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Hazard Analysis and Risk Assessment Form

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Hazard Analysis and Risk Assessment Form

Audit

Task
Position/Occupation
Company
Location
Supervisor Name and Title
Worker(s) Name and Title
Frequency Rating (3-Daily/Frequently, 2-Monthly/Occasionally, 1-Quarterly/Rarely) Severity Rating (3-Fatality/Catastrophic Property Damage, 2-Lost Time Injury/Major Property Damage, 1-Medical Aid/Minor Property Damage) Probability Rating (3-Reasonably Probable, 2-Remote, 1-Extremely Remote)
Task Analysed

Task Analysis

Task Steps-Activities
Photo Support
Existing or Potential Hazards
Health and/or Safety
Frequency
Severity
Probability
Priority Rating
Current Hazard Control
Hazard Control Required or Improvement Recommended
Department Involved in Implementation
Assigned to
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