Job Hazard Analysis

• Project Name

• Project Number

• Work Activity/Work Task

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Instructions:
  -------------------------------------
  
  1. Answer "Adequate or Inadequate" for the questions below.
  2. Fill out required fields and answer other questions as needed.
  3. Add photos and notes/comments by clicking on the paperclip icon.
  4. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
  5. Complete audit by providing a digital signature.
  6. Share your report by exporting as PDF, Word, Excel or Web Link.

JOB HAZARD ANALYSIS

• To start the job hazard analysis click "Add Step"

Step

• Identify the Step

• Hazard ( Considerations to: People, Equipment, Material, Environment, Tools,(Chemical, Biological, Physical, Hygiene and Ergonomics )

• Pre-control Risk Rating

  Low

  Medium

  High

• Control

• Post Control Risk Rating

  Low

  Medium

  High

• Controls Verified

  Yes

  No

• Scroll up and click + to add more

REVIEWED BY:

• Supervisor:

  Sign

• Foreman:

  Sign

• Safety rep:

  Sign

SPECIAL REVIEW BY:

• Name and Signature

  Sign

CREW REVIEWED WITH SIGNATURES

• CREW REVIEWED: (to add name and signature of Crew who reviewed the JHA, click Add Crew)

Crew

• Name and Signature of Crew

  Sign

• click + to add more

JOB HAZARD ANALYSIS AUDIT

• Work Activity/Work Task Description

  Adequate

  Inadequate

• Steps Identified

  Adequate

  Inadequate

• Hazard Identification

  Adequate

  Inadequate

• Pre/Post control Risk Rating

  Adequate

  Inadequate

• Hazard Controls

  Adequate

  Inadequate

• Controls Verified

  Adequate

  Inadequate

• All sections completed

  Adequate

  Inadequate

• Review Signatures Required

  Adequate

  Inadequate

• Crew Signatures

  Adequate

  Inadequate

• JHA at task location

  Adequate

  Inadequate

COMPLETION

• Auditor’s Name and Signature

  Sign