JHA

• JOB HAZARD ANALYSIS

• Conducted on

  Date

• JOB #

• Foreman

• Operation:

STEP BY STEP PLAN

Steps

Access Identification:

• Location

• Type

JOB HAZARD ANALYSIS

Steps:

• STEP

• WHAT IS THE WORST THAT COULD HAPPEN?

  Select Slips Trips Falls Pinch Points Muscle Dehydration Abrasions / Lacerations Crush / Pinch Points

  • Slips
  • Trips
  • Falls
  • Pinch Points
  • Muscle
  • Dehydration
  • Abrasions / Lacerations
  • Crush / Pinch Points

• If other explain

• PREVENTION PLAN? (Focus on Behavior)

• HOW ARE YOU MOST LIKELY TO GET HURT?

  Select Slips Trips Falls Pinch Points Muscle Dehydration Abrasions / Lacerations Crush / Pinch Points

  • Slips
  • Trips
  • Falls
  • Pinch Points
  • Muscle
  • Dehydration
  • Abrasions / Lacerations
  • Crush / Pinch Points

• If other explain

• PREVENTION PLAN? (Focus on Behavior)

• OTHER RISKS TO BE AWARE OF?

• PREVEN TION PLAN? (Focus on Behavior)

ERGONOMIC RISKS

• Ergonomic Risk:

  Select Lifting Repetitive Motion Vibration Awkward Position

  • Lifting
  • Repetitive Motion
  • Vibration
  • Awkward Position

STRATEGIC RISKS

• Equipment

  Select Evident Risk Needs Special Planning Needs Addition Safety Training Crane Forklift Aerial Lift Rail Equipment

  • Evident Risk
  • Needs Special Planning
  • Needs Addition Safety Training
  • Crane
  • Forklift
  • Aerial Lift
  • Rail Equipment

• Exposure to Falls

  Select Evident Risk Needs Special Planning Fall Protection

  • Evident Risk
  • Needs Special Planning
  • Fall Protection

• Vehicle Traffic

  Select Evident Risk Needs Special Planning Flagger

  • Evident Risk
  • Needs Special Planning
  • Flagger

• Night Work

  Select Evident Risk Needs Special Planning Flagger

  • Evident Risk
  • Needs Special Planning
  • Flagger

• Live Trains

  Select Evident Risk Needs Special Planning RWP / Track Access EIC / POC

  • Evident Risk
  • Needs Special Planning
  • RWP / Track Access
  • EIC / POC

• Lock-Out / Tag-out

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Power Tools

  Select Evident Risk Needs Special Planning Needs Additional Safety Training Cut-off Saw Circular Grinder Jack Hammer Chain Saw Chipping Gun Sawzall Other:

  • Evident Risk
  • Needs Special Planning
  • Needs Additional Safety Training
  • Cut-off Saw
  • Circular
  • Grinder
  • Jack Hammer
  • Chain Saw
  • Chipping Gun
  • Sawzall
  • Other:

• Underground Utilities

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Trench / Excavation

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Falsework / Shoring

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Confined Spaces

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Overhead Powerlines

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Electrical

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Critical Lift Plan

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Hazardous Materials

  Select Evident Risk Needs Special Training Needs Additional Safety Training Respiratory Protection Silica Awareness Lead Awareness HAZWOPER Other:

  • Evident Risk
  • Needs Special Training
  • Needs Additional Safety Training
  • Respiratory Protection
  • Silica Awareness
  • Lead Awareness
  • HAZWOPER
  • Other:

• Other:

• MSDS Attached?

  Yes

  No

  N/A

• Public Safety

  Select Evident Risk Needs Special Planning

  • Evident Risk
  • Needs Special Planning

• Other Safety Risks?

UNIQUE PPE

• REQUIRED PPE

  Select Harness / Lanyard Face Shield / Goggles Leather / Kevlar Chaps Toe / Foot Guards Ear Plugs / Muffs Respiratory Protection Cutting Googles Welding Hood Welding Leathers Life Vest

  • Harness / Lanyard
  • Face Shield / Goggles
  • Leather / Kevlar Chaps
  • Toe / Foot Guards
  • Ear Plugs / Muffs
  • Respiratory Protection
  • Cutting Googles
  • Welding Hood
  • Welding Leathers
  • Life Vest

• 

• 

• Other:

PERMITS

• Permits Required

  Select Traffic Control RWP / Track Access Excavation / Dig One-Call (Utility locates) Confined Space Hot Work Scaffolding

  • Traffic Control
  • RWP / Track Access
  • Excavation / Dig
  • One-Call (Utility locates)
  • Confined Space
  • Hot Work
  • Scaffolding

• Other:

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