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Machine Guarding Risk Assessment Form

फारम · FORM-31349

संस्करण 2

The Machine Guarding Risk Assessment Form helps a business identify the physical hazards of machinery, such as moving parts, flying debris, sharp edges and electrical hazards, and plan the controls that reduce them.

It sets out a seven-step procedure for undertaking a risk assessment, a guidance sheet, the hierarchy of controls and a risk matrix. The form records the activity, workplace details, the overall risk rating after controls, the assessor and the workers consulted, then works through machine-guarding tasks from new and used equipment to emergency stops, LOTO permits and decommissioning, each with its hazard, risk, inherent and residual ratings, control measures and responsible person.

It is part of the Health and Safety Manual, whose documents refer to each other.

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

Machine Guarding Risk Assessment Form

फारमVersion 2

Procedure for undertaking a risk assessment

Risk assessment form guidance sheet

Stage 1: Introduction

Stage 2: Hazard identification

Stage 3: Risk control

Stage 4: Monitor and review

Summary: key outcomes

Hierarchy of controls

Risk matrix

Step 1: Determine likelihood

Likelihood	Criteria	Description
Almost certain
Likely
Possible
Unlikely
Rare

Step 2: Determine consequence

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

Risk assessment details

Activity: —
Risk assessment no.: —
Company name: [Company]

Contact name: —
Position: —
Phone no.: —

Risk assessment approved by

Name/signature: —
Job title: —

Date: —

Workplace details

Location: —

No. of workers at the workplace: —

Overall risk rating after controls

Assessor

Assessor name / signature: —
Job title: —

Date: —

Workers consulted

Name	Signature	Date

Hazards and control measures

Evaluating safety features of new equipment

Reviewing maintenance and safety records of used equipment before purchase

Training in safe machine operation and guarding procedures

Ensuring machinery is operated by authorised and trained individuals

Regularly checking the safety features of machinery

Checking guard compliance with AS 4024 or relevant standards

Identifying areas with pinch points or nip hazards

Checking for flying debris during machinery operation

Ensuring emergency stops are positioned and accessible

Evaluating exposure to moving parts

Checking for sharp edges or blades

Evaluating electrical hazards

Ensuring proper installation and fastening of guards

Evaluating machinery noise levels

Evaluating ergonomic hazards

Assessing risks of slips, trips, and falls around machinery

Evaluating the condition of machine guards

Managing LOTO (Lockout/Tagout) permits

Reviewing historical incidents associated with machinery

Safely decommissioning and disposing of old or unsafe machinery

Other

यसको मार्गदर्शन र नमुना प्रविष्टिहरू लक गरिएका छन्

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ब्राउजरमा यो कस्तो देखिन्छ

यो प्रणाली लिनुहोस्

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सशुल्क प्लानहरूमा समावेश
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यसले के समेट्छ

22 फिल्ड

Likelihood
Criteria
Description
Almost certain
Likely
Possible
Unlikely
Rare
Activity
Risk assessment no
Company name
Contact name

र थप 10

टेम्प्लेटहरू कसरी काम गर्छन्

यसलाई पैसा तिर्नुअघि नै चलाएर हेर्नुहोस्।

निःशुल्क पूर्वावलोकन
हरेक टेम्प्लेटका कामका चरण, खतरा र पहिलो काम पढ्न खुला छन्। साइन अप चाहिँदैन।
एडिटर चलाएर हेर्नुहोस्
कम्प्युटर वा फोनमा, डेमो SWMS लाई आफ्नो कम्पनी, काम र साइटअनुसार मिलाउनुहोस्।
निःशुल्क साइन अप गर्नुहोस्
तपाईंको विवरण र लोगो सर्छन्। यो टेम्प्लेट विवरण भरिएरै खुल्छ।
क्रेडिट प्रयोग गर्नुहोस् वा एकपटक किन्नुहोस्
सशुल्क प्लानहरूमा हरेक महिना टेम्प्लेट क्रेडिट आउँछ। वा सधैँका लागि यो एउटा किन्नुहोस्।

Machine Guarding Risk Assessment Form