Information
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Site Name
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Conducted on
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Completed by
Site Job Safety Analysis
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Date
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Site Address
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Building Name / Level Details:
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To help identify site specific hazards not included in JSAs, for sites receiving multiple visits form to be completed weekly and by each technician.
Staff are to view and refresh themselves of the tasks to be undertaken and identify the hazards and controls against task in order to safely complete work to be carried out. -
JSA task codes to be followed are:
- CI - Commercial Inspection
- DEC - Decontamination
- WA - Working Alone
- DS - Drive to/from Site
- SS - Site Survey
- SAS - Soil Assessment & Sampling
- RSI - Residential Site Inspection
- RSS - Residential Site Sampling
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The location of first aid kit = Vehicle
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The assembly location in event of emergency = Vehicle
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PPE available and in use
- P3 Half Face
- Safety Glasses
- HiViz
- Steelcap Footwear
- Hearing Protection
- P3 Full Face
- Disposable Suit
- Disposable Boots
- Hard Hat
Additional Site Specific Hazards
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Are there any additional hazards?
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Please detail hazard and method of risk control
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Add media
Operation of field based equipment
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1. Manual handling
2. Electrical safety
3. Access
4. Ladder safety -
Are there any unidentified hazards?
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Please detail hazard and method of risk control
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Add media
5. Any onsite inductions to be completed?
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Have onsite inductions been completed?
Job Sign Off
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All CES employees and sub-contractors involved in the JSA have been trained and briefed in the processes.
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All CES employees and sub-contractors working on site have discussed site specific Hazards and are understanding of agreed controls
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All visitors have been fully briefed and are aware of Hazards and controls
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CES Name / Signature
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Add media
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Name / signature
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Name / signature
