CTMD Form 1-8 "Risk Management Worksheet" - Connecticut

What Is CTMD Form 1-8?

This is a legal form that was released by the Connecticut Military Department - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2013;
  • The latest edition provided by the Connecticut Military Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CTMD Form 1-8 by clicking the link below or browse more documents and templates provided by the Connecticut Military Department.

ADVERTISEMENT
ADVERTISEMENT

Download CTMD Form 1-8 "Risk Management Worksheet" - Connecticut

497 times
Rate (4.5 / 5) 25 votes
CTMD 1-8
(Rev 4/2013)
CONNECTICUT MILITARY DEPARTMENT
INSTRUCTIONS FOR
RISK MANAGEMENT WORKSHEET
PURPOSE: To ensure safety precautions are taken in the execution of training of the Armed Forces of the State of
Connecticut
COMPLETION:
UNIT INFORMATION: Basic information of the unit executing the training
TRAINING EVENT: Name of the overall mission (ie: Weapons Qualification) and the date, time and location
of the event with the name of the individual responsible for the supervision of all training
RISK MANAGEMENT:
SUBTASK: List each subtask that is to be executed during the course of the training event
o
HAZARDS: List all potential hazards related to the subtask
o
INITIAL RISK LEVEL: Commandant’s initial assessment of the risk prior to implementing controls
o
(use Risk Assessment Matrix)
CONTROLS: Provide a description of how the hazard will be eliminated or reduced
o
RESIDUAL RISK LEVEL: Commandant’s risk assessment after controls have been implemented
o
IMPLEMENTATION PLAN: Describe how the control will be implemented
o
SUPERVISOR: Name of the individual responsible for the supervision of these controls
o
EFFECTIVENESS: Describe the effectiveness of the control upon the completion of the event and
o
include with the event After Action Review for reference in future similar events
OVERALL ASSESSMENT: Circle the overall risk assessment for this event. Use the Risk Assessment
Matrix
RISK DECISION AUTHORITY: Signature of the Commandant or his designated representative. Designated
representative must be approved prior to the submission of this worksheet
RISK ASSESSMENT MATRIX:
PROBABILITY
SEVERITY
Frequent
Likely
Occasional
Seldom
Unlikely
Catastrophic
Extremely High
Extremely High
High
High
Moderate
Critical
Extremely High
High
High
Moderate
Low
Marginal
High
Moderate
Moderate
Low
Low
Negligible
Moderate
Low
Low
Low
Low
SEND WORKSHEET & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
Military Administrative Officer
360 Broad Street – Room #113
Hartford, Connecticut, 06105-3795
(860) 548-3288 (fax)
(860) 524-4904 (alt fax)
CTMD 1-8
(Rev 4/2013)
CONNECTICUT MILITARY DEPARTMENT
INSTRUCTIONS FOR
RISK MANAGEMENT WORKSHEET
PURPOSE: To ensure safety precautions are taken in the execution of training of the Armed Forces of the State of
Connecticut
COMPLETION:
UNIT INFORMATION: Basic information of the unit executing the training
TRAINING EVENT: Name of the overall mission (ie: Weapons Qualification) and the date, time and location
of the event with the name of the individual responsible for the supervision of all training
RISK MANAGEMENT:
SUBTASK: List each subtask that is to be executed during the course of the training event
o
HAZARDS: List all potential hazards related to the subtask
o
INITIAL RISK LEVEL: Commandant’s initial assessment of the risk prior to implementing controls
o
(use Risk Assessment Matrix)
CONTROLS: Provide a description of how the hazard will be eliminated or reduced
o
RESIDUAL RISK LEVEL: Commandant’s risk assessment after controls have been implemented
o
IMPLEMENTATION PLAN: Describe how the control will be implemented
o
SUPERVISOR: Name of the individual responsible for the supervision of these controls
o
EFFECTIVENESS: Describe the effectiveness of the control upon the completion of the event and
o
include with the event After Action Review for reference in future similar events
OVERALL ASSESSMENT: Circle the overall risk assessment for this event. Use the Risk Assessment
Matrix
RISK DECISION AUTHORITY: Signature of the Commandant or his designated representative. Designated
representative must be approved prior to the submission of this worksheet
RISK ASSESSMENT MATRIX:
PROBABILITY
SEVERITY
Frequent
Likely
Occasional
Seldom
Unlikely
Catastrophic
Extremely High
Extremely High
High
High
Moderate
Critical
Extremely High
High
High
Moderate
Low
Marginal
High
Moderate
Moderate
Low
Low
Negligible
Moderate
Low
Low
Low
Low
SEND WORKSHEET & SUPPORTING DOCUMENTATION TO:
Connecticut Military Department
Military Administrative Officer
360 Broad Street – Room #113
Hartford, Connecticut, 06105-3795
(860) 548-3288 (fax)
(860) 524-4904 (alt fax)
CTMD 1-8
(Rev 4/2013)
CONNECTICUT MILITARY DEPARTMENT
RISK MANAGEMENT WORKSHEET
UNIT INFORMATION
UNIT
COMMANDANT
UNIT ADDRESS
TRAINING EVENT
DATE OF
OFFICER IN CHARGE
MISSION
START TIME
END TIME
LOCATION OF EVENT
EVENT
(OIC)
RISK
SUBTASK #1
SUBTASK #2
SUBTASK #3
SUBTASK #4
MANAGEMENT
SUBTASK:
HAZARDS:
INITIAL RISK LEVEL:
CONTROLS:
RESIDUAL RISK
LEVEL:
IMPLEMENTATION
PLAN:
SUPERVISOR:
EFFECTIVENESS:
page 2 of 3
CTMD 1-8
(Rev 4/2013)
CONNECTICUT MILITARY DEPARTMENT
RISK MANAGEMENT WORKSHEET
RISK
SUBTASK #5
SUBTASK #6
SUBTASK #7
SUBTASK #8
MANAGEMENT
SUBTASK:
HAZARDS:
INITIAL RISK LEVEL:
CONTROLS:
RESIDUAL RISK
LEVEL:
IMPLEMENTATION
PLAN:
SUPERVISOR:
EFFECTIVENESS:
OVERALL ASSESSMENT (circle one)
LOW
MODERATE
HIGH
EXTREMELY HIGH
RISK DECISION AUTHORITY
PRINTED NAME
RANK
DUTY POSITION
SIGNATURE
page 3 of 3
Page of 3