Free Hazard Evaluation Form Template
Hazard Evaluation Form
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Date: |
[Month Day, Year] |
|
Location/Area: |
[Location/Area Name] |
|
Evaluator: |
[Your Name] |
1. Hazard Identification:
Hazard Description:
Type of Hazard:
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Chemical
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Physical
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Ergonomic
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Others (Please specify):
Potential Impact:
2. Risk Assessment:
Likelihood of Occurrence
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Low
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High
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Medium
Severity of Consequence:
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Low
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High
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Medium
Risk Level
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Low Risk
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Medium Risk
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High Risk
Existing Controls:
3. Recommended Actions:
Proposed Controls:
Responsibility:
Timeline:
4. Additional Comments/Notes:
