Brewery Risk Assessment Form
Evaluate operational and workplace hazards, controls, and follow-up actions in the brewery environment.
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Area or Process Assessed
*
Type of Hazard Identified
*
Please Select
Chemical Exposure
Slip/Trip/Fall
Machinery/Equipment
Manual Handling
Noise
Confined Space
Other
Describe the Specific Hazard
*
Likelihood and Severity Assessment
*
Rows
Likelihood
Severity
Before Controls
1
2
After Controls
3
4
Current Controls in Place
*
Are Additional Controls Needed?
*
Yes
No
Proposed Additional Controls (if any)
Responsible Person for Follow-Up
*
Priority Level for Action
*
High
Medium
Low
Submit Assessment
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