Project: Churchill Risk Assessment No:
Operation / Task: Method Statement Title:
Location / Area: Plot bb A05 002 Business Bay Method Statement No:
S L RR S L RR
Catastrophic
Very Likely Intolerable
Likely Intolerable
Unlikely Substantial
Highly Moderate
Signature: Date:
Risk Assessment Prepared by : _______________________________ _____________
Signature: Date:
Risk Assessment Noted by : _______________________________ _____________
Signature: Date:
Risk Assessment Approved by : _______________________________ _____________
Construction HSE Forms
SU Substantial
MO Moderate
TO Tolerable
_____________________________
Tolerable Moderate
UL Unlikely
C Catastropihic
EH Extremely harmful
H Harmful
SH Slightly harmful
_____________________________
_____________________________
H Highly unlikely
Risk Rating
Extremely
Harmful
Harmful
IN Intolerable VL Very Llikely
L Likely
Severity
Activity Item
Health, Safety & Environment
Hazard/Risk Assessment Proforma
Hazards/Risks
Identified
Risk Rating
Control Measure
Residual Risk
Likelihood
HSE Forms
HSEF_020
Rev_2006
Intolerable
Intolerable
Substantial
Intolerable
Substanstial
Moderate
Responsibility
Monitoring
Responsibility
Slightly Harmful
Substantial
Moderate
Tolerable
Tolerable
_____________
_____________
_____________
Construction HSE Forms
HSE Forms
HSEF_020
Rev_2006
Monitoring
Responsibility
Project: Churchill Risk Assessment No:
Operation / Task: Method Statement Title:
Location / Area: Plot bb A05 002 Business Bay Method Statement No:
S L RR S L RR
C UL SU C C IN
C L IN EH L IN
C L IN C L IN
C VL IN C VL IN
C L IN C L IN
EH UL SU H VL MO
H UL MO H UL MO
EH UL SU EH UL SU
C L IN C H TO
Catastrophic
Very Likely Intolerable
Likely Intolerable
Unlikely Substantial
Highly Moderate
Signature: Date:
Risk Assessment Prepared by : _______________________________ _____________
Signature: Date:
Risk Assessment Noted by : _______________________________ _____________
Signature: Date:
Risk Assessment Approved by : _______________________________ _____________
Health, Safety & Environment HSE Forms
HSEF_020
Rev_2006
Intolerable
Foreman Site Engineer
Intolerable
Hazard/Risk Assessment Proforma
Control Measure
Residual Risk Risk Rating
Substanstial
Moderate
Lack of knowledge by the workers when
working on elevated floor w/ opening.
Conduct a tool box meeting before start of work &
orient them how importance is safety.
Severity
Workers
working on
elivated floor
with an
opening and
had a depth
of 3.5 meter.
Lack of inspection by the foreman on the
area before start of work.
Inspection of foreman should be done on the
area before start of work.
Always use PPE
Likelihood
Activity
1
Lack of coordination w/ the HSE dep't
incase risk is identified
Hazards/Risks Identified
Slip and trip over debris on the ground.
Accidental dropping of materials and tools.
Unuse PPE (safety belt,safety
helmet)upon working on elevated floor with
an opening.
Item
Falling through the elevated floor opening.
Possibly fatal,fracture,cuts and wounds.
Provision of guarding, marking and signages
Install safety net
Falling of debris on the ground.
Risk Rating
Extremely
Harmful
Harmful
Site
Engineer/Foreman/
HSE
HSE
Foreman / HSE
HSE
IN Intolerable
Moderate
Responsibility
Monitoring
Responsibility
Inform our HSE dep't for immediate action and
educate them to identify risk.
Cover the floor with an opening or use safety
harness when working thru an open floor
stop working if you are assign on the area with an
opening if there is no safety protection
remove all debris beside the edges of opening
floor 1 meter away from the edge and install
barriers
Site
Engineer/Foreman/
HSE
Foreman /
Workers
H Highly unlikely
C Catastropihic
EH Extremely harmful
H Harmful
SH Slightly harmful
Foreman
VL Very Llikely
L Likely
UL Unlikely
Site
Engineer/Foreman/
HSE
_____________________________
_____________________________
Construction HSE Forms
SU Substantial
MO Moderate
TO Tolerable
_____________________________
Tolerable
Intolerable
Substantial
Foreman /
Workers
HSE HSE
HSE
Foreman / HSE HSE
Site
Engineer/Foreman/
HSE
Site
Engineer/Foreman/
HSE
Slightly
Harmful
Substantial
Moderate
Tolerable
Tolerable
_____________
_____________
_____________
HSE Forms
HSEF_020
Rev_2006
Site Engineer
Site
Engineer/Foreman/
HSE
HSE
Monitoring
Responsibility
Site
Engineer/Foreman/
HSE
Construction HSE Forms
Foreman /
Workers
HSE
HSE
HSE
Site
Engineer/Foreman/
HSE