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Date of Assessment:
Department:
Assessor(s)/Team:
Building:
Room Number:
Lab Operation Hours (if operational hours impact the Risk Assessment):
Hazard/Exposure Category
Consequences (Outcome)
What is the
expected harm?
Value
0 to 5
Existing Control
Measure In Place
Probability
Risk
Value 0 to Rating
5
Number
Hazard/Exposure Category
Consequences (Outcome)
What is the
expected harm?
Value
0 to 5
Existing Control
Measure In Place
Probability
Risk
Value 0 to Rating
5
Number
/
0
Exposure to
Biohazards/Bloodborne Pathogens
0
Combustible Dust
0
Oxidizer
0
Pyrophoric Material
0
Exposure to Compressed
Gases
cryogenic
(including
material)
Exposure to heat/cold
0
Hazard/Exposure Category
Consequences (Outcome)
What is the
expected harm?
Value
0 to 5
Existing Control
Measure In Place
Probability
Risk
Value 0 to Rating
5
Number
Exposure to Noise
0
Walking/Working Surfaces
0
Means of Egress (Emergency)
0
Energy Control (Lock-out/Tag-out)
0
Exposure to Fall Hazards
0
Pressure vessels
0
Material Handling of
Chemicals (Bulk)
0
to
0
Welding/Cutting Hazards
0
Exposure to Electrical Hazards
0
Employee knowledge of the chemical hygiene plan
Hazard/Exposure Category
Consequences (Outcome)
What is the
expected harm?
Value
0 to 5
Existing Control
Measure In Place
Probability
Risk
Value 0 to Rating
5
Number
Eye Hazards
0
Unattended Operations
Working Alone
0
Working with Animals or Biological Agents
0
Probability
Unlikely
People
1
Fatality(s) / Chronic Illness with no recovery
Probably
Possible will occur
to occur under
over time routine
conditions
Will occur
under
current
conditions
Frequent/
Regular /
Continuous
Occurrence
High Risk
Injury/Illness requiring medical treatment by a medical
professional beyond first aid / no time off work required
Medium Risk
Low Risk
Minimal - no medical treatment or assistance
needed.