Incident Risk Assessment Worksheet 1. Incident/Activity Name 2. Location Prescribed Fire Identification of Hazards and 3. Name and Title of Analyst 4. Date Risk Assessment 6. Mitigation or Abatement Action 5. Pre-Mitigation (Engineering, Administrative, PPE, Avoidance, 7. Post-Mitigation Education, etc) 9. 10. 12. 13. 15. 11. 14. 8. Hazard Hazard Severity Hazard Severity Acceptable RAC RAC Probability Code Probability Code Yes/No Personnel will meet physical requirements established for regular firefighting duties with Qualifications current training and qualifications & Training Leadership will meet prescribed burn qualifications as outlined for pile burning Provide briefings and tailgate safety session prior to operation Document briefings on unit log or comparable document Determine and clarify firing order for firing and holding groups Explain leadership responsibilities and expectations from group leaders Determine hazards, and mitigation protocol Tailgate Safety Briefing to limit exposure Discuss expected fire behavior, and plans for an escape Discuss weather, Escape Routes, Safety Zones Discuss communication plan for firing group, and holding group tactical frequencies Discuss Emergency Plan outlined in burn plan and Risk Assessment for burn Discuss mop-up standards for holding group
Incident Risk Assessment Worksheet 1. Incident/Activity Name Prescribed Fire 2. Location Identification of Hazards and Risk Assessment 3. Name and Title of Analyst 4. Date 5. Pre-Mitigation 6. Mitigation or Abatement Action (Engineering, Administrative, PPE, Avoidance, Education, etc) 7. Post-Mitigation 8. Hazard 9. Hazard Probability 10. Severity Code 11. RAC 12. Hazard Probability 13. Severity Code 14. RAC 15. Acceptable Yes/No Qualifications & Training Personnel will meet physical requirements established for regular firefighting duties with current training and qualifications Leadership will meet prescribed burn qualifications as outlined for pile burning Tailgate Safety Briefing Provide briefings and tailgate safety session prior to operation Document briefings on unit log or comparable document Determine and clarify firing order for firing and holding groups Explain leadership responsibilities and expectations from group leaders Determine hazards, and mitigation protocol to limit exposure Discuss expected fire behavior, and plans for an escape Discuss weather, Escape Routes, Safety Zones Discuss communication plan for firing group, and holding group tactical frequencies Discuss Emergency Plan outlined in burn plan and Risk Assessment for burn Discuss mop-up standards for holding group
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