Project Name: Ref. No.: Operation / Tasks: Date: SN Task/ Activity and Location Potential Hazards Potential Harms/ Damages Risk Rating Existing Control Measures Responsible Party Additional Control Measure Residual Risk Risk Acceptable (Yes/No) Opportunity Probability (P) Severity (S) Rating (P X S) (Refer to Hierarchy of Control) (P) (S) (R) Notes: (Legal Compliance) Assessed by: Reviewed by: Approved by: Date of next review: Name : Name : Name : Designation: Designation : Designation : Sign & Date : Sign & Date : Sign & Date :

1. HSE RISK ASSESSMENT
Page 1 of 1 Form # HSEQ – HSERA (Rev 4 – Mar 23)
Project Name: Ref. No.:
Operation / Tasks: Date:
SN
Task/
Activity and
Location
Potential
Hazards
Potential
Harms/
Damages
Risk Rating
Existing Control
Measures Responsible
Party
Additional
Control
Measure
Residual Risk Risk
Acceptable
(Yes/No)
Opportunity
Probability
(P)
Severity
(S)
Rating
(P X S)
(Refer to Hierarchy of
Control)
(P) (S) (R)
Notes:
(Legal Compliance)
Assessed by: Reviewed by: Approved by: Date of next review:
Name : Name : Name :
Designation: Designation : Designation :
Sign & Date : Sign & Date : Sign & Date :
Risk Rating Severity (S) Hierarchy of Control
Probability (P)