Synchronous Electrical JSA

• Document No.

• Client / Site

• Location
  Address

• Job number

• Job description

• Conducted on

  Date

• Prepared by

Safe Work Method Statements (if all hazards are addressed by controls in SWMS then no further risk assessment is required)

• SWMS 1: Domestic maintenance indoor V5

  Safe

  At Risk

  N/A

• SWMS 2: Live testing V5

  Safe

  At Risk

  N/A

• SWMS 3: Isolation V5

  Safe

  At Risk

  N/A

• SWMS 5: Portable step ladder V5

  Safe

  At Risk

  N/A

• SWMS 6: Working around Asbestos V5

  Safe

  At Risk

  N/A

• SWMS 8: Manual handling V5

  Safe

  At Risk

  N/A

• Click link to review SWMS
  https://www.dropbox.com/sh/olizu6t1m7p9une/05eqVHx4It

Hazards

• 
Hazard

• Hazard

• Hazard

  Media

• Consequences before control measure

  [5] Insignificant

  [4] Minor

  [3] Moderate

  [2] Major

  [1] Catastrophic

• Likelihood before control measure

  [A] Almost Certain

  [B] Likely

  [C] Possible

  [D] Unlikely

  [E] Rare

• Risk before control measure

  Low

  Medium

  High

• Control measure

  Select 1: Eliminate 2: Substitute 3: Redesign 4: Isolate 5: Administrative 6: PPE (last resort)

  • 1: Eliminate
  • 2: Substitute
  • 3: Redesign
  • 4: Isolate
  • 5: Administrative
  • 6: PPE (last resort)

• Consequences after control measure

  [5] Insignificant

  [4] Minor

  [3] Moderate

  [2] Major

  [1] Catastrophic

• likelihood after control measure

  [A] Almost Certain

  [B] Likely

  [C] Moderate

  [D] Unlikely

  [E] Rare

• Residual risk

  Low

  Medium

  High

• Workers signature

  Sign

• Workers signature

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• Workers signature

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• Workers signature

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• Workers signature

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