Occupational health and safety.

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RAFormTemplate.doc

Risk Assessment Form

1. Hazard Identification

2. Risk Evaluation

3. Risk Control

1a

1b

1c

1d

2a

2b

2c

2d

3a

3b

3c

3d

3e

3f

3g

Ref

Work Activity

Hazard

Possible Injury / ill health

Existing Risk Controls

S

L

Risk

Additional Controls

S

L

Risk

Implementation Person

Due Date

Remarks

1

Usage of machinery

2

Contact with chemicals (hazardous substances)

Disposable face masks are provided as well as plastic goggles

Description of Severity, Likelihood and Risk Matrix

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RPN

Risk Level

1-3

Low

4-12

Medium

15-25

High

Risk Acceptability

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