Job Hazard Analysis (JHA) Information

  • Job Title

  • Document No.

  • Date Created

  • Location
  • Supervisor Name

  • Supervisors Number

  • Prepared by

  • Division

  • Branch

  • Branch

  • Branch

  • Work Center

  • Work Center

  • Work Center

  • Office

Risk Assessment

Hazards identified and controls implemented.

  • List the major steps of the task.

  • Step
  • Describe Step.

  • Identify and assess hazards.

  • Hazard
  • Injury Code.

  • Hazard associated with injury code.

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

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

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

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

  • Describe


Personal Protective Equipment

  • Is PPE Required

  • Select PPE Required


  • Is Training Required?

  • Type of Training

  • "Other" Specified


  • Is Special Equipment Required?

  • Select

Inspection Requirements

  • Are there requirements to conduct inspections?

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.