Broomfield Steel Co. - Job Hazard Assessment Form

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

JHA details

• This JHA was completed by the person named above. It is everyone's responsibility to ensure all personnel present in the area are familiar with the hazards and controls described here. /Este JHA fue completado por la persona nombrada arriba. Es responsabilidad de todo asegurarse que todo el personal presente esté familiarizado con el peligro y el control descrito aquí.

• Job Name/ Nombre De Trabajo:

• Date/Fecha:

• Job/Area supervisor/ Supervisor De Trabajo/Area:

• Work area (If applicable):/Area De Trabajo (Si Aplica)

• Job Number/ Numero De Trabajo:

Task Assessment

• General work description- What is/are the primary objectives today? (for example, 'complete erection of west walls' or, 'Install all decking on second level'.)

• Common tasks, equipment, & conditions (select all that apply to the days work)

  Select None observed Load/ unload materials & equipment Staging, storing, moving, and working with materials by hand. Hot work (welding & cutting) Use of powered handheld grinder Use of ladders Use of hand & power tools Install decking Working with elevated/ suspended materials (crane or forklift) Use of demo saw Working with/ near other trades and contractors Working with active cranes Fork lift operation Working at height Use of scaffold Use of aerial lift Outdoors/ hazardous weather Asbestos, lead, or other material being worked with Co2,combustible dust, and other hazardous environments Exposure to noise levels exceeding 80 dB

  • None observed
  • Load/ unload materials & equipment
  • Staging, storing, moving, and working with materials by hand.
  • Hot work (welding & cutting)
  • Use of powered handheld grinder
  • Use of ladders
  • Use of hand & power tools
  • Install decking
  • Working with elevated/ suspended materials (crane or forklift)
  • Use of demo saw
  • Working with/ near other trades and contractors
  • Working with active cranes
  • Fork lift operation
  • Working at height
  • Use of scaffold
  • Use of aerial lift
  • Outdoors/ hazardous weather
  • Asbestos, lead, or other material being worked with
  • Co2,combustible dust, and other hazardous environments
  • Exposure to noise levels exceeding 80 dB
Additional tasks, hazards, & conditions that apply to the days work

• describe individual task (for example, removing a large underground rock may be 2 items including 'using excavator to dig' and 'use chain-fall to lift rock')

Hazard Controls

• General controls for identified hazards (select all that apply)

  Select Partner lifting loads over 50 lb. Use material handling equipment (carts, dollies, etc.) Hot Work permit Hot work PPE (safety glasses, face shield minimu tint of 7, welding gloves, FR clothing, ...) Inspect and remove damaged/ defective hand and power tools Do not place decking without securing it Flagging on active decking zones Use of fall protection equipment (100% tie-off) Inspect and confirm service on all powered equipment (fork lift, aerial lift, crane, etc.) CP inspects and is present for all active work on scaffolding systems. Scaffold inspection tags suspended worker rescue plan Monitor weather for stop-work conditions Stop-work if any material hazards are present and do not start again until the hazard has been mitigated Use atmospheric monitoring if there is any concern of a hazardous atmoshpere (e.g. forklift used indoors) Use fans and opening to establish fresh air exchange Inspect all rigging material prior to each use Only use equipment with which you are trained and proficient Stretch and bend prior to working Toe boards/ falling object protection Hearing protection Safety glasses and clear face shield Store/stage material to minimize handling and ensure safe opperation Install guard rails Setup restricted area with minimal points of access Respiratory protection Pre-work discussion with other contractors to coordinate work

  • Partner lifting loads over 50 lb.
  • Use material handling equipment (carts, dollies, etc.)
  • Hot Work permit
  • Hot work PPE (safety glasses, face shield minimu tint of 7, welding gloves, FR clothing, ...)
  • Inspect and remove damaged/ defective hand and power tools
  • Do not place decking without securing it
  • Flagging on active decking zones
  • Use of fall protection equipment (100% tie-off)
  • Inspect and confirm service on all powered equipment (fork lift, aerial lift, crane, etc.)
  • CP inspects and is present for all active work on scaffolding systems.
  • Scaffold inspection tags
  • suspended worker rescue plan
  • Monitor weather for stop-work conditions
  • Stop-work if any material hazards are present and do not start again until the hazard has been mitigated
  • Use atmospheric monitoring if there is any concern of a hazardous atmoshpere (e.g. forklift used indoors)
  • Use fans and opening to establish fresh air exchange
  • Inspect all rigging material prior to each use
  • Only use equipment with which you are trained and proficient
  • Stretch and bend prior to working
  • Toe boards/ falling object protection
  • Hearing protection
  • Safety glasses and clear face shield
  • Store/stage material to minimize handling and ensure safe opperation
  • Install guard rails
  • Setup restricted area with minimal points of access
  • Respiratory protection
  • Pre-work discussion with other contractors to coordinate work

Participation

Pre-work verification

• Sign prior to beginning work to verify you have reviewed and are aware of JHA contents and requirements

• Name & sign

  Sign

• What is your title/ role on this project?

End of shift verification

• Review prior to leaving job site, note any new or uncontrolled hazards, and sign to verify your contribution to a safe workplace

• Uncontrolled or newly identified hazards

  Select None observed Load/ unload materials & equipment Staging, storing, moving, and working with materials by hand. Hot work (welding & cutting) Use of powered handheld grinder Use of ladders Use of hand & power tools Install decking Working with elevated/ suspended materials (crane or forklift) Use of demo saw Working with/ near other trades and contractors Working with active cranes Fork lift operation Working at height Use of scaffold Use of aerial lift Outdoors/ hazardous weather Asbestos, lead, or other material being worked with Co2,combustible dust, and other hazardous environments Exposure to noise levels exceeding 80 dB

  • None observed
  • Load/ unload materials & equipment
  • Staging, storing, moving, and working with materials by hand.
  • Hot work (welding & cutting)
  • Use of powered handheld grinder
  • Use of ladders
  • Use of hand & power tools
  • Install decking
  • Working with elevated/ suspended materials (crane or forklift)
  • Use of demo saw
  • Working with/ near other trades and contractors
  • Working with active cranes
  • Fork lift operation
  • Working at height
  • Use of scaffold
  • Use of aerial lift
  • Outdoors/ hazardous weather
  • Asbestos, lead, or other material being worked with
  • Co2,combustible dust, and other hazardous environments
  • Exposure to noise levels exceeding 80 dB

• Specific hazards that are not listed?

  Yes

  No
Additional hazard

• Describe each hazard separately

• Name & signature

  Sign

• What is your title/ role on the project?

Supervisor Close-out

• ONLY complete this section after all employees have signed off and uncontrolled/ new tasks have been noted. Supervisors are responsible for ensuring that any new hazards are included and controlled the following work shift.

• Supervisor Name & Signature

  Sign