Field Level Risk Assessment with MatrixBy Jennifer Filgate / June 27, 2025 Date Form Completed *Job Name / # *Location *Work To Be Done *HAZARDSENVIRONMENTAL Dust/Mist/FumesExcessive NoiseExtreme TemperaturesSpill PotentialFire/Explosion RiskRIGGING & HOISTING Equipment InspectedSlings InspectedProper Tools UsedOthers Working OverheadACCESS/EGRESS Confined SpaceSlips/TripsLaddersScaffoldingAppropriate PPEOVERHEAD Powerlines OverheadFalling ItemsMoving Loads OverheadElevated Fixed ObjectsERGONOMIC Awkward Body PositionOver ExtensionProlonged BendingRepetitive MotionFrequent LiftingOTHER IDENTIFIED HAZARDS: TASKS Risk = Severity X Likelihood SeverityLikelihood 1 - - - - - Minor1 - - - - - Rare 2 - - - - - Moderate2 - - - - - Possible 3 - - - - - Serious3 - - - - - Highly Likely 1. Task 1. Hazards 1. Controls 1. Risk (select calculated value from dropdown) 1234692. Task 2. Hazards 2. Controls 2. Risk 1234693. Task 3. Hazards 3. Controls 3. Risk 1234694. Task 4. Hazards 4. Controls 4. Risk 1234695. Task 5. Hazards 5. Controls 5. Risk 1234696. Task 6. Hazards 6. Controls 6. Risk 123469TASK RISK VALUETask 1 Impact NegligibleMinorModerateSignificantSevereTask 1 Likelihood Very UnlikelyUnlikelyPossibleLikelyVery LikelyTask 1 Risk Value (as per chart) LowLow MedMediumMedium HighHighTask 2 Impact NegligibleMinorModerateSignificantSevereTask 2 Likelihood Very UnlikelyUnlikelyPossibleLikelyVery LikelyTask 2 Risk Value LowLow MedMediumMedium HighHighTask 3 Impact NegligibleMinorModerateSignificantSevereTask 3 Likelihood Very UnlikelyUnlikelyPossibleLikelyVery LikelyTask 3 Risk Value LowLow MedMediumMedium HighHighTask 4 Impact NegligibleMinorModerateSignificantSevereTask 4 Likelihood Very UnlikelyUnlikelyPossibleLikelyVery LikelyTask 4 Risk Value LowLow MedMediumMedium HighHighTask 5 Impact NegligibleMinorModerateSignificantSevereTask 5 Likelihood Very UnlikelyUnlikelyPossibleLikelyVery LikelyTask 5 Risk Value LowLow MedMediumMedium HighHighTask 6 Impact NegligibleMinorModerateSignificantSevereTask 6 Likelihood Very UnlikelyUnlikelyPossibleLikelyVery LikelyTask 6 Risk Value LowLow MedMediumMedium HighHighWORKERS ON SITE1. Name 1. Signature 1. Time 2. Name 2. Signature 2. Time 3. Name 3. Signature 3. Time 4. Name 4. Signature 4. Time 5. Name 5. Signature 5. Time 6. Name 6. Signature 6. Time NameSubmit Save and Continue
