General Information

Basic details about the project and hazard identification.

Project Name

Hazard ID

Hazard Name

Date of SRA

Conducted By

Office Name

Severity Determination

Calculate severity based on impact criteria.

Hazard ID --

Hazard Name --

Severity Score

Severity Value

Severity Level

Table S1: Impact Calculation

SN	Impact Area	Score (0-5)	Impact Level	Weight	Weighted Score
Total Weighted Score:					0

Table S2: Impact Level Guide

Level	Score
Very High	5
High	4
Moderate	3
Low	2
Negligible	1
Nil	0

Table S3: Severity Matrix

Score Range	Sev.	Category
52 - 65	A	Catastrophic
39 - 51	B	Hazardous
26 - 38	C	Major
13 - 25	D	Minor
01 - 12	E	Negligible

Determination of Probability

Barrier quality, Strength value and robustness

Hazard ID --

Hazard Name --

Severity Score --

Severity Value --

Severity Name --

Table 0: Probability Table

Type of Barrier	Total BSV	Probability
Existing	0	--
Resultant (Existing + New)	0	--

Table P1: Existing Barriers

SN	Barrier	Effectiveness (3)	Cost Benefit (1)	Practicality (1)	Acceptability (1)	Enforceability (1)	Durability (1)	Disinclination (2)	Total BQV	Corr. BSV	Robustness	Remarks (Prev/Rec)
Total BSV (Existing):										0

Table P2: New / Future Barriers

SN	Barrier	Effectiveness (3)	Cost Benefit (1)	Practicality (1)	Acceptability (1)	Enforceability (1)	Durability (1)	Disinclination (2)	Total BQV	Corr. BSV	Robustness	Remarks (Prev/Rec)
Total BSV (New):										0

Reference Tables

Table P3: Barrier Strength Value (BSV)

Total BQV	BSV (Correlated)
0 - 9	0
10 - 17	1
18 - 25	2
26 - 33	3
34 - 41	4
42 - 50	5

Probability Determination (Optimum CBSV-Likelihood Correlation)

Severity A

Range	Val	Desc
0-7	5	Certain
8-15	4	Likely
16-23	3	Possible
24-31	2	Unlikely
32-40	1	Exc. Imp

Severity B

Range	Val	Desc
0-5	5	Certain
6-11	4	Likely
12-17	3	Possible
18-23	2	Unlikely
24-30	1	Exc. Imp

Severity C

Range	Val	Desc
0-3	5	Certain
4-7	4	Likely
8-11	3	Possible
12-15	2	Unlikely
16-20	1	Exc. Imp

Severity D

Range	Val	Desc
0-2	5	Certain
3-5	4	Likely
6-8	3	Possible
9-11	2	Unlikely
12-15	1	Exc. Imp

Severity E

Range	Val	Desc
0-1	5	Certain
2-3	4	Likely
4-5	3	Possible
6-7	2	Unlikely
8-10	1	Exc. Imp

Risk Matrix

Composite Risk Index & Tolerability

Hazard ID --

Hazard Name --

Severity --

Probability --

Composite Risk Index

Risk Tolerability

Risk Calculation Summary

Current Risk		Resultant Risk
Existing Preventive Control / Barriers		New Preventive Control / Barriers (NCB)
Barrier	BSV	Barrier	BSV	Action by whom and when
Total BSV	0	Total BSV (New)	0
		Grand Total BSV	0
Risk Probability	--	Risk Probability	--
Risk Severity	--	Risk Severity	--
Risk Index	--	Risk Index	--
Risk Tolerability	--	Risk Tolerability	--

Risk Matrix (Severity vs Probability)

5
Certain

4
Likely

3
Possible

2
Unlikely

1
Exceptional

A - Catastrophic

B - Hazardous

C - Major

D - Minor

E - Negligible

Barrier Register

Tracking and Implementation Plan

1. Existing Preventive Controls/Barriers

S.No.	Barrier Description	Hazard No.	SRM Date	Barrier Strength	Implementation Status	Action by whom and when	Follow-up date

2. Existing Recovery Controls/Barriers

S.No.	Barrier Description	Hazard No.	SRM Date	Barrier Strength	Implementation Status	Action by whom and when	Follow-up date

3. New Preventive Controls/Barriers

S.No.	Barrier Description	Hazard No.	SRM Date	Barrier Strength	Implementation Status	Action by whom and when	Follow-up date

4. New Recovery Controls/Barriers

S.No.	Barrier Description	Hazard No.	SRM Date	Barrier Strength	Implementation Status	Action by whom and when	Follow-up date

Risk Register

Assessment Summary & Risk Reduction

Hz. code	SRM Date	Description of Hazard	Consequence(s)	Existing Risk				Resultant Risk				Status		Follow up
Hz. code	SRM Date	Description of Hazard	Consequence(s)	Severity	Probability	Risk Index	Risk Tolerability	Severity	Probability	Risk Index	Risk Tolerability	Open	Close/date	Follow up

About SRA Tool

This tool facilitates the Safety Risk Assessment process.

Version 1.0.0