RISK ASSESSMENT RECORD Format Revision :

Name of the Activity/ Location: Doc. No:

Date: Sept. 17,2019 PIZZA HUT RA No.: 03

Activity/ Situation/ Possible Risk rating Residual rating

Sl.
Facility/ Hazard outcome Control Measures
No. S L RR S L RR
Arrangement (Consequences)
1 SIGNAGE WORKS
Planning and Lack of coordination may 3 2 6 Fully coordinate with management, ensure following the approved 3 2 6
preparation lead property damage drawings, specifications and methodologies.
Preparation of Hand Slips, Trips and 3 2 6 All hand tools to be regularly inspected by technicians to identify any 3 2 6
Tools / materials Operational injury. product defects. Any defects to be recorded and equipment disposed of
or replaced.
Erection of Scaffolding As enumerated in the risk 3 2 6 As specified in the risk assessment for scaffolding. 3 2 6
to install the signage assessment for scaffolding
Installation of signage Slips, Trips and 3 3 9 All operatives in contact with this material must wear proper PPE at all 3 3 9
Operational injury. times.

Add additional rows where required for all activities and associated risk & hazards.
Additional information: Legal requirement: (not exhaustive)
 UAE Federal Labour Law 8 of 1980
 Ministerial Order No. 32 of 1982, UAE
 Code of Safety Practice and Technical guidelines from Dubai Municipality
 UAE fire & life safety code of practice
Supervisory/ Managerial input (if needed): Personal protective equipment:
Mandatory PPE:
Job Specific:
Prepared By: HSE Representative Approved by: Project Manager

Name: ............................................................................................................. Name: ...............................................................................................

Signature & Date: ........................................................................................... Signature & Date: .............................................................................

- Low risk - Moderate risk - High risk - Very high risk S- Severity L – Likelihood RR – Risk Rating (S x L = RR)
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 RISK ASSESSMENT RECORD Format Revision :

Name of the Activity/ Location: Doc. No:

Date: Sept. 17,2019 PIZZA HUT RA No.: 03
ACTION REQUIRED SEVERITY
No action required unless further mitigation possible LIKELIHOOD Insignificant Minor Major Moderate Catastrophic
1-3 Low risk
without extra effort (1) (2) (3) (4) (5)
Activity can proceed subject to management or Rare (1) 1 2 3 4 5
4-6 Moderate risk
modification Possible (2) 2 4 6 8 10
Activity shall be modified for remedial actions and subject Likely (3) 3 6 9 12 15
8-12 High risk
to detailed assessment Often (4) 4 8 12 16 20
Frequent (5) 5 10 15 20 25
15-25 Very high risk Activity should not proceed in this form
Likelihood (L) x Severity (S) = Risk Rating (RR)

- Low risk - Moderate risk - High risk - Very high risk S- Severity L – Likelihood RR – Risk Rating (S x L = RR)
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