Issue Date: 15/12/2016 Document Code:

Effective Date: 15/12/2016 HSE SOP 002/01

Hazard Identification and Risk Management Form

Location (Department/ Section) Task/ Activity

Date
Risk Assessment team

Approved by Date

Severity
Severity () Likelihood () Result
5 4 3 2 1
1 First aid 1 Unlikely 5 25 20 15 10 5 Range Evaluation Action

Likelihood
2 Minor Injury 2 Possible 4 20 16 12 8 4 1-6 T(trivial risk) NON
value

value

3 Moderate Injury 3 3 15 12 9 6 3
Likely 8-10 M(medium risk) C.A

4 Major Injury 4 Very likely 2 10 8 6 4 2 12-15 H(high risk) O&P

5 Fatality 5 Imminent 1 5 4 3 2 1 16-25 N(non-acceptable risk) O&P

Issue/Revision: 001/ 00 Issue Date: 15 /12 /2016 Revision Date: / / Page 1 of 2

 Issue Date: 15/12/2016 Document Code:
Effective Date: 15/12/2016 HSE SOP 002/01

Hazard Identification and Risk Management Form

Risk Analysis

1_st Eval.
Existing Required Additional Control Risk Analysis Required Additional Control
Activity Risk (Existing

2_nd
Eval.
No Control Measures (with Controls) Measures
Control)

S L R S L R

Issue/Revision: 001/ 00 Issue Date: 15 /12 /2016 Revision Date: / / Page 2 of 2