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Ra Form

This document contains a risk assessment template for identifying hazards, assessing risks, and maintaining a risk register. It includes sections for documenting the task/activity being assessed, associated department/area, and risk assessment number. Severity and likelihood of consequences are rated on multi-level scales. A risk rating is then calculated based on the severity and likelihood ratings, with risks categorized as low, medium, high, or extreme. The risk assessment team members and their designations are also documented.

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EngrHazrat Maaz
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as XLSX, PDF, TXT or read online on Scribd
100% found this document useful (1 vote)
227 views5 pages

Ra Form

This document contains a risk assessment template for identifying hazards, assessing risks, and maintaining a risk register. It includes sections for documenting the task/activity being assessed, associated department/area, and risk assessment number. Severity and likelihood of consequences are rated on multi-level scales. A risk rating is then calculated based on the severity and likelihood ratings, with risks categorized as low, medium, high, or extreme. The risk assessment team members and their designations are also documented.

Uploaded by

EngrHazrat Maaz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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HAZARD IDENTIFICATION AND RISK ASSESSMENT & REGISTER

Risk Assessment (Baseline and full RA)


TASK/ACTIVITY/PROCESS NAME: DEPARTMENT/AREA:
RA Number: DATE:
SEVERITY / CONSEQUENCE (Impact/Hazard Effect) (Where an event has more than one ' Loss Type ', choose the ' Consequence' with the highest rating)
Loss Type Additional "Loss Types" may exist for an
event: Identify & rate accordingly (1) Insignificant (2) Minor (3) Moderate (4) Major (5) Catastrophic
Medical Treatment Case Single Fatality or Loss of Quality of Life / Multiple Fatalities / Impact on health Ultimately
(S/H) Harm to People (Safety/Health) First Aid Case/Exposure to Minor Health Risk Exposure to Major Health Risk Loss Time Injury / Reversible Impact on Health Irreversible impact on Health Fatal
(EI) Environmental Impact Minimal environment harm incident with workplace Material Environment harm (RST) Material Environment harm (RST) Serious environmental harm incident (RMT) Major environmental incident (RLT) Major environmental harm – Incident Irreversible
(BI/MD) Business Interruption / Material / Fire Damage & Other Partial Loss of Operation/1M SR Substantial or Total Loss of Operation / 10M SR
No disruption to operation / 1000 SR to Less than 10k SR Brief Disruption to Operation / 10k SR to Less Than 100k SR Partial Shutdown/100k SR to Less than 1M SR To Less than10M SR
Consequential Losses and more
LIKELIHOOD Examples (Consider Near-Hits as well as actual events) RISK RATING / PROFILE
(5) ALMOST The unwanted event has occurred frequently : Occurs in order of (1) or more per year & is likely to reoccur within 1 year
CERTAIN 11 (M) 16 (H) 20 (H) 23 (Ex) 25 (Ex)
(4) LIKELY The unwanted event has occurred infrequently : Occurs in order of less than once per year & is likely to reoccur within 5 yrs.
7 (M) 12 (M) 17 (H) 21 (Ex) 24 (Ex)
(3) POSSIBLE The unwanted event has occurred in the business at some time: or could happen within 10 years.
4 (L) 8 (M) 13 (H) 18 (H) 22 (Ex)
(2) UNLIKELY The unwanted event has occurred in the business at some time: or could happen within 20 years.
2 (L) 5 (L) 9 (M) 14 (H) 19 (H)
(1) RARE The unwanted event has never known to occur in the business or it is highly unlikely to occur within 20 years.
1 (L) 3 (L) 6 (M) 10 (M) 15 (H)
RA TEAM (Names) DESIGNATION SIGNATURE RISK RATING RISK LEVEL GUIDELINES FOR RISK MATRIX
Stop operation and review controls- Eliminate, avoid risk & implement high
1. - 21 to 25 (Ex) - Extreme priority action plans
Proactively manage & implement specific controls/action plans-Review
2. - 13 to 20 (H) - High after 7 days
Actively manage & monitor – Additional controls is advised & review after
3. - 6 to 12 (M) - Medium 14 days
Risk acceptable – Monitor & manage as appropriate with frequent review
4. - 1 to 5 (L) - Low
DEPARTMENT / AREA: APPROVED BY / MANAGER or SUPERVISOR DATE: NEXT REVIEW DATE:

Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.

HAZARD IDENTIFICATION CONTROL Risk Assessment RISK REDUCTION ACTION PLAN

Risk Ranking /
Risk Ranking /
Consequence

Consequence
Risks Issue

Likelihood

Likelihood
Item Work Activity Improve existing controls / implement new

Profile

Profile
(Process, Equipment, RA task No #1 Hazards (Possible incident)
Existing Controls Depth of Excavation Follow up by Whom Controls Implemented
# Materials)
[What can go wrong]
(Accident / ill health to persons, fire
controls (name) & By When (date) Yes/No
or property loss)

● Eye irritation ● Always wear safety glass and dust mask during dusty weather ● Ground 2 Talha Alam
● High wind & dust ● Affect to lungs ● Good housekeeping will be enforced. meter 3 2 6 ● Conduct TBT on weather update. 2 2 4 Maher Musa YES
● Falling objects ● Avoid loading and unloading of materials from carriage trucks ● Manpole 1.2 01-06-2023
● Do not store any materials on elevated areas and keep the material secure. meter

● Do not work under direct sunlight between from 12 PM - 3 PM during summer Talha Alam
● Drink sufficient amount of water at least one glass in every 30 minutes
● Hot weather ● Heat stress ● Remain hydrated 2 3 6 ● Conduct TBT on weather update. 2 4 8 Maher Musa YES
● Report incident/accident immediately to the responsible person if happen 01-06-2023

• Slit trench using shovel, Do not use pickaxe for slit trench. Talha Alam
•Cave-ins and collapses •Too much pressure • Detection of underground facilities using metal or cable detector. 2 1 2 • slope or bench the walls of the excavation. 3 1 3 Maher Musa YES
• Trial excavation shall be carried out to ensure protection of underground • excavated walls are composed of stable rock 01-06-2024
facility before mechanical excavation.

• Evaluate soil conditions and select appropriate


protective systems.
• Construct protective systems in accordance
with the standard requirements.
If heat • Adapting soil protection method like stepping, sloping, shoring and close • Preplan; contact utilities to locate underground
temperature sheeting. lines, plan for traffic control if necessary, and Talha Alam
•Trenching accidents •Improper sloping • excavation reached more than 1 meter, shoring or close sheeting shall be done 1 3 3 determine proximity to structures that could affect 2 3 6 Maher Musa YES
reach to 50 01-06-2025
°C as well as the choice of protective system.
Atmospheric affecting humidity • Test for low oxygen, hazardous fumes, and toxic
safe work practice(If in and limited gases.
case) air • Provide safe access into and out of the
movement excavation
the work
should be • The creation of a safe place of work.
stop. • operator error and Adequate barricade and excavation sign board. • The development and operation of safe working Talha Alam
•Heavy equipment accidents malfunctions Gas test inside excavation before job 3 2 6 practices. 3 1 3 Maher Musa YES
• Ensuring the personal safety of all employees. 01-06-2026
If heat
temperature
reach to 50
°C as well as Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.
Atmospheric affecting humidity
safe work practice(If in and limitedHAZARD IDENTIFICATION CONTROL Risk Assessment RISK REDUCTION ACTION PLAN
case) air
movement
the work

Risk Ranking /
Risk Ranking /
Consequence

Consequence
should be Risks Issue

Likelihood

Likelihood
Item Work Activity Improve existing controls / implement new

Profile

Profile
(Process, Equipment,
stop.
RA task No #1 Hazards (Possible incident)
Existing Controls Depth of Excavation Follow up by Whom Controls Implemented
# Materials)
[What can go wrong]
(Accident / ill health to persons, fire
controls (name) & By When (date) Yes/No
or property loss)

• Move extra excavation materials at least 2 feet


away from the trench
• Temporary support shall be provided for existing foundations. • sloping the ground Talha Alam
• Adequate spacing between workers.
•Falls •tools being placed • Ladder shall be positioned at least 1 meter above the landing level and is 2 2 4 • benching the ground 2 2 4 Maher Musa YES
excavation exceed 1.2 meter two access is required. • shoring the trench with supports such as 01-06-2027
planking or hydraulic jacks
• shielding the trench (using a trench box)

• lack of ground-fault • not running leads across the floor or ground,


protection • Electrical switches or access to them should not be blocked by any material through doorways and over sharp edges. Talha Alam
•Electrical hazards • path to ground • Workers should ensure that the electrical equipment and its switches are 2 1 2 • using lead stands or insulated cable hangers to 1 2 2 Maher Musa YES
keep leads off the ground.
missing easily accessible and visible. • using cable protection ramps or covers to 01-06-2028
• discontinuous
protect cables and cords, where applicable.

• flooring type • cleaning all spills immediately.


• footwear • Walkways across excavations should be made by scaffolding and jumping • marking spills and wet areas.
• levels of lighting across excavation is not allowed. • mopping or sweeping debris from floors. Talha Alam
•Slips, trips, and falls • contrast between 1 1 1 • removing obstacles from walkways and always 2 1 2 Maher Musa YES
floors • Excavated soil, materials, equipment shall maintained distance of 0.5 meter keeping walkways free of clutter. 01-06-2029
away from the edge of excavation
• walls and doors • securing (tacking, taping, etc.) ...
and obstructions • always closing file cabinet or storage drawers.

• flooring type • clean work areas using vacuum cleaners rather


• footwear than brushing
• Capture the Dust at Its Source. ...
• levels of lighting If engine driven equipment is using inside excavation; confined space conditions • Clean "Hidden" Areas Regularly. ... Talha Alam
•Dust and fumes • contrast between shall be followed 1 2 2 • Design a Dust-Free Workplace. ... 4 3 12 Maher Musa YES
floors • Properly Maintain Your Equipment and Service 01-06-2030
• walls and doors It Often. ...
and obstructions
• Understand the Properties of Your Materials.

● Obtained valid permit to work from SEC prior to start the job
Physical hazard: ● Only authorized personnel are allowed to be perform the job
● Unauthorized ● Supervisor must conduct daily tool box talk about the nature of the work and ● Demarcation of the area to prevent unauthorized
personnel ● Property damage associated 3 3 9 entry 3 1 3
● Unauthorized start ● Physical Injury potential hazards and their essential precautionary measure until completion of ● Barricade the area with warning signages to avoid
of work work unauthorized entry in the working area
● Do not assigned the job task for those workers who does not know about the
nature of the job
If heat
temperature
reach to 50
°C as well as
humidity ● Physical Injuries due
and limited to
air mechanical failure or ● All hand and power tools shall be in safe working condition and maintained safe
movement loss
the work of control when using ● All tools & equipment shall be inspected and monthly color coded
should be Wrong tools for the job: defective tool ● Use, handle, store and care according to Talha Alam
stop. ● Defective tools ● Physical Injuries due ● The weight, size●and
The correct tool shall be selected for the job 2 4 8 manufacturer’s instructions 3 1 3 Maher Musa YES
● Wrong selection of to type of tool chosen should be appropriate and suitable for ● Withdrawn from service if found defective and 01-06-2031
tools and material the work tagged not to be used
malfunctioning of being undertaken
equipment
● Illness, environmental ● Hand made tools are strictly prohibited at site/Do not use hand made tools.
damage due to wrong
selection of material

Vehicles/Pedesterian:
● Moving vehicle and
heavy equipment ● Obtained valid PTW from the client prior to start the work
● Unfamiliar to the job ● Toolbox talk must be conducted by responsible foreman/supervisor before ● Only authorized personell who have valid driving
activity starting the work activity licence are allowed to drive vehicle inside the work
● Bumping of ● Only Authorized personnel are allowed to perform the task station.
equipment together ● Serious Injury/ ● Appropriate PPEs must be provided for the workers as per task requirement 4 3 12 ● Operator/Driver should follow traffic rules and 4 1 4
● Scattered debris ● Property Damage ● All the necessary tools and equipment should be inspected, Monthly color maintain/follow speed limit signage's.
and materials in the coded and secured ● Assign flag-man for save moving
working area ● Remove all the unwanted materials from the working area and keep working ofvehicle/equipments.
● Unfamiliar to the area neat and tidy
routes and access.
● Wrong and
defective tools.

Preparation / Set-up
Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.

HAZARD IDENTIFICATION CONTROL Risk Assessment RISK REDUCTION ACTION PLAN

Risk Ranking /
Risk Ranking /
Consequence

Consequence
Risks Issue

Likelihood

Likelihood
Item Work Activity Improve existing controls / implement new

Profile

Profile
(Process, Equipment, RA task No #1 Hazards (Possible incident)
Existing Controls Depth of Excavation Follow up by Whom Controls Implemented
# Materials)
[What can go wrong]
(Accident / ill health to persons, fire
controls (name) & By When (date) Yes/No
or property loss)

Preparation / Set-up

Manual Handling: ● Use of mechanical aids where applicable to avoid manual handly
● Poor posture/ ● Encourage proper body mechanics and use of manual handling techniques
Ergonomic ● Avoid lifts that require stretching or bending to reach the load, don’t twist or
● Repeated, turn spine while
sustained or high ● Musculoskeletal carrying the load ● Always follow bussy system. Talha Alam
force. problems ● Perform a detail manual handling assessment to determine risks associated with 4 3 12 ● Take rest breakes regularly. 4 1 4 Maher Musa YES
● Sustained awkward manual ● Do not work under direct sun-light.
posture. ● Back injury handling or mechanical handling (Max. 25 kg for one person). more than 25kg ● Adopt manual handling safety techniques. 01-06-2032
● Repetitive follow buddy
movements. system or mechanical handling
exposure to ● Ensure appropriate rest breaks, job rotation and training is involved
sustained vibration. ● Reduce the load risk by using lighter weights or more stable containers

● Ensure (if required) isolation been carried out as per Isolation Procedure
● LOTO must be secure and provide before starting the activity ● Operator should carry valid licence.
● A valid work permit (hot work) must be obtained and available on site ● Only TUV authorised personell are allowed to
Use of excavator equipment: ● Check all controls are functioning correctly before proceeding perform task with excavator.
● Equipment hit the ● Electrocution ● Equipment will be checked before using on site. ● Excavator TUV/fitness certificate should be Talha Alam
underground services (cables & ● Property damage ● Daily plant and equipment checklist will be made by the operator to ensure the 4 3 12 available. 4 1 4 Maher Musa YES
pipe) ● Hydraulic failure equipment is safe to use ● Only competent operators will be allowed to 01-06-2033
● Equipment & ● Equipment should be inspected and certified by a 3rd party operate the plant and equipment
control failures ● Maintenance team will be on site to ensure the damage is rectified immediately.
● Daily visual inspection by competent person prior to use. ● TBT and daily task briefing will be given to all
● Damage equipment should be tag with (damaged do not use) and discarded operatives involve in the activity.
from site.

● Strong site visit and clean the site and maintain


neat and tidy to prevent contact from lying
● Provide adequate PPE (Safety shoes, gloves,safety eye glass, helmet, mask, particles.• Men shall not be permitted to work
coverall / long underneath loads or in places where they could be
● Eye injury sleeve, face shield) struck by any part of a mechanical excavator. Talha Alam
● Flying particles ● Face Injury ● Ensure house-keeping maintained (before starting the job, during and after 2 3 6 • A trained banks man shall coordinate 2 3 6 Maher Musa YES
finish the job on movement and operation of excavation machines 01-06-2034
daily basis). and trucks at all times.
• Ensure that NO underground services available
before excavation. Conduct inspection with SEC
authorized persons.

• Men shall not be permitted


to work underneath loads or in
places where they could be ● Provide adequate PPE (Safety shoes, gloves,safety eye glass, helmet, mask,
struck by any part of a coverall/long sleeve, face shield and other as per job requirement)
mechanical excavator. ● Obtain work permit for the specific job prior to start the work
• A trained banks man shall ● Electrocution ● Suitability of grinder disk and RPM to be checked. ● Ensure the power tools which were going to use Talha Alam
● Ensure the electrical power cable is place in safely manner without any are monthly inspected and color coded.
coordinate movement and ● Physical Injury obstruction 3 3 9 ● Power tools/grinders must be provided a safe 2 2 4 Maher Musa YES
operation of excavation ● Fire ● Provide adequate safety signage and barricade to prevent from unauthorized guard (DO NOT REMOVE THE SAFE GUARD) 01-06-2035
machines and trucks at all times. personnel entry
• Ensure that NO underground and to intended for awareness of workers working nearby or within the area
services available before ● Provide adequate fire extinguisher in the working area
If heat excavation. Conduct inspection
temperature with SEC authorized persons.
reach to 50
Mechanical Excavation °C as well as
work humidity
using excavator and limited
equipment, (using of air
power tools if required) movement
the work
should be
stop.
Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.

HAZARD IDENTIFICATION CONTROL Risk Assessment RISK REDUCTION ACTION PLAN

Risk Ranking /
Risk Ranking /
Consequence

Consequence
If heat Risks Issue

Likelihood

Likelihood
Item Work Activity Improve existing controls / implement new

Profile

Profile
temperature
RA task No #1
(Process, Equipment, Hazards (Possible incident)
Existing Controls Depth of Excavation Follow up by Whom Controls Implemented
# Materials) reach to 50 [What can go wrong]
(Accident / ill health to persons, fire
controls (name) & By When (date) Yes/No
Mechanical Excavation °C as well as or property loss)
work humidity
using excavator and limited
equipment, (using of air
power tools if required) movement
the work
should be
stop.

● Provide adequate PPE (Safety shoes, gloves,safety eye glass, helmet, mask,
coverall/long sleeve, face shield and other as per job requirement)
● Obtain work permit for the specific job prior to start the work
● Electrocution ● Suitability of grinder disk and RPM to be checked. ● Ensure the power tools which were going to use Talha Alam
● Ensure the electrical power cable is place in safely manner without any are monthly inspected and color coded.
● Hand tool failure ● Physical Injury obstruction 3 3 9 ● Power tools/grinders must be provided a safe 2 2 4 Maher Musa YES
● Fire ● Provide adequate safety signage and barricade to prevent from unauthorized guard (DO NOT REMOVE THE SAFE GUARD) 01-06-2036
personnel entry
and to intended for awareness of workers working nearby or within the area
● Provide adequate fire extinguisher in the working area

● Provide adequate p.p.e's for ear protection. Talha Alam


● Noise ● Hearing loss ● Hearing loss 3 3 9 ● Maintain job rotation system 1 3 3 Maher Musa YES
01-06-2037

● Ergonomics by ● Sprain, strain & ● Correct body positioning while using vibrating equipment Talha Alam
exposing to vibrating muscular ● Task rotation, do not use vibrating equipment for long time 2 3 6 ● Maintain ergonomics checklist and discuss with 2 2 4 Maher Musa YES
equipment injury ● Use right equipment and tool for the job crew/team involve in task. 01-06-2038
If heat
temperature
reach to 50
Backfilling and °C as well as
humidity
compaction using plate and
compactor and hand limited
air
tools movement ● Provide adequate PPE (Safety shoes, gloves,safety eye glass, helmet, mask,
the work coverall/long sleeve, face shield and other as per job requirement)
should be ● Ensure the hand tools which were going to use are monthly inspected and color ● Competent work supervisor and OHS should Talha Alam
stop. ● Hand / finger injury●
● Hand tool failure Foot Injury coded 2 3 6 conduct the inspection and remove/discard 2 3 6 Maher Musa YES
● Ensure house-keeping maintained (before starting the job, during and after damaged tools immediately from site. 01-06-2039
finish
the job)

● Approve permit to work must be in place


● Inspect the area prior to take the permit and ensure that the isolation is done
and mentioned in the permit
● Wear appropriate hand gloves such as electrical rubber insulated hand gloves ● Ensure no one set on the energized equipment /
● Make sure Equipment or processes are locked out/tagged out and verified
If heat isolated from hazardous energy sources (hydraulics, water, electrical, steam, cables
temperature stored energy, and pneumatic) in accordance with, Instructions for "Lockout/Tag ● Wear earplug or ear muff if the noise level is
reach to 50 out" above 85 decibel
°C as well as ● Electrical hazards ● NOTE: Do not attempt to change the status of any equipment tagged as like, ● Must be have suitable fire extinguisher at the
Isolation, confirmation & humidity ● Expired Work ● Electrocution Danger “Do Not Operate” Tag (Lockout/Tagout) working area Talha Alam
LOTO, Electrical and limited Permit ● Property damaged ● If during the performance of work, it is determined that LOTO (permit or non- 5 4 20 ● Good housekeeping shall be maintained at all 3 3 9 Maher Musa YES
Exacvation Works air ● Non-isolated ● Burn/ Fire permit) is necessary, Then stop the work, place machine or system in a safe times 01-06-2040
movement machinery/line ● Physical injury configuration, and contact the Supervisor ● Ensure workers have LOTO training and entry
permit
the work ● Protect hands with gloves; avoid touch the moving machinery ● Ensure no one touch the live equipment
should be ● Inspect all the tools and equipment and discard the electrical tools and fix ● Engage skilled workers for the work
stop. inspection sticker ● Always cordinate with operation and ensure loto
● Ensure all workers and team leader know the first aider and emergency contact
numbers by competent permit receiver.
● Cooperate with LOTO guard
● Avoid hot working in the energized area
● inspect for 2 Cables of Fiber Optic and 2 cables of Electic wire

● Environmental ● Housekeeping to be performing after the completion of work arrange materials ● Follow the house-keeping procedure Talha Alam
● Poor housekeeping pollution and dispose all debris properly 2 3 6 ● Before starting the work and after completion of 2 2 4 Maher Musa YES
If heat work. 01-06-2041
temperature
reach to 50
°C as well as
Work completion, humidity
Identify the hazard on the given task and conduct assessment of the actual site condition, all identified risk should provide with a plan to eliminate or control the risk.

HAZARD IDENTIFICATION CONTROL Risk Assessment RISK REDUCTION ACTION PLAN

Risk Ranking /
Risk Ranking /
Consequence

Consequence
Risks Issue

Likelihood

Likelihood
Item Work Activity Improve existing controls / implement new

Profile

Profile
(Process, Equipment, RA task No #1 Hazards (Possible incident)
Existing Controls Depth of Excavation Follow up by Whom Controls Implemented
# Materials) If heat [What can go wrong]
(Accident / ill health to persons, fire
controls (name) & By When (date) Yes/No
temperature or property loss)
reach to 50
°C as well as
Work completion, humidity
housekeeping and and limited
closing of work permits air ● Injuries/accident thru
movement miscommunication
the work ● Collect all used items and return to the store ● Always keep copy of closed permit. Talha Alam
should be ● Failure to close the permit ● Permit violation that ● Ensure Housekeeping done prior to close the permit 2 3 6 ● Permit receiver should do the cross check with 3 1 3 Maher Musa YES
stop. cause the delay of work ● Close the work permit as per procedure of the project issuer regarding the work permit closed status. 01-06-2042
and disciplinary action

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