Company : To insert RA Leader: Name Approved by: Reference No.
Process: Forklift Operation RA Member 1: Name / forklift Signature:
supervisor
Process/Activity Location To insert RA Member 2: Name / forklift operator
Original Assessment Date: 4/9/2010 RA Member 3: Name: To insert
Last Review Date: 3/9/2013 RA Member 4: Designation: Manager
Next review Date: 2/9/2016 RA Member 5: Date: 4/9/2013
Hazard Identification Risk Evaluation Risk Control
Possible
Existing Risks Implementa
Level
Level
Risk
Risk
Ref
Work Activity Hazard Injury / Ill- S L Additional Controls S L Due Date Remarks
Controls tion Person
health
1 Loading of load Loose / Struck by Assigned licensed 5 2 H Designate loading and 5 1 M Facility 6/9/2013
unstable falling forklift operator. unloading area for forklift Manager
loads load – Check forklift before
Fatality
use.
Adjust forks to the
required width
Confirm weight of
load.
Do not overload
Ensure load center of
gravity is within the
forks.
Secure load with belt.
Keep all people clear
from loading area.
Sharp Minor Remove or protect 2 2 M Nil
edges Cuts sharp edges.
Hazard Identification Risk Evaluation Risk Control
Possible
Existing Risks Implementa
Level
Level
Risk
Risk
Ref
Work Activity Hazard Injury / Ill- S L Additional Controls S L Due Date Remarks
Controls tion Person
health
Wear hand gloves.
2 Transporting of Speeding Struck by Strictly no speeding. 5 2 H Display speed limit warning 4 1 M Facility 6/9/2013
load to moving Comply to speed limit sign. Manager
destination forklift – of 20km/h Construct / provide road
fatality hump before corners and
Use designated travel
pedestrian crossings
path.
Obstructed Struck by Reverse if view is 5 2 H Install mirror at obstructed 5 1 M Facility 6/9/2013
view moving obstructed. corners Manager
forklift – Assign a banksman
fatality
0verloading Struck by No overloading. 5 2 H Mark/display the weight of 5 1 M Facility 6/9/2013
toppling Use of seat belt. load Manager
forklift – Strictly no passenger.
fatality
Unauthorize Fatality Turn off forklift and 5 2 H Use of key press to control 5 1 M Facility 6/9/2013
d use remove key after use. key movement Manager
Improper Struck Assign licensed forklift 3 2 6 Paste yellow and black and 3 1 L Department 6/9/2013
placement against operator white warning tapes at pinch Head
of hands / structures point areas of forklift
fingers / –
legs laceration
3 Unloading of Incorrect Struck by Fully stop forklift 5 2 H Designate loading and 5 1 M Facility 6/9/2013
load sequence falling before lowering load. unloading area for forklift Manager
load – Lower the forks slowly.
Fatality
Stable load before
removing securing
Hazard Identification Risk Evaluation Risk Control
Possible
Existing Risks Implementa
Level
Level
Risk
Risk
Ref
Work Activity Hazard Injury / Ill- S L Additional Controls S L Due Date Remarks
Controls tion Person
health
belts.
Keep all people clear
from loading and
unloading area.
