No.: Rev.

#: HIRADC Page:
Location:
Job / Equipment / Process Description:
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No Step / Risk Identification Risk Control Risk Assessment Risk Risk Reduction
Compone (Existing) Control C
Hazard Risk C E L Level E L Leve
nt (Recom
of l of
mended)
Risk Risk
1.
2.
3.
4.
5.
6.
dst.

Assessed by: Date:

Name Unit Sign Checked by: Sign:

Approved by: Sign: