HAZARD IDENTIFICATION FORM

1. Hazard Description:

Hazard Type:

• Chemical

• Physical

• Ergonomic

• Others (Please specify):                               

Description:

Location:

2. Potential Impact:

Severity:

• Low Risk

• Medium Risk

• High Risk

Likelihood:

• Low Risk

• Medium Risk

• High Risk

Initial Controls (if any):

Existing Measures:

3. Additional Comments/Notes:

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