UOOLAB3-2015LaboratoryRiskAssessmentTemplatePartA:ProcedureDetailsTitle:Briefsummaryofprocedure:(appenddetailedprocedurestoriskassessment)LocationDetails:Department:LocationAssessmentappliesto:☐AllHSNOExemptLabsinDepartment☐SpecificLocation,Building:Room:PartB:ApprovalPreparedby:(addadditionalrowsifrequired)Name:Signature:Date:DepartmentLaboratoryManagerApproval:Name:Signature:Date:ThisRiskAssessmentistobereviewedby:Date://PartC:HazardsIdentificationAddadditionalrowsasrequiredHazardousSubstances/MaterialsSubstancenameHazardClassificationsOtherHazards/ExposurelimitsMaxConc.usedMaxQtyusedHazardousEquipment/ProcessesHazardUOOLAB3-2015PartD:RiskAssessmentUsethetablebelowtodocumenttherisksassociatedwiththeprocedure(thepotentialinjuryorharmthatcouldarisefromthehazardsidentificationinSectionC),includingthelikelihood(usingthedescriptorsontherightasaguide)andconsequences.Considerthelikelihoodandconsequenceswithnocontrolsimplemented(pre-control).OnceyouhavedocumentedyourcontrolsinSectionE,reassessthelikelihoodandconsequences(post-control).Addadditionalrowsasrequired.1LikelihoodDescriptorsLikelihoodDescriptionNegligibleCannotoccurorisextremelyimprobableUnlikelyNotexpectedtooccurduringnormaloperationsbutconceivableitcouldLikelyCouldbeexpectedtooccurfromtimetotimeduringnormaloperationsAlmostcertainExpectedtooccurduringnormaloperationsDescriptionofriskPre-controlriskassessment(withnotcontrolsimplemented)Post-controlriskassessment(withcontrolsstipulatedinSectionEimplemented)Likelihood1ConsequencesLikelihood1ConsequencesUOOLAB3-2015PartE:ControlPlanSpecifythecontrolstobeimplementedtominimisetherisksidentified,followingtheboxesbelowasaguide.Engineering/EquipmentControlsAnyitemsofequipment(otherthanPPCE)usedtominimiseahazarde.g.fumehood,guards,spillkits:PersonalProtectiveClothingandEquipmentControlsItemsthatarewornbytheusertoprotectthemselvessuchassafetyglasses.PleasebespecificForexample,ifglovesspecified,specifytypeofglovetobeused(e.g.aredisposableglovessuitableorisachemicalresistantgloverequired?Wherechemicalresistantglovesarerequired,specifythemake/modeltobeused,e.g.AnsellChemi-Pro224):AdministrativeControlsWorkpracticesorproceduresfollowedtominimiseahazard(e.g.disposalofsharpsintosharpsbinatpointofuse):WorkinginIsolationControlsIstheproceduresubjecttoanyrestrictionsonworkinginisolation?E.g.taskmayonlybeconductedbetweenspecifiedhours/Mon-Fri/ormorethanonepersonmustbepresent.☐No☐Yes,specifybelow:HazardousWasteDisposalIstheprocedureexpectedtogeneratehazardouswastes?☐No☐Yes,specifydisposalmethod:UOOLAB3-2015EmergencyProceduresDoestheprocedurerequireanyspecificemergencyproceduresnotcoveredbyUniversityofOtagoEmergencyProcedures?☐No☐Yes,specifiybelow:AdditionalInformation:Specifyanyotherimportantadditionalinformation:PartF:TrainingApprovedTrainers–Specifypersonnelapprovedtotrainusersinthisprocedure:NamePositionLaboratoryTrainingRecord–RecordtrainedusersbelowTraineeNameSignatureTrainerNameTrainerSignatureDate
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