1. GENERAL DETAILS. RISK ASSESSMENT 2. Programme/Project: Project Code: Start Date: End Date: Duration: Name/Location of Activity:

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1 1. GENERAL DETAILS. Programme/Project: Project Code: RA No/ Date: Start Date: End Date: Duration: Name/Location of Activity: Brief Description of Activity: Site Conditions/Other Operations/Contractors: Main Equipment and Substances Involved (refer to guidance notes/msds and CoSHH assessments for those which pose a significant risk): Key Activities/Hazards Identified:. Minimum PPE Required: Persons who may be affected: Field Party: Others in the vicinity. Environmental Considerations: EMERGENCY PROCEDURES in the event of: Accident/Illness: Fire/Explosion: Spillage: Accidental Release of gases/hazardous/noxious substances: W:H&S/RA Blank Gen Project_ Page 1 of 6

2 2. CONTACT DETAILS. CONTACT / ROLE NAME TEL / MOBILE No BGS Project Leader: BGS Field Team Leader: BGS Staff Contact: Local Host / Client: BGS H&S Advisor: First Aider: Site Medical Facilities / Hospital A&E Dept: ACCOMMODATION: ADDRESS CONTACT/TEL No From: To: TIDE TIMES: Date Time (BST) Datum Source: HM COASTGUARD: W:H&S/RA Blank Gen Project_ Page 2 of 6

3 3. GUIDANCE / REFERENCE / ACCOMPANYING DOCUMENTATION. The procedures and control measures in this SSW and RA must be read and applied in conjunction with and with reference to the following NERC/BGS Guidance and accompanying documentation: 4. SAFE SYSTEM OF WORK (SSW - identified from the Risk Assessment). Prior to the Project/Visit Start Date: Preparation for Travel:. On Arrival: Daily Operation / Project Itinerary: On Return / Review: Any changes will be brought to the attention of all relevant staff. W:H&S/RA Blank Gen Project_ Page 3 of 6

4 RISK ASSESSMENT AND SAFE SYSTEM OF WORK 2.D. RISK ASSESSMENT Consider each activity involved in the trip/project and the hazards that may arise from them; include any equipment that may be used, individual and team capabilities, and any potential health issues. Record your findings in the columns below. Think about what could happen; how severe could the outcome be (H) and how likely is it to occur (L)? Use the guide opposite to score each H and L Multiply H x L to give the Initial Risk Rating (IR) Where the IR is 3 or above, appropriate measures must be put in place to reduce to an acceptable level of risk. With the control measures in place, review the H and L ratings and multiply these to give a Residual Rating (RR) Activity Potential hazard effect Field Rating Score Guide to Ratings High (H) 3 Capable of resulting in death, severe injury or illness, major loss/damage to equipment, buildings or the environment. Hazard Moderate (M) 2 Capable of resulting in injury or illness requiring absence from work, or equipment/environmental damage. Low (L) 1 Capable of resulting in minor injury requiring first aid, or inconsequential loss of equipment or environmental impact. High (H) 3 Likely to occur frequently or the hazard exists permanently. Moderate (M) 2 May occur in time hazard exists intermittently or the operation occurs occasionally. Likelihood Low (L) 1 Unlikely to occur hazard exists infrequently and there is a low expectation of occurrence. None (N) 0 Hazard removed completely or effect of potential hazard made impossible by design (applies only to residual rating). High (H) 6, 9 Priority risk. Must be reduced to a level that is acceptable through practical and effective control measures. Initial Risk Moderate (M) 3, 4 Lesser priority risk. Should be assessed to see if further control measures can be applied to reduce to low risk. Rating Low (L) 0, 1, 2 No further action is required but should be monitored. NB: ALL CONTROL MEASURES MUST BE IN PLACE BEFORE TRAVELLING. Initial Rating Control measures in Place Residual Rating H L R H L R BGS RA / SSW Position: Name: Signature: Date: Ref No: Prepared By: Initial RA Date: Reviewed By: Next Review Date: W:H&S/RA Blank Gen Project_ Page 4 of 6

5 RISK ASSESSMENT AND SAFE SYSTEM OF WORK INSERT SITE/LOCATION MAPS: (where appropriate) W:H&S/RA Blank Gen Project_ Page 5 of 6

6 Declaration to be signed by all personnel working to Safe System of Work: I have read and understood the information contained in this Safe System of Work and associated Risk Assessment(s) and agree to abide with all recommended safety controls. I will also inform other staff and visitors of such RAs and the SSoW and other known hazards as appropriate. Name Signature Date W:H&S/RA Blank Gen Project_ Page 6 of 6

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