Project Risk Assessment Form
The School of Civil Engineering requires users of the facility to conduct a risk assessment of their projects prior to commencing work in the
School in compliance with the University of Sydney WHS Policy 2012 and WHS Procedures 2012.
NOTE: NO LAB WORK CAN COMMENCE WITHOUT THIS PROJECT RISK ASSESSMENT APPROVAL
RISK ASSESSMENTS ARE APPROVED FOR 12 MONTHS ONLY. ANY CHANGES TO THE PROJECT
WILL REQUIRE A RE-SUBMISSION OF THIS DOCUMENT.
PROJECT RISK ASSESSMENT FORM
You must complete all parts of this form as required. All documents are to be forwarded to the School of Civil Engineering’s Departmental
Safety Officer Mr Garry Towell.
NAME:
SUPERVISOR:
LOCATION/S:
PROJECT TITLE:
PROJECT SAFETY CLASSIFICATION:
(Project Safety Classifications are defined on page 2)
August 2015
Civil Engineering
Project Risk Assessment Form
HAZARD RATING FOR ACTIVTIES
CARRIED OUT IN THE
LABORATORY
Matrix (on the right) defines the Hazard
Classification to be used in the
following pages when describing
possible Experimental Risks. The
Hazard rating is based on the likelihood
that a particular activity/procedure can
hurt someone (vertical column) and on
the possible severity of the injury that it
can lead to (horizontal rows).
Note: likelihood of injury will be reduced
if effective risk control measures are
already in place e.g. safe operating
equipment and procedures, trained staff
etc.
PROJECT SAFETY CLASSIFICATION (BASED ON MINIMUM HAZARD RATING OF IDENTIFIED EXPERIMENTAL RISKS)
RISK CLASSIFICATION
OF PROJECT
MINIMUM HAZARD RATING
OF IDENTIFIED
EXPERIMENTAL RISKS
LOW
L6
MEDIUM
L4-L5
(i) Provide detailed testing procedure
(ii) Academic/Supervisor in charge of project needs to be present during first
test
L2-L3
(i) Approval for the project to be provided by HoS and Risk Management Office
(ii) Provide detailed testing procedure
(iii) Academic/Supervisor in charge of project needs to be present during first
test and satisfied that student/s is/are competent
HIGH
ADDITIONAL WHS REQUIREMENTS (in addition to information requested
in this form)
None
August 2015
Civil Engineering
Project Risk Assessment Form
(A) THE RESEARCH PROJECT
Title of research project
Types of samples
For example, what types of samples will be used? Where will they be prepared? Will they be stored? How will they be safely disposed of in an environmentally
protective manner?
Overview of experimental work
For example, how the samples will be prepared? What experimental set-up will be used? How the loading will be applied to the specimens?
August 2015
Civil Engineering
Project Risk Assessment Form
(B) REQUIRED TRAINING ACTIVITIES TO SUPPORT RESEARCH AND TEACHING SPECIFIC TASKS
Required training activities
Name of person who
provided the training
Signature of the person
providing the training
Signature of trained
person
Date of the
training
August 2015
Civil Engineering
Project Risk Assessment Form
(C) EXPERIMENTAL RISK ASSESSMENT
Details of experimental risks
List each significant risk that
pertains to your planned
experiments
Possible injury
What injury could happen if the
risk occurs?
Control measures
Consider the hierarchy of controls
to reduce the risk of potential
injury
Hazard rating
(refer to matrix outlined
on page 2)
Elimination
Substitution
Isolation
Engineering
Administrative
PPE
Elimination
Substitution
Isolation
Engineering
Administrative
PPE
Elimination
Substitution
Isolation
Engineering
Administrative
PPE
August 2015
Civil Engineering
Project Risk Assessment Form
(D) HAZARDOUS SUBSTANCES & DANGEROUS GOODS (provide yes/no answers for middle columns only)
Area
(laboratory
name)
Chemicals
MSDS
attached
Toxic
Flammable Carcinogenic Irritant
Disposal
August 2015
Civil Engineering
Project Risk Assessment Form
(E) REQUIREMENTS FOR AFTER HOURS ACCESS
Details of activity to be
carried out after hours
List each significant risk
that pertains to your
planned experiments
Details of experimental
risks
List each significant risk
that pertains to your
planned experiments
Possible injury
What injury could
happen if the risk
occurs?
Control measures
Consider the hierarchy of
controls to reduce the risk
of potential injury
Hazard rating
(refer to matrix outlined
on page 2)
Elimination
Substitution
Isolation
Engineering
Administrative
PPE
Elimination
Substitution
Isolation
Engineering
Administrative
PPE
Elimination
Substitution
Isolation
Engineering
Administrative
PPE
Elimination
Substitution
Isolation
Engineering
Administrative
August 2015
Civil Engineering
Project Risk Assessment Form
PPE
DECLARATION
I have read and understood the attached MSDS and have completed this form to accurately assess the WHS risks associated with my project
at the School of Civil Engineering.
Name of User/Staff/Student:
. . .............................................
Signature of User/Staff/Student: . ................................................ Date: .. ..............
Name of User’s Supervisor:
. .................................................
Signature of User’s Supervisor:
. ................................................. Date: . ...............
Name of Assessor:
. ................................................
Signature of Assessor:
................................................ Date: . .................
Name of Departmental Safety Officer: . ......................................
Signature of Departmental Safety Officer:
.................................... Date: . ..................
Attach all MSDS
August 2015
Civil Engineering
Project Risk Assessment Form
ATTACHMENT A – LABORATORY WORK PERMIT
ROOMS/LABS:
PROJECT TITLE:
PROJECT SAFTEY CLASSIFICATION:
EXPIRY DATE:
EQUIPMENT AND ACTIVITIES PERMITTED
DURING NORMAL WORKING HOURS (To be listed only once
training is Completed)
EQUIPMENT AND ACTIVITIES PERMITTED AFTER HOURS
(ONLY ACTIVITIES WITH HAZARD RATING OF L4-L6 ARE
ALLOWED FOR AFTER HOURS ACCESS)
General requirements for working after hours in the lab:
1) Tell someone in the School or University Security that you
are working alone in the lab
2) Have emergency contact details with you
Name of User/Staff/Student
Phone number
Signature
Date
Name of Supervisor
Phone number
Signature
Date
Name of Assessor
Phone number
Signature
Date
Name of OHS Officer
Phone number
Signature
Date
August 2015
Civil Engineering