Title Page

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Job Name and Job Number

  • Job Supervisor

  • Project Manager

JHA

  • Date and day of week

  • Are Safety Meetings or Tool Box talks being performed?

  • Take Picture of Safety Meeting or Tool Box Topic and sign in sheet

  • Weather and Temp:

  • Crew Size

Crew Job Hazard Analysis

  • Work Description and Location for Crew :

  • Hazards Involved:

  • Tools and/or Equipment to be used:

  • Precautions to take:

  • PPE Requirements:

  • Comments or Concerns?:

  • Foreman:

  • Employee #1

  • Employee #2

  • Employee #3

  • Employee #4

  • Employee #5

  • Employee #6

  • Employee #7

  • Employee #8

  • Employee #9

  • Employee #10

  • Employee #11

  • Employee #12

  • Employee #13

  • Employee #14

  • Employee #15

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.