J.S.A. Installation of Glass

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Please add any additional information that pertains to this specific job task.

STEP 1 Open crates of glass

Hazards

• Crate Tipping

• New hazard?

  No

  Yes

Safe Work Procedures/PPE for Step 1

• Lean crate on an angle and block

STEP 2 Put glass in

Hazards

• Heavy
  Potential glass breakage

• New hazard?

  No

  Yes

Safe Work Procedures/PPE for Step 2

• Put gaskets on.
  Ensure enough man power to lift glass
  Tip into the supports and secure with screws

STEP 3

Hazards

Safe Work Procedures/PPE for Step 3

STEP 4

Hazards

Safe Work Procedures/PPE for Step 4

Job Site and Task Checklist

• Are permits required? ( hot work, confined spaces, etc. )

  No

  Yes

  N/A

• Is special training needed ( forklift, lift, etc)

  No

  Yes

  N/A

• Can weather conditions affect safety?

  No

  Yes

  N/A

• Is lighting a problem?

  No

  Yes

  N/A

• Are you in contact with acids or toxic products? ( MSDS)

  No

  Yes

  N/A

• Will there be exposure to dust, fumes or mist? ( MSDS)

  No

  Yes

  N/A

• Is the employee working with sharp or rough materials that require PPE?

  No

  Yes

  N/A

• Can the worker slip, trip or fall?

  No

  Yes

  N/A

• Do tools, machines or equipment present any hazards?

  No

  Yes

  N/A

• Can any body part get caught in, struck by, or caught between objects? This includes hands. Think before you reach.

  No

  Yes

  N/A

• Can pushing, pulling, lifting, bending or twisting cause strain?<br>

  No

  Yes

  N/A

• Is there a danger of falling objects?

  No

  Yes

  N/A

• Is excessive noise or vibration a problem?

  No

  Yes

  N/A

• Are there flammable, explosive or electrical hazards?

  No

  Yes

  N/A

• Any fall arrest hazards?

  No

  Yes

  N/A

Signatures

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign