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Job Hazard Analysis Form

This document contains a job hazard analysis template for evaluating potential hazards in job procedures. It includes sections for documenting the job/task procedures, observations, descriptions of identified hazards, and recommendations for hazard control and remedial actions. Emergency procedures are also outlined for responding to injuries at the work site. The overall process involves identifying tasks, observing them for hazards, researching potential issues, discussing with workers, and determining appropriate controls.

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Charl Regencia
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© © All Rights Reserved
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18 views

Job Hazard Analysis Form

This document contains a job hazard analysis template for evaluating potential hazards in job procedures. It includes sections for documenting the job/task procedures, observations, descriptions of identified hazards, and recommendations for hazard control and remedial actions. Emergency procedures are also outlined for responding to injuries at the work site. The overall process involves identifying tasks, observing them for hazards, researching potential issues, discussing with workers, and determining appropriate controls.

Uploaded by

Charl Regencia
Copyright
© © All Rights Reserved
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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COMPANY :

ADDRESS :
DEPARTMENT :
LOCATION :
OCCUPATION:
JOB/TASK TITLE :
DATE PREPARED :

JOB HAZARD ANALYSIS (JHA)

JOB/TASK PROCEDURES JOB/TASK OBSERVATION HAZARDS DESCRIPTION HAZARD CONTROL/REMEDIAL


EVALUATION ACTION
Eng'g. / Adm. / PPE Controls
Step 1:

Step 2:

Step 3:

Step 4:

Step 5:

Step 6:

Step 7:

Emergency Procedures/Instructions
Work supervisors are responsible for developing and discussing field emergency evacuation procedures (EEP) and alternatives in the
event a person(s) becomes seriously ill or injured at the work site, as follows:
1. Shut off all working machine at the accident site / Pull at once the workers in the Confined Space.
2. Evaluate the condition of the injured but do not move the injured.
3. Seek medical assistance at once.
4. Prepare the emergency vehicle (Always on stand-by)
5. Prepare the accident report.

APPROVED BY: Date:


_______________________________
TITLE/POSITION:
JOB HAZARD ANALYSIS PROCESS

JOB/TASK PROCEDURE - Identify all the task/job procedures associated with the job classification

JOB/TASK OBSERVATION - Observe each task procedure and make sure that each jobs step is examined thoroughly
for the following:
1. The workers action for each specific step; ;
2. The materials used
3. The equipment used and
4. The condition under which the step is performed.

HAZARD DESCRIPTION - Identify all known or suspect hazards associated with each job procedure after each
job/task observation.
a. Research past accidents/incidents.
b. Research the Health and Safety Code, OSHS and other appropriate standards.
c. Discuss the work activity with workers

HAZARD CONTROL - Identify appropriate actions to reduce or eliminate the hazards identified in HAZARD
DESCRIPTION. Abatement measures listed below are in the order of the preferred
abatement method.
a. Engineering Controls (the most desirable method of abatement).
c. Administrative Controls. For example, limiting exposure by reducing the work schedule;
establishing appropriate procedures and practices.
d. PPE (least desirable method of control; For example: safety shoes, hearing protection,
hand gloves.)
hedule;

ction,

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