TITLE:	ES&H Manual
DOCUMENT ID:	3210Appendix T2 Task Hazard Analysis (THA) Worksheet

Author:
Date:	Task #: If applicable		Frequency of use:
Complete all information. Use as many sheets as necessary
Task Location:		Task Title:
Division:		Department:
Lead Worker:
Mitigation already in place: Standard Protecting Measures Work Control Documents

Sequence of Task Steps	Task Steps/Potential Hazards	Consequence Level	Probability Level	Risk Code (before mitigation)	Proposed Mitigation (Required for Risk Code >2)	Safety Procedures/ Practices/Controls/Training	Risk Code (after mitigation

Highest Risk Code before Mitigation:

Highest Risk Code after Mitigation:

When completed, if the analysis indicates that the Risk Code before mitigation for any steps is “medium” or higher (RC≥3), then a formal Work Control Document (WCD) is developed for the task and attach this completed Task Hazard Analysis Worksheet. Have the package reviewed and approved prior to beginning work. (See ES&H Manual Chapter 3310 Operational Safety Procedure Program.)

ISSUING AUTHORITY	APPENDIX AUTHOR	APPROVAL DATE	EFFECTIVE DATE	EXPIRATION DATE	REV.
ESH&Q Division	Harry Fanning	10/05/09	01/01/09	10/05/12	0

This document is controlled as an on line file. It may be printed but the print copy is not a controlled document. It is the user’s responsibility to ensure that the document is the same revision as the current on line file. This copy was printed on 10/13/2009.