How to Supervise Evaluate OPERATIONAL RISK ASSESSMENT WORKSHEET Mission/Task: Mission Date: Date Prepared: Page: Prepared By: Personnel & Position Phase of Mission or Task: Step 3 Develop Controls & Make Risk Decisions Step 1 Identify Hazard Step 2 Assess Hazard Residual Risk Step 4 How to Implement Step 5 How to Supervise Evaluate Evaluate (AAR) Risk Decision Authority: Determine overall mission/task risk level after controls are implemented (Circle one): LOW (L) MODERATE (M) HIGH (H) EXTREMELY HIGH (E)

SAMPLE OPERATIONAL RISK ASSESSMENT WORKSHEET I. M. Tough Mission/Task: 1 2 Mission/Task: Mission Date: Date Prepared: 3 Page: 4 Film Water Safety Video at Oura Wan Beach 26 Jan 09 16 Jan 09 1 of 1 5 Prepared By: Personnel & Position Shawn Curtis, Occupational Safety & Health Specialist 6 Phase of Mission or Task: Entire evolution of activity Step 1 Step 2 Step 3 Assess Residual Step 4 Step 5 Evaluate Identify Hazard Hazard Develop Controls Risk How to Implement How to Supervise (AAR) 7 8 9 10 11 12 Safety Specialist/ Water 13 Provide lifeguard support. Have Coordinate w/ local MCCS Safety & Lifeguard Wave surges SAMPLE B-I RAC-1 safety boats in water. Keep Rescue B-III RAC-3 lifeguards to assist. Utilize Instructor on site. Rescue equip. on site to include Blankets, only experienced swimmers first aid kit, O2, & spine board boats with operators & in the water for scenes. lifeguards Coordinate w/ local MCCS Safety Specialist/ Water A-I RAC-1 Contact Japanese weather service C-III RAC-4 lifeguards to assist. Utilize Safety & Lifeguard Currents for conditions. Inform RAS of only experienced swimmers Instructor on site. Rescue activities on beach. in the water for scenes. Stay out boats with operators & of water if conditions are unsafe. lifeguards B-1 RAC-1 Contact Japanese weather service Safety Specialist/ Water Do enter water during hazardous sea states . Sea Conditions & Oura Wan Boating for C-III RAC-4 Safety & Lifeguard conditions. Instructor and Boating Manager on site. Ensure people are clear of the Launching & boat, trailer & vehicle during Have boat staff conduct Safety Specialist/ Water C-II RAC-3 launching& recovering operations. D-III RAC-5 launch & recover Safety & Lifeguard recovering Utilize radios during boating operations. Train people who Instructor and Boating Watercraft operations to keep comm. with boat will assist prior to task. Manager on site. house. Risk Decision Authority: Determine overall mission/task risk level after controls are imp lemented (Circle one): 15 14 I. M. Tough LOW (L) MODERATE (M) HIGH (H) EXTREMELY HIGH (E)

OPERATIONAL RISK ASSESSMENT WORKSHEET GUIDE BLOCK 1. Mission/Task – Briefly describe the intent of the activity. 2. Mission date – Enter date when the activity is planned to begin and when it is planned to be completed. 3. Date prepared – Enter year/month/day the worksheet was prepared. 4. Page – Enter the page number. Depending on the number of hazards identified, you may have additional pages. 5. Prepared by – Enter the rank, last name and position of the person who prepared the worksheet. 6. Phase of mission or task – Put the portion of the activity being conducted. 7. Identify hazards – Identify hazards that are most likely to result in accidental injury, damage, or mission degradation. 8. Assess hazards – Determine the risk of each hazard by applying the Risk Assessment Code for each hazard. Use the Risk Assessment Matrix to get the code. 9. Develop controls – For each hazard, develop one or more controls to eliminate or reduce the risk. 10. Determine residual risk – For each hazard, determine the Risk Assessment Code to establish the level once the control measures are identified. Use the Risk Assessment Matrix. 11. Implement controls – For each control listed in block 9 how will it be put into effect and/or communicated to the personnel who will make it happen. 12. Supervise – Enter how each control will be monitored to ensure it is implemented. 13. Evaluate – After the exercise is completed, determine the effectiveness of each control to reduce the risk of the targeted hazard. Enter “yes” if the control was effective. Enter “no” if the control was not effective. For each control that was not effective, determine why and document what to do the next time this hazard is identified. 14. Overall risk level after controls are implemented – This is the same as the hazard with the highest residual risk for the exercise. 15. Risk decision authority – Enter the rank, name, and position of the decision making authority for the level of risk involved in block 13.

2 A 1 3 4 5 I II III IV B C D RISK ASSESSMENT MATRIX Probability A - Likely to occur immediately or within short period of time. B - Probably will occur in time. C - May occur in time. D - Unlikely to occur. Severity I - May cause death, loss of facility/asset. II - May cause sever injury illness, property damage. III - May cause minor injury, IV – Minimal threat. RISK ASSESSMENT MATRIX 1. Accept risk when the benefit is greater than the cost. 2. Accept no unnecessary risk. 3. Anticipate and manage risk by planning. 4. Make risk decisions at the right level 2 A Likely 1 3 4 5 I II III IV B Probable C May D Unlikely P R O B A B I L I T Y Risk ASSESSMENT Matrix MCO 3500.27B Death, Loss of Asset Severe Injury, Damage Minor Injury, Minimal Threat 1-Critical 2-Serious 3-Moderate 4-Minor 5-Negligible S E V E R I T Y