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Biểu mẫu HSE TASK BASED HAZARDS ANALYSIS

Standard 17 Appendix 4
September 2008

TASK BASED RISK ASSESSMENT
Works

Assessor’s
Name
Date

Location

Task
Significant Hazards

Control Measures in Place

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

Additional Controls
(To reduce the risk to as low as is reasonably practicable)


Who

Risk Level determination
Consequence - Risk Severity (RS) of
Injury/Incident/Illness, Actual or
potential
May cause death
May cause a severe accident
May cause a LTA
May cause a non LTA
May cause Minor Injury

5
4
3
2
1

Severity
correction
factor

20
10
7
4
1

Severity

When

Likelihood

Current
Risk

Done


Risk after
actions

Safety Committee Comments

Likelihood - Risk occurrence probability (ROP)
Very High
Inevitable
Probability
Probable
Less Probable Least Probable
8
6
4
2
10
1000
800
600
400
200
400
320
240
160
80
210
168
126
84
42
80
64
48
32
16
10
8
6
4
2

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

Date

Negligible – 5 Years)

Responsible Manager

Signature

Date

Senior Manager

Signature

Date



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