JHA

Site Information

Job Name

Personal Protective Equipment Checked

Personal Protective Equipment Checked

Hard Hat

Safety Glasses

Foam Lined Safety Glassed

Cutting Goggles

Face Shield

Welding Hood

Welding Sleeves

Respirator

Leather Gloves

Ear Plugs

Rebar Positioning

Fall Protection

Tie Off Cables

OSHA Approved Stantions

Full Body Harness Inspected

Lanyard Inspected

Date

Site Number/ Name

General Contractor

Project Lead

Ensure all hazards identified are addressed in the JHA below.

1. Sequence of basic job step in order

1. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

1. Safety Controls used to reduce or eliminate hazards

2. Sequence of basic job step in order

2. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

2. Safety Controls used to reduce or eliminate hazards

3. Sequence of basic job step in order

3. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

3. Safety Controls used to reduce or eliminate hazards

4. Sequence of basic job step in order

4. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

4. Safety Controls used to reduce or eliminate hazards

5.Sequence of basic job step in order

5. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

5. Safety Controls used to reduce or eliminate hazards

6. Sequence of basic job step in order

6. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

6. Safety Controls used to reduce or eliminate hazards

7. Potential Hazards. (Ex. site conditions, falls, cuts, slips trips, housekeeping)

7. Sequence of basic job step in order

7. Safety Controls used to reduce or eliminate hazards

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Date
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.