RISK ASSESSMENT FORM Risk Assessment No GENERIC RA019

List identified hazards and detail measures taken to address the hazards: Reference to SOP No GENERIC SOP019
Cost Centre Department Location Area Supervisor
University Wide University Wide University Wide OH&S Unit
Plant/equipment/procedure Assessed by Date Review Date
Laminator Generic OH&S Unit 28/01/2009 28/01/2011

Probability - Risk Factors Consequence - Risk Factors

Probably occur immediately or within a
Very Likely Fatality May cause death or loss of facility
short period of time

Severe injury or illness or major property damage

Likely Probably occur in time Major

Could happen occasionally

Possible Minor Minor (usually reversible) injury or illness resulting in days off work or minor property damage

Unlikely Could eventually happen First Aid First aid level treatment

Highly Has potential to occur, but probably never

Negligible No medical treatment
Unlikely will

Forms of Hazard

Physical Mechanical action, impact, electrical exposure, heat/cold, noise, vibration, explosion etc.
Chemical Corrosive liquid, toxic gases, noxious fumes etc.
Ergonomic Height of workbench, design of chair, set-up of a work station etc.
Radiation x-ray machine, infrared beams etc.
Psychological Stress from using equipment without proper training or instruction, interpersonal conflict
Biological Sharps, specimen containers carrying infected material, viruses from A/C system
Sources Environment Substances Equipment/plant Work systems

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Plant/equipment/procedure
Laminator Generic

Risk Probability Control Hierarchy

Consequence
Matrix
Very Likely Possible Unlikely Highly
likely unlikely Elimination Is it necessary
Extreme High High High Medium
Fatality Substitution Is there a less hazardous alternative
High High High Medium Medium
Major injury Isolation Eg Restrict access, use in a closed container,
fume cabinet
High Medium Medium Medium Medium Eg Trolleys to move loads, guards on machinery,
Minor injury Engineering Fume cupboard
Medium Medium Medium Low Low
First aid Administration Eg: Training, Safe Work Procedure, signage
Medium Medium Low Low Low PPE - Personal
Negligible Protective Equipment Eg: Gloves, respirator, safety glasses

Controls
implemented
Identified Hazards Risk Assessment Risk Required Controls
Number Description Consequences Probability Measure Yes No
? ? (see matrix)

1 Electrical hazards Fatality Highly unlikely Medium All electrical items are tested and tagged as required by
Legislation
First aid Highly unlikely Low Follow instructions as per operators manual
Burns from hot surfaces
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SUMMARY OF RISK Review the risk measured, and the controls, then please select the relevant risk summary statement:
A The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is not currently significant

B The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is significant, however controls are
in place that reduce risk to acceptable levels
C The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is significant. Interim controls are in
place to reduce risk to acceptable levels.

Approved by Supervisor.. Date

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