3 4 3 4 3 4 4 3 3 4 3 4 ORM ASSESSMENT WORKSHEET MISSION: SNOWMOBILE DATE WORKSHEET PREPARED: _________________ APPROVAL / AUTHORITY: _______________________ PARTICIPANT(S): APPROVED / DISAPPROVED STEP 2: ASSESS HAZARDS STEP 1. IDENTIFY HAZARDS STEP 3: MAKE RISK DECISIONS STEP 4: IMPLEMENT CONTROLS STEP 5: SUPERVISE OPERATION HAZARD CAUSES INIT RAC DEVELOP CONTROLS RESID RAC HOW TO IMPLEMENT HOW TO SUPERVISE ALL HIGH SPEED IMPACT W/ OBSTACLES 3 STAY AWAY FROM KNOWN OBSTACLES RESEARCH AREA TO USE 4 TAKE SNOWMOBILE TRAINING CLASS / KNOW ENVIRONMENT KNOW PERSONAL LIMITS / ADJUST ACTIVITY TO ENSURE SAFETY HEAD INJURY INJURY OR COLLISION W/ OTHERS OPERATING AROUND OTHERS AVOID CROWDED AREAS SCAN THE AREA PRIOR TO ENTRY – ESTAB. SAFE AREA TO OPERATE 3 4 KEEP HEAD ON SWIVLE / KEEP SA HIGH / ADJUST PLAN AS PLAN CHANGES SO MUST YOU AND YOUR ACTIVITY ALL OBSTACLES HIDDEN UNDER SNOW USE GUIDE OR MAKE DECISION TO OPERATE AT SAFE LOCALE EQUIPMENT/ BODILY INJURY 3 STUDY AREA TO USE CONSIDER LOCAL ORIENTATION COURSE IF TOO MANY OBSTACLE EXIST MOVE AWAY / STOP ALL 4 AVOID ALCOHOL TAKE WATER ALONG WITH YOU ON ACTIVITY USE APPROP. CLOTHING DRINK WATER TAKE FREQUENT REST BREAKS. ADJUST CLOTHING LAYERS LACK OF H20 / LAYERED CLOTHING 4 IF YOU ARE THIRSTY THEN YOU ARE ALREADY DEHYDRATED ALL DEHYDRATION SUN / COLD 3 POOR DRIVING SKILLS / NOT ANTICIPA. HAZARDS PLAN TO DRIVE CONSERVATIVELY AND SAFELY. ACCOMP. SAFETY CHECKS AUTO WRECK EQUIP DAMAGE 3 4 TRANSPORT / KEEP ITEMS SECURED FROM MOVEMENT CHECK STATUS OF TRAILER / GEAR / ENSURE SAFE OPS TRANSPORT ATTACK / BITE PROXIMITY / OFF TRAIL 3 HAVE FIRST AID KIT / STAY CLOSE TO TRAILS 4 KNOW FIRST AID KIT CONTENTS / MAP / HAVE COMM DEVICE SCAN FOR THREATS INFORM OTHERS WILDLIFE LESSONS LEARNED: ACCEPT RISK: YES NO COMM WITH HIGHER: YES NO ALL WORKSHEETS ARE IN COMPLIANCE WITH OR MEET THE INTENT OF CNATRA 3058/1 (5-05)