RISK / IMPACT ASSESSMENT

CONTROL SHEET

Contract No. HFM-Q-0994-09-23

Project Title 200mm Headwall Removal at DIC
RA Reference RA/0994/09/23/HJ
RA Date 08/09/2023
RA Revision No.
‫٭‬Scope / Activity 200mm Headwall Removal at DIC

SEVERITY RATING: MATRIX

Please Note
If the severity rating lies between 4 to 25, then corrective actions needs to
People/Equipment/Production be taken by concerned persons with documentary evidence provided in
conjunction with WI HSE 07 and 45
Health Safety Loss & Environmental Impact
Probability (P)
OH&S Environmental 1 2 3 4 5
1 1 2 3 4 5

Severity (S)
1-3 Acceptable Low – L Minor / <3 Days Injury Minor 2 2 4 6 8 10
4-9 Before task commences Medium - M Moderate / >3 Days Injury Moderate 3 3 6 9 12 15
Major / Permanent Disability
10-16 Before task commences High - H Injury Major 4 4 8 12 16 20
20-25 Immediate Very High - VH Catastrophic / Fatality Catastrophic 5 5 10 15 20 25
Working group Designation May Very
Unlikely Likely Certain or Imminent
Happen Likely
Fill in & enclosed herewith WI HSE 07 and 45
Note: *Mandatory

Verified by: Approved by:

HSE Officer : Client

Saim Ali Signature :___________Date 08/09/2023 Name:______________________Signature:_____________Date: / /

Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai Page 1 of 7

‫ ٭‬Scope / Activity: 200mm Headwall Removal at DIC
No. Hazard /Aspect
01 Engineering Services
02 Site Preparation
Unfamiliar with site
situation, roles & re –
03
possibilities, process
steps involved in the task
Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai
RISK / IMPACT ASSESSMENT
CONTROL SHEET
Risk Assessment Date 08/09/2023
Severity
Control Measures Residual Risk Monitored By
of Risk
Risk / Impact People at Risk
H&S H&S
H&S Environmental
Ergonomic – Training on how to avoid Detect and expose the
Repetitive Motion ergonomic risks, Ability to vary under-ground services
Engineering
Injuries, working from workers position i.e. chair height, prior to machine
LOW
and staff Site Supervisor/Site
HIGH
a fixed position for work surfaces angles etc. Ability excavation. PTW, craft
associated with Rep
prolonged periods of to take breaks as needed to Training, System in
this work
time alleviate stress place for disposal of
contaminated earth.
Where possible utilize
mechanical means to
move large materials
1. Training regarding good lifting
Stress good lifting
techniques and how to recognize
From erecting techniques during tools
Workers as your own limitations.
hoardings, traffic box talk prior to and
HIGH
LOW
signed as 2. Team work if it looks like two or Site Supervisor/Site
barriers, barricades during this project. This
material even three workers would do the Rep
and posting safety training should include
handlers job more effectively and safe
signage lifting with the legs while
than one, then that is probably
keeping the back
true.
straight and keeping the
load as close the body
as possible
All personnel to be fully briefed
Damage to the on task & Risk Assessment, TBT
property, Injury (tool box tool) should be
LOW
Site Supervisor/Site
HIGH
Workers conducting prior to start the task
to work Rep
& must cover emergency
personnel. preparedness. IMS induction to
be given to all staff
Page 2 of 7
 RISK / IMPACT ASSESSMENT
CONTROL SHEET

MEDIUM
Use mechanical aid for handling

LOW
Site Supervisor/Site
04 Manual Handling Personal Injury Workers materials Tool Box Talk use of
Rep
appropriate PPE

Full time skilled and experienced Site Supervisor/Site

MEDIUM
Improper barricading and Property supervision in the work All activities should be

LOW
Workers Rep
05 closure of area during damage/serious injury area .HSE assistant shall be carried out in the day
works present in the work area ,the area time busy hours to
should be properly cordon off and reduce noise.
closed
Wear proper PPE, Equipment
should be protection cover and
good working condition needs to

MEDIUM
Site Supervisor/Site

Construction Tools and
06 accessories, Jack
hammer, air compressor,
& etc.
LOW
Workers be check prior to application. Rep
electrical cable and accessories
Injury/sharp edge should be without damage and
plugging way should be proper,

Periodical maintenance and If any leakage identified

MEDIUM inspection shall be carried out the machine shall be Site Supervisor/Site
Poor maintenance of Property damage Workers every month. Visual checks shall moved to the Rep

LOW
07 machinery /serious injury/soil be done by operator daily prior to maintenance area. Spill
contamination start work. Defective plant or kit shall be used to
equipment shall be immediately clean up in case of any
stopped and rectified. spillage

Proper cleaning to be done at all

MEDIUM

Affect working Site Supervisor/Site

times, flammable material to be

LOW
Poor house keeping environmental, injury Workers Rep
08 to slips and trips regularly removed, material keep
hazard it designated storage areas.

Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai Page 3 of 7

Hazardous gasses
09
explosions and
environment. Lack of
oxygen
Hazardous environment,
10 lack of oxygen less than
19.5% and above 23.5%
Harmful gasses (H2S,
11 CO) reducing oxygen
level.
Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai
RISK / IMPACT ASSESSMENT
CONTROL SHEET
No person shall be
required to enter any
confined spaces unless
positive steps have
Inspection and tests as below been taken. Gas test at
Fatality. Severe injury Workers needs to be conducted and
atmosphere shall be
to body. Explosion, certified.
MEDIUM
suffocation, fatality, done before and during
VERY
HIGH
progress of work by Site Supervisor/Site
severe injury to body, Rep
Works supervisor to issue permit trained gas tester. All
death
after preventive. entry shall be controlled
by a permit to work
system specifying the
description of work and
hazard and should be
clearly understood and
followed.
Correct measures
Suffocation. Burns to Workers Nobody is allowed to enter until should have done. Gas
MEDIUM
body- fatality, coma the testing is over
VERY
HIGH
test at atmosphere shall Site Supervisor/Site
and death be done before and Rep
Measures and checks have been during progress of work
done. by trained gas tester.
Space must be
Ensure that H2S Less than adequately well
Explosion, ventilated tested and
MEDIUM
10ppm permissible exposure
VERY
suffocation, fatality,
HIGH
level 8hrs, Ventilation Fans to be certified for toxic Site Supervisor/Site
severe injury to body Workers
positioned such that they are allowable limits, Rep
from flames, coma,
effective. Supervisor to check if flammable atmosphere
death or oxygen level in the
ventilation is up to standard
air.
Page 4 of 7
 RISK / IMPACT ASSESSMENT
CONTROL SHEET

Gas test at atmosphere

shall be done before
Oxygen readings to be taken on and during progress of

MEDIUM
work by trained gas

VERY
HIGH
a continuous basis. Site Supervisor/Site
12 Changing conditions. Suffocation Workers tester ensure that gases Rep
all allowable limit O2
Foreman to monitor. level, Toxic gas level,
LEL ,monitor 8hrs once
every day.

Not being able to Anyone entering

remove worker from confined space must
hazardous working Safety harnesses to be made wear safety

MEDIUM
area in time. Other Fatality. Workers available and used. harness/safety belt with

VERY
HIGH
Site Supervisor/Site
13 employees exposing life line and second Rep
themselves in attempt Foreman to check if this is done person as a standby to
to so do. and included in the procedure. assist him in case of
emergency.

A breathing apparatus
and oxygen resuscitator
Not using correct Fatality. Workers Users to be trained/instructed as should be made

MEDIUM
personal protective to use of equipment. available as standby.
VERY
HIGH
Site Supervisor/Site
14 equipment Rep
Foreman to comply with use
page instructions.

Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai Page 5 of 7

Not receiving first aid
15
treatment immediately.
Knowing the amount
16 workers in the confined
space at all times.
Untrained persons in
17
confined space.
Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai
RISK / IMPACT ASSESSMENT
CONTROL SHEET
First aider to be aware
of completeness
HIGH
LOW
Foreman to instruct and check if Site Supervisor/Site
Fatality. Workers procedures.
a procedure is complied with. Rep
Entry in confined space
for a any purpose
The number of persons in the should be only
confined space should always be
MEDIUM
considered when all
VERY
HIGH
known. reasonably practicable Site Supervisor/Site
Fatality. Workers
steps have been taken Rep
Supply first aider with register to deal with.
makes sure it is used.
No unauthorised
MEDIUM
Foreman might require persons to be allowed
VERY
HIGH
barricading of work area. put all in working area. Ensure Site Supervisor/Site
Fatality. Workers
related warning signage around that people trained and Rep
working site yard. having valid safety
certificate.
Page 6 of 7

Not having fire
18
extinguishers available.
19 Working with Electricity
Document Name: Risk / Impact Assessment Control Sheet – 800mm Headwall Removal at Bur Dubai
RISK / IMPACT ASSESSMENT
CONTROL SHEET
Check if equipment is useable Check if equipment is
and pressures are correct. useable and pressures
HIGH
LOW
Fatality. Increases Site Supervisor/Site
Workers are correct. Expired
injury to people. Rep
Foreman to check if all is in date need to be check.
order.
1.Isolate the power supply prior
to start the task
2. Wear appropriate PPEs.
3.non-electrical tools to be used
inside the Manholes
4. Fitter, contractors and
relevant others discuss
Electrocution / electrical safety before each job
Electrical shock / begins to ensure that relevant
Fire / Fatality. Fitter/ machinery, circuits etc. are
HIGH
LOW
Worker may suffer Workers isolated and locked off Site Supervisor/Site
shock and burns throughout the job. Rep
injuries from faulty 5. Contractors told to inspect all
electrical equipment electrical appliances pre-use
or installation. and not to bring any equipment
on site where condition of
cables, switches etc. give rise
to concern.
6. Electrical installation and all
equipment (including machinery
in fitter’s workshop) is inspected
to a planned schedule.
Page 7 of 7