JSA - Substation

• Site Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Do all personnel have:

• EH rated footwear

• Hard Hat

• Change Request

  Yes

  No

  N/A

• Electrical levels of protection needed?

  Yes

  No

  N/A

Prior to arrrival

• Do all personnel have:

• EH rated footwear

• Hard Hat

• Change Request

  Yes

  No

  N/A

• Tools required

  Yes

  No

  N/A