Terminal Operator Risk Assessment Form
Complete the Terminal Operator Risk Assessment Form to evaluate operational risks at your terminal.
Date of Assessment
*
-
Month
-
Day
Year
Date
Assessor Name
*
Operational Area Assessed
*
Please Select
Loading/Unloading Zone
Storage Yard
Gate/Access Point
Equipment Area
Other
Overall Risk Level for This Area
*
Low
Moderate
High
Rate the Condition of Critical Equipment
*
1
2
3
4
5
Compliance with Safety Procedures
*
Rows
Not Compliant
Partially Compliant
Fully Compliant
PPE Usage
1
2
3
Hazard Signage
4
5
6
Emergency Exits
7
8
9
Incident Reporting
10
11
12
Likelihood of Incident Occurrence
*
Very Unlikely
1
2
3
4
Very Likely
5
1 is Very Unlikely, 5 is Very Likely
Emergency Response Readiness
*
Adequate
Needs Improvement
Inadequate
Additional Observations or Comments
Submit Assessment
Should be Empty: