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1. Assessment Information: Basic details including date, assessor name, location, and department
2. Task Description: Detailed description of the job/task being assessed, including equipment and materials used
3. People Involved: List of workers, contractors, and others who may be affected by the task
4. Hazard Identification: Systematic identification of all potential hazards associated with the task
5. Risk Evaluation: Assessment of likelihood and severity of each identified hazard
6. Current Control Measures: Existing safety measures and protocols in place
7. Additional Control Measures Required: New or enhanced safety measures needed to reduce risks to acceptable levels
8. Risk Rating Matrix: Standard matrix for evaluating risk levels (High/Medium/Low)
9. Action Plan: Detailed plan for implementing additional control measures, including timelines and responsibilities
10. Review and Sign-off: Signatures of assessor, supervisor, and relevant safety personnel
1. Environmental Impact Assessment: Required when task may have significant environmental implications
2. Specialized Equipment Assessment: Needed when task involves complex or high-risk machinery
3. Chemical Hazard Analysis: Required when task involves handling of hazardous substances
4. Emergency Response Procedures: Added for high-risk activities requiring specific emergency protocols
5. Training Requirements: Detailed when task requires specific certifications or training
6. PPE Requirements Matrix: Added for tasks requiring multiple types of personal protective equipment
1. Schedule A - Risk Rating Guidelines: Detailed guidelines for risk evaluation and scoring
2. Schedule B - Hazard Checklist: Standard checklist of common workplace hazards to consider
3. Schedule C - Control Measures Library: Reference list of standard control measures for common hazards
4. Appendix 1 - PPE Reference Guide: Detailed specifications for required personal protective equipment
5. Appendix 2 - Relevant Safety Procedures: References to related safety procedures and protocols
6. Appendix 3 - Incident Report Form: Template for reporting any incidents that occur during the task
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