INTEGRATED MANAGEMENT SYSTEM FORMAT

ASPECT IMPACT ASSESSMENT

Significant Impact Identified : Date:

Next review
Impact Assessment Reference:
Date:

Probability of occurrence
1 2 3 4 5
Likely i.e.
Rare i.e. Last Possible i.e. Likely i.e.
Reported Often i.e.
time reported Reported Reported
Severity of Occurrence within two Reported once
more than 5 within 5 several time in
years in an year
years years period an year
period

Extremely High Impact resulting stoppage of 5

5A 5B 5C 5D 5E
works/ Permanent damage to the environment

Very High from the regulatory authority 4

Impact causing serious land, water, air 4A 4B 4C 4D 4E
contamination that resulted fine or notice

High Impact in terms of serious land, water, 3

air contamination limited within the cliet area 3A 3B 3C 3D 3E
causing fine or notice from the client

Moderate and momentary impact 2

2A 2B 2C 2D 2E

Minor aspect causing insignificant impact 1

1A 1B 1C 1D 1E

Risk Impact Assessment Committee/ HSEO Department head

Name & Designation: ............................................................. Name & Designation:............................................

Document No: KFS/IMSF/HRA/02/ Risk Assessment Revision: 02 / Issue Date: 15-
Page PAGE 1 of NUMPAGES 1
September-2015
 INTEGRATED MANAGEMENT SYSTEM FORMAT
ASPECT IMPACT ASSESSMENT

Signature & Date: .................................................................. Signature & Date:............................................

Severity
Probabi
Impact
ACTION
Sl No Aspects Impacts Legal Reference Control Measures
PARTY

Document No: KFS/IMSF/HRA/02/ Risk Assessment Revision: 02 / Issue Date: 15-

Page PAGE 1 of NUMPAGES 1
September-2015