

Low
Preferred Hierarchy of Controls

Possible 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

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Section 6 Comments and Endorsements

Comments of Person carrying out the assessment:

Name:

Signature:

Date:

Signature:

Date:

Line manager to endorse the assessment:

Name:

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