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SEVERITY RISK ASSESSMENT MATRIX

CORRECTION
Catastrophic 1 1 2 4 7 11 LEVEL OF RISK DESCRIPTION PERIOD

Fatality 2 3 5 8 12 16 ALTO Intolerable risk, requires immediate controls. If DANGER cannot be controlled, operational work on the job is
stopped.
0-24 HOURS

9
Permanent 3 6 13 17 20 MEDIO Initiate measures to eliminate/reduce the risk . Evaluate whether the action can be executed immediately. 0-72 HOURS

Temporary 4 10 14 18 21 23 UNDER This risk may be tolerable. 1 MONTH

Menor 5 15 19 22 24 25
A B C D E

It has Practically
It could Rare to impossible to
Common happen happen
happened happen

FREQUENCY

TASK

DATA OF THE WORKERS:

DATE TIME LEVEL / ZONE / AREA NAMES AND SURNAMES POSITION SIGNATURE

IPERC CONTINUOUS

IPERC EVALUATION RESIDUAL RISK ASSESSMENT

DESCRIPTION OF THE HAZARD CONSEQUENCE (RISK) CONTROL MEASURES TO BE IMPLEMENTED
A M B AM B

SEQUENCE TO CONTROL THE HAZARD AND REDUCE THE RISK:

SUPERVISORS' DATA:

TIME SUPERVISORY NAME CORRECTIVE ACTION SIGNATURE

NOTE: Eliminate s is a Priority Task prior to the start of daily operations.

Danger
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WORK ORDER
Basic / Specific PPE:

Equipment and/or tools to be used:

ANALYSIS OF THE WORK.

Is it a Routine Task? YES NO Have workers been trained in the procedures? YES NO
Are all controls in place to start the task?
Is there a procedure in place? YES NO YES NO
Is a High Risk Work Permit (PETAR) required?
YES NO Is there permanent supervision in the High Risk task? YES NO

TASK DESCRIPTION.

SUPERVISOR AUTHORIZING THE EXECUTION OF THE TASK

Time Name and Surname Remarks Signature

SUPERVISORS VERIFYING THE SAFE EXECUTION OF THE TASK

Time Name and Surname Remarks Signature

NOTE:
• Any task change will require a new IPERC.

• Take as a reference the base IPERC, then elaborate the Continuous IPERC (FP-CORP-04-03) before starting any task; where all present Hazards must
be identified, Risks must be evaluated and controls must be determined.
• Validate with the Supervisor the information recorded in the IPERC Continuous (within 02 hours) and Do not start the task when new hazards are
identified and proposed controls are not in place.
• When a worker joins the work started, he/she must review the IPERC Continuous form prepared and record his/her data in the "Worker Data" box
in accordance with the fact that he/she has become aware of the hazards and risks of the task.
- If it is a non-routine task, an ATS must be performed.

SEVERITY AND PROBABILITY TABLES

 CRITERIA CRITERIA
Frequency Property Damage to the
PROBABILITY Frequency of exposure SEVERITY Personal injury
probability damage process
Stoppage of the process
Several fatalities. Several
It happens all too Many (6 or more) people Losses in excess for more than 1 month
Common (very likely) Catastrophic people with permanent
often exposed. Several times a day of US$ 100,000. or definitive stoppage.
injuries.

Losses between Process stoppage of

Moderate (3 to 5) people Fatality (Major US$10,000 and more than 1 week and
Has happened (probable) It happens frequently. A fatality. Vegetative state.
exposed several times a day. loss) US$100,000. less than 1 month.

Injuries that incapacitate the

Few (1 to 29 people exposed Losses between Stoppage of the process
Occasionally Permanent person for normal activity for
Could happen (possible) several times a day. Many US$ 5,000 and from more than 1 day
happens. loss life. Advanced occupational
people exposed occasionally. US$ 10,000. up to 1 week.
diseases.

Rarely occurs. It is Injuries that temporarily Losses between

not very likely to Moderate (3 to 5) people Temporary incapacitate the person. US$ 1,000 and
Rare to happen (unlikely) Shutdown of 1 day
happen. occasionally exposed. loss Ergonomic position injuries US$ 5,000.

Very rarely occurs.

Practically impossible to Few (1 to 2) people occasionally Losses less than Stoppage of less than 1
Impossible to Minor loss Injury that does not disable
happen exposed. US$ 1,000. day.
happen. the person. Minor injuries.