Professional Documents
Culture Documents
Supervisor:
Revised
Reviewed by:
HSE Professional (Sign Name & Position):
AWTP
Job Steps
Erect mobile scaffold
Potential Hazards
Fall from height
Controls
Page 1 of 6
Residual Risk
Assessment
C
3
P R
C 13
Responsibility
Supervisor
Scaffolder
BUN1A-L-FM-0010-01[2]
BAWTP1A Project
Supervisor:
Revised
AWTP
Page 2 of 6
C 13
Supervisor
Scaffolder
C 13
Supervisor
Scaffolder
All Workers
BUN1A-L-FM-0010-01[2]
BAWTP1A Project
Supervisor:
Revised
AWTP
Page 3 of 6
C 13
Supervisor
Scaffolder
C 13
Scaffolder
BUN1A-L-FM-0010-01[2]
BAWTP1A Project
AWTP
UNCONTROLLED ENERGY CREATES POTENTIAL Have you considered each of the following Energy sources?
(Tick to Indicate Each Energy Source You Have Considered & Controlled)
Mechanical
Electrical
Falling objects
Chemical
Gasses/Liquid/Vapour
Thermal
Pressure
Radiation
Biological
Page 4 of 6
Kinetic / Stored
Solar
Human Force
Personnel participating in this job/task activity
Name
Signature
Name
Signature
BUN1A-L-FM-0010-01[2]
BAWTP1A Project
AWTP
Page 5 of 6
BUN1A-L-FM-0010-01[2]
BAWTP1A Project
AWTP
LEVEL
IMPACT
Insignificant
Minor
Moderate
Major
Catastrophic
EXAMPLE OF CONSEQUENCE
Minor Injury; low plant damage < $1,000; minor loss of productivity; no environmental impact
Medical Treatment Injury / Restricted Work injury; plant damage < $100K; interruption to
productivity; environmental release immediately contained
Extensive injury (LTI), plant damage $100K - $500K; loss of productivity 1 to 5 days; loss of
production; environmental release off site with no detrimental effects;
Permanent Disability; plant damage $500K - $1M; loss of productivity >5 days; toxic
environmental release off site with detrimental effect
Fatality. Losses in excess of $1M. Permanent offsite contamination
MEASURE
Common
Has
Happened
Could
Happen
Not likely
Practically
impossible
DESCRIPTION
The event is expected to occur in most circumstances
Will probably occur in most circumstances
GUIDE
Once per week
H = High risk Immediate action required, activity must not start or be stopped if started. Highest level of Management needs to be involved.
M = Medium risk Monitoring controls are required. Management responsibility must be specified.
L = Low risk.
Identify hazards and implement controls. Manage by routine processes. Ie inspections / observations
Page 6 of 6
BUN1A-L-FM-0010-01[2]