JOB RISK ASSESSMENT
Vessel: _______________________ Date: ___________ Risk Assessment No: _____________________
Description of Task/Activity: ____________________________________________
Carrying out a Risk Assessment – Refer to Risk assessment procedures
1. Identify all the Hazards associated with the task
2. List each of the effects the hazard would have if allowed to develop to its full potential. The hazard may impact more than one entity.
3. Consider the consequences of each hazard effect, and identify the relevant band – refer to the Risk Matrix
4. Consider the probability of that occurring, and identify the relevant band – refer to the Risk Matrix
5. Note the resultant assessed risk in the risk matrix – e.g. in square B – II. Record same under the Risk Column
6. Ascertain whether the risk is High, Moderate or Low as displayed by the chart shading.
7. Identify preventative and mitigating actions that would bring the risk to acceptable levels. Each hazard effect requires a corresponding action.
8. List items requiring heightened monitoring or the imposition of additional controls.
9. Review the modified risk, taking into account the preventative and mitigating actions in place, by referring to the Risk Matrix
10. Confirm that the residual risk is within acceptable levels. Record same under the Risk Column
No. Hazard Hazard Effect Risk Preventative and Mitigating actions Item/Equipment Action Required on Modified
risk
In cases where the Risk is:
High Work shall not start unless approval obtained from management ashore
pg. 1
Moderate Efforts should be made to reduce the risk, with heightened monitoring of the additional controls implemented
Low No additional controls required, monitoring required to ensure controls maintained
A B C D E
RISK LETTER LIKELIHOOD OF IT HAPPENING ESTIMATED FREQUENCY OF
I H H H H M INCIDENTS
II H H H M M A Possibility of repeated events One or more times per month
B Possibility of isolated incidents One or more times per quarter
III H H M M L
C Possibility of occurring sometime One or more times in 1 year
IV H M M L L D Not likely to occur Less than once in 5 years
V M M L L L E Very Remote Probability of occurrence Less than once in 10 years
Consequence
Health and Safety Damage to Vessel / Property Environmental Impact Financial Impact
Category
Total Loss. Immediate lay up / dry Major Industry Reaction. Fleet-wide
Fatality, Serious impact Spill/discharge in water >
I docking for major repairs, blacklist by one or more Oil Majors,
on Public 100L
Major claims from 3rd Parties >1M $
Extensive Off-hire, Loss of Charter,
Permanent Disability, Requiring lay up repairs, Spill/discharge in water < Blacklisting of vessel by more than
II
Limited impact on public 3rd Party Claims 100L one Oil Major,
100K – 1M $
Serious injury or multiple
Affecting sea worthiness, repaired Major Off-hire,
minor injuries requiring
III with or without shore assistance. Spill on deck Blacklisting of vessel by one Oil Major,
Hospitalisation (Sign off)
Leading to COC to be cleared by >1m3 25K – 100K $
(LTI)
next DD
Not affecting sea worthiness,
Injury requiring Medical Spill on deck Minor off-hire,
IV repair requiring external
treatment ashore (MTC) < 1m3 5K – 25K $
assistance
Accidental discharge
Not affecting sea worthiness,
V Simple First Aid or NLTI within containment <5K $
repairable by ship staff
tray
NOTE :
All relevant Work Permits to be filled in and duly verified prior commencement of job.
pg. 2
A Toolbox meeting must be held prior start of the job, for discussing this Risk Assessment and detailing work and emergency procedures
involved.
Equipment Lock out / tag out procedures to be complied with.
Additional precautions / Special Instructions:
Risk Assessment sent to Office? (Tick box) YES NO Office Response(s) included in assessment? Y/N
Risk Assessment prepared by (Name and Rank): Date :
Date Toolbox meeting held: Declaration: We have attended the Toolbox meeting, understand the work instructions and the risks
involved, are satisfied with the precautions taken and the safety measures in place.
No Rank / Name Signature No Rank / Name Signature No Rank / Name Signature
Approved By: Signature / Date : _________________________ _________________________
Chief Eng / Chief Officer Master
Name : __________________________ __________________________
pg. 3
