Information

  • Document No.

  • Conducted on

  • Prepared by ;

  • Location

JOB HAZARD ANALYSIS / JHAs are valid for the duration of the task.

  • Hazzards

  • Spot the hazard,
    Assess the risk,
    Make the changes

  • Title of TASK:

  • Task and Equipment

  • Date and Time:

  • Contractor

  • Location

  • Supervisor:

  • Name & Sign:

  • competent person writing JHA

  • Name & Sign:

JOB SAFETY ANALYSIS

  • Job Step No / Hazards / Control Measures.

  • Job Step

  • Step
  • Add Job Steps

  • Hazards
  • Add Hazards

  • Control Measures

Team Members Name & Sign "Must read and agree to the JSA before signing onto it as it is a legal binding contract.

    Team Members
  • Name & Sign.

JSA Reviewed / Changes made & Approved

  • Date & Time:

  • Job Step
  • Job Step:

  • Description of Change
  • Change:

  • New Controls:

  • New Controls
  • New Controls:

  • Add media

  • Chance Approved

  • Change Approved
  • Name $ Sign:

  • Date & Time:

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.