Occupational risk assessment card

Employer / organization​ No. Document number​ dated Document date

Workplace / type of work: Workplace / type of work and its identifier​. Occupation / position: Occupation / position of the employees assessed​. Assessment date: Assessment date. Basis and survey materials: Assessment basis, assessors and survey materials​. This card is prepared as part of occupational risk management under Articles 214 and 218 of the Labor Code of the Russian Federation (ТК РФ).

The matrix method is used; likelihood and severity values are determined by the approved scales. Method, scales and criteria: Method details; scales, formula, thresholds and acceptability rules​.

Additional details based on actual conditions: Register: hazard ID, source, event, consequences and persons exposed​ Existing measures and assessment of their effectiveness: Specify only technical, organizational and personal protective measures actually in place. An instruction alone, without evidence of its application, is not sufficient evidence of effectiveness.

Additional details based on actual conditions: Existing measures and evidence of their effectiveness by hazard ID​.

The assessment is determined by the combination of likelihood and severity in the approved matrix; arithmetic multiplication is used only if provided for by the method.

Additional details based on actual conditions: For each hazard: ID, likelihood, severity, index, level and rationale​

Priority is given to eliminating the source, replacing the process and collective protection. Necessary temporary restrictions are established pending implementation of long-term measures.

Additional details based on actual conditions: Additional measures: ID, action, person responsible, deadline, resources and monitoring​

The employer determines whether work may proceed, taking account of mandatory requirements and the actual state of protection. Unacceptable risk requires measures to be taken before the relevant work continues. Expected reductions must not be presented as reductions actually achieved. Survey limitations and unresolved hazards are recorded separately. Additional details based on actual conditions: Conclusions and decision on whether work may proceed​ A low numerical index does not in itself authorize work that breaches mandatory occupational safety requirements. Review procedure: The card is reviewed when equipment, technology, materials or duties change, following an incident, or when a new hazard or ineffective measures are identified. If there are no changes, scheduled monitoring is carried out under the procedure established by the employer; the person responsible checks that the underlying information remains current. Additional details based on actual conditions: Review date / triggers and person responsible​. Prepared by and signatures: Prepared by: positions, full names and space for each signature​ Approved by:

Signatory's position​ ______________ / Head's full name​ /

Additional details based on actual conditions: Acknowledged by: full name, position, date and space for each signature​