Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Was the JSA presented and explained to any new personnel arriving after the job had started?
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Is there a JSA for each task being performed?
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Was the JSA discussed and written in the area where the work is being performed?
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Is there 3-5 job steps listed?
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Are specific hazards, including hand and finger hazards, adequately identified?
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Are mitigations listed for each hazard?
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Has everyone performing the job task signed the JSA?
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Is general information such as location, date, job description, etc., written accurately?
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Are emergency procedures and specifics listed accurately?
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Was SIMOPS considered with potential hazards and mitigations identified?
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Was the JSA updated if any condition or job scope changed or new hazards identified?
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Was Stop Work Authority discussed during the JSA?
