Method of Statement and Risk Assessment Form
Method of Statement and Risk Assessment Form
SIGNATURE:
RISK RATING
WORK ACTIVITY HAZARD(S) CONTROL MEASURE(S)
1-25
Break the activity down into steps. Each step should Identify the hazards in each step and give Identify what control measures will be
accomplish some major task and be in a logical sequence. them a risk rating using the Hazard ID and implemented to eliminate the hazard or
Risk Assessment Summary. minimize the risk.
• Step Lights
• Any undesirable shutdown can cause 3 • Ensure proper shutting down of dedicated
Step 1 Shutting down of power for the dedicated circuits disruption in basic amenities, communication, circuits only
etc.
The lights that are not working are identified (Snag
Step 2 - -
List) and repaired
• Chances of an open circuit fault • Neutral wires to be properly connected
Testing of lights is done after switching on the power
Step 3 • Chances of short circuit 10 • Terminal connection should be properly
circuit
connected
• Dwarf Wall Refurbishment
Identify relevant Legislation, Standards and Codes of Practice relating to the work:
Qualifications / Competencies required of Persons carrying out this Activity (Licenses, Qualifications, Permits):
Trained Personals
Type
Any undesirable circuit shutdown Any undesirable shutdown can cause Basic manual handling training.
1 (unintended) disruptions
Less L
Ensuring good housekeeping and a clear working area.
ACTION REQUIRED
2 Workers are not allowed to work without proper and compete PPEs
3 Making sure that trolleys and handling tools and equipment are available
Probability
1 2 3 4 5