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DOCUMENT: DOCUMENT NO.

:
BUSINESS UNIT - SHES ASSESSMENT FILE DATE OF EFFECTIVITY:
Superseded: N/A
SUBJECT:
Revision No.: 00
HAZARD IDENTIFICATION, RISK ASSESSMENT AND RISK CONTROL (HIRARC)
Date Revised -
This is a controlled document. Should a revision be issued, please return the surperseded document and replace with updated document PAGE 0 OF 3

Occupational Safety and Health Risk Identification Risk Assessment Risk Evaluation Additional Control

Legal Significant Determination of Heirarcy Control


Working Enviroment Applicable Legal and Comp. Hazard Risk Risk
No Main Activity Sub-Activity Risk/s Existing Control Measures L S 1. Elimination 3. Engineering 5. PPE
Identified Hazards Other Compliance Rating Category
2. Substitution 4. Administrative
C|PC|NC Y/N
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Assessor/s Name Position Title Signature Prepared By: Reviewed By Approved By


Department:

Area of Assessment:

Date and Time:

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