No: IOT-10-2-2

Title: Plant and Equipment Risk Management Form

Authorised By: Mana

Issue Date: August 2017 Page Number: 1 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

1. Hazard Management Details – General

Plant/Equipment Item: Make Up/Break Out Unit Make/Model No.: Serial No.:

Work Location: Region:

Name of Person(s) Conducting Activity: Date Conducted:

Description of Use: Summary of Key Risks:

(refer to appropriate subsections)

 Entanglement
 Impact and cutting
 Pressurised content
 Electricity
 Ergonomics
 Noise
 Friction
 Condition
 Slips/trips/falls

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 2 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

2. Documentation
Relevant Legislation/Standards Y/N Comments
Is plant required to be registered? Y N
Is a user license required? Y N
Key reference material: AS 4024.3101 Safety of machinery - Materials cutting - Milling machines (including boring machines) -
Safety requirements
AS/NZS 3760 In service safety inspection and testing of electrical equipment
AS 4024.1 Safety of machinery
Plant Documentation Y/N Comments
Are operator’s manuals accessible? Y N
Is this a restricted use item? Y N
Does this item require safe use documents/test? Y N
3. Hazard Identification

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 3 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

ENTANGLEMENT Major Possible High Long hair, loose clothing, rags, Ensure hair, loose clothing, rags
Can anyone’s hair, clothing, gloves, cleaning cleaning brushes and jewellery and jewellery is kept clear of
brushes, tools, rags or other materials become could become entangled in the moving parts when in use.
entangled with moving parts of the plant or moving parts of the equipment.  Overalls can be used to
materials? restrict loose clothing.
 Hair ties/hair nets must be
used to secure long hair.
Ensure inappropriate jewellery and
Y N accessories (e.g. bracelets) are
not worn when operating
equipment.

Maintain red emergency stop

button in good working order and
ensure it is checked regularly as
part of the maintenance schedule.

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level
IMPACT AND CUTTING INJURIES The exposed moving parts Ensure operator’s hands and body
Can anyone be crushed/cut/struck etc. due to present a risk to an operator’s parts are kept clear of moving
 Material falling off the plant? hands and body parts. parts during operation and
Y N maintenance.
 Uncontrolled/unexpected movement of Brake does not stop machine
Y N Ensure work pieces are
plant/load? immediately and may continue
 Lack of capacity to slow, stop or immobilise Major unlikely Medium to rotate after machine is appropriately secured prior to
Y N disabled. operation.
plant?
 The plant tipping or rolling over? Y N Install guard and interlock over
 Parts of the plant disintegrating or collapsing? Y N Severe Rare Medium chuck. Where applicable, ensure

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 4 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

Hazards Inspected Risk Assessment Description of Risk Control Measures

 Contact with moving parts during testing, Moderate Rare Low the outer spindle arm from the
inspection, operation, maintenance, cleaning or Y N headstock is guarded.
repair?
 Being thrown off or under the plant? Y N Ensure operator has been trained
in safe work practices and
 Contact with sharp or flying objects? (e.g. work Moderate Possible Medium appropriate PPE (e.g. eye
Y N
pieces being ejected) protection) is worn whilst operating
 The mobility of the plant? Y N equipment.

 Inappropriate parts and accessories being used? Y N Consideration must be given to

diameter and length of material, so
 Other it can be machined safely.
Y N

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level
SHEARING
Can anyone’s body parts be sheared between two
Y N
parts of plant, or between a part of the plant and a
work piece or structure?
PRESSURISED CONTENT Minor Possible Medium Cutting fluid being incorrectly Operator to ensure fluid is correctly
Can anyone come into contact with fluids or gases directed or hose bursting. directed on work piece and eye
Y N
under high pressure, due to plant failure or misuse protection worn at all times
of the plant?
ELECTRICITY Damaged or frayed electrical Operator to check for damaged
Can anyone be injured or burnt due to: cords d. electrical cords prior to use.
 Live electrical conductors? (e.g. exposed wires)
Y N

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 5 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

Hazards Inspected Risk Assessment Description of Risk Control Measures

 Working in close proximity to electrical Ensure equipment is serviced on a
conductors? Y N regular basis, tested and tagged (if
not hardwired) and appropriate
 Access to electricity?
Y N isolation procedures (e.g. lock out
tags) are in place.
 Damaged or poorly maintained electrical leads, Major Unlikely Medium
cables or switches? Y N

 Water near electrical equipment?

Y N

 Lack of isolation procedures?

Y N

 Other
Y N

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level
ERGONOMICS
Can anyone be injured due to:
 Poorly designed workstation?
Y N

 Repetitive body movement?

Y N

 Constrained body posture or the need for

excessive effort? Y N

 Design deficiency causing psychological stress?

Y N

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 6 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

Hazards Inspected Risk Assessment Description of Risk Control Measures

 Inadequate or poorly placed lighting?
Y N

 Does the plant impact on the surrounding Major Possible High

workplace and create potential hazards? Plant may be incorrectly Ensure plant is positioned in such
Y N positioned in relation to a manner that normal operations
(Consider safe access and egress from plant,
workflow and design of the workplace) walkways and or work being do not intrude on walkways and
 Is the location of the plant inappropriate? undertaken may intrude on where other operations may
(Consider potential effects due to environmental Y N walkways. impede on pedestrian safety,
conditions and terrain) isolate area until operation has
 Other ceased.
Y N

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level
RADIATION
Can anyone using the plant, or in the vicinity of the
Plant suffer injury or illness due to exposure to
radiation in the form of any of the following: Y N
 infra-red radiation
 ultra violet light
 microwaves
NOISE Moderate Unlikely Medium Operation of the plant Ensure operator wears appropriate
Can anyone using the plant, or in the vicinity of the Y N equipment can result in high PPE (e.g. ear plugs, ear muffs)
plant, suffer injury due to exposure to noise? noise levels. whilst operating the equipment.
VIBRATION
Can anyone be injured or suffer ill-health from Y N
exposure to vibration?

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 7 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

Hazards Inspected Risk Assessment Description of Risk Control Measures

FRICTION Moderate Unlikely Medium Hand may contact metal being Ensure hand is not in close
Can anyone be burnt due to contact with moving Y N turned or chuck. proximity to work.
parts, materials or surfaces of the plant?
SUFFOCATION
Can anyone be suffocated due to lack of oxygen, or Y N
atmospheric contamination?
CONDITION
Is a hazard likely due to the age and condition of the
Y N
plant? (Consider how hard the machine has been
worked, and whether it is used constantly or rarely).
 Can anyone be injured as a result of the plant Moderate Unlikely Medium Plant not serviced appropriately Schedule planned servicing and
not serviced appropriately and/or maintained in and/or maintained in line with inspection requirements in
line with manufacturer’s recommendations? Y N manufacturer instruction can accordance with manufacturer
result in a risk to health and maintenance instructions.
safety.

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level
SLIPS/TRIPS/FALLS Poor housekeeping practices Ensure appropriate cleaning and
Can anyone using the plant, or in the vicinity of the allowing the build-up of waste housekeeping practices are
plant, slip, trip or fall due to: materials or failure to maintained to minimise the risk of
 Uneven, slippery or steep work surfaces? immediately clean up spills a slip, trip or fall.
Y N could result in a slip hazard.
 Poor housekeeping, e.g. spillage in the vicinity? Minor Possible Medium
Y N Inappropriate placement of
objects (e.g. spare materials,
 Obstacles being placed in the vicinity of the Minor Possible Medium bags etc) in the immediate
plant? Y N

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 8 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

Hazards Inspected Risk Assessment Description of Risk Control Measures

 Inappropriate or poorly maintained floor or vicinity of the plant equipment
walking surfaces (i.e. lack of a slip-resistant may result in a trip hazard.
Y N
surface, unprotected holes, penetrations or
gaps?)
If operating or maintaining plant at height can
anyone slip, trip or fall due to:
 Use of work platforms, stairs or ladders?
Y N

 Lack of guardrails or other suitable edge

protection? Y N

 Other
Y N

Hazards Inspected Risk Assessment Description of Risk Control Measures

Cons Like Risk
Level
FIRE AND EXPLOSION
Can anyone be injured by fire? Y N

 Can anyone be injured by explosion of gases,

Y N
vapours, liquids, dusts, or other substances?
TEMPERATURE/MOISTURE
Can anyone come into contact with objects at high Y N
or low temperatures?
 Can anyone suffer ill-health due to exposure to
Y N
high or low temperatures?
 Can anyone be injured or suffer ill-health due to
Y N
exposure to moisture?

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED

 No: IOT-10-2-2
Title: Plant and Equipment Risk Management Form
Authorised By: Mana

Issue Date: August 2017 Page Number: 9 of 9

Last Reviewed: August 2018 CENTRAL OFFICE USE ONLY
Next Review Date: August 2019

Hazards Inspected Risk Assessment Description of Risk Control Measures

OTHER
Can anyone be injured or suffer ill-health from
exposure to:
 Chemicals? Y N
 Toxic gases or vapours? Y N
 Fumes/Dusts? Y N
 Other? (please specify) Y N

4. Risk Assessment Signoff

Authorised By: Signature: Date:

THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED