RISK ASSESSMENT FORM

Company: $o"*site: /"ocess1 2ocation: App"o5ed by: (Name, designation (!ate CTCI IR + II ,-O !.N /"o0ect Ne3 $14 a"ea M"# I*e 4su Site Manage"
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Conducted by: (Names, designations (!ate 2ast Re5ie3 !ate:

M"# Ande"son $ang Const"uction Manage" %&'%('(%)(

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Ne6t Re5ie3 !ate:

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)# 4a8a"d Identi9ication
)a# )b# )c# )d# /ossib:e Accident 1 4ea:t; - /e"sons'at'Ris*

(# Ris* E5a:uation
(a# E6isting Ris* Cont"o: (i9 any (b# Se5e"ity (c#
2i*e:i;ood

7# Ris* Cont"o:
7a# 7b# Action O99ice", !esignation

(d# Ris* 2e5e:

No#

$o"* Acti5ity

4a8a"d

Additiona: Ris* Cont"o:

1.

Manual Excavation at existing oxygen line

Damage the oxygen line

"ea#ages o! oxygen can injury to the wor#ers by the ressure release.

'one

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(ro er care and su ervision to the wor#ers when activity is ongoing. )a!ety training !or the wor#ers s ecially that s eci!ic job.

Mr. Abdul Muqeeth

Tools can cause injury

$and and body injuries are ossibility to the wor#ers. 'one Mi " "

Tools must be ins ected rior to use. &se tools that a licable and sa!ety to the wor#ers. (ro er ((E must be wear.

Falling or rolling the excavated materials and tools into the excavated area.

%njury to the wor#ers. 'one Dust can cause to res iratory and Mi " "

All excavated materials and hand tools must #ee 1.*m away !rom the edge o! the excavation.

Dust accumulation by the excavated materials.

lungs roblem. %njury to the wor#ers by !alling

'one 'one 'one

Mi Mi

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Dust condition should be #e t at minimum level by the use o! water or other sa!e means.

Adequate access way can cause sli s and !alling. Tools can cause ro erty damage "ac# o! su ervision "ac# o! sa!ety monitoring "ac# o! sa!ety awareness

and sli s.

&se dust mas# !or rotecting dusty atmos here. (ro er ste s+ ram s or other sa!e means o! access

Damage the oxygen i e

'one

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shall be rovided.

&nsa!e act and condition to wor#ers &nsa!e act &nsa!e the wor#ers condition

'one 'one 'one

M M M

" " "

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,rew )u ervisor - )a!ety (ersonnel always monitor the job. (rovide (hysical barriers with sa!e distance. (rovide adequate sa!ety awareness signs. .alid wor# ermits at site. (lot lan and area s#etch co y at site. A A roved method statement co y at site. roved /is# assessment and daily 0)A at site.

1hen the excavation goes to dee er do gas test. 2e!ore start the job ,rew )u ervisor - Assigned sa!ety should to give )a!ety Toolbox tal# about the sco e and sequence o! the job. )har edge tools not ermitted while the sa!e distances reach.

$ 4 $igh /is#+ M 4 Medium /is#+ " 4 "ow /is#

"i#elihood )everity Major 5Ma6 Moderate 5Mo6 Minor 5Mi6

/emote 5/6 M " "

7ccasional 576 $ M "

Frequent 5F6 $ $ M