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Asbestos Risk Assessment Form

양식 · FORM-31265

작업 단계 5개
51회 구매됨
버전 1
Asbestos
어떤 휴대폰에서든 읽기 가능

The Asbestos Risk Assessment Form helps businesses identify and manage asbestos-related hazards on work sites. It supports the development and implementation of effective control measures for workplace safety and compliance.

It opens with a guidance sheet on who should complete the form, the sources used to identify hazards and the key outcomes, then a risk rating matrix to weigh likelihood against consequence. The form records workplace details, the workers consulted, and worked examples of tasks with their hazards and control measures.

Monitoring and review arrangements, a review record and a worker sign-off finish the document. It suits site managers, supervisors, contractors and the workers involved in asbestos-related tasks.

Written by SafetyDocs safety experts, who have been writing safety documents since 2004.

Asbestos Risk Assessment Form

양식Version 1

Risk Assessment Form Guidance Sheet

Stage 1. Introduction.

Stage 2. Hazard Identification.

Stage 3. Risk Control.

Stage 4. Monitor and review.

Summary - Key Outcomes:

Risk Rating Matrix

Step 1: Determine Likelihood: What is the possibility that the effect will occur?

Likelihood	Criteria	Description

Step 2: Determine Consequence: What will be the expected effect?

Level of Effect	Example of each level

Step 3: Determine the risk score:

Likelihood ↑	InsignificantNo effect, or so minor that the effect is acceptable	MinorMinor first aid treatment, minimal business disruption, minimal environmental effect	ModerateSerious injuries, medium business interruption, medium environmental impact	MajorExtensive injuries or fatality, significant business interruption, environmental harm, prosecution	CatastrophicMultiple permanent disabilities or fatalities, business failure, substantial environmental harm, prosecution or imprisonment
	Consequence →
Almost certainExpected in most circumstances	2 Moderate	2 Moderate	3 High	4 Acute	4 Acute
LikelyWill probably occur in most circumstances	2 Moderate	2 Moderate	3 High	4 Acute	4 Acute
PossibleCould possibly occur at some time	1 Low	2 Moderate	2 Moderate	3 High	4 Acute
UnlikelyUnlikely but possible	1 Low	1 Low	2 Moderate	3 High	4 Acute
RareHighly unlikely to occur	1 Low	1 Low	2 Moderate	2 Moderate	3 High

1 LowRecord and monitor. Proceed with work, and review the risks regularly.
2 ModerateMaintain control measures. Be cautious when working, and monitor and review regularly.
3 HighReview before commencing work. Introduce new controls or maintain high-level controls to lower the risk level, and monitor the controls frequently.
4 AcuteDo not proceed until the risk level is reduced. Immediately introduce high-level controls, and re-assess before proceeding.

Step 4: Record risk score on the worksheet

Score	Action

Hierarchy of control

Asbestos Risk Assessment Form

Activity: —
Risk Assessment No.: —
Risk Assessment Approved by: —
Name/Signature: —
Company Name: —
Address: —

ABN: —
Contact Name: —
Position: —
Phone No.: —
Job Title: —
Date: —

Personal protective equipment

Workplace Details

Location: —

No. of workers at the workplace: —

Specify: —

Specify: —

Assessor Name / Signature: —
Job Title: —

Date: —

Names of workers consulted with during development of this Risk Assessment / Signature/s: —
Job Title/s: —

Date: —

Person Responsible for ensuring compliance with Risk Assessment / Signature: —
Job Title: —

Date: —

Hazards and Control Measures

Work activity
Working with asbestos (Examples only)
Competent person, site information, the Asbestos Register and notes for future reference.
Work activity
Unauthorised access (Examples only)
Barriers, warning signage, no-go zones and distance from the asbestos location.
Work activity
Transport ACM (Examples only)
Identifying, wrapping, labelling and bins for transporting asbestos-containing material.
Work activity
De-contamination (Examples only)
Cleaning facilities, restricted access, airlocks, water run-off filters and the removal work area.
Work activity
Wearing PPE during the task
PPE to wear at the loading site, including a P1 or P2 half-face respirator.

Monitor & Review

Person/s Responsible: —

Signature/s & Date: —

Review Record

Review Date	Review conducted by	Signature/s	Next review due

Worker Sign-Off & Acknowledgement

This Risk Assessment has been developed in consultation and cooperation with workers and the Organisation. I have read the above Risk Assessment, and I understand its contents. I confirm that I have the skills and training, including relevant certification, to conduct the task as described. I agree to comply with safety requirements within this Risk Assessment, including risk control measures, safe work instructions and management direction.

Worker’s name	Job role / positione.g. supervisor, worker, trainee	Company	Date	Signature
-	-	-	-	-
-	-	-	-	-
-	-	-	-	-

작업 단계 5개 더: Working with asbestos (Examples only)부터 Wearing PPE during the task까지

단계마다 위험 요소, 위험도 평가, 관리 조치가 있고, 작업자 서명란도 포함됩니다.

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다루는 내용

작업 단계 5개

Working with asbestos (Examples only)Competent person, site information, the Asbestos Register and notes for future reference.
Unauthorised access (Examples only)Barriers, warning signage, no-go zones and distance from the asbestos location.
Transport ACM (Examples only)Identifying, wrapping, labelling and bins for transporting asbestos-containing material.
De-contamination (Examples only)Cleaning facilities, restricted access, airlocks, water run-off filters and the removal work area.
Wearing PPE during the taskPPE to wear at the loading site, including a P1 or P2 half-face respirator.