HIRARC FORM

HAZARD IDENTIFICATION , RISK ASSESSMENT AND

Rev. 0
DETERMINING CONTROL FORM
(HIRARC FORM)
Page 1 of 1
Department: PROJECT SAFETY Function / Main Activity: WORK AT HEIGHT Date:

HAZARD IDENTIFICATION RISK ASSESSMENT CONTROL MEASURES

Probability
Legal &

Severity

Total
Activity Potential Of Potential Controls Action Other
NO Hazard
Description Hazard Risk Required By Requirement
s
WORKING AT MAJOR INJURY i. PROVIDE FMA (SHW) 1970,
GRAVITY FALL FROM HEIGHT 3 5 15
HEIGHT DURING OR FATALITY Reg. 12
PROPER AND
CABLE LAYING GRAVITY FALLING OBJECT
MINOR/ MAJOR 5 15
3 SAFE WORKING i. Work
AND PULLING ON INJURY
Supervis FMA (BOWEC)
THE CABLE TRAY PLATFORM 1986, Reg. 15
or
ii. PROVDE
ii. Safety
PROPER Supervis
ACCESS AND or
EGRESS WITH
HANDRAIL AND
ADEQUATE
OVERHEAD
PROTECTION
 HIRARC FORM
HAZARD IDENTIFICATION , RISK ASSESSMENT AND
Rev. 0
DETERMINING CONTROL FORM
(HIRARC FORM)
Page 1 of 1
Department: PROJECT SAFETY Function / Main Activity: WORK AT HEIGHT Date:

1 1) HOUSEKEEPING
SHOULD BE DONE
iii. Work
REGULARLY
TRIP AND FALL DUE TO Supervis FMA (BOWEC)
MECHANICAL POOR HOUSEKEEPING
MAJOR INJURY 3 5 15 2) PROVIDE RAILING
or 1986, Reg. 9
OR BARRICADE AT
BUILDING EDGES iv. Safety
Supervis
or
 HIRARC FORM
HAZARD IDENTIFICATION , RISK ASSESSMENT AND
Rev. 0
DETERMINING CONTROL FORM
(HIRARC FORM)
Page 1 of 1
Department: PROJECT SAFETY Function / Main Activity: WORK AT HEIGHT Date: