RISK ASSESSMENT (RA) FORM
RISK ASSESSMENT TITLE: FCU Quarterly PPM PROJECT/LOCATION: Etched Airways RA DATE: 10/04/2023
PREPARED BY:
Sagar Singh SIGNATURE:
RISK ASSESSMENT NUMBER: 01 (Supervisor/Engineer/Manager)
REVIEWED BY:
(HSE Representative) Felix Ntinche SIGNATURE:
RISK ASSESMENT COMMITTEE
APPROVED BY:
MEMBERS:
(Engineer/Manager) Mohammad Yashar SIGNATURE:
CONTROLS/ ADDITIONAL CONTROLS/ ACTION REQUIRED / Approved by
HAZARD/ CONSEQUENCES/ SAFEGUARDS, THAT RISK WITH RESIDUAL RISK COMMENTS (Moderate Risk-
EXISTING SAFEGUARDS, THAT WITH ADDITIONAL Supervisor
ASPECT IMPACT EXITS
(List the hazards for each (List the potential (List the Existing controls that’s exist in CONTROLS NEED TO IMPLEMENTED CONTROLS (High Risk- Project
ACTIVITY/ activity Consequence of each hazard/ the workplace in the order of HSE
(List the Additional controls in the order Manager/Operation
S.№ (List the step by step of Main e.g., noise, manual e.g., hearing loss, Hierarchy of controls
(L-Likelihood, S- of HSE Hierarchy of controls (L-Likelihood, S- Manager
task/activity) handling, slip, trip fall, bruises/fracture/cut, eye e.g. Elimination, Substitution, Severity, RR- Risk e.g. Elimination, Substitution, Severity, RR- Risk Very high – Operation
electricity, falling items, damage/tissue damage, crush Engineering Controls, Administrative
Engineering Controls, Administrative Rating) Controls, Personal Protective Equipment Rating) Manager/Head of
rotating machinery etc. or injury, electrocution and Controls, Personal Protective Equipment
Environmental impact). impact). and as per the Environmental Hierarchy, Department)
and as per the Environmental Hierarchy,
as relevant. L S RR as relevant. L S RR NAME and SIGN
Elimination 3 4 12 Elimination 1 4 4 Wear safety goggles, hand gloves and
N/A N/A safety shoes when conducting this PPM
procedure.
Substitution Substitution
N/A N/A Switch OFF the FOU that needs PPM.
De-energize the circuit breaker of the
Engineering Control Engineering Control specific fan coil unit.
N/A Open the cover of the FCU to access the
Administrative Control Administrative Control blower and motor assembly.
Check the condition of the blower for
possible dirt or damage clean or replace
if found any.
PPE PPE Inspect and check the motor for possible
N/A
noise. This can be done by turning the
shaft of the motor freely. If sound due to
bearing problem is heard, replace the
bearing.
Check the intake Air Filters. Replace if
Notice: A hard copy of this document may not be the document currently in effect. The current version is always on the EFS SharePoint.
Parent Doc №: HSE 200-SOP-0010 Document №: HSE 400-FRM-0010A Revision №:02 Version №:01
Document Published Date: 06/07/2022 Last Review Date: 28/06/2022 Next Review Date: 28/06/2022 Doc Validity: 3 years
RISK ASSESSMENT (RA) FORM
found dirty.
Visually check the condition of drain pan.
Clean any foreign material and dust that
may contribute to the drain pipe dogging.
Check the condition of the drain pipe.
Apply air pressure to remove any slime or
Elimination Elimination
N/A N/A
Substitution Substitution
N/A N/A
Engineering Control Engineering Control
N/A N/A
Administrative Control Administrative Control.
PPE PPE
Notice: A hard copy of this document may not be the document currently in effect. The current version is always on the EFS SharePoint.
Parent Doc №: HSE 200-SOP-0010 Document №: HSE 400-FRM-0010A Revision №:02 Version №:01
Document Published Date: 06/07/2022 Last Review Date: 28/06/2022 Next Review Date: 28/06/2022 Doc Validity: 3 years