5_Activity_Hazard.pdf

EM 385-1-1

30 Nov 14

FIGURE 1-2

Activity Hazard Analysis (AHA)

Activity/Work Task:

__________________ Overall Risk Assessment Code (RAC) (Use highest code)

Project Location:

__________________ Risk Assessment Code (RAC) Matrix

Contract Number:

__________________ Severity

Probability

Date Prepared:

_ _/_ _/_ _ _ _ Frequent Likely Occasional Seldom Unlikely

Prepared by (Name/Title):

Catastrophic E E H H M Critical E H H M L

Reviewed by (Name/Title):

Marginal H M M L L Negligible M L L L L

Notes: (Field Notes, Review Comments, etc.)

Step 1: Review each “Hazard” with identified safety “Controls”. Determine RAC (See above) Probability: likelihood the activity will cause a Mishap (near miss, incident or accident).

Identify as Frequent, Likely, Occasional, Seldom or Unlikely.

RAC Chart

Severity: the outcome if a mishap occurred.

Identify as Catastrophic, Critical, Marginal, or Negligible

E = Extremely High Risk

H = High Risk

Step 2: Identify the RAC (probability vs.

severity) as E, H, M, or L for each “Hazard” on AHA. Annotate the overall highest RAC at the top of AHA.

M = Moderate Risk

L = Low Risk

Job Steps Hazards Controls RAC 1.

2.

1.

2.

1.

2.

1.

2.

Equipment to be Used Training Requirements & Competent or Qualified Personnel name(s)

Inspection Requirements