PPM Task Sheet - LV Maintenance
PPM Task Sheet - LV Maintenance
Site Address:
Date: Ref No: PPM TASK SHEET LV
Tasks / activities being assessed and location e.g. Carrying Out PPM on LV Systems
Risk Assessment for LV Distribution – Miscellaneous Equipment
1: Checklist of hazards / aspects which require assessing for this activity:
‘E’ indicates environmental aspects which must always be considered.
Competence (REF A) is ticked by default and should be assessed first.
Include abnormal conditions i.e. explosion, flood, fuel spill
Ref: Ref: Ref: Ref:
HAZARD/ HAZARD/ HAZARD/ HAZARD/
A, B, A, B, A, B, A, B,
ASPECT ASPECT ASPECT ASPECT
Etc. Etc. Etc. Etc.
Competence
Lead or Temperature Transport
(including A N AA AN
products Cold & Heat (E)
vendors) E)
Communication
Spills Lighting Vehicle
(including B O AB AO
(E) (E) Movement
vendors) (E)
Pesticides/ Wildlife/
Slips/Trips &
Herbicides M Z Lone working AM Biodiversity AZ
Falls
(E) (E)
Communication Supervisors being unaware When working alone tell the manager /
B& of an accident or other supervisor of the expected duration and its L2 x S3 =
AM significant event due to location. Ensure you maintain a means of two 6 (LOW)
Lone working way contact every 30 minutes and that the
Risk Assessment for PPM Task Sheets
Work on isolated equipment De-isolation by another Signs and safety locks are to be displayed to
person being unware of warn of the activity taking place i.e. “Caution –
activity. equipment Isolated” Stating;-Time, Date &
Contact Details
Slips/Trips & Falls Risk of injury through slips, Correct footwear to be worn at all times.
trips or falls on uneven Ensure adequate lighting is available on route L1 x S3 =
Z ground. to work and at working location. 3 (LOW)
Be aware of surroundings at all times.
Assessment completed by
Sign Date
(print name):
If consultant company
Manager acceptance
(print name):
Sign Date stamp
LIKELYHOOD
2 2
make the task/activity safe and protect the consequence. 4 4 8 12 16 20
environment.
Medium - Medium risk/impact - 3 3 6 9 12 15
Additional controls are necessary to make the Badly harmed (incapacitated for 3 day +, WRULD etc.) or
3 3 2 2 4 6 8 10
task/activity safe and protect the environment. moderate environmental consequence.
Moderate 3rd party interest / enforceable standard.
Medium/High - Medium/High risk/impact - 1 1 2 3 4 5
Formal and documented controls are required to Severely harmed/Maimed (Paralysis/Blinded/Badly
1 2 3 4 5
4 protect individuals and the environment. 4 burned/Loss of limbs etc)
Uncontrolled environmental release/significant 3rd party
interest/risk of prosecution.
High/imminent - Unacceptable high risk/impact - SEVERITY
Formal and documented controls are required to Death or chronic illness (i.e.
protect individuals and the environment. Further Electrocution / Asbestos related illness/Dangerous
5 5
action is necessary to mitigate unacceptable Occurrence)
risk/impact. Severe/Chronic/large quantity environmental release/ 3rd
party instruction/ High risk of prosecution.
HIGH = 20-25 – Unacceptable / High RISK / IMPACT Do not attempt this work: seek advice from QHSE Manager
MEDIUM = 8 – 16 Medium to High RISK / IMPACT Additional control measures should be sought to reduce the risk before proceeding.
LOW = 1- 6 Low to Medium RISK/IMPACT Adequate control measures may be in place: proceed with caution.