SAMPLE TOOL FOR HAZARD IDENTIFICATION.

RISK ASSESSMENT & DETERMINING CONTROLS (HIRADC)

Risk Assessment and Control Worksheet

Initial Assessment Date: Re-Assessment Date:
Team: John L., Paul M., George H., Ringo S.
January 15, 2016 June 30, 2016
Area/Activity: Motorpool (Oil changing and welding) Area Responsibility: Brian Epstein
Health_Safety Health_Safety Significa Controls
Phase 2 Phase 3
Sequence of Hazard or Harm / nce Needed
Steps Environmental Environmental (Phase Existing RP Risk RP Risk
S L C S L C
Aspect Impact 1) Controls N Level N Level
May cause mild
eye irritation. Orient
Splashes on No controls Unacc Substa
Oil changing Symptoms include S 3 3 5 45 personnel 3 2 3 18
eyes in place eptable ntial
stinging, tearing, proper PPE
and redness.
May cause mild Orient
Direct skin skin irritation. personnel
No controls Substa Substa
contact with oil Prolonged or NS 2 3 5 30 proper PPE and 2 2 3 12
in place ntial ntial
and lubricants repeated contact provided
may dry the skin. complete PPE
Orient
personnel on
May result to
Fire Substa safety practices Accept
Fire hazard 2nd to 3rd degree S 3 1 5 15 3 1 3 9
extinguisher ntial provided able
burns
warning signs

Orient
personnel on
Spills may Land
proper waste
infiltrate contamination Unacc Substa
S 3 3 Oil pan 5 45 disposal and 3 2 2 12
subsurface soil and water eptable ntial
build an
and groundwater pollution
oil/water
separator