Assessors Name: Assessors signature: Location of Date of Review date:

Method
task/operation being Task Carried assessment: Ongoing
Statement Action by
Sajimon KK assessed: out by? 15 January 09
by When?
Site
Ref No: Rev – 02 – RA – 2009 - Depa Cross reference to N.B. Residual risk:
SSOW/method Other on site The risk left
statement: (Highlight SSOW/Method statement control measures after all control
one below) Ref No: may be required measures have
Page No: due to weather been put in
YES NO M/S 001 conditions/other place – see
Risk Persons at risk reasons at time risk matrix at
severity of footer:
E C P Oth
(before task/operation:
Activity/ Significant ers
controls Control measures Work must not
Operation hazard
are in required: start until the
place) risks have
been assessed:

Oxygen High Yes Yes Yes Prior to the  Foreman to secure Project Site Engineer
15 Deficiency commencement confined space Manager
of the activity operation entry Supervisor
permit and comply Construction
Confine with detailed Manager Foreman
Space instructions /
Operation requirements Site Manager Charge hand
specified in the work
permit Project Workers
Engineer
 Safety to perform air Helpers
monitoring using HSE Manager
oxygen analyzer

 Safety to perform
atmospheric testing
to ensure within the
safe level.
Toxic High Yes Yes Yes
Substances  Removal of toxic Medium
substances using
pump or any other
machine.

 Safety to perform
monitoring to ensure
lower explosive limit
or LEL < 10% safe.

RISK RATING MATRIX 1 E = employees

C = contractors/subcontractors
Likelihood: 5 very likely 4 likely 3 fairly likely 2 unlikely 1 very unlikely P = Public
Severity: 5 catastrophic 4 major 3 moderate 2 minor 1 insignificant QMS – Rev – 02 – RA – 2009
Sajimon KK – January 09
Assessors Name: Assessors signature: Location of Date of Review date:
Method
task/operation being Task Carried assessment: Ongoing
Statement Action by
Sajimon KK assessed: out by? 15 January 09
by When?
Site
Ref No: Rev – 02 – RA – 2009 - Depa Cross reference to N.B. Residual risk:
SSOW/method Other on site The risk left
statement: (Highlight SSOW/Method statement control measures after all control
one below) Ref No: may be required measures have
Page No: due to weather been put in
YES NO M/S 001 conditions/other place – see
Risk Persons at risk reasons at time risk matrix at
severity of footer:
E C P Oth
(before task/operation:
Activity/ Significant ers
controls Control measures Work must not
Operation hazard
are in required: start until the
place) risks have
been assessed:

Fire High Yes Yes Y Yes  Gas cylinder should

Explosion e not be taken to the
s confined space.

 Provide adequate
ventilation to ensure
air circulation.

Confine  Ensure wearing of

Space the required PPEs.
Operation
 Standby supervision
must be available at
all times.

RISK RATING MATRIX 2 E = employees

C = contractors/subcontractors
Likelihood: 5 very likely 4 likely 3 fairly likely 2 unlikely 1 very unlikely P = Public
Severity: 5 catastrophic 4 major 3 moderate 2 minor 1 insignificant QMS – Rev – 02 – RA – 2009
Sajimon KK – January 09
Assessors Name: Assessors signature: Location of Date of Review date:
Method
task/operation being Task Carried assessment: Ongoing
Statement Action by
Sajimon KK assessed: out by? 15 January 09
by When?
Site
Ref No: Rev – 02 – RA – 2009 - Depa Cross reference to N.B. Residual risk:
SSOW/method Other on site The risk left
statement: (Highlight SSOW/Method statement control measures after all control
one below) Ref No: may be required measures have
Page No: due to weather been put in
YES NO M/S 001 conditions/other place – see
Risk Persons at risk reasons at time risk matrix at
severity of footer:
E C P Oth
(before task/operation:
Activity/ Significant ers
controls Control measures Work must not
Operation hazard
are in required: start until the
place) risks have
been assessed:

Fall High Yes Yes Yes  Ensure visible

warning barricade Low
provided on the
opening access /
ladder or any means
of man lift must
properly secure.

 Wearing of full body

harness attached
separately from the
man lift basket.

RISK RATING MATRIX 3 E = employees

C = contractors/subcontractors
Likelihood: 5 very likely 4 likely 3 fairly likely 2 unlikely 1 very unlikely P = Public
Severity: 5 catastrophic 4 major 3 moderate 2 minor 1 insignificant QMS – Rev – 02 – RA – 2009
Sajimon KK – January 09