WME Job Safety Analysis

JSA Details

Individuals involved with the development of the JSA

Click "Add Personnel" to enlist names & roles

Personnel

• Full Name & Role

Work Permits / Authorizations Required
Select the applicable work permit(s) / authorization(s) required

Enter other work permit

Safety Equipment Required

MC_PPE.jpg
Select the applicable safety equipment(s) required for the job
Competencies & Trainings

List down applicable competencies & training to carry out individual tasks (Enumerate)

Equipment Check & Special Considerations

List down checked equipments & any special considerations (Enumerate)

Job Safety Analysis & Risk Assessment

Job Step / Tasks and Risk Analysis

Click "Add Job Step / Task" to enlist the job steps / tasks, hazards, controls & risk ratings

Job Step / Task

• Step in Process / Task

• Hazards

People
Work Environment
Environmental
Equipment / Plant / Machinery

• Existing Controls

• Initial Risk Analysis

Consequence

Likelihood

Risk Rating

VLOW.jpg

LOW.jpg

MEDIUM.jpg

HIGH.jpg

Additional Controls

• Residual / Revised Risk Analysis

VLOW.jpg

LOW.jpg

MEDIUM.jpg

HIGH.jpg

VHIGH.jpg

VHIGH.jpg

Additional Controls

• Residual / Revised Risk Analysis

VLOW.jpg

LOW.jpg

MEDIUM.jpg

HIGH.jpg

VHIGH.jpg
JSA Acknowledgement & Completion

Status of the JSA

JSA conducted by (Name and Signature)

NOTE: If there are changes or if the JSA is incomplete, REVIEW the whole JSA and initiate the Task Review below.

Task Review

Were any additional hazards identified while doing the task?

Were hazards and controls have been added to the JSA form?

• Has a copy been filed in the central filing system?

• Is a Permit to Work required?

• Does a procedure need amending as a result of this JSA?

• Does the JSA trigger a training need?

Reviewed by Area / Manager (Name and Signature)
Supervisor Authorization (Name and Signature)

Personnel Details

Click "Add Personnel" to enlist names & signatures of those who were involved with the JSA

Personnel
Name and Signature