RA-000
Site:
CQUniversity
Team Leader:
Legislative references:
Other references:
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
279822388.doc
Risk Score
Control measures
Pre treatment
Page 1 of 9
Risk Score
Post treatment
Controls Implemented?
Yes
No
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
Risk Score
Control measures
Pre treatment
Risk Score
Post treatment
Controls Implemented?
Yes
No
Page 2 of 9
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
6. Substances Hazardous to
Health
279822388.doc
Risk Score
Control measures
Pre treatment
Page 3 of 9
Risk Score
Post treatment
Controls Implemented?
Yes
No
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
7.2.
279822388.doc
Control measures
Pre treatment
Risk Score
Post treatment
Controls Implemented?
Yes
No
8. Engulfment
Risk Score
Page 4 of 9
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
Risk Score
Control measures
Pre treatment
Risk Score
Post treatment
Controls Implemented?
Yes
No
11.1.
12.2.
9.1.
10. Electrical Hazards
279822388.doc
Page 5 of 9
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
Risk Score
Control measures
Pre treatment
Risk Score
Post treatment
Controls Implemented?
Yes
No
14.1.
16.1.
279822388.doc
Page 6 of 9
JOB SAFETY ANALYSIS AND RISK ASSESSMENT PROCESS Planning, Task Preparation and Site Setup
List of events/steps in the
activity or identified hazard/s
Risk Score
Control measures
Pre treatment
Risk Score
Post treatment
18.1.
21.
21.1.
279822388.doc
Page 7 of 9
Controls Implemented?
Yes
No
Likeliho
od
How likely
could it
happen
Almost Certain
is expected to
occur at most times
Likely
will probably occur
at most times
Possible
might occur at
some time
Unlikely
could occur at
some time
Rare
may occur in rare
circumstances
Insignificant
No Injury
Minor
First Aid Injury
No lost time
Moderate
Medical
Treatment
Major
Serious bodily
Injury
ISOLATE
ENGINEER
ADMIN
PPE
E
H
SUBSTITUTE -
Page 8 of 9
List the JSA/Risk Assessment control measures that have not been implemented:
1.
2.
3.
4.
5.
Date
Action Plan/Item
Action By
Completion Date
1.
/ /
2.
/ /
3.
/ /
4.
/ /
5.
/ /
Comments:
Signature
Date
The Risk Assessment is now completed and requires a number to be allocated from the area Risk
Assessment register it would then be copied with the original being retained by management and the copy
being returned to the originator.
279822388.doc
Page 9 of 9