Blank Risk Assessment Template
Blank Risk Assessment Template
Blank Risk Assessment Template
1 of 5
Hazard Identification
Entanglement
Can anyones hair, clothing gloves, necktie, jewellery, rags and other materials become entangled with moving parts of plant, or materials in motion ? For example, on the lathe is there a micro switch to cut the power off when the guard to the pulley system is opened ?
Risk Control
Sign Off
Yes
Crushing
No
Can anyone be crushed due to falling, uncontrolled or unexpected movement of plant or its load, lack of capacity to slow, stop or immobilise the plant, tipping or rolling over, parts of plant collapsing, contact with moving parts during testing, inspection, maintenance, cleaning or repair, thrown off, under or trapped between plant and materials or fixed structures?
Yes
No
Yes
Shearing
No
Can anyones body parts be cut off between two parts of the plant, or between a part of the plant and a work piece or structure? For example, on a metal guillotine can a finger fit under the guard ?
Yes
No
2 of 5
Hazard Identification
Electrical
Can anyone be injured by electrical shock or burnt due to damaged or poorly maintained leads or switches, water near electrical equipment, working near or contact with live electrical conductors, lack of isolation procedures or the factors not mentioned? For example, are any switches broken, is there a red emergency stop ? Can each machine be locked off for repairs ?
Risk Control
Sign Off
Yes
Explosion
No
Can anyone be injured by an explosion of gas, vapours, liquids, dusts or other substances, triggered by plant operation? For example, build up of dust under the table saw.
Yes
Friction
No
Can anyone be burnt due to contact with moving parts or surfaces of the plant, or material handled by the plant ? For example, on the grinder is there more than 1 mm gap between the tool rest and the wheel ?
Yes
Striking
No
Can anyone be struck by moving objects due to plant or work pieces being ejected or disintegrated, mobility, uncontrolled or unexpected movement of the plant or other factors? For example, has the thicknesser got an anti kick back device ? On the table saw is the riving knife/splitter in place ?
Yes
No
3 of 5
Hazard Identification
Slipping, Tripping and Falling
Can anyone using the plant or in the vicinity of the plant, slip, trip or fall due to the working environment or other factors?, poor housekeeping, dust on the floor around machines, slippery or uneven work surfaces or lack of guardrails.
Risk Control
Sign Off
Yes
Suffocation
No
Can anyone be suffocated due to lack of oxygen, or atmospheric contamination? For example, MIG or TIG welding is there extraction at floor level or an elephant truck extraction system ?
Yes
No
Yes
No
Yes
No
4 of 5
Hazard Identification
Ergonomic
Can anyone be injured due to seating design, repetitive body movement or posture, excessive effort, poor workplace or plant design causing mental or physical stress, lack of consideration for human behaviour, poor lighting or other factors not mentioned?
Risk Control
Sign Off
Yes
No
Yes
No
Other Hazards
Can anyone be injured or suffer ill health from exposure to:
Chemicals Toxic Gases Or Vapours Fumes Dusts Noise Vibration Radiation Or Other Factors Not Mentioned?
Yes
No
5 of 5