PWS_Attachment_3_-_Activity_Hazard_Analysis.pdf
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PWS Attachment 3
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Risk Assessment Code (RAC):
S e v e r i t y
Project: Job:
E = Extremely High Risk
M = Moderate Risk L = Low Risk
Recommended Protective Clothing & Equipment:
H = High Risk
Prepared By: Reviewed By:
Date Prepared (dd-mmm-yy):
ACTIVITY HAZARDS ANALYSIS
JOB STEPS
Catastrophic
Critical
Marginal
Negligible
ACTIONS TO ELIMINATE OR
MINIMIZE HAZARDS
HAZARDS
E
H
M L
E
H
M
L
(PARA REF)
H
H
M
H
EM 385-1-1
E
L
P r o b a b i l i t y Frequent Likely Occasional UnlikelySeldom
M
L
M
L
L
L
CELRL Form 1259, November 2001 Previous Versions are Obsolete and Should Not Be Used
Attachment 3
Page 2 of 5ACTIVITY HAZARDS ANALYSIS Date Prepared (mm-dd-yyyy):
Project: Job:
JOB STEPS HAZARDS
ACTIONS TO ELIMINATE OR EM 385-1-1
MINIMIZE HAZARDS (PARA REF)
Page 3 of 5ACTIVITY HAZARDS ANALYSIS
ACTIONS TO ELIMINATE OR EM 385-1-1
MINIMIZE HAZARDS (PARA REF)
Project: Job:
JOB STEPS HAZARDS
JOB STEPS HAZARDS
ACTIONS TO ELIMINATE OR EM 385-1-1
MINIMIZE HAZARDS (PARA REF)
Date Prepared (mm-dd-yyyy):
Project: Job:
ACTIVITY HAZARDS ANALYSIS
Page 5 of 5ACTIVITY HAZARDS ANALYSIS
Project: Job:
JOB STEPS HAZARDS
ACTIONS TO ELIMINATE OR EM 385-1-1
MINIMIZE HAZARDS (PARA REF)
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