Scribd
Upload
92 views6 pages

Tiic Risk Management Forms

This document contains a hazard identification and risk assessment form. It lists various processes/tasks/activities, identifies potential hazards and contributing risk factors. It then evaluates existing risk controls such as engineering, administrative and PPE measures. Finally it contains tables to estimate likelihood, severity of consequences and risk level of each identified hazard. The overall purpose is to document the company's significant occupational safety and health risks.

Uploaded by

Mark Rusiana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
92 views6 pages

Tiic Risk Management Forms

This document contains a hazard identification and risk assessment form. It lists various processes/tasks/activities, identifies potential hazards and contributing risk factors. It then evaluates existing risk controls such as engineering, administrative and PPE measures. Finally it contains tables to estimate likelihood, severity of consequences and risk level of each identified hazard. The overall purpose is to document the company's significant occupational safety and health risks.

Uploaded by

Mark Rusiana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd

DEPARTMENT SECTION/AREA NOTED BY APPROVED BY

HAZARD IDENTIFICATION AND


ASSESSEMENT OF OSH RISK
DATE
HAZARD IDENTIFICATION EXISTING RISK CONTROL MEASURE RISK ESTIMATION
NO. RISK CONTROL LIKELIHOOD
PROCESS/ TASK/ACTIVITY R/NR HAZARD CONTRIBUTING FACTOR ENGINEERING ADMIN PPE
RATING FREQUENCY PROBABILITY
1 1 1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
APPROVED BY PREPARED BY

RISK ESTIMATION RISK EVALUATION


LIKELIHOOD RISK
SEVERITY SCORE
LEVEL LEVEL
1 1 1 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
1 0 I
APPROVED BY APPROVED BY PREPARED BY

COMPANY WIDE LIST OF SIGNIFICANT OSH


RISK
SBU Head EHS Manager Safety Officer

EXISTING RISK CONTROL MEASURE RISK EVALUATION


NO. DEPARTMENT PROCESS HAZARD DETAILS OF THE RISK
DETAILS/DESCRIPTION SCORE RISK LEVEL
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
DEPARTMENT SECTION/AREA APPROVED BY APPROVED BY CHECKED BY PREPARED BY

DEPARTMENT'S LIST OF SIGNIFICANT OSH RISK Department Rep

DATE
HAZARD IDENTIFICATION EXISTING RISK CONTROL PROPOSED RISK REDUCTION CONTROL MEASURES
RISK EVALUATION
DETAILS OF THE MEASURE RISK ESTIMATION RISK EVALUATION
NO. CONTRIBUTING IMPLEMENTATION ASSESSMENT REMARKS ASSESSED BY APPROVED BY
PROCESS R/NR HAZARD RISK RISK DETAILS HIERARCHY LIKELIHOOD RISK
FACTOR DETAILS/DESCRIPTION SCORE DATE SEVERITY SCORE
LEVEL INCHARGE DATE FREQUENCY PROBABILITY LEVEL LEVEL
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
I 1 0 I
DEPARTMENT SECTION/AREA

SIGNIFICANT OSH RISK PROGRAM


DATE

Process Hazard Risk Risk Score Risk Level Priority Number

Objective
Target
Indicator
Action Items Responsible Person Completion Date Signature when Done Resources Required Budget Review Date

TABULAR GRAPHICAL DATA

ANALYSIS RECOMMENDATIONS

Prepared By Approved By Approved By

Department Supervisor Safety Officer Department Manager EHS Manager SBU Head

RISK AND IMPACT ASSESSMENT PROGRAM (FMS-HOS-F-025)


For CHH Internal Use Only Page 6 of 6
ver01_Oct 10, 2017

You might also like