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Hazard Identification Report Form

This hazard identification report form documents a potential workplace hazard. It records the business name, location of the hazard, those conducting and attending the assessment. Details of the hazard and associated risks are noted. Those affected are identified and any existing controls listed. The initial and residual risk ratings are scored and further action needed by a target date is outlined, to reduce the risk to a low level.

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garthraymundo123
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Download as DOCX, PDF, TXT or read online on Scribd
73 views

Hazard Identification Report Form

This hazard identification report form documents a potential workplace hazard. It records the business name, location of the hazard, those conducting and attending the assessment. Details of the hazard and associated risks are noted. Those affected are identified and any existing controls listed. The initial and residual risk ratings are scored and further action needed by a target date is outlined, to reduce the risk to a low level.

Uploaded by

garthraymundo123
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Hazard Identification Report Form

Ref: Version:

Business name:

Conducted by: In attendance:

Location of hazard: Date:

What is the hazard?

What are the risks associated with the hazard?

People/person who may be affected by the hazard:

What has already been done to control the hazard?


(Note: leave this section blank if nothing has been done)

Initial risk rating: low moderate high critical catastrophic


(Note: further action needs to be taken if the initial risk rating for the hazard is higher than “low”)

What further action needs to be taken?


(eg. provide training, review of safe work procedure, provide manual task equipment, etc…)

By when (date):

Residual risk rating: low moderate high critical catastrophic


(Note: the residual risk rating should be “low” at this stage, if this is not the case, think of a more effective way to control the
hazard)

Completion date: Completed by:

A10692774

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