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Standard 17 Appendix 4

September 2008

TASK BASED RISK ASSESSMENT

Name

Uncontrolled Hazards: (What is it, When does it occur, Who is at risk) Severity Likelihood Current

Risk

Additional Controls

Risk after actions

Safety Committee Comments

Inevitable Very High Probability Probable Less Probable Least Probable

10 8 6 4 2

5 20 1000 800 600 400 200

4 10 400 320 240 160 80

3 7 210 168 126 84 42

2 4 80 64 48 32 16

1 1 10 8 6 4 2 May c se Minor Injur

May cause death

May cause a severe accident

May cause a LTA

May cause a non LTA

Risk Level determination

Consequence - Risk Severity (RS) of

Injury/Incident/Illness, Actual or

potential

Severity correction factor

Likelihood - Risk occurrence probability (ROP)

au y

Review Due ( Very Critical – Stop Work, Critical – 3 month, Medium – 12 months, Low – 3 Years,

Negligible – 5 Years )

Date

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