Hazard Identification Form
HAZARD IDENTIFICATION FORM
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Identified By: |
[Your Name] |
|
Date: |
[Month Day, Year] |
1. Hazard Description:
Hazard Type:
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Chemical
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Physical
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Ergonomic
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Others (Please specify):
Description:
Location:
2. Potential Impact:
Severity:
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Low Risk
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Medium Risk
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High Risk
Likelihood:
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Low Risk
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Medium Risk
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High Risk
Initial Controls (if any):
Existing Measures:
3. Additional Comments/Notes:
