Ri
sk
As
se
ss
me
n
t
C
o
mp
a
n
y
N
a
me
:
G
re
e
n
Me
c
h
L
td
Act
ivi
ty:
EVO
2
0
5
D
SAF
E
/
SU
R
E
-T
ra
k
H
a
za
rd
A
t
R
is
k
C
on
s
e
qu
e
n
c
e
(
C
)
Lik
e
li
ho
od
(
L
)
R
is
k
S
c
ore
C
on
trol
s
R
e
v
is
e
d
Fina
l
R
is
k
S
c
ore
Th
o
s
e
l
ike
ly
to
b
e
a
ff
e
ct
e
d
L
ike
ly
in
ju
ry
fr
o
m
h
a
za
rd
R
a
tin
g
O
f
in
ci
d
e
n
t
R
a
tin
g
C
R
a
tin
g
L
R
a
tin
g
IM
P
A
C
T
S
tr
u
ck
b
y
ro
ta
ti
n
g
m
a
ch
in
e
d
u
ri
n
g
20
d
e
g
re
e
t
u
rn
O
P
E
R
A
TOR
TH
IR
D
P
A
R
TY
B
ro
ke
n
b
o
n
e
s,
b
ru
ise
s.
3
R
E
M
O
TE
L
Y
P
O
S
S
IB
L
E
2
6
C
o
rd
o
n
o
ff
a
re
a
.
R
e
st
ri
ct
a
cce
ss.
Tr
a
in
e
d
o
p
e
ra
to
r.
3
1
3
C
U
TT
IN
G
S
h
a
rp
co
rn
e
rs
o
n
w
h
e
e
l
co
v
e
r,
w
h
e
n
ro
ta
te
d
f
ro
m
lo
cke
d
p
o
si
ti
o
n
.
O
P
E
R
A
TOR
TH
IR
D
P
A
R
TY
C
u
ts
a
n
d
b
ru
ise
s
to
l
e
g
s.
2
P
O
S
S
IB
L
E
3
6
A
s
a
b
o
v
e
.
P
o
si
ti
o
n
b
o
lla
rd
s
o
r
si
m
ila
r
a
d
ja
ce
n
t
to
sh
a
rp
co
rn
e
rs.
2
1
2
Ke
y:
Consequenc
e
Score
Likelihood
Score
T
o find risk Score mul
tiply consequence
rating by the likelihood rating
Fatality
5
Very likely
5
Final revised
risk score
acceptable to the
company is 10 o
r less. If higher,
further
controls are required
.
Final revised
likelihood sco
re must be
2 or
less
Disability
4
Probable
4
Very serious (
broken
limbs)
3
Possible
3
Important (3 day
accident)
2
Remotely
possible
2
Noticeab
le (first a
id)
1
Improbable
1
A
ss
es
sm
ent
N
o:
R
015
-5
S
igne
d:
……………………………
D
at
e:
…………………………….
Re
vi
ew
D
at
e
:
…………………………….