SafetyCulture Staff

Preliminary Hazard Analysis Template

Use this comprehensive preliminary hazard analysis template to identify potential hazards early in the planning or design stages of a project, process, or system. Empower your PHA team and promote accountability by allowing them to assign immediate responses to responsible personnel. This checklist covers 1) Process overview; 2) Hazard identification; 3) Risk assessment matrix; and 4) Action plan for hazard identification.

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Preliminary Hazard Analysis Overview

Process/Project Name
PHA Team Lead
PHA Team Members
Project Location/Facility
Date of Inspection

Process Overview

Process Description
Process Flow Diagram (Attach file if available.)
List of Equipment and Materials Used

Hazard Identification

Name of Task
Hazard Description
Consequence
Probability of Risk (5x5 Risk Matrix)
Impact of Risk (5x5 Risk Matrix)
Current Control Measures

Action Plan for Hazard Mitigation

Name of Task
Recommended Action/Control (Assign person and deadline)
Status
Completion Date

Sign-off

Preliminary Hazard Analysis Reviewed By
Designation of the Reviewer
Reviewer's Comment or Feedback
Date Reviewed
Next Scheduled PHA Template Review (At least within the next 6 months)

SafetyCulture Staff

Preliminary Hazard Analysis Template

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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.