Information

  • Department / Area

  • Task being performed

  • Conducted on

  • Prepared by

Job Hazard Analysis

Step by Step Hazard Evaluation

Steps

  • Describe the overall job task or job title being performed.

  • Describe what happens during the first step of the task.

  • Describe what happens during the next step of the task.

  • Describe what happens during the next step of the task.

  • Describe what happens during the next step of the task.

  • Describe what happens during the next step of the task.

  • List the type of Hazard(s)

  • Impact hazard?

  • Chemical hazard?

  • Penetration hazard?

  • Compression hazard?

  • Electrical hazard?

  • Thermal hazard?

  • Ergonomic hazards?

  • Misc. hazards?

  • Describe any other hazards not listed?

  • Can the hazard(s) be reduced or eliminated without the use of PPE?

  • Describe how to reduce or eliminate the hazard.

Risk Evaluation

  • What are the "Consequences"?

  • What is the "Likelihood" of an unsafe event happening?

  • Overall Risk Level of this step (Consequence X Likelihood)

PPE Assessment

  • PPE Requirements

  • Other PPE not listed above?

  • Is the employee performing the task wearing the proper PPE?

  • If Not, Why?

Additional Safety Requirements

  • Are there any additional Safety Requirements for this job task?

  • Other?

Additional information about this JHA?

  • Additional photos

  • Contributing Factors that present a hazard or may cause this task to be unsafe?

  • Any other "Contributing Factors"

Signatures

  • Employee signature

  • Lead signature

  • Supervisor signature

  • EHS Manager signature

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.