Hirarc Form Sample

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HIRARC FORM

Company Limau Wood Sdn.


Bhd.
Process / Location: Workshop
i. HIRARAC FORM Approved by: Roland Jau
(Name, designation)
Date: 10-Jun-23 Conduct Date: 10 Review Date: 23
June 2023 June 2023

1. Hazard Identification 2. Risk Analysis 3. Risk Control


No Work Activity Hazard What Cause/ Effect Existing Risk Likelihood Severity Risk Recommended PIC (Due
Control (if any) Control Measure date/status)
1 Wood Sawing Physical Hazard- Noise Hazard Repeated exposure to loud noise PPE 3 2 6 Use ear muff

Biological Hazard N/A N/A N/A N/A N/A

Chemical Hazard- Exposed to Wood Dust Wood dust from the sawing machine PPE 4 4 16 Use respiratory mask

Ergonomic Hazard- Repetitive Motion Repetitive posture from sawing the wood Safe work 2 2 4 Job rotation
practice
Psychological Hazard N/A N/A N/A N/A N/A N/A

Muthu Rajawali
(13 Jun 2023)

2 Wood Sanding Physical Hazard- Cutting, Laceration and Entrapment Hand tools that have sharp edge Permit to work 3 2 6 Using a glove to avoid
PPE getting cuts

Biological Hazard N/A N/A N/A N/A N/A N/A

Chemical Hazard- Exposed to Wood Dust Dust from the grinding process PPE 4 4 16 Wear a suitable
respiratory mask
Ergonomic Hazard- Awkward Posture Prolonged awkward posture Training 2 2 4 Conduct training to
PPE
Psychological Hazard- Noise Stress Loud noise from machinery PPE 2 2 4 Use ear muff
David Roger
(14 Jun 2023)
3 Assembling wood Physical Hazard- Soreness Heavy load from tools PPE 3 1 3 Job rotation at the
Training workplace
Biological Hazard- Molds and Fungi Damp and moldy wood can release spores PPE 2 1 2 Conduct workplace
into the air Workplace inspection to make
inspection sure the wood is in
good condition
Chemical Hazard- Exposed to Wood Glue Long term inhalation of wood glue PPE 4 4 16 Use the right
Permit to work respiratory mask
Ergonomic Hazard- Manual Handling Repeatedly Lifting heavy object with no support Buddy system 3 2 6 Encourage worker to
work in pair

Psychological N/A N/A N/A N/A N/A N/A

Alexis
(15 Jun 2023)

1
4 Transportation of Physical Hazard- Falling and Shifting Object Wood can shift or fall if not properly Permit to work 2 3 6 Get a permit to work
Wood secured to avoid any unwanted
accident
Biological Hazard N/A N/A N/A N/A N/A N/A
Chemical Hazard N/A N/A N/A N/A N/A N/A
Ergonomic Hazard- Stationary Position The driver will be in a seated position for a Permit to work 2 2 4 Make sure the worker
long time is in a good condition
of health and get a
permit to work
Psychological Hazard- Isolation and Loneliness Experience the feeling of loneliness due to Buddy system 2 2 4 Encourage worker to
long time spending alone on the road work in pair to avoid
loneliness

Anakin Anakun
(16 Jun 2023)
5 Shaping Wood Physical Hazard- Slip, Trip and Fall Obstructions or other trip hazards that is Barricade 3 2 6 Inspection at the
absence on the floor at the works station workstation workplace to make
Workplace sure the workplace is
inspection always neat
Biological Hazard N/A N/A N/A N/A N/A N/A
Chemical Hazard N/A N/A N/A N/A N/A N/A
Ergonomic Hazard- Vibration Vibration from machine PPE 3 Use the right
protective gear to
minimise the vibration

Psychological Hazard N/A N/A N/A N/A N/A N/A


Ambatukam
(20 Jun 2023)

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