Machine Safety Specialists 04/13/2009 Page 1

Equipment: Minster AB-123-CD Assessment Team Members:

Manufacturer Model / Generation / Tooling Design Contact Person
Location: Module # 1 #33 #12345 Starting Date: 5/1/2009
Line # Machine #
Type of Equipment: Press ABC-123 Plant: Plant B
Instruction: Please follow Safe Guarding Seminar Risk Assessment Flow Chart and Risk Estimation Matrix!
Use the ANSI B11.TR3-2000 Hazard Table to Assist in Identification of Hazards and Promote Consistency!
1–8 Represents Low Level, 9–14 Represents Medium Level, 15–20 Represents High Level
Hazard Identification Risk Level Estimate Method of Reduction Follow-Up
Identified Hazard Type (From Frequency Probability Severity Number Est. Accident Tolerable By By Safe- By Method of Addressing Risk Frequency of Probability of Severity of Number of Final Risk Tolerable?

Annex A #
#

Hazard Hazard Table Annex A) of Exposure of Injury of Injury of People Risk Review Yes/ No Design guarding Admin. Exposure Injury 1,2,4,6 Injury People Level
rd

Reduction or Current Method in

za

1,2,4 1,2,4,6 Exposed Level Yes/No

1,3,6,10 Controls 1,2,4 1,3,6,10 Exposed
Place Making it Tolerable!
Ha

Guarding Concerns
1 E-stops not redundant or 14.0 Failure of Control 2 2 6 1 10 y No X X Add redundancy and safety 2 2 6 1 10 No
properly monitored Circuit monitoring relay
2 Guard switches not in 14.0 Failure of Control 2 4 6 1 12 No X X Change guard switches & add safety 1 1 1 1 3 Yes
conformance Circuit monitoring relay
3 D.C. capacitive buss of 14.0 Failure of Control 2 2 6 1 10 No X Make M1 contactor a safety type and 1 1 1 1 3 Yes
AC drive not isolated Circuit move between drive & motor
from motor
4 Inch function on guards 14.0 Failure of Control 2 2 6 1 10 No X X X Change guard switches and add 1 2 1 1 4 Yes
open not appropriate Circuit safety monitoring relay. Add two-
hand control monitoring relay.
5 CR2, CR3, MCR not in 14.0 Failure of Control 2 2 6 1 10 No X Change to safety relays with 1 2 2 1 5 Yes
conformance Circuit appropriate monitoring
6 No flywheel motion 1.d Mechanical Hazard- 2 2 6 2 16 No X X Add stopped motion detector and 1 2 1 2 5 Yes
detection mass and velocity indicator
(kinetic energy of
elements in controlled
of uncontrolled motion)
7 Software not adequate 3 3 3 1 9 No X Modify software to accommodate 0 Yes
for above items 1-6 above modifications. Items 1-6
8 Main motor drive belts 1.3 Cutting Severing 1 2 3 1 6 Yes X The backside of this guard is open. 0 Yes
1.4 hazard, Entanglement This unit sits approx. 15 ft. above the
hazard ground. No access on top of press
while running
9 Flywheel 1.d Mechanical Hazard- 1 2 6 1 9 No X Flywheel is "counter sunk" in press 0 Yes
mass and velocity housing & covered with fiberglass
(kinetic energy of guard.
elements in controlled
of uncontrolled motion)

12 Main jackshaft 1.3 Cutting Severing 1 1 3 1 5 Yes X Drive belt is totally surrounded by a 0 Yes
1.4 hazard, Entanglement guard
hazard
34 0 0 Yes
35 0 0 Yes
Operational Concerns 0 0 Yes
0 Yes
0 Yes
0 0 Yes
Maintenance Concerns 0 0 Yes
0 0 Yes
0 0 Yes

Page 1 of 7 Form Revision: 4/13/2009