1 Guide to use Risk Assessment Templates No Specific Task Step (In sequence of works) Hazard Details Consequence/Risk Initial Risk Rating Control Measures Residual Risks Additional Control Measures RR L C RR 1 COMPLETE RISK ASSESSMENT IN THE SEQUENCE OF TASK HAZARDS, NOT RISK. EXAMPLE: A FORKLIFT IS A HAZARD IT HAS THE POTENTIAL TO CAUSE HARM OR DAMAGE PROPERTY RISK LIKELYHOOD AND CONSEQUENCE OF INJURY, DAMAGE ETC. RESULTING FROM A HAZARD FORKLIFT EXAMPLE: • UNTRAINED OPERATOR; • COLLISION WITH PEDESTRIANS; • OVERLOADING; • OVERTURNING; • ETC. A B C CONTROLS TO MITIGATE THE RISKS ARISING FROM THE TASK • CONTROL MEASURES IN LINE WITH RELEVANT MINIMUM ACCEPTABLE STANDARD • INCLUDE SPECIFICS FOR THE TASK 2

1. HEALTH SAFETY AND ENVIRONMENT Author: Approved:
RISK ASSESSMENT: ACT/HSE/RA 001 RISK ASSESSMENT TEMPLATE GUIDE
Issued: Rev. Date:
Revision: 0
Page 1 of 1 HSEQ -Rev-01(Aug-2018)
No
Specific Task Step
(In sequence of
works)
Hazard Details Consequence/Risk
Initial Risk
Rating Control Measures Residual Risks
Additional Control
Measures
RR
L C RR
1
COMPLETE RISK
ASSESSMENT IN THE
SEQUENCE OF TASK
HAZARDS, NOT RISK.
EXAMPLE:
A FORKLIFT IS A
HAZARD
IT HAS THE
POTENTIAL TO
CAUSE HARM OR
DAMAGE PROPERTY
RISK
LIKELYHOOD AND
CONSEQUENCE OF INJURY,
DAMAGE ETC. RESULTING FROM
A HAZARD
FORKLIFT EXAMPLE:
 UNTRAINED OPERATOR;
 COLLISION WITH
PEDESTRIANS;
 OVERLOADING;
 OVERTURNING;
 ETC.
A B C
CONTROLS TO MITIGATE THE RISKS ARISING FROM THE TASK
 CONTROL MEASURES IN LINE WITH RELEVANT MINIMUM
ACCEPTABLE STANDARD
 INCLUDE SPECIFICS FOR THE TASK
2
RISK SCORE CALCULATOR
Use the Risk Score Calculator to Determine the Level of Risk of each Hazard
What would be the
CONSEQUENCE
of an occurrence be?
What is the LIKELIHOOD of an occurrence? Hierarchy of Controls
Frequent/Almost certain (5)
Continuous or will happen
frequently
Often (4)
6 to 12 times a year
Likely (3)
1 to 5 times a year Possible (2)
Once every 5 years
Rarely (1)
Less than once every 5
years
Can the hazard be Eliminated or removed
from the w ork place?
Catastrophic (5)
Multiple Fatalities
High 25 High 20 High 15 Medium 10 Medium 5
Can the product or process be substitutedfor
a less hazardous alternative?
Serious (4)
Class 1 single fatality
High 20 High 16 High 12 Medium 8 Low 4
Can the hazard be engineered aw ay w ith
guards or barriers?
Moderate (3)
Class2 (AWI or LTI) or Class 1
Permanently disabling effects
High 15 High 12 Medium 9 Medium 6 Low 3
Can Administration Controls be adopted
I.e. procedures, job rotation etc.
Minor (2)
Medical attention needed, no work
restrictions. MTI
Medium10 Medium 8 Medium 6 Low 4 Low 2 Can Personal Protective Equipment &
Clothing be w orn to safe guard against
hazards?Insignificant (1)
FAI
Medium10 Medium 4 Low 3 Low 2 Low 1
Project Name: xxx
RA Ref No.: xxx
RA compilation
Date:
Review date:
Date:
Compiled by: CONSTRUCTION TEAM MEMBER
Reviewed by: HSE MANAGER / LEAD
Approved by: PROJECT DIRECTOR
Overall Task Details
THE GENERIC TEMPLATES ARE A GUIDE TO COMPILING RISK
ASSESSMENTS, COVERING THE BASIC REQUIREMENTS FOR MAS
COMPLIANCE
Relevant Applicable MAS:
BE AWARE OF THE LOCATION AND TYPE OF MAS -
CONTAINED IN SAPPHIRE AVAILABLE FOR REVIEW
Additional Training required:
ADD ANY ADDITIONAL TRAINING REQUIRED FOR
THE TASK
NOC’s Required for task:
ANY AUTHORITY NOCs – DM, ADM, RTA, DEWA, ETC.
L X C = RR