List groups of people who could be affected: What numbers of people are involved? What existing precautions are in place to reduce risks? Risk level with existing precautions No. Risk level with What additional actions are required to ensure precautions are implemented/effective or to reduce the risk further? additional precautions No. Is health surveillance required? YES/NO If YES, please detail: Who will be responsible for implementing By When: precautions: Inspection Form Date: Building & room number: Type: Make: Mode: 1 Max Serial No.: Power: Class Class Class Class Precautions 2M Class 4 1 1M 2 3R 3B Remote Interlock Key Control Emission indicator Beam Shutter Beam Stop Beam Level
List groups of people who could be affected: What numbers of people are involved? What existing precautions are in place to reduce risks? Risk level with existing precautions No. What additional actions are required to ensure precautions are implemented/effective or to reduce the risk further? Risk level with additional precautions No. Is health surveillance required? YES/NO If YES, please detail: Who will be responsible for implementing precautions: By When: Inspection Form Date: Building & room number: Type: Make: Mode: 1 Serial No.: Max Power: Precautions Class 1 Class 1M Class 2 2M Class 3R 3B Class 4 Remote Interlock Key Control Emission indicator Beam Shutter Beam Stop Beam Level
Risk-Assessment-forms_Research_July16.docx