HIRARC FORM

HAZARD IDENTIFICATION , RISK ASSESSMENT AND

Rev. 0
DETERMINING CONTROL FORM
(HIRARC FORM)
Page 1 of 1
Department: PROJECT SAFETY Function / Main Activity: WORK AT HEIGHT Date:

HAZARD IDENTIFICATION RISK ASSESSMENT CONTROL MEASURES

Probability
Legal &

Severity

Total
Activity Potential Of Potential Controls Action Other
NO Hazard
Description Hazard Risk Required By Requirement
s
WORKING AT MAJOR INJURY i. PROVIDE
GRAVITY FALL FROM HEIGHT 3 5 15
HEIGHT DURING OR FATALITY
PROPER AND
CABLE LAYING
AND PULLING ON SAFE WORKING i. Work
Supervis
THE CABLE TRAY PLATFORM
or
1 ii. PROVDE
ii. Safety FMA (SHW) 1970,
PROPER Supervis Reg. 12
MINOR/ MAJOR ACCESS AND or
GRAVITY FALLING OBJECT INJURY 3 5 15 EGRESS WITH FMA (BOWEC)
1986, Reg. 15
HANDRAIL AND
ADEQUATE
OVERHEAD
PROTECTION

TRIP AND FALL DUE TO MAJOR INJURY 3 5 15 FMA (BOWEC)

MECHANICAL POOR HOUSEKEEPING 1986, Reg. 9
1) HOUSEKEEPING
SHOULD BE DONE
iii. Work
REGULARLY
Supervis
 HIRARC FORM
HAZARD IDENTIFICATION , RISK ASSESSMENT AND
Rev. 0
DETERMINING CONTROL FORM
(HIRARC FORM)
Page 1 of 1
Department: PROJECT SAFETY Function / Main Activity: WORK AT HEIGHT Date:

2) PROVIDE RAILING or
OR BARRICADE AT
BUILDING EDGES iv. Safety
Supervis
or