PROJECT RISK ASSESSMENT FORM
Job No/Title:
Manager
Date
Health and Safety Issues
Yes
No
Action/Comments
Does the client require a health and safety plan?
List the health and safety risk types that apply
(for typical risks see checklist over)
Where possible the risk should be eliminated or
reduced in the design.
Approved:
Risk Rating*
L
M
Details/Action/Comments
H
Residual
risk**
(Y/N)
Risk control issues to be
considered on site
(for typical issues see
checklist over)
Date:
* For guidance on determination of Risk Rating (Health & Safety) see explanatory note included with checklist of health and safety risks.
** Method statement from contractors must include how any residual risks will be managed to ensure a safe system of work and/or environmental protection
*** Control Period should be Investigation (I), Construction (C), Maintenance (M) and/or Demolition (D)
^ For guidance on determination of Risk Rating (Environmental) see explanatory note included with checklist of environmental risks.
Control
Period ***
(I/C/M/D)
PROJECT RISK ASSESSMENT FORM
Job No/Title:
Manager
Date
Checklist for potential health and
safety risks
Checklist for risk control measures
Guidance on Determination of Risk Rating
Work near:

underground services

drains

overhead power lines

overhead equipment/structures

water
Work in/on/at:

confined spaces

live highways/railways

public areas

height

slopes/gradients/unstable ground
Use of

mobile plant /machinery/vehicles

static plant/machinery

portable work equipment

hazardous materials
Materials:

Contaminated soil/materials

Asbestos
Work activities:

Demolition

Excavations

Hot work

Equipment maintenance

Manual handling
Work Environment:

Dust/fume

Noise/vibration

Exposure to extremes of temperature/sun

Radiological issues

Fire protection
Training/Instruction:

Site inductions for contractors

Site security

Visitor management
Controlled environment:

PPE for staff and visitors

Permit to Work system

Emergency procedures

First aid provision

Welfare facilities

Communications on site

Accident/incident reporting and investigation

Safety signage

Fire protection
Physical Measures:

Lighting

Fencing

Barriers
Recording likelihood
When all factors have been considered and a decision
made on the likelihood of the hazard actually causing
harm, a number is entered in the Likelihood column on
the Risk Assessment Form using the following scale:
Recording Severity
The judgement of the severity of the most probable
consequences of the hazard is entered on the Risk
Assessment Form in the Severity column as a number
using the following scale:
Certain or imminent
Very likely
Likely
May happen
Unlikely
Very unlikely
Multiple death
Single death
Major injury, disabling illness,
major damage
Lost time injury, illness, damage
Minor injury, minor damage
Delay Only
10
8
6
4
2
1
Severity
Single
Death
Major
Injury
Lost time
Injury
Minor
Injury
Delay
Multiple
Death
Certain
100
80
60
40
20
10
Very likely
80
64
48
32
16
8
Likely
60
48
36
24
12
6
May
happen
40
32
24
16
8
4
Unlikely
20
16
12
8
4
2
Likelihood
Very
10
8
6
4
2
1
unlikely
For the purposes of evaluation, the matrix can be used to
provide an initial breakdown of the hazards into
categories, as follows. In general, the darker the shading
the more likely it is that the decision will be that the risk is
not adequately controlled, but the guidelines listed here
should be followed:
10
8
6
4
2
1
Dark Shading – High Risk (H)
Light Shading – Medium Risk (M)
No Shading – Low Risk (L)
i.
ii.
iii.
iv.
* For guidance on determination of Risk Rating (Health & Safety) see explanatory note included with checklist of health and safety risks.
** Method statement from contractors must include how any residual risks will be managed to ensure a safe system of work and/or environmental protection
*** Control Period should be Investigation (I), Construction (C), Maintenance (M) and/or Demolition (D)
^ For guidance on determination of Risk Rating (Environmental) see explanatory note included with checklist of environmental risks.
Those hazards with residual risk ratings that
appear in the unshaded area can usually be
considered as trivial risk.
Hazards with risk ratings that appear in the shaded
area below the lower double line can be considered
as adequately controlled risk.
Hazards with risk ratings above the upper double
line must be considered as not adequately
controlled. Further controls will be required.
Hazards with risk ratings in the darker shaded
areas will require consideration of whether to
suspend or start the operation until controls are
introduced.
The control measures provided for hazards with
risk ratings between the two double lines must be
examined against current standards to arrive at a
decision as to whether the hazard is adequately
controlled or not adequately controlled.
PROJECT RISK ASSESSMENT FORM
Job No/Title:
Manager
Date
Environmental Issues
Environmental Impact Assessment
Is an environmental method statement required by client?
Is an EIA required for the project at some stage?
Has an EIA already been carried out?
Yes
No
Action/Comments
List any requirements for consents or
licences (for typical issues see checklist over)
Where possible the requirement should be
eliminated in the design.
Details
Action/Comments
List any existing legal controls in place
(for typical issues see checklist over)
Details
Action/Comments
* For guidance on determination of Risk Rating (Health & Safety) see explanatory note included with checklist of health and safety risks.
** Method statement from contractors must include how any residual risks will be managed to ensure a safe system of work and/or environmental protection
*** Control Period should be Investigation (I), Construction (C), Maintenance (M) and/or Demolition (D)
^ For guidance on determination of Risk Rating (Environmental) see explanatory note included with checklist of environmental risks.
PROJECT RISK ASSESSMENT FORM
Job No/Title:
Manager
Date
Environmental Issues
List any potential environmental impacts or
opportunities (For typical impacts and opportunities see
checklists over) Where possible the Impact should be
eliminated or reduced in the design.
Risk
Rating ^
L
M H
Details/Action/Comments
Residual
risk***
Risk control issues to be
considered on site
(for typical issues see
checklist over)
* For guidance on determination of Risk Rating (Health & Safety) see explanatory note included with checklist of health and safety risks.
** Method statement from contractors must include how any residual risks will be managed to ensure a safe system of work and/or environmental protection
*** Control Period should be Investigation (I), Construction (C), Maintenance (M) and/or Demolition (D)
^ For guidance on determination of Risk Rating (Environmental) see explanatory note included with checklist of environmental risks.
Control
Period ***
(I/C/M/D)
PROJECT RISK ASSESSMENT FORM
Job No/Title:
Manager
Date
(eg for on-site disposal, treatment or storage
of waste)
Surface water discharge consent (EA)
(for discharges to rivers, lakes, streams, etc)
Trade effluent discharge consent (Water co)
(for discharges to sewer)
Archaeological issues
Recording Severity
The judgement of the severity of the most probable
environmental impact is entered on the Risk
Assessment Form in the Severity column as a
number using the following scale:
Certain (daily or continuous)
Very likely or frequent
Likely
Unlikely
Very unlikely or never
Major environmental impact or complaints certain or
legal breach probable
5
Significant impact or high risk of complaints or legal
breach likely 4
Local damage or some risk of complaints or legal
breach possible 3
Limited impact only, no legal implications 2
No potential impact
1
For the purposes of evaluation, the matrix can be
used to provide an initial breakdown of the hazards
into categories, as follows. In general, the darker the
shading the more likely it is that the decision will be
that the risk is not adequately controlled, but the
guidelines listed here should be followed:
Noise & Vibration
Tree protection order(s)
Storage of fuel/oil/hazardous materials
environmental
Checklist for environmental
opportunities:
Likelihood
Certain
(daily
continuous)
or
Very likely or frequent
Use of:



5
4
3
2
1
Severity
Air Quality (odours, air pollution, dust)
Listed building(s) or structures
Checklist
for
control measures:
Recording likelihood
When all factors have been considered and a decision made on the
likelihood of an environmental impact, a number is entered in the
likelihood column on the Risk Assessment Form using the following
scale:
substitute materials
recycled materials
Tank bunds/drip trays/designated storage
areas

Emergency procedures and equipment
Control/prevention of:

Pollution (eg spill kits)

Water pollution

Traffic
Storage/Disposal

Hazardous waste

General waste including segregation
Use of waste products (eg road planning, timber,
industrial waste products)
Likely
Energy efficiency measures
Unlikely
Use of recycled materials (eg recycled demolition
waste)
Very unlikely or never
No Potential Impact
Local Authority planning conditions
Guidance on Determination of Environmental Risk
Limited Impact
Use of:

natural resources (incl energy)

potentially hazardous materials
Potential for

off-site pollution

conflict with the local community

light pollution
Generation of:

inert/general wastes

hazardous wastes

liquid wastes

traffic
Impacts on:

land use and/or buildings

water courses/drainage

human beings (off-site)

landscape / views

ecology / habitats

transport & traffic
Exemption from waste management licensing
environmental
Local Damage
Waste management licence(s)
eg for on-site disposal, treatment or storage of
waste)
for
Significant Impact
Checklist
impacts:
Major Impact
Checklist for environmental legal
issues:
25
20
15
10
5
20
16
12
8
4
15
12
9
6
3
10
8
6
4
2
5
4
3
2
1
Dark Shading – High Risk (H)
Light Shading – Medium Risk (M)
No Shading – Low Risk (L)
i.
ii.
iii.
iv.
Soft Landscaping
Improving ecology/habitats
Bio-remediation
* For guidance on determination of Risk Rating (Health & Safety) see explanatory note included with checklist of health and safety risks.
** Method statement from contractors must include how any residual risks will be managed to ensure a safe system of work and/or environmental protection
*** Control Period should be Investigation (I), Construction (C), Maintenance (M) and/or Demolition (D)
^ For guidance on determination of Risk Rating (Environmental) see explanatory note included with checklist of environmental risks.
Those hazards with residual risk ratings that
appear in the unshaded area can usually be
considered as trivial risk.
Hazards with risk ratings that appear in the
shaded area below the lower double line can be
considered as adequately controlled risk.
Hazards with risk ratings in the shaded area
above the upper double line must be considered
as not adequately controlled. Further controls will
be required. Hazards with risk ratings in the
darker shaded areas will require consideration of
whether to suspend or start the operation until
controls are introduced.
The control measures provided for hazards with
risk ratings between the two double lines must
be examined against current standards to arrive
at a decision as to whether the hazard is
adequately controlled or not adequately
controlled.