Scribd
Upload
11 views4 pages

HIRAC Form

Uploaded by

rmlalegarbes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
11 views4 pages

HIRAC Form

Uploaded by

rmlalegarbes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 4

Group Name:

Members:

HAZARD IDENTIFICATION, RISK ASSESSMENT and CONTROL (HIRAC)

1. Hazard Identification 2. Risk Assessment 3. Risk Control


(Initial Evaluation)
Residual Due Date/
Proposed Control Measure(s) Probability Severity
Work Activity Hazard(s) Possible Effects Probability Severity Risk Risk Status

Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
Group Name:
Members:

1. Hazard Identification 2. Risk Assessment 3. Risk Control


(Initial Evaluation)
Residual Due Date/
Proposed Control Measure(s) Probability Severity
Work Activity Hazard(s) Possible Effects Probability Severity Risk Risk Status

2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Group Name:
Members:

1. Hazard Identification 2. Risk Assessment 3. Risk Control


(Initial Evaluation)
Residual Due Date/
Proposed Control Measure(s) Probability Severity
Work Activity Hazard(s) Possible Effects Probability Severity Risk Risk Status

Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Health Hazard(s):
1.
2.
Safety Hazard(s):
1.
2.
Group Name:
Members:

1. Hazard Identification 2. Risk Assessment 3. Risk Control


(Initial Evaluation)
Residual Due Date/
Proposed Control Measure(s) Probability Severity
Work Activity Hazard(s) Possible Effects Probability Severity Risk Risk Status

Health Hazard(s):
1.
2.

You might also like