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
Assessment Type
Baseline
Routine Periodic
Pre-Operational
Post-Incident
Expansion/Modification
Decommissioning
Assessment Scope
Single Facility
Multi-Site
Regional
Product Lifecycle
Supply Chain
Other
Evaluate potential impacts on ambient air quality and atmospheric emissions generated by your operations.
Does your operation generate atmospheric emissions?
Are any air pollutants classified as persistent or toxic?
Is there potential for odour nuisance beyond site boundary?
Are greenhouse gases (GHG) emitted?
Risk Level for Air Quality Impact
Very Low
Low
Moderate
High
Very High
Rate the effectiveness of air emission controls
Very Poor
Poor
Adequate
Good
Excellent
Identify potential impacts on surface water, groundwater, and marine environments.
Do you withdraw water from natural sources?
Are any effluents discharged to the environment?
Could discharged water alter temperature or pH?
Is there potential for spills or leaks of chemicals to water?
Risk Level for Water Quality Impact
Very Low
Low
Moderate
High
Very High
Rate the following water management aspects
Very Poor | Poor | Adequate | Good | Excellent | |
|---|---|---|---|---|---|
Water use efficiency | |||||
Effluent treatment reliability | |||||
Spill prevention systems | |||||
Groundwater protection |
Assess risks of soil contamination, erosion, and land degradation.
Are hazardous substances stored on site?
Is there potential for soil contamination?
Are excavation or earthworks planned?
Could operations affect geotechnical stability?
Risk Level for Land/Soil Impact
Very Low
Low
Moderate
High
Very High
Rate the following land protection measures
Very Poor | Poor | Adequate | Good | Excellent | |
|---|---|---|---|---|---|
Secondary containment integrity | |||||
Spill response readiness | |||||
Erosion controls | |||||
Site history knowledge |
Identify waste streams, treatment methods, and potential environmental impacts.
Does your operation generate solid waste?
Are any wastes classified as hazardous?
Is waste treated on site?
Is waste disposed off site?
Risk Level for Waste Impact
Very Low
Low
Moderate
High
Very High
Rate waste management practices
Very Poor | Poor | Adequate | Good | Excellent | |
|---|---|---|---|---|---|
Waste minimisation efforts | |||||
Segregation effectiveness | |||||
Storage safety | |||||
Documentation accuracy |
Evaluate potential impacts on habitats, species, and ecosystem services.
Are sensitive ecological areas present nearby?
Could operations affect protected species?
Is there potential for noise or light disturbance to wildlife?
Could invasive species be introduced?
Risk Level for Ecological Impact
Very Low
Low
Moderate
High
Very High
Rate ecological management
Very Poor | Poor | Adequate | Good | Excellent | |
|---|---|---|---|---|---|
Habitat protection measures | |||||
Wildlife monitoring | |||||
Restoration efforts | |||||
Stakeholder engagement |
Use the matrix below to rate consequence and likelihood for each environmental aspect. Risk = Consequence × Likelihood.
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 | |
|---|---|---|---|---|---|
Air Emissions | 3 | 2 | 6 | Medium | |
Effluent Discharge | 4 | 3 | 12 | High | |
0 | |||||
0 | |||||
0 | |||||
0 | |||||
0 | |||||
0 | |||||
0 | |||||
0 |
Detail the controls already in place and any additional measures needed to reduce environmental risk.
Select control categories currently implemented
Elimination/Substitution
Engineering Controls
Administrative Controls
Personal Protective Equipment
Emergency Response
Monitoring & Inspection
Training & Awareness
Other
Describe key mitigation measures for highest risks
Are residual risks acceptable?
Outline any further actions required
Define how environmental performance and risks will be monitored, reviewed and improved over time.
Is there an environmental monitoring programme?
List key environmental indicators tracked
Review frequency
Monthly
Quarterly
Semi-Annually
Annually
Event-Driven
Other
Describe stakeholder engagement approach
I confirm this assessment was completed competently and without bias
Assessor Signature