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Comprehensive Noise Risk Assessment Template

Use this template for a comprehensive noise risk assessment by regularly reviewing the survey parameters, noise collection and exposure, and control measures or use our general noise risk assessment template to implement control measures.

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Audit
Has the noise risk assessment been out and is it still valid?
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Completion
Full Name and Signature of Inspector
Is the personal noise dose likely to be below the lower exposure action values for everyone involved?
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Completion
Full Name and Signature of Inspector
Try a simple listening check
Is the personal noise dose likely to be below the lower exposure action value for everyone involved?
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Completion
Full Name and Signature of Inspector
Will the personal noise dose be below the lower exposure action values for everyone involved?
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Will the personal noise dose be below the upper exposure action for everyone involved?
Recommendation: Implement health surveillance for any employees susceptible to noise. Make hearing protection available. Establish maintenance programme for hearing protection and other noise-reduction equipment. Provide training.
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Completion
Full Name and Signature of Inspector
Will the personal noise dose be below the exposure limit values for everyone involved?
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Completion
Full Name and Signature of Inspector
Recommendation: Immediately reduce noise exposure and/or provide suffiecient hearing protection
Noise Survey and Exposure
Click + to add equipment producing noise
Item Name
Location of equipment
Noise level (LAeq)*
EXPOSURE
Exposure duration
Enter control measures required
Completion
Full Name and Signature of Inspector
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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.

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