RISK ASSESSMENT FORM

Date : 25.07.2013 Time: 09:00hrs Wp:p131715962

Activity / Task : Thermography of DCS Panel Risk Assessment no. : RA-EPRU-001

Sub Task Hazard / RiskMeasure(s) Priority Responsibilty

E S P R E S P R By whom By when

No hazard

NIL 1 1 0.5 0.5

NIL

1 1 0.5 0.5 4 JK Before job

E = Exposure ; S = Severity ; P = Probability ; R = Risk = E X S X P

Risk assessment prepared by:S.no. Name designation department role signature date

1 Leader2 RA member3

Risk assessment approved by:RA shall be approved by some authority as of respective permit approval authorityS.no. Name designation signature date

1

Permit holder/contractor supervisorS.no. Name designation signature date

1

Description of Sub Task

1. Thermography to be done.

Person(s) at risk

Initial Risk Factor

Actual Risk Factor

1. Thermography to be done.