RISK ASSESSMENT FORM

Company: Worksite: Process/ Location: Approved by: (Name, designation) (Date) CTCI IR II U&O DBN Project New W/H area Mr. Ike Hsu Site Manager
08-02-2012

Conducted by: (Names, designations) (Date) Last Review Date:

Mr. Anderson Wang Construction Manager 08-02-2012

08-02-2012

Next Review Date:

08-03-2012

1. Hazard Identification
1a. 1b. 1c. 1d. Possible Accident / Health & Persons-at-Risk

2. Risk Evaluation
2a. Existing Risk Control (if any) 2b. Severity 2c.
Likelihood

3. Risk Control
3a. 3b. Action Officer, Designation

2d. Risk Level

No.

Work Activity

Hazard

Additional Risk Control

1.

Manual Excavation at existing oxygen line

Damage the oxygen line

Leakages of oxygen can injury to the workers by the pressure release.

None

Mo

Proper care and supervision to the workers when activity is ongoing. Safety training for the workers specially that specific job.

Mr. Abdul Muqeeth

Tools can cause injury

Hand and body injuries are possibility to the workers. None Mi L L

Tools must be inspected prior to use. Use tools that applicable and safety to the workers. Proper PPE must be wear.

Falling or rolling the excavated materials and tools into the excavated area.

Injury to the workers. None Dust can cause to respiratory and Mi L L

All excavated materials and hand tools must keep 1.5m away from the edge of the excavation.

Dust accumulation by the excavated materials.

lungs problem. Injury to the workers by falling

None None None

Mi Mi

L L

L L

Dust condition should be kept at minimum level by the use of water or other safe means.

Adequate access way can cause slips and falling. Tools can cause property damage Lack of supervision Lack of safety monitoring Lack of safety awareness

and slips.

Use dust mask for protecting dusty atmosphere. Proper steps, ramps or other safe means of access

Damage the oxygen pipe

None

shall be provided.

Unsafe act and condition to workers Unsafe act Unsafe the workers condition

None None None

M M M

L L L

L L L

Crew Supervisor & Safety Personnel always monitor the job. Provide Physical barriers with safe distance. Provide adequate safety awareness signs. Valid work permits at site. Plot plan and area sketch copy at site. Approved method statement copy at site. Approved Risk assessment and daily JSA at site. When the excavation goes to deeper do gas test. Before start the job Crew Supervisor & Assigned safety should to give Safety Toolbox talk about the scope and sequence of the job. Sharp edge tools not permitted while the safe distances reach.

H = High Risk, M = Medium Risk, L = Low Risk

Likelihood Severity Major (Ma) Moderate (Mo) Minor (Mi)

Remote (R) M L L

Occasional (O) H M L

Frequent (F) H H M