Risk Assessment-Blank
Risk Assessment-Blank
Risk Assessment-Blank
Risk Assessment
Activity Ref
Description
Assessor Date
Hazard Identification
Hazard Likelihood Severity Risk
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
L M H L M H L M H
People at Risk
Workers
Adjacent Workers
Site Wide Workers
Occupants
Visitors
Members of Public
Controls
Risk Control Measures
Risk Level
<L L M H !
Very Low Low Medium High Very High
safe to proceed safe to proceed proceed with proceed with unsafe DO NOT
work under work under caution under caution under proceed -
standard additional additional further controls essential
control control controls with further action
measures measures measures supervision needed
Further Action
Action Required Timeframe By Date
Acknowledgement
Name Signature Date