1. Organization and Unit Location:
HHC, 4-1 BSTB
Page
01
of
03
2. Mission:
CS Chamber
3. DTG Begin:
200900OCT08
4. DTG End:
211700OCT08
5. Date Prepared:
25 SEP 08
6. Operational Phase in which the Mission/Task will be conducted:
7. Prepared by: (Name/Rank/Duty Position
8. Subtask 9. Hazards 10. Assess the
Initial Risk Hazards:
(Analyze the hazards
using FM 5-19 to
determine Probability
& Severity)
11. Developed Control Measures for Identified Hazards:
(Specific measures taken to reduce the probability and severity of
a hazard)
12. Make Residual
Risk Decisions:
(Risk level after the
precautions applied)
13. How to
Implement the
Controls:
(Include SOPs and
Opns Orders, etc.)
14. How to
Supervise
(Who):
15: Were
Controls
Effective?
(Be Specific)
L M H E
(Be Specific)
L M H E
(Be Specific) (Be Specific)
Dismounted
Movement
Dehydration & heat
injuries
Snake & insect bites
X
X
- Safety Brief
Prior heat injuries identified
- Soldiers carry hydration systems and/or water on
course
- Shaded break area available on course
- Additional water available on course
- Evacuation vehicle on standby
- CLS w/aid bags will be on course
- RSO w/CLS patrols
- NCO supervision of active squads on course
- Safety brief
- Soldiers with allergies to bees identified and epi-kits
carried on person
- Evacuation vehicle on standby
- RSO w/CLS patrols
- Medics w/aid bags will be on course
X
X
OIC will give
safety brief prior
to start outlining
safety measures
available, Squad
NCOs and RSO
will supervise
troops on course
OIC will give
safety brief prior
to start outlining
safety measures
available, Squad
NCOs and RSO
will supervise
troops on course
All leaders
All leaders
14. Remaining Risk Level After Control Measures Are Implemented:
(CHECK HIGHEST REMAINING RISK LEVEL)
LOW MODERATE HIGH EXTREMELY HIGH
15. SAFETY OFFICE REVIEW:
16. RESIDUAL RISK DECISION AUTHORITY: Extremely High Risk (Commanding General), High Risk (Brigade Commander), Moderate Risk (Battalion Commander), and Low Risk
(Company Commander)
PHUONG H. NGUYEN
CPT, CM
SIGNATURE:_________________________________________________________________________________________________________ Commanding
(Signature indicates that the appropriate risk decision authority was notified of the initial risk level, control measures taken and approves the Residual Risk level)
Looking for more documents like this one?AskTOP.net Leader Development for Army Professionals
