Information

  • JOB HAZARD ANALYSIS

  • Conducted on

  • JOB #

  • Foreman

  • Operation:

STEP BY STEP PLAN

    Steps

Access Identification:

  • Location

  • Type

JOB HAZARD ANALYSIS

    Steps:
  • STEP

  • WHAT IS THE WORST THAT COULD HAPPEN?

  • If other explain

  • PREVENTION PLAN? (Focus on Behavior)

  • HOW ARE YOU MOST LIKELY TO GET HURT?

  • If other explain

  • PREVENTION PLAN? (Focus on Behavior)

  • OTHER RISKS TO BE AWARE OF?

  • PREVEN TION PLAN? (Focus on Behavior)

ERGONOMIC RISKS

  • Ergonomic Risk:

STRATEGIC RISKS

  • Equipment

  • Exposure to Falls

  • Vehicle Traffic

  • Night Work

  • Live Trains

  • Lock-Out / Tag-out

  • Power Tools

  • Underground Utilities

  • Trench / Excavation

  • Falsework / Shoring

  • Confined Spaces

  • Overhead Powerlines

  • Electrical

  • Critical Lift Plan

  • Hazardous Materials

  • Other:

  • MSDS Attached?

  • Public Safety

  • Other Safety Risks?

UNIQUE PPE

  • REQUIRED PPE

  • ppe 1.jpg
  • ppe 2.jpg
  • Other:

PERMITS

  • Permits Required

  • Other:

REVIEWED BY (please print name legibly): DO NOT SIGN IF REVERSE SIDE IS BLANK!

    Signature
  • Name

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.