Ref. No. Sheet No.

of
Risk Assessment
This Risk Assessment should be accompanied by a Point of Work Assessment relating to the specific location and completed on the day/shift by th
RA-04
01 01
Part 1 – Risk Assessment Details Part 4 – Additional Safety Information Risk Rating Matrix Likelihood of
incident or injury
Details of related safety information; i.e. further documents required for the activity.

Inevitable

Probable

Possible

Remote
Title
All employees entering the site are to be inducted. All Risk Assessments must be written
Noise Pollution All operatives must be competent to undertake the given task. by a Competent Person

Assessed by Contract All operatives entering the site are to wear the following PPE: Major R R A G

incident or injury
Safety Boots. The Risk Rating should

Extent of
be determined using the Serious R R A G
Safety Helmet.
Approved by Site matrix set out on the right.
Safety Glasses. Minor R A G G
Protective Gloves. Low R A G G
High Visibility Vest Hazards should be
Part 2 – Review History All Risk Assessments must, as a minimum, be reviewed annually. Once reviewed the assessed before and after
updated document must be communicated to all those who use it. Once a document has The following additional PPE may be worn as necessary: determining what the
Date been reviewed twice (or three years since it was originally created) it must be rewritten. Ear Defenders. control measures are to be.
established Reviewer Signature Safety Harness. R Red Do not proceed – Re-assess
Dust Mask. Once a final Risk Rating
Review 2 A Amber
has been Reviewthe
established therules
Control Measures
set out
(Date) below must be applied.with activity
G GreenProceed
Review 3
(Date)

Part 3 – Hazards & Risks Who could be affected? To what extent? This is how safe we ha
What might go wrong?
(Hazard)
Outcome or consequence
(Risk) Select all relevant options.
Select only one option.
This Risk Rating is
How we will stop this activity from going Residual
wrong Risk. This Risk Rating is determined using the Ris
Specify “other” in the Additional determined using the Risk (Control Measures)
Public

Client

(Specify)
Other

Red

Amber

Red

Amber
Control measures should always seek to eliminate the hazards that are described.
Safety Information box. Rating Matrix.
Employee

1.

Green
Hazardous Noise Injury Ensure that machinery generating noise is well maintained.

Green
Use machinery in workshops/dedicated areas wherever possible.
Contact the IMS Team for further guidance.
Avoid areas of high levels of noise.
Warning signs to be posted.
Use certified ear defenders.
Employee

Amber
(Specify)
Other

Amber
2.

Green
Red
Noise Pollution Disruption Ensure that work is carried out within the specified hours.
Red
Client

Green
Public

Warning signs to be posted.

Carryout noise assessments as required.
Situated noisy equipment away from populated areas.
Amber
Employee

Amber
3.
(Specify)
Other

5. Provide engineering control measures Where possible (Encase,

Green
Client

Red
Public

Green

Red
Barriers etc.
6. Awareness training to the site operatives periodically.
Employee

(Specify)
Other

Amber
4.
Amber

Green

Red
Public

Green
Client

Red
Employee

Amber
(Specify)
Other

Amber

5.

Green
Red

Red
Green
Public

Client