Environmental Risk Assessment Form

1. Assessment Overview & General Information

Complete this form to systematically identify and evaluate environmental risks associated with your operations. Provide accurate information to support effective environmental management and risk mitigation.

Assessment Title

Facility/Project Name

Brief Description of Operations

Assessment Location

Assessment Start Date

Assessment Completion Date

2. Air Quality & Emissions

Evaluate potential impacts on ambient air quality and atmospheric emissions generated by your operations.

Does your operation generate atmospheric emissions?

Yes

No

Are any air pollutants classified as persistent or toxic?

Yes

No

Describe control measures and monitoring protocols

Is there potential for odour nuisance beyond site boundary?

Yes

No

Are greenhouse gases (GHG) emitted?

Yes

No

3. Water Resources & Discharges

Identify potential impacts on surface water, groundwater, and marine environments.

Do you withdraw water from natural sources?

Yes

No

Are any effluents discharged to the environment?

Yes

No

Could discharged water alter temperature or pH?

Yes

No

Describe mitigation measures

Is there potential for spills or leaks of chemicals to water?

Yes

No

Rate the following water management aspects

	Very Poor	Poor	Adequate	Good	Excellent
Water use efficiency
Effluent treatment reliability
Spill prevention systems
Groundwater protection

4. Land & Soil Quality

Assess risks of soil contamination, erosion, and land degradation.

Are hazardous substances stored on site?

Yes

No

Is there potential for soil contamination?

Yes

No

Are excavation or earthworks planned?

Yes

No

Could operations affect geotechnical stability?

Yes

No

Rate the following land protection measures

	Very Poor	Poor	Adequate	Good	Excellent
Secondary containment integrity
Spill response readiness
Erosion controls
Site history knowledge

5. Waste Generation & Management

Identify waste streams, treatment methods, and potential environmental impacts.

Does your operation generate solid waste?

Yes

No

Are any wastes classified as hazardous?

Yes

No

Is waste treated on site?

Yes

No

Is waste disposed off site?

Yes

No

Rate waste management practices

	Very Poor	Poor	Adequate	Good	Excellent
Waste minimisation efforts
Segregation effectiveness
Storage safety
Documentation accuracy

6. Ecology & Biodiversity

Evaluate potential impacts on habitats, species, and ecosystem services.

Are sensitive ecological areas present nearby?

Yes

No

Could operations affect protected species?

Yes

No

Is there potential for noise or light disturbance to wildlife?

Yes

No

Could invasive species be introduced?

Yes

No

Rate ecological management

	Very Poor	Poor	Adequate	Good	Excellent
Habitat protection measures
Wildlife monitoring
Restoration efforts
Stakeholder engagement

7. Risk Evaluation Matrix

Use the matrix below to rate consequence and likelihood for each environmental aspect. Risk = Consequence × Likelihood.

Risk Matrix

Environmental Consequence Scale: 1 = Insignificant, 2 = Minor, 3 = Moderate, 4 = Major, 5 = Catastrophic

Environmental Likelihood Scale: 1 = Rare, 2 = Unlikely, 3 = Possible, 4 = Likely, 5 = Almost Certain

	Environmental Aspect	Consequence (1 = Insignificant, 5 = Catastrophic)	Likelihood (1 = Rare, 5 = Almost Certain)	Risk Score	Risk Rank
	A	B	C	D	E
1	Air Emissions	3	2	6	Medium
2	Effluent Discharge	4	3	12	High
3				0
4				0
5				0
6				0
7				0
8				0
9				0
10				0

8. Mitigation & Control Measures

Detail the controls already in place and any additional measures needed to reduce environmental risk.

Describe key mitigation measures for highest risks

Are residual risks acceptable?

Yes

No

Outline any further actions required

9. Monitoring, Review & Continuous Improvement

Define how environmental performance and risks will be monitored, reviewed and improved over time.

Is there an environmental monitoring programme?

Yes

No

List key environmental indicators tracked

Describe stakeholder engagement approach

I confirm this assessment was completed competently and without bias

Assessor Signature