Job Hazard Analysis

Job Hazard Analysis (JHA) Information

• Job Title

• Document No.

• Date Created

  Date

• New

  Revision
• Location
  Address

• Supervisor Name

• Supervisors Number

• Prepared by

• Division

  Facilities Management Division

  Facilities Engineering & Acquisitions Division

  Production Division

  Environmental Division

  Admin and Staff

• Branch

  Requirements Branch

  Asset Management Branch

• Branch

  Engineering Branch

  Construction Management

  Acquisitions

• Branch

  Facility Maintenance and Sustainment Branch

  Utilities & Energy Managment

  Base Vehicle and Equipment Maintenence

• Work Center

  Select AC&R and Boilers Plumbers Electronics Low Voltage Sign Shop Locksmith Shop Steel Shop Builder/Carpentry Shop Waste Water Treatment Plant Tool Room Administrative

  • AC&R and Boilers
  • Plumbers
  • Electronics
  • Low Voltage
  • Sign Shop
  • Locksmith Shop
  • Steel Shop
  • Builder/Carpentry Shop
  • Waste Water Treatment Plant
  • Tool Room
  • Administrative

• Work Center

  Select Water Treatment Plant NAS 1 Water Treatment Plan NAS 2 Water Distrobution Waste Water Treatment Plant NAS 1 Waste Water Treatment Plant NAS 2 High Voltage Commodity Manager Admin/Staff

  • Water Treatment Plant NAS 1
  • Water Treatment Plan NAS 2
  • Water Distrobution
  • Waste Water Treatment Plant NAS 1
  • Waste Water Treatment Plant NAS 2
  • High Voltage
  • Commodity Manager
  • Admin/Staff

• Work Center

  Select Operations Light/Heavy Mechanic Shop Cranes Body/Paint Shop Machine Shop Admin/Staff Tool Room

  • Operations
  • Light/Heavy Mechanic Shop
  • Cranes
  • Body/Paint Shop
  • Machine Shop
  • Admin/Staff
  • Tool Room

• Office

  Safety

  Department Suite

  Financial

Hazards identified and controls implemented.

• List the major steps of the task.

Step

• Describe Step.

• Identify and assess hazards.

Hazard

• Injury Code.

  Select Struck-By Struck-Against Caught Between Contact-With Contact-By Caught-On Caught-In Fall Same Level Fall to Below Overexertion Exposure

  • Struck-By
  • Struck-Against
  • Caught Between
  • Contact-With
  • Contact-By
  • Caught-On
  • Caught-In
  • Fall Same Level
  • Fall to Below
  • Overexertion
  • Exposure

• Hazard associated with injury code.

• Yes

  No

  N/A

• What is the likelihood of a injury, illness or property damage occurring?

  Likely Very Soon

  Probably in Time

  May Occur in TIme

  Unlikely to occur

• Yes

  No

  N/A

• If a injury, illness or Property Damage were to occur how severe would it be?

  Catastrophic

  Critical

  Moderate

  Negligible

• Yes

  No

  N/A

• Using Risk Assessment Matrix, what is the Risk Assessment Code?

  Critical

  Serious

  Moderate

  Minor

  Negligible

• Select the type of control you will use to mitigate the risk and describe.

  Elimination

  Substitution

  Engineering Controls

  Administrative Controls

  Personal Protective Equipment

• Describe

Personal Protective Equipment

• Is PPE Required

  Yes

  No

• Select PPE Required

  Select Eye Protection Head Protection Face Protection Hearing Protecion Respiratory Protection Foot Protection Hand Protection Body Protection Fall Protection Arc Flash Protection

  • Eye Protection
  • Head Protection
  • Face Protection
  • Hearing Protecion
  • Respiratory Protection
  • Foot Protection
  • Hand Protection
  • Body Protection
  • Fall Protection
  • Arc Flash Protection

Training

• Is Training Required?

  Yes

  No

• Type of Training

  Select Safety Brief On The Job Training Web Based Training Instructor Led Training Other (Specify)

  • Safety Brief
  • On The Job Training
  • Web Based Training
  • Instructor Led Training
  • Other (Specify)

• "Other" Specified

Equipment

• Is Special Equipment Required?

  Yes

  No

• Select

  Select Ladder Scaffolding Manlift Trench Box/ Shoring Portable Ventalaion Fall Arrest System Barricades/Fencing Fall Restraining System Temporary Guard Rail System Lock Out Tags and Locks Material Handling Equipment Weight Handling Equipment

  • Ladder
  • Scaffolding
  • Manlift
  • Trench Box/ Shoring
  • Portable Ventalaion
  • Fall Arrest System
  • Barricades/Fencing
  • Fall Restraining System
  • Temporary Guard Rail System
  • Lock Out Tags and Locks
  • Material Handling Equipment
  • Weight Handling Equipment

Inspection Requirements

• Are there requirements to conduct inspections?

  Hourly

  Daily

  Weekly

  Special (Specify)

  None