Site Specific Risk Assessment

Site Specific Risk Assessment – SDS MA

Company

Site Address of assessment visit

Address Line 1

Address Line 2

City

County

Post Code

Country

Date

Site Emergency Contact

Nearest First aid Facilities

SVQ Qualification

For Plant Operation Qualifications – Please select the type of plant

Type

Wheeled

Tracked

Size – 180°

Below 5 tonne

Above 5 tonne

Size

Below 10 tonne

Above 10 tonne

Tasks

Additional Hazards (Not covered by generic risk assessment)

Additional Control Measures (required to reduce risk to acceptable level

Additional Hazards (Not covered by generic risk assessment)

Additional Control Measures (required to reduce risk to acceptable level

Additional Hazards (Not covered by generic risk assessment)

Additional Control Measures (required to reduce risk to acceptable level

Additional Hazards (Not covered by generic risk assessment)

Additional Control Measures (required to reduce risk to acceptable level

Additional Hazards (Not covered by generic risk assessment)

Additional Control Measures (required to reduce risk to acceptable level

Risk Assessment completed by:

Name

Signature

Sign Here

Date

Candidate Declaration

I (the candidate) understand the risk assessments that have been carried out for the event that I am attending and the control measures that must be implemented. I have also received information regarding action in case of Fire, Medical Emergency and Accident Reporting and Recording. I declare that I am fit to take part in the event and I agree to inform my assessor of any medical conditions that may affect my ability to take part in the event.

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

Candidate Name

Signature

Sign Here

Date

Candidate emergency contact

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