Risk Assessment/Management Form

Ref:
Section / Dept: civil Activity: Risk Assessment- Location:-
Contractor:- Deshuttering Work

Consequence Current control measures

bility

bility
Sl Basic Job Potential Risk rating Init Addition

Proba
Ri

Proba
N Steps Hazard ial al sk
o. Ris control ra
k measure ti
P E A R P E A R
n
Working plateorm to be made for g
every 2.1m with double
railings,toeguard and scaffolding 1 0 0 0 2 2
staging ladder as access whose
Climbing up on
Fall of man due rungs are not spaced greater than
1 the top of the Get Injury
to slip 500mm
scaffolding
Use of Double rope full body safety
harness and one point must be
achored at all times while ascending
or descending
Fall of Get Injury/Fatality Deployment only experienced
man/Materials workmen
Arrangement of
2 platform for Lifting of planks are to be done by 2 0 0 1 2 4
Deshuttering rope/binding wire
Fall of materials Get Injury
All the planks are to be tied up with
coir rope & tools must be tied up
Deployment only experienced To
workmen establishe
d the drop
zone at the
Use of Double rope safety harness
ground
3 Deshuttering work Fall of materials Get Injury/Fatality and it must be fixed above the head 2 0 0 0 3 6 level & 1 0 1 0 2
height
give the
Barricade the area below. Daily tool
box Talk
Use of safety shoes,Helmet with
chin strip and hand gloves
All the materials shall be lowered
down by rope
Lowering of All the loose materials shall be
Fall of Fall of collected in a gunny bag
4 shuttering boards 2 0 0 1 2 4
materials/man materials/man
& planks
Use of Double rope safety harness
and it must be fixed above the head
height
Shifting of the
dismantled Slip of man/Fall Movement of path is to be free from
5 Get Injury/Fatality 2 0 0 1 2 4
materials to a of materials any obstruction
designated place
Material means --Shuttering boards & planks
Additional Measures:

1 Full body safety harness with double lanyard to be used and its hooks must be anchered at
two different points.

2 Skilled Supervisor to be deployed at the time of dismantling.

3 Sufficient illumination to be provided at night work.
4 Proper working platform with tightened planks to be provided for dismantling.

5 Tool box talk before starting of the work.

6 No material shoul be thrown from top to bottom.

Prepaired by Approved by Reviewed by
contractor contractor
Date Date Date

1of2
 Risk Assessment/Management Form

Location:-

ual
Resid

risk

eans --Shuttering boards & planks

2of2