RISK ASSESSMENT FORM -

Date : 11-03-2015

Ref No:

RA/AK/34

Project Name : Roads and Infrastructure in Al Kheesa North and East

Assessment location : Site locations for pipeline works

Description of work : Hydro pressure testing

Risk Rating

Likelihood

Consequences

RISK
Safety precautions needed to control the Risk to ALARP *

Risk Rating

Who Might be
Harmed

Likelihood

Hazard / Conditions that could

develop hazard

Consequences

Activity

Manual Works inside Improper accesses to trenches / workers, public in

trenches
No access to come out in case of the vicinity.
an emergency.

Provide proper access into the trench.Ladders shall be securred by

tying against sliding. There shall be one ladder at minimum 50 mtr
apart.

Falling of loose materials from Workers inside the

the sides of trenches - injury
trench

Clear loose materials including stones from the edges trenches

Install and secure green mesh at the walls of trench.

12

Conduct TBT on heat stress symptoms and Precaustions.Ask

workers to come out of trench at frequent intervals on rotation
basis, breathe fresh air and to cool down their body. Drink cool
water. Avoid each man remain for long time inside trench.Report
any symptoms of heat stress immediately.

SR #

:
RESIDUAL

Initial Risk

Fatigue
/ Heat stress while
working inside trench.
Involved workers

"

Responsible Person

Gen. Foreman,
Foreman
Gen.Foreman,
,Foreman
Gen.Foreman,
Foreman

*ALARP - As Low As Reasonably Practicable

Assessed By:
Date:

Eng.Enrique Fajardo

11/3/2015

Signature :

1
2
3
4

Likelihood /

Severity /

Remote /
Unlikely /
Likely /
Frequent /

Minor /
Major /
Severe /
Fatality /

HSEF 4.3.1-01-01 Issue: 1 Rev: 2 Issue Date: 20 Mar 2012

Reviewed by :
Date:

Signature:

Likelihood
Severity
4
3
2
1

Eng.Salameh Haddadin (Project Manager)

11/3/2015

16
12
8
4

12

8
6
4
2

4
3
2
1

9
6
3

:
:

Page No. 1 of 7]

working near
dewatering area.

"

Risk Rating

Likelihood

/

Slip / Trip and Fall

Safety precautions needed to control the Risk to ALARP *

Consequence
s

Who Might be
Harmed

RESIDUAL RISK

Risk Rating

Hazard / Conditions that could

develop hazard

Likelihood

Activity

SR #

Consequence
s

Initial Risk

Responsible Person

1. Area to be barricaded and signs to be displayed

2. Sides of excavation to be stepped or protected against collapse
while doing dewatering.
Engineer, Gen.Foreman,
Foreman, HSE

3. Ensure proper illumination during night.

4. Ensure operators are trained and work is under close
supervision.ocedure. No unauthorized / job related personnel
should be on site

Involved workers,
others nearby

5. Proper usage of PPES

6. Good house keeping.
7. Proper access to the dewatering area.

Date:

Eng.Enrique Fajardo

11/3/2015

Signature :

1
2
3
4

Likelihood /

Severity /

Remote /
Unlikely /
Likely /
Frequent /

Minor /
Major /
Severe /
Fatality /

HSEF 4.3.1-01-01 Issue: 1 Rev: 2 Issue Date: 20 Mar 2012

Engineer, Gen.Foreman,
Foreman

6. Good house keeping.

*ALARP - As Low As Reasonably Practicable

Assessed By:

Reviewed by :

Date:

Signature:

Likelihood
Severity
4
3
2
1

Eng.Salameh Haddadin (Project Manager)

11/3/2015

16
12
8
4

12

8
6
4
2

4
3
2
1

9
6
3

:
:
:

Page No. 2 of 7]

T FORM -
:
:
:

RA/AK/34

Use pressure testing equipments of appropriate capacity and hose,

fittings etc of adequate pressure rating. Assign trained
1
workers.Barricade
the area
andLocations
Prevent unauthorised
.Barricade
the pressurising
area.
of pipe joints,entry.
valves

Likelih
ood

Risk
Rating

Safety precautions needed to control the Risk to ALARP *

Conseq
uences

RESIDUAL RISK

Likelih
ood

Risk
Rating

Conseq
uences

Date: 11-03-2015
:
Ref No:
Project Name : Roads and Infrastructure in Bani Hajer North . Phase 1 & 2
Assessment location : Site locations for potable water works
Description of work : Potable water works

Initial Risk
Hazard / Conditions that could
Who Might be
Activity
develop hazard
Harmed
SR #
/

Electric shock / Over Heated
Machineries.
Involved workers,
2
3
6
others

:
Responsible Person

Gen.Foreman, Foreman

Gen.Foreman, Foreman

etc to be barricaded and watchman to be posted.

Releasing pressurised water /
draining

Involved workers,
others in the
vicinity

*ALARP - As Low As Reasonably Practicable

Assessed By: Eng.Enrique Fajardo

Date:
11/3/2015

:
:

Signature :

1
2
3
4

Likelihood /

Severity /

Remote /
Unlikely /
Likely /
Frequent /

Minor /
Major /
Severe /
Fatality /

HSEF 4.3.1-01-01 Issue: 1 Rev: 2 Issue Date: 20 Mar 2012

Likelihood
Severity
4
3
2
1

Instruct and ensure nobody tamper with, or tighten any fittings,

1
valves,hoses, guage etc.) during pressurising/under pressure.
Location of pressure releasing should be barricaded and ensure
unauthorised entry. Water should be drained into prepared sumps
or into
a tanker(Project
to prevent
flowing around.
Reviewed by : Eng.Salameh
Haddadin
Manager)
Date:
3

Signature:

11/3/2015

16
12
8
4

12

8
6
4
2

4
3
2
1

9
6
3

:
:
:

Page No. 3 of 7]

HSEF 4.3.1-01-01 Issue: 1 Rev: 2 Issue Date: 20 Mar 2012

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HSEF 4.3.1-01-01 Issue: 1 Rev: 2 Issue Date: 20 Mar 2012

Page No. 5 of 7]

HSEF 4.3.1-01-01 Issue: 1 Rev: 2 Issue Date: 20 Mar 2012

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