The document outlines a risk assessment form used for identifying potential hazards and harms in specific operations or tasks. It includes sections for assessing risk ratings, existing control measures, responsible parties, and additional control measures. The form is designed to help ensure legal compliance and is subject to review and approval by designated individuals.

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)