Doc.

No: SSA-HSE-COR-PR-007-FORM 001 Prepared by Reviewed by Approved by

HIRARC
(Hazard Identification, Risk Assesment and Risk Control)
HSE Manager Site Manager Project Manager

Job Title Location Date Rev.

HIRAC Team Members 1. 2. 3. 4.

(Name & Position)
List of assessed task as per attached sheet, & will update as per actual condition or site visit.
Regular tool box talk / pre-work briefing shall be organized before commencing.
NOTE
Talk & pre-work briefing shall reflect the emergency actions elaborated in emergency plan.
WCC / permit to work will be available as required.

Risk Rank = Probability Likelihood x Severity Consequence

Score Level Probability / Likelihood Description Severity Index Description

13 -25 High 5 - Frequent The event is expected to occur in most 5 - Catastrophic Death, Permanent serious environmental damage, multiple fatalities damage, toxic release of site, huge financial loss.
circumstance
6 - 12 Medium 4 - Probable Will occur frequently 4 - Major Lost time icident, permanent/partial disability, non permanent environmental damage, high financial loss.

1-5 Low 3 - Occasional Will occur several time 3 - Moderate Medical treatment required/work restriction, high financial loss, on site release contained with outside assistance

2 - Unlikely Unlikely, but it can reasonable be 2 - Minor First aid treatment, on site release immediately contained medium financial loss
expected to occur

1 - Improbable Unlikely to occur but possible 1 - Negligible No affecting work performance, No injury, low financial loss.

Note : Remark :
Our Objectives are Zero Illness, Zero Injury, Zero Property Demage/Loss and Zero Environmental Damage

HAZARD IDENTIFICATION ASSESSMENT CONTROL

No. Task/Activity Potential Hazards Which Can Cause/Effect P S R Control Measure Residual Risk PIC
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

NOTE : IN EVENT OF EMERGENCY, STOP ALL ACTIVITY, TURN OFF ALL EQUIPMENT AND MAKE SAFE AND GO TO MUSTER POINT.
E : Elimination Control Mn : Impact to the person or human
S : Substitution Control Fc : Impact to the facilities or property damage
G : Engineering Control En : Impact to the environment
A : Administration Control
 HAZARD IDENTIFICATION ASSESSMENT CONTROL
No. Task/Activity Potential Hazards Which Can Cause/Effect P S R Control Measure Residual Risk PIC
P : PPE control
 PROBABILITY
Unlikely to occure, Unlikely, but it can Will occur several time Will occur frequently The event is expected
People Asset Environment but possible reasonable be expected to occur in most
to occur circumstance

1 2 3 4 5
No potential injury or No potential or Slight No potential or Slight 1 2 3 4 5
1 Slight
effects
injury or health damage impact

Minor injury or health Minor damage Minor impact 2 4 6 8 10

effect
2
SAVERITY

Moderate injury or Moderate damage Moderate impact 3 6 9 12 15

3 health effect

Major injuty or health Major damage Major impact 4 8 12 16 20

4 effect

Fatality and serious Major and potential Major and potential 5 10 15 20 25

5 health effect massive damage massive impact