Location Risk Assessment Form-Part A: Basic Information & Hazard List
Location Risk Assessment Form-Part A: Basic Information & Hazard List
Location Risk Assessment Form-Part A: Basic Information & Hazard List
Distribution
Locations
Hazard list select your hazards from the list below and use these to complete Part B
Situational hazards Tick Physical / chemical hazards Tick Health hazards Tick
Assault by person Contact with cold liquid / vapour Disease causative agent
Attack by animal Contact with cold surface Infection
Breathing compressed gas Contact with hot liquid / vapour Allergic reaction
Cold environment Contact with hot surface Lack of food / water
Crush by load Electric shock Lack of oxygen
Drowning Explosive blast Physical fatigue
Entanglement in moving machinery Explosive release of stored pressure Repetitive action
High atmospheric pressure Fire Static body posture
Hot environment Hazardous substance Stress / anxiety
Manual handling Ionizing radiation Venom poisoning
Object falling, moving or flying Laser light
Slight e.g. small cut, deep bruise Trivial Trivial Low Low Medium
Moderate e.g. deep cut, torn muscle Trivial Low Medium Medium High
Severe e.g. fracture, loss of consciousness Low Medium High High Extremely high
Very Severe e.g. death, permanent disability Low Medium High Extremely high Extremely high
Risk Assessment Form Part B: Hazards & Control Measures
Hazards Who exposed Risk Control measures Risk
Risk Assessment Form Part C: Emergency Contact information
Job Title Name Phone No. Email Emergency Contact/Relationship
Address
Emergency Service CUMBRIA (101) ask for Carlisle City Carlisle City Centre, Civic Centre, Rickergate Carlisle CARLISLE COLLEGE MAIN RECEPTION CAN BE
CONSTABULARY Centre NPT CA3 8QG
REACHED ON
Emergency Service CUMBERLAND 01228 523444 Newtown Rd, Carlisle
INFIRMARY CA2 7HY 01228 822700
Emergency Service FIRE 01228 221689 Eastern Way, Carlisle
SERVICE CA1 3RA IN AN EMERGANCY ALWAYS CALL 999