Form No.

: EHS/AMC/008-F40
Revision No.: 00

Effectivity Date: 18/02/2019

Department:
Prepared by Jay Joco

Location/Area Activity/Process

Meeting room Work Evaluation

Condense pump room

Mobilization of tools
& materials
 Set-up of ladder

Ascending (Use of ladder)

Checking of water level on Domestic tank
Opening/Closing/Checking of Motorized
Gate valve (Use of ladder)
Descending to ladder
 Risk Assessment - Aspect

Approved By Date:

Pre-Control Evaluation
Aspect /Hazard Impact
S L R Risk Level

Dis-organization
Uncertified worker 1 2 2 Low
of the job

Slip & trip Hazard/Slippery surface Accident 1 2 2 Low

 Fall Hazard / Noise in area /
Accident/ill
Electrocusion / Substandard and 2 3 6 Medium
health
Improper set-up of ladder

Accident/ill
Fall Hazard/Noise in area 2 2 4 Low
health
Fall Hazard/Noise in area/Low Accident/ill
2 3 6 Medium
clearance bump hazard health
 Accident/ill
Fall Hazard/Noise in area 2 2 4 Low
health
sment - Aspect Impact

Post-Control Eva
Current Control Measures Additional control measures
S
Technical:
Technical: - N/A
- N/A Organization:
Organization: - N/A
- Conduct toolbox meeting/discuss step by step PPE:
procedures and potential hazard to workers - N/A
PPE:
- N/A

Technical:
Technical: - N/A
- N/A Organization:
Organization: - N/A
- Ensure to mopped/dry the surface or area before prior PPE:
to start the activity - N/A
-Buddy system
- Work and safety instruction and awareness/ SOP
PPE:
- Use of Safety shoes, Ref. vest, Hard hat
 Technical:
- N/A
Organization:
- Secure the ladder on ground and at the top
Technical: - Climb and go down from a ladder facing it and
- Use of Inspected ladder (Passed on inspection from maintain 3 point contact point with the ladder (2
EHS on load capacity and standard hands 1 foot, 2 feet 1 hand)
accessories/components) - Do not lean out from the ladder in any direction
Organization: PPE:
- Visual inspection of ladder to be use - Use of full body harness, safety shoes, safety
- Respect safe distance gloves, ref. vest, hard hat, ear plug or earmuff
- Put the ladder on stable ground
- Verify the absence of electrical lines next to the ladder
- Use a blocking system, safety feel or someone hold
the ladder
- If you have fear on heights - don't climb a ladder
- Do not allow more than one person on a ladder
1
- Do not allow others to work under a ladder in use
- Firm footing
- Do not use ladder with incomplete parts or
components
- Fall arrest system / SOP
- Safety awareness and work instruction
- Emergency response and preparedness plan
- Proper body positioning
- Buddy system
- Permit to work system (W@H if necessary)
PPE:
- Use of full body harness, safety shoes, safety gloves,
ref. vest, hard hat, ear plug or earmuff

Technical:
- N/A
Organization:
Technical: - N/A
- Use of Inspected ladder (Passed on inspection from PPE:
EHS on load capacity and standard - N/A
accessories/components)
Organization:
- Engineering supervision
- Only visual checking on water level
- Use a blocking system, safety feel or someone hold
the ladder
- If you have fear on heights - don't climb a ladder
- Do not allow more than one person on a ladder
- Do not allow others to work under a ladder in use
- Climb and go down from a ladder facing it and
maintain 3 point contact point with the ladder (2 hands 1
foot, 2 feet 1 hand)
- Do not lean out from the ladder in any direction
- Fall arrest system / SOP
- Safety awareness and work instruction
- Emergency response and preparedness plan
- Proper body positioning
- Buddy system
- Permit to work system (W@H if necessary)
PPE:
- Use of full body harness, safety shoes, safety gloves,
ref. vest, hard hat, ear plug or earmuff
 Technical:
- N/A
Organization:
- Engineering supervision
Technical: - Secure the ladder on ground and at the top
- Use of Inspected ladder (Passed on inspection from - Climb and go down from a ladder facing it and
EHS on load capacity and standard maintain 3 point contact point with the ladder (2
accessories/components) hands 1 foot, 2 feet 1 hand)
Organization: - Ensure that lanyard hook is properly anchor to
- Visual inspection of ladder to be use durable lifeline always especially when moving
- Respect safe distance PPE:
- Put the ladder on stable ground - Use of full body harness, safety shoes, safety
- Verify the absence of electrical lines next to the ladder gloves, ref. vest, hard hat, ear plug or earmuff
- Use a blocking system, safety feel or someone hold
the ladder
- If you have fear on heights - don't climb a ladder
- Do not allow more than one person on a ladder
1
- Do not allow others to work under a ladder in use
- Firm footing
- Do not use ladder with incomplete parts or
components
- Fall arrest system / SOP
- Safety awareness and work instruction
- Emergency response and preparedness plan
- Proper body positioning
- Buddy system
- Permit to work system (W@H if necessary)
PPE:
- Use of full body harness, safety shoes, safety gloves,
ref. vest, hard hat, ear plug or earmuff, hard hat
 Technical:
- N/A
Organization:
- N/A
Technical: PPE:
- Use of Inspected ladder (Passed on inspection from - N/A
EHS on load capacity and standard
accessories/components)
Organization:
- Engineering supervision
- Climb and go down from a ladder facing it and
maintain 3 point contact point with the ladder (2 hands 1
foot, 2 feet 1 hand)
- Ensure that lanyard hook is properly anchor to durable
lifeline always especially when movin
- Visual inspection of ladder to be use
- Respect safe distance
- Put the ladder on stable ground
- Verify the absence of electrical lines next to the ladder
- Use a blocking system, safety feel or someone hold
the ladder
- If you have fear on heights - don't climb a ladder
- Do not allow more than one person on a ladder
- Do not allow others to work under a ladder in use
- Firm footing
- Do not use ladder with incomplete parts or
components
- Fall arrest system / SOP
- Safety awareness and work instruction
- Emergency response and preparedness plan
- Proper body positioning
- Buddy system
- Permit to work system (W@H if necessary)
PPE:
- Use of full body harness, safety shoes, safety gloves,
ref. vest, hard hat, ear plug or earmuff, hard hat
Post-Control Evaluation
L R Risk Level

0
2 2 Low

0
2 2 Low
0