AREA / PROJECT:Buffer Zone

ROYAL COMMISSION RISK ASSESSMENT FORM

Contract #:021-C05R
DATE Assessed:29/12/2014
Reviewed date: 29/12/2014

SPECIFIC LOCATION

TOOLS &
EQUIPMENT IN USE:

15

Uncontrolled releasing
Death, Fatality
of Energey or water

15

WITH CONTROLS
Current Controls / Safeguards (What do we
do to prevent incidents?)

1-Area Shall be demarcated

Properly.
2Display safety signboard for preventing
unauthorized Entrance.
3-Make sure all pipe supports
are in good condition and have been
inspected.
4-All hoses
must be tied down.
5-Water
temperature must be more than 60 F
6-The Hydrostatic
-presurizing pump is completed with
safety relief valve.
7-Wear Proper P P E .
8Ensure the gage meter is caliberated by
third party & Certificate should be keep
in site safety office.
9-Safety relief valve to be caliberated

1-Start depressurization by opening

gradually the vent valve.Do it slowly
2-Do not open the drain valve if the
vent valve if still closed.This is to
avoid vacum condition inside the Pipe
line.
3Open the lowest drain point to
completely remove water from the
pipe line.
5Ensure that no remaining presure
trapped inside the pipe line.
6-

6-

RISK RATING

Presure Pump

RISK SCORE

Death, Fatality

Hydro Test

Explosion

Harm / Consequence /
Parties affected (What can
happen / go wrong)

RISK SCORE

Hazards identified with

each task
(What can hurt one /
others?)

RISK RATING

Tasks
(What one does
in logical steps)

SEVERITY (S)

Hydro Test
PROBABILITY (P)

Responsible Person

Site engineer & Site

safety officers make
sure all safety
precuations
implemented before
start Job

Engineer/Safety
officer/ Forman.

Site engineer & Site

supervisors.

Engineer/Safety
officer/ Forman.

Additional & or Site Controls

(What additional
could we do to reduce the
risk?)

Additional PPE:

PROBABILITY (P)

Risk Rating =
Probability
x
Severity
1

SEVERITY

Unlikely

First Aid or slight injury

Rare

Recordable, medical and restricted work

Possible

Lost time injury or permanent disability

Likely

Single fatality or permanent disablity of 3 or more

person

Very Likely

multiple fatalities

Probability (P)

Ser No.

TASK /
OPERATION /
ACTIVITY
DESCRIPTION:

Instellation of water and Fire Line

SEVERITY (S)

RISK ASSESSMENT:

PROBABILITY (P)

RA No:

SEVERITY
1

1 - Low

2 - Low

3 Low

4 - Low

5 - Med

2 - Low

4 - Low

6 - Medium 8 - Medium

10 - High

3 Low

6 - Medium

9 - Medium

12 - High

15 - High

4
5

4 - Low
5 - Medium

8 - Medium
10 - High

12 - High
15 - High

16 - High
20- High

20- High
25 - High

Name

Designation

Date

Prepared by:

ROBY.K.THOMAS

H S E MANAGER

29/12/2014

Reviewed by:

MAGDY ELSHERIBING

CONSTRUCTION MANAGER

30/12/2014

Approved by:

KULDEEP TYAGI

PROJECT MANAGER

30/12/2014

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Safety