This
form is provided by RSK ENSR Health & Safety Ltd.
Form wording:
| Area/location description |
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| Date(s) of hazard identification study |
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| Hazard identification study conducted by (risk assessor(s)) |
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| Assessment carried out by |
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Signature |
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| Reviewed and approved by (manager or director) |
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Signature |
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| Personnel activities in area |
Frequency (daily, weekly, etc) |
Duration (hours per day, week,etc) |
Persons involved in activities (state number, jobs, employer) |
Other persons affected by activities (state number, jobs, employer) |
| Routine activities |
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| Non-routine activities |
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Notes/further information:
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| Checklist guidance |
| Step 1 - hazard identification |
1st column - hazard description |
Add other hazards where necessary |
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2nd column - hazard present? |
Tick either YES if the hazard is present, or N/A if the hazard is not applicable |
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| Step 2 - eliminate hazard |
3rd column - hazard eliminated? |
Where possible hazards must be eliminated |
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| Step 3 - action from hazard identification |
4th column - risk assessment needed? |
Tick either YES if risk assessment should be carried out, or N/A if not applicable |
Note: Hazards considered to present insignificant risk do not normally require full risk assessment and may be marked as N/A in this column |
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5th column - risk assessment reference no |
If a relevant risk assessment has already been prepared for the particular hazard, enter the risk assessment reference number. |
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