HAZOP Checklist
Use this form to document a Hazard and Operability Study review, record deviations and safeguards, and track recommendations to closure.
HAZOP Review Details
Project / Process Name
*
Facility / Site or Location / Area
*
Date of HAZOP Review
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Facilitator / Leader Name
*
Core Participants / Team Members
*
Process Node and Design Intent
Process Node / Equipment / Segment
*
Design Intent
*
Operating Mode / Condition
*
Normal Operation
Startup
Shutdown
Maintenance
Abnormal Operation
Other
Reference Documents / Drawing IDs
Hazard/Deviation Analysis
HAZOP Items
*
Severity and likelihood may be assessed using the ranking fields within each HAZOP item row.
Record each identified deviation as a separate row for clear review and traceability.
Include only existing safeguards or controls currently in place; recommendations are captured in the next section.
Use the most relevant deviation type; select Other when no listed option fits.
Recommendations and Actions
Recommended Actions / Additional Safeguards
*
Action Owner / Responsible Person
*
Target Completion Due Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Action Priority
*
High
Medium
Low
Current Action Status
*
Open
In Progress
Completed
Deferred
Submit Checklist
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