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					                                                Plant Risk Assessment Template
Date:                              Plant:                                            Workplace:
Assessors:

                Hazard Identification                  Hazard Detail & Risk Assessment      Risk Control   Sign Off
Entanglement
Can anyone’s hair, clothing gloves, necktie,
jewellery, rags and other materials become
entangled with moving parts of plant, or materials
in motion?


Yes       No
Crushing
Can anyone be crushed due to falling,
uncontrolled or unexpected movement of plant or
its load, lack of capacity to slow, stop or
immobilise the plant, tipping or rolling over, parts
of plant collapsing, contact with moving parts
during testing, inspection, maintenance, cleaning
or repair, thrown off, under or trapped between
plant and materials or fixed structures?


Yes       No
Cutting, Stabbing and Puncturing
Can anyone be cut, stabbed or punctured by
coming in contact with moving plant or parts,
sharp or flying objects, work pieces ejected, work
pieces disintegrated or other factors not
mentioned?
For example, are all guards in place?


Yes          No
Plant Risk Assessment Form                                                                        1 of 5
                Hazard Identification                Hazard Detail & Risk Assessment   Risk Control   Sign Off
Shearing
Can anyone’s body parts be cut off between two
parts of the plant, or between a part of the plant
and a work piece or structure?


Yes      No
Electrical
Can anyone be injured by electrical shock or
burnt due to damaged or poorly maintained leads
or switches, water near electrical equipment,
working near or contact with live electrical
conductors, lack of isolation procedures or the
factors not mentioned? For example, are any
switches broken, is there a red emergency stop?
Can each machine be locked off for repairs?

Yes          No
Explosion
Can anyone be injured by an explosion of gas,
vapours, liquids, dusts or other substances,
triggered by plant operation? For example, build
up of dust.

Yes          No




Plant Risk Assessment Form                                                                2 of 5
                Hazard Identification                 Hazard Detail & Risk Assessment   Risk Control   Sign Off
Friction
Can anyone be burnt due to contact with moving
parts or surfaces of the plant, or material handled
by the plant? For example, on the grinder is there
more than 1 mm gap between the tool rest and
the wheel?

Yes          No
Striking
Can anyone be struck by moving objects due to
plant or work pieces being ejected or
disintegrated, mobility,   uncontrolled    or
unexpected movement of the plant or other
factors?
Yes       No
Slipping, Tripping and Falling
Can anyone using the plant or in the vicinity of
the plant, slip, trip or fall due to the working
environment       or   other     factors?, poor
housekeeping, dust on the floor around
machines, slippery or uneven work surfaces or
lack of guardrails.

Yes          No
Suffocation
Can anyone be suffocated due to lack of oxygen,
or atmospheric contamination? For example,
welding is there extraction at floor level or an
elephant truck extraction system?

Yes          No

Plant Risk Assessment Form                                                                 3 of 5
                Hazard Identification              Hazard Detail & Risk Assessment   Risk Control   Sign Off
High Temperature or Fire
Can anyone come into contact with objects at
high temperature or injured by fire?

Yes          No
Temperature (Thermal Comfort)
Can anyone suffer ill health due to exposure to
high or low temperatures?


Yes          No
Ergonomic
Can anyone be injured due to seating design,
repetitive body movement or posture, excessive
effort, poor workplace or plant design causing
mental or physical stress, lack of consideration
for human behaviour, poor lighting or other
factors not mentioned?


Yes          No
High Pressure Fluid
Can anyone come into contact with fluids under
high pressure, due to plant failure or misuse of
the plant?


Yes          No




Plant Risk Assessment Form                                                              4 of 5
                Hazard Identification             Hazard Detail & Risk Assessment   Risk Control   Sign Off
Other Hazards
Can anyone be injured or suffer ill health from
exposure to:
   Chemicals
   Toxic Gases Or Vapours
   Fumes
   Dusts
   Noise
   Vibration
   Radiation Or
   Other Factors Not Mentioned?


Yes          No




Plant Risk Assessment Form                                                             5 of 5

				
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