Risk Assessment Form
Risk Assessment Form
Risk Assessment Form
Risk Assessment
Location: Project: Main Contractor: Activity Assembly Maintenance Laboratory Description Task
DISTRIBUTION BOARDS Installation Repair Maintenance Test/Inspection Commissioning Component Ass. ASSEMBLY Mechanical Manual Soldering Cleaning Marking/Printing Wiring Epoxy Test/Inspection GENERAL POWER Installation Repair Maintenance Test/Inspection Commissioning Termination CABLE Mngnt Cable Tray Metal Conduit PVC Conduit Metal Trunking PVC Trunking DADO Trunking Cable Ladder Power Poles Bus Bar Trunking Other Other LIGHTING Installation Repair Maintenance Test/Inspection Commissioning Splice/Term DRILLING Battery Drill 110v Drill Weld/Soldering Electrical Gas OFFICE Clerical Typing Design/Drawing VDE General
Materials Handling
FIRE ALARM Installation Repair Maintenance Test/Inspection Commissioning CHEMICAL USE Alcohol Epoxy Petrol/Diesel Aerosol Cleaners EXTERNAL Roads Manholes Masts Ducts Open Areas Private Road
SECURITY Installation Repair Maintenance Test/Inspection Commissioning TOOLING/Test Equip Signage Megger Electrical Test Equip Multi Meter Hydraulic Crimper Hand Tools Generator OTHER (specify Rope Harness Wall Anchor
DATA Installation Assembly Maintenance Test/Inspection Commissioning Component MATERIALS HANDLING Mechanical Manual USE OF Ladders Scaffold Mobile platform MEWP Fork lift truck Lifting equip
Hazards Noise Vibration Confined Space Mobile Plant Fall from a height Explosion Sewage/Rodent Infection Hand Tools Weight Specific Site Conditions Page 1 of 5 Hazardous Substances Manual Handling Pressure Discharge Weather Access Equipment Fire Ergonomics Lone Working Liquid (non-hazardous) Fibre Optic Splinters Electricity Machinery Flying/Falling objects Excavations Power Tools Restricted Access Vehicles Asbestos Fibre Optic Laser Light Exposure Floor Tile Removal Machinery Moving Parts Slips, trips and falls Heat Biological Height/Roof Work Sharps Cold
Describe the site/activity/process that creates risks requiring precautions to be taken: HAZARD RISK CONTROLS RATING RESPONSIBILITY
Persons at Risk Directly affected: Indirectly affected: employee employer employee employer contractor contractor visitor visitor trainee trainee Key Risks 1 2 3 4 5 6
other (all site personnel incl. Delivery, security & management teams) other (all site personnel incl. Delivery, security & management teams)
Risk Evaluation Hazard Potential Risk (A) 1-5 Potential Injury (B) 1-5 Risk Score (A) x (B) =
Mechanical aids Risk Assessment Method Statement Isolate/lock off Traffic Cones
SK Electrical Health & Safety Manual, Policy & Statement. FAS Safe Pass.
Health and Safety Training, Site Induction, Safe Pass Training, Manual Handling Training, Abrasive wheel Training, Mobile Tower Training Course, MEWP training
Safety helmet Safety footwear Overalls (general) Overalls (specific) Gloves (specify) Respiratory protection (specify) Ear defenders (standard/special) Safety harness Breathing apparatus (specify) High Visibility Vest Eye protection Specific site requirements for PPE to be assessed locally & on a daily basis Access Environment Equipment Other Procedures
Record additional information here:PPE to be assessed. Work area to be kept tidy to minimise the risk of slips, trips, and falls. Care to be taken in confined spaces & and on the ramps . Care to be taken when working off ladders & mobile towers
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Date of GRA Assessment: Date Amended/applied to Site: Site Manager: Person carrying out GRA Assessment: Name: Position
Review date Name: Review date Name: Review date Name: Action arising as a result of the review should be recorded in the risk assessment/record file.
EMERGENCY DETAILS CONTACT NAMES: TELEPHONE NUMBERS: FIRST AIDER: LOCATION OF FIRST AID BOX: LOCATION OF NEAREST HOSPITAL:
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