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Task Risk Assessment Form
Task Risk Assessment Form
Task Risk Assessment Form
I agree with the residual risk levels and control measures required to perform the tasks based on the identified tasks and
hazards. I have instructed the TRA Team Members in the TRA process and their roles and have verified that the team
understands the assessment process and what the process is trying to achieve. Additionally, I attest that the members of the
TRA team have visited the job site to identify and document hazards associated with the physical layout of the area which are
pertinent to the permit related tasks to be performed.
We confirm we have been instructed in the TRA process and understand our role in this process. We agree with the residual
risk levels and control measures required to perform the tasks based on the identified tasks and hazards, and therefore
recommend the task for the appropriate approval.
TRA Approval
Approval Authority Position Signature Date
I agree with the residual risk levels and control measures required to perform the tasks based on the identified tasks and
hazards. I have instructed the TRA Team Members in the TRA process and their roles and have verified that the team
understands the assessment process and what the process is trying to achieve. Additionally, I attest that the members of the
TRA team have visited the job site to identify and document hazards associated with the physical layout of the area which are
pertinent to the permit related tasks to be performed.
I agree with the residual risk levels and control measures required to perform the tasks based on the identified tasks and
hazards and approve the use of this Level 2 TRA (signed approval required which can be recorded with use of fax, email or
other electronic means). Details of the Approver of the Highest Residual Risk required below as per ANZ Level 2 Approval
Table.
Risk Assessment
SOURCE OF
TASK HAZARD CONTROL RESIDUAL RISK PERSON RESPONSIBLE
ENERGY
Describe all hazards identified for each Decide on the Level of Risk using
Describe all controls applicable for each the Level 2 RA Matrices. Is the Who is responsible to implement
List the tasks required to perform the activity in Select the relevant TASK. Consider Task Hazards, Job site
hazard. Use the Hierarchy of Controls Task safe to do? the control measure identified?
the sequence they are carried out Source of Energy hazards, Process hazards, SIMOP’s and
located on the following page. Name Required of person
Human Factors
C P Risk Level
Describe all hazards identified for each Decide on the Level of Risk using
Describe all controls applicable for each the Level 2 RA Matrices. Is the Who is responsible to implement
List the tasks required to perform the activity in Select the relevant TASK. Consider Task Hazards, Job site
hazard. Use the Hierarchy of Controls Task safe to do? the control measure identified?
the sequence they are carried out Source of Energy hazards, Process hazards, SIMOP’s and
located on the following page. Name Required of person
Human Factors
C P Risk Level
Biological Mechanical
Biological - covers the many sources of energy in life forms, including wildlife Mechanical - includes mobile equipment as well as moving parts on stationary
and viruses or bacteria, e.g., as found in sewage systems, drain lines, cooling equipment and rotating equipment. Even though items are non-powered, their
towers). momentum as they are moved may crush or cut people or vulnerable equipment.
Also includes sharp edges of tools and / or equipment.
Co ns e que nce
1 or 2 fatalities Future im pact- Other advers e e nforcem e nt action by
10 or m ore injurie s or he alth e ffe cts , Localize d dam age or e xte nsive damage to a regulators .
eithe r pe rm anent or re quiring hospital non-se ns itive e nvironm e nt, w hich can be Lim ite d ‘inte re s t-group’ outrage F L M H H VH
tre atm e nt for m ore than 24 hours. re s tore d to an e quivale nt capability in a Short-te rm adve rse national or inte rnational
period of around 1 ye ar, or a pe riod of m edia cove rage .
E m onths , re s pe ctively.
Dam age to re lations hips w ith key
Localize d dam age or e xte nsive damage to a s take holde rs of be ne fit to the Strategic
s ens itive e nvironm ent, w hich can be G L L M H H
Pe rform ance Unit (SPU).
re s tore d to an e quivale nt capability in a
period of m onths, or a period of days or
w e e ks re spective ly.
Pe rm ane nt partial dis ability(ie s ) Future im pact- Re gulatory com pliance is sue that does not H L L M M H
Se ve ral non-perm ane nt injuries or Localize d dam age to a non-s e ns itive le ad to regulatory or other highe r s everity
health im pacts . e nvironm e nt or an im m e diate area dam age le vel Cons e quence .
DAFWC (Days Aw ay From Work to a s ens itive e nvironm e nt all of w hich can Prolonge d local m edia cove rage .
Cas e ) be res tored to an equivale nt capability in a Local adve rs e social im pact.
F period of m onths .
Dam age to re lations hips w ith key
Exte nsive dam age to a non-s e nsitive s take holde rs of be ne fit to the Pe rform ance
e nvironm e nt or localize d dam age to a Unit (PU).
s ens itive e nvironm ent all of w hich can be
re s tore d to an e quivale nt capability in a
period of days or w eeks .
Single or m ultiple re cordable injury or Future im pact- Short-te rm local m edia cove rage .
health e ffects from com m on Im m ediate are a dam age or localize d Som e dis ruption to local ope rations , e .g.,
RES IDUAL RIS K S CORE APPROVAL REQUIRED
source /e ve nt. dam age to a non-s e ns itive e nvironm e nt, los s of s ingle road acces s les s than 24
w hich can be re s tored to an equivale nt hours .
capability in a period of m onths or in a Ve ry Hig h Not allow e d
period of days or w e eks , res pe ctive ly.
G Future im pact with localize d dam age to a
non-se ns itive e nvironm e nt and that m ay be Hig h Re fe r to Individual Bus ine s s Unit Approval Table
re s tore d to an e quivale nt capability.
Im m ediate are a dam age to a s e nsitive
e nvironm e nt that can be res tore d to an
Me dium Re fe r to Individual Bus ine s s Unit Approval Table
e quivalent capability in a pe riod of days or
w e e ks . Lo w Re fe r to Individual Bus ine s s Unit Approval Table
Firs t aid Future im pact with im m ediate are a dam age Is olated and s hort -te rm com plaints from
to a non-s ens itive e nvironm ent that can be neighbours , (e.g., com plaints about s pe cific
H Single or m ultiple ove r-expos ure s
causing noticeable irritation but no re s tore d to an e quivale nt capability in a noise e pisode).
actual he alth effe cts period of days or w e eks .