Information

  • Jobsite Name

  • Conducted on

  • Foreman

  • Location

JHA

Site Information

  • Job Name

Personal Protective Equipment Checked

  • Personal Protective Equipment Checked

  • Hard Hat

  • Safety Glasses

  • Cutting Goggles

  • Face Shield

  • Respirator

  • Hand Protection

  • Ear Plugs

  • Fall Protection

  • Tie Off Cables

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

  • 1. Sequence of basic job step in order

  • 1. Safety Controls used to reduce or eliminate hazards

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

  • 2. Sequence of basic job step in order

  • 2. Safety Controls used to reduce or eliminate hazards

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

  • 3. Sequence of basic job step in order

  • 3. Safety Controls used to reduce or eliminate hazards

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

  • 4. Sequence of basic job step in order

  • 4. Safety Controls used to reduce or eliminate hazards

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

  • 5.Sequence of basic job step in order

  • 5. Safety Controls used to reduce or eliminate hazards

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

  • 6. Sequence of basic job step in order

  • 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

  • Prepared By

Attendees

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Reviewed By

  • Date

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.