11.07.2015 Views

Risk Assessment Template: - Wurth

Risk Assessment Template: - Wurth

Risk Assessment Template: - Wurth

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Appendix 1 to HSI 005<strong>Risk</strong> <strong>Assessment</strong> Matrix. Multiply scores to arrive at risk rating (RR)ProbabilityRemoteUnlikelySeverityPossibleProbableVery LikelyCertainNo Injury 0 1 2 3 4 5Minor Injury 1 1 2 3 4 5First Aid Injury 2 2 4 6 8 103 Day Injury 3 3 6 9 12 15Major Injury 4 4 8 12 16 20Fatality/Disability 5 5 10 15 20 25Low 1 – 6 Monitor Tolerable risk. No additional controls required. Employees made aware of safe/correct system of work.8 – Improvement Action required to further reduce risk to acceptable level. Review of process or activity.Med12Immediate Unacceptable risk. Stop activity immediately. Inform next level of management & refer to Safety Coordinator. PossibleHigh 15+Action withdrawal of process or activity.Monitoring and ReviewReview Date Assessed by: Job Title: Signature: Date: Approved by:3

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