Audit
Job Task
Picture of Task
Where does the task occur?
Are there hazards associated with the job?
Hazards Identified
Hazard Identification
Hazard
Other Contributing Factors
Hazard Controls
Can the hazards be eliminated?
Engineered Controls
Engineered Control
Are all hazards able to be eliminated?
Hazards Not Eliminated
Hazard
Personal Protective Equipment
Is Personal Protective Equipment needed?
Gloves
Goggles
Respirator
Long Sleeves
Pants
Work Boots
Apron
Hard Hat
Body Harness
Arc Flash Protection
Other
Procedure to Complete:
Evaluated Steps to Complete Task
Step
Employees
Signature
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