Risk Assessment/Management Form

Ref:
Section / Dept: civil Activity: Risk Assessment Location-
Contractor :- -Dismantling of staging

Sl Basic Job Potential Conseque Current control measure

Proba
Init Additio

Proba
bility

Resid
Risk rating Ri

risk
ual
bility
No. Steps Hazard nce ial nal sk
Ris control ra
k measur ti
P E A R P E A R
e n
Deployment only experienced workmen g
Only authorised persons are allowed for working
at height 1 0 0 0 2 2
Fall of man Get
Climbing up on due to slip Injury/Fatality To fill up the Wah permit & daily attachment sheet
1 the top of the before starting the activity
scaffolding Use double rope full body harness while
ascending or descending
2 0 0 1 2 4
Slip of All the portable tools must be tied with rope while
tools/Materials working for preventing the accidental fall
Area should be properly barricaded and nobody
allow under the suspended load
Slip/Fall of Get
Deployment only experienced workmen
Lowering of materials Injury/Fatality
Pulley and rope must be checked before starting
pipe,clamps
the activity on daily basis
2 planks etc.by 2 0 0 1 2 4
using rope Only authorised persons are allowed for working
pulley at height
Working at Get
height Injury/Fatality Use double rope full body harness and it must be
fixed above the head height

Movement of path is to be free from any

Shifting of the obstruction
dismantled Slip of
Get All the materials should be stored in a proper
3 materials to a man/Fall of
Injury/Fatality
1 0 0 1 2 2
designated materials place and kept it in orderly manner
place Tool box talk required on daily basis before
starting the activity
Access to be provided for acsending and
descending through the ladder (min. gap 500mm
Slip of
Working at Get with the stagging) , Lynyards of full body safety Daily tool
4 man/Fall of 2 0 0 2 3 6 2 0 0 2 2 4
height
materials
Injury/Fatality harness are to be anchored in two separate box talk
anchoring points. , In case of bad weather i.e rain
work must be stopped.

Prepaired by: Approved by: Reviwed by:

Contractor Contractor
Date Date Date
Prepaired by Approved By Reviewed By

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