Location: Terga Date of Assessment:

Assessor(s): FRIDI.ALI System/Activity:

P
r
o
b
a
b
i
l
i
t
y
&
F
r
e
q
u
e
n
c
y
Definite 5 5 10 15 20
High 4 4 8 12 16
Moderate 3 3 6 9 12
Low 2 2 4 6 8
Negligible 1 1 2 3 4
1 2 3 4
Minor Serious Major Catastrophic
Severity
Key to Priorities
Medium Priority (5
days)
High Priority (2-3 days) Immediate
INTRODUCTION
The table below provides a simplified representation of the methodology used and the processes
Management) to be undertaken by OCIA and all Subcontractors in order to initi
IDENTIFICATION - Pre planning, Method
statement , Job safety analysis.
ASSESSMENT
Mitigation measure, Residual risk
Identify activities , Identify hazards Assess Impacts, Analyze Risk ,
Establish Mitigation Measures.
RISK ASSESSMENT FORM
Date of Assessment: 21-07-2010 Assessment No:
System/Activity: Erection of Steel Structure Building (B12)1.2.3
The table below provides a simplified representation of the methodology used and the processes involved in this Hazard Identification & Risk Analysis Procedure (Risk
Management) to be undertaken by OCIA and all Subcontractors in order to initi ate, act on, review and effectively manage project-related risks
ASSESSMENT Impact, Risk factor,
Mitigation measure, Residual risk
IMPLEMENTATION &
COMMUNICATION
REVIEW & UP DATE
Assess Impacts, Analyze Risk ,
Establish Mitigation Measures.
Communication & Training Audit, Inspection & Up dating of Log.
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106
1.2.3
involved in this Hazard Identification & Risk Analysis Procedure (Risk
related risks throughout the Construction Phase.
REVIEW & UP DATE
Audit, Inspection & Up dating of Log.

Tasks Hazards Identified (include
the exposed groups)
Probability
1 - 5
Transfer
equipment
Transfer device collide
with other things;
Oil leakage
4
Locate the crane Hitting injury 4
Transport Traffic risk
Collision with person
Collision device
3
Movement of
traffic Slip/trip/all
3
RISK ASSESSMENT FORM
Severity
1 - 4
Risk
1 - 20
Control Measures to be Implemented
Probability
1 - 5
3 12 Chose a qualified driver before
work
Check the calibration of all tools
Make sure the transport device in
good condition
1
3 12 Solid the ground
Reinforce the pads beneath the
outriggers
Check the around circumstance
before working
1
3 9 The trucks must respect:
The limited speed in the site
The circulation signs
The circulation plan (updated)
2
3 9
All hose/ropes/cables in use shall
be secured to the side of walkways
and handrails
All unnecessary materials and
equipment to be immediately
removed from site
All exits and walkways to be kept
clear for use of personnel
High standard of housekeeping to
be maintained at all times
2
Page 3 sur 5
Probability Severity
1 - 4
Risk
1 - 20
Residual
Risk
Date
Action
Completed
2 2
2 2
3 6
2 4

Tasks Hazards Identified (include
the exposed groups)
Probability
1 - 5
Lifting Fall from height and
hurt workers
Component fall down
Component collide
with other things
surrounded
collision with person
collision between
frame and scaffolding
collision between the
crane and equipments
falling materials
Poor visibility for the
driver
4
RISK ASSESSMENT FORM
Severity
1 - 4
Risk
1 - 20
Control Measures to be Implemented
Probability
1 - 5
4 16 Lifting crane, forklift wires should
be regularly calibrated, safe
working loads are announced max
speed at site is respected for all
vehicle
It is not allowed to work under
loads
Handling by qualified riggers worn
the related PPE and under
supervision
Qualified crane operator and
qualified rigger to operate lifting
work
Crane in calibrated period
Barricade the lifting area
Proper lifting tools
Make sure lifting wok operated in
good weather
mark the area of operations of the
crane
officer commanding the ship
maneuver through regulatory
actions to avoid accidents
Control of the safety catch hook
the slings
Ensure the crane on his dashboard
that the load weight does not
exceed the maximum allowed
Ban the person be under a
suspended load
defining the radius of the rotary
crane
prohibit the movement of people
around the handling
stop the lifting operation in strong
winds exceed the 50km /h
2
Page 4 sur 5
Probability Severity
1 - 4
Risk
1 - 20
Residual
Risk
Date Action
Completed
3 6

Tasks Hazards Identified (include
the exposed groups)
Probability
1 - 5
Work at height
(Scaffolding and
Man basket)
falls from height
falling objects
4
Use tools Hand injuries
crushed fingers
smooth head against the
frame
3
Environmental
Pollution the air:
Exhaust gas, The dust
Leaking oil or diesel
machines on soil
3
Assessor Print :
RISK ASSESSMENT FORM
Severity
1 - 4
Risk
1 - 20
Control Measures to be Implemented
Probability
1 - 5
3 12 the scaffolding should be based on
graded soil with good foundation
protect a guard with a height of
1.15 m
Protection of Persons with safety
harnesses
protect with an end-board 10 to 15
cm high
prohibit work at height if the
weather affected the safety of
persons
2
3 9 ensure protection adequate PPE
(gloves, helmet, goggles, harness
2
3 9
Checking the condition of
equipments before beginning the
work
ventilation Workstation
2
Sign: Date:
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Probability Severity
1 - 4
Risk
1 - 20
Residual
Risk
Date
Action
Completed
2 4
2 4
2 4