ADAS Daily Risk Assessment and Job Hazard Assessment Form

OPERATION/ACTIVITY/TASK:
LOCATION:
DATE: REGISTRY NUMBER:
JOB/STEP/RISK ASSESSMENT PREPARED BY:
APPROVING SUPERVISOR:
(RESPONSIBLE FOR ACKNOWLEDGING AND IMPLEMENTING CONTROLS)

REGISTER OF ATTENDANCE JHA LEADER / AUTHOR:

All the persons named in this register of attendance have read the attached JHA (and associated documentation) and fully understood all the steps to perform the task safely.

ATTENDEE NAME SIGNATURE ATTENDEE NAME SIGNATURE

Emergency Emergency Emergency

Response Response Response
N/A

N/A

N/A
Yes

Yes

Yes
Factors Checklist Comments Factors Checklist Comments Factors Checklist Comments
Operations Manual Flag A DDC Checked
AS/NZS2299.1:2015 Lazy Shot Personnel DMT
First Aid Kit Lost Divers Float Communications
Oxygen Supervisors Bag
Diving Lights Medivac Plan

Copyright ADAS Page 1 of 4

File Ref: TA-CM-COM-PUB-JHA_and_Risk_Assessment_v2.2
16/01/2017
 ADAS Daily Risk Assessment and Job Hazard Assessment Form

PART A
The checklist of diving related factors, mechanisms of injury and physical factors which can lead to harm are listed below to stimulate thought when preparing the JHA in Part B. The list
is not definitive.

ENVIRONMENTAL FACTORS TASK RELATED FACTORS TASK RELATED FACTORS contd MECHANISM OF INJURY PHYSICAL FACTORS
Wind Entry and exit methods HP Jetting Struck by Hot/cold/heavy objects
Current/tide Sufficient trained personnel Sonar/impressed current Caught in/on Electricity
Visibility Lifeline entanglement Dive profiles Strain/overexertion Depth Height
Maximum depth Cutting Buoyancy control Dropped objects Noise
Water temperature Welding Strike against Chemicals
Atmospheric temperature Dredging Slip/trip/fall Vibration
Time of day Explosives HYPERBARIC & PHYSIOLOGICAL Inhalation Radiation
Underwater terrain Inspection Barotrauma descent Fire/explosion Rotating equipment
Contaminants Overhead environments Barotrauma ascent Exposure to gas/heat/fumes/ Confined spaces
Biological hazards Cranes/winches/cables/rigging Decompression illness dust/chemicals Tools/equipment
Entrapment hazards Airlifting Hypothermia Vehicles
Isolation remote sites Hydraulic/pneumatic tools Hyperthermia Access
Floating hazards Search patterns CO2 poisoning PRE & POST DIVE FACTORS Bacteria
Dangerous marine hazards Reservoir cleaning CO poisoning Pre-dive fitness Moving objects
Noise Unstable structures Narcosis Dehydration Adverse weather
Sea state Boat handling O2 toxicity Drugs/alcohol
Sun/ice Unguarded propellers Drowning Exercise
Altitude Shipping movement Exhaustion Sleep deprivation
Sharps Manual handling Cross infection Pressure
Water pressure - suction Hydrocarbon/gas release
Entrapment
Electric currents

Copyright ADAS Page 2 of 4

File Ref: TA-CM-COM-PUB-JHA_and_Risk_Assessment_v2.2
16/01/2017
 ADAS Daily Risk Assessment and Job Hazard Assessment Form

PART B
Pre control Post control
assessment assessment
SAFE CONDITION OR ACTIVITY

PROBABILITY

PROBABILITY
RISK RATING

RISK RATING
Job REQUIRED
DESCRIPTION OF JOB / STEP POTENTIAL ACCIDENTS OR HAZARDS ACTIONED BY?
Step (Note: multiple controls can/may be

SEVERITY

SEVERITY
identified for each hazard)

Activity to be undertaken during this Control measures to be put in place to mitigate Who will implement
Number List the identified hazards that could cause harm
step the identified potential accidents or hazards the controls?

Copyright ADAS Page 3 of 4

File Ref: TA-CM-COM-PUB-JHA_and_Risk_Assessment_v2.2
16/01/2017
 ADAS Daily Risk Assessment and Job Hazard Assessment Form

RISK ASSESSMENT TABLES

PROBABILITY SCALE SSEVERITY SCALE
RATING PROBABILITY RATING SEVERITY
6 Almost certain almost always occurs 6 Extreme multiple deaths
5 Likely-Frequent expected, occurs repeatedly 5 High death
4 Probable not surprised, will occur several times 4 Moderate major injury
3 Possible could occur sometimes 3 Low over 3 days injury
2 Remote unlikely, though conceivable 2 Very Low under 3 days injury
1 Improbable so unlikely the probability is close to zero 1 Not significant no significant injury
RISK RATING TABLE
HAZARD SEVERITY
6 5 4 3 2 1
6 36 30 24 18 12 6
RISK
5 30 25 20 15 10 5
PROBABILITY
OF 4 24 20 16 12 8 4
OCCURRENCE
3 18 15 12 9 6 3
2 12 10 8 6 4 2
1 6 5 4 3 2 1

Diving If the risk rating identified is above 12 (area in red), no diving is to take place until control measures are
Seek Approval introduced to reduce the risk.
No Diving
If the risk rating is either 10 or 12 (area in yellow) and no further controls can be identified, seek further
consultation, advice and discussion prior to diving. Document the outcomes.

Copyright ADAS Page 4 of 4

File Ref: TA-CM-COM-PUB-JHA_and_Risk_Assessment_v2.2
16/01/2017