HAZOP Worksheet Template | MMRisk

Project Name

Facility / Site

Study Leader

Scribe

P&ID Reference

Study Date(s)

Session No.

Page ___ of ___

Team Member 1

Team Member 2

Team Member 3

Team Member 4

Team Member 5

Team Member 6

Node: _________________________________________________

Node ID: __________ Drawing Ref: __________

Design Intent:

Dev #	Guide Word	Parameter	Deviation	Possible Causes	Consequences	Existing Safeguards	Risk (L×C)	Recommendations	Action By
1
2
3
4
5
6
7
8

Risk Matrix & Definitions

Risk Ranking Matrix (L × C)

	CONSEQUENCE
LIKELIHOOD	1 Negligible	2 Minor	3 Moderate	4 Major	5 Catastrophic
5 - Almost Certain	M	M	H	H	H
4 - Likely	L	M	M	H	H
3 - Possible	L	L	M	M	H
2 - Unlikely	VL	L	L	M	M
1 - Rare	VL	VL	L	L	M

Risk Response

H - High: Immediate action required. Unacceptable risk.

M - Medium: Action within 6-12 months. ALARP review.

L - Low: Manage by routine procedures.

VL - Very Low: Monitor only. Acceptable risk.

Likelihood Definitions

Rating	Description	Frequency
5	Almost Certain	Once per year or more
4	Likely	Once per 1-10 years
3	Possible	Once per 10-100 years
2	Unlikely	Once per 100-1000 years
1	Rare	Less than once per 1000 years

Consequence Definitions

Rating	People	Asset/Environment
5	Multiple fatalities	>R100M damage, Major env impact
4	Single fatality or permanent disability	R10-100M damage
3	Serious injury requiring hospital	R1-10M damage
2	Minor injury, first aid treatment	R100K-1M damage
1	No injury

📋 Action Items Summary

Action #	Dev Ref	Action Description	Responsible	Priority	Target Date	Status	Close Date
1
2
3
4
5
6
7
8

Prepared By (HAZOP Leader)

Name: _________________ Date: _________

Reviewed By (Process Owner)

Name: _________________ Date: _________

Approved By (Management)

Name: _________________ Date: _________