Navigate / EASA

GM2 NCO.SPEC.105 Checklists

ED Decision 2014/016/R

TEMPLATE FORMS

The following templates are examples, which could be used for developing checklist.

(a)     Template Form A — Risk assessment (RA)

Date:                                RA of   Responsible:

Purpose:

Type of operation and brief description:

Participants, working group:

Preconditions, assumptions and simplifications:

Data used:

Description of the analysis method:

External context:

—          Regulatory requirements

—          Approvals

—          Environmental conditions (visibility, wind, turbulence, contrast, light, elevation, etc.; unless evident from the checklists)

—         Stakeholders and their potential interest

Internal context:

—          Type(s) of aircraft

—          Personnel and qualifications

—          Combination/similarity with other operations/SOPs

—         Other RA used/considered/plugged in

Existing barriers and emergency preparedness:

Monitoring and follow up:

Description of the risk:

Risk evaluation:

Conclusions:

 

(b)     Template Form B — Hazard identification (HI)

Date:                   HI of  Responsible:

Phase of operation

Haz ref

Hazard / accidental event

Cause / threat

Current Treatment Measures (TM)

Further treatment required

TM

ref

Comment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Haz ref:             A unique number for hazards, e.g., for use in a database

TM ref:              A unique number for the treatment method

 

(c)      Template Form C — Mitigating measures

Date:………………..   RA of  Responsible:………………………

Phase of operation

Haz ref

Hazard/ accidental event

Current Treatment Measures (TM)/ controls

TM

ref

L

C

Further treatment required

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Haz ref:             A unique number for hazards, e.g., for use in a database

TM ref:              A unique number for the treatment method

L:                         Likelihood (probability)

C:           Consequence

 

(d)     Template register A — Risk register

Ref

Operation/ Procedure

Ref

Generic hazard

Ref

Accidental event

Treatment/ control

L

C

Monitoring

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

L:           Likelihood (probability)

C:           Consequence

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