Risk Assessment/Management Form
Ref:
Section / Dept: civil , Contractor :                                        Activity: Risk Assessment for                     Location:
                                                                            Grouting work
                                                                                                                              Risk rating
                                                                                                                                                                                      bility
                                                                                                                                              Proba
                                                                                                                                                                                     Proba
                                                                                                                                                                                               Resid
 Sl      Basic Job                                                                                                                                      Initial Additional Ri
                                                                                                                                               bility
                                                                                                                                                                                                risk
                            Potential Hazard          Consequence                 Current control measure
                                                                                                                                                                                                 ual
No.       Steps                                                                                                                                         Risk    control    sk
                                                                                                                                                                measure    ra
                                                                                                                                                                           ti
                                                                                                                              P E A R                                      P
                                                                                                                                                                           n E A R
                                                                            Both the activity upper and ground level should                                                g
                                                                                     not be started simantaniously
                            Fall of materials from                                Deployment skill workmen only
      Grouting at ground                              Get Injury/Fatality
                                    height                                   Use of safety shoe,Helmet with chin strap &
             level
                                                                                            Hand Gloves
                                                                               Access should be free from obstruction
  1                                                                                                                           2 0 0       0        2      4
                                Skin Irritation        Effects of skin               To use rubber hand gloves
                                                                             To use double rope full body harnesss and
       Grouting at height   Person fall form height   Get Injury/Fatality     anchored it above the head height to a fix
                                                                                           stable structure
                                                                            Proper access to be made foe ascending and
                                                                                             descending
        Prepared By                                                                        Approved By                                                             Reviwed By
         Contractor                                                                         Contractor
           Date                                                                               Date                                                                    Date
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