The Job Hazard Analysis And Safe Work Procedure Form
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1his Job Hazard Analysis and Safe Work Procedure Form needs to be used with the Field Level Hazard Assessment (FLHA) Form
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Job Hazard Analysis (JHA)
Safe Work Procedure (SWP)
Identified Task:
1. Can any body part get caught in or between objects?
9. Is lighting a problem?
2. Do tools, machines or equipment present any hazards?
10. Can weather conditions affect safety?
3. Can the worker make harmful contact with objects?
11. Is harmful radiation a possibility?
4. Can the worker slip, trip or fall?
12. Can contact be made with hot, toxic or caustic
substances?
5. Can the worker suffer strain from lifting, pushing or pulling?
13. Are there dusts, fumes, mists or vapours in the air?
6. Is the worker exposed to extreme heat or cold?
14. Is there a risk of contact with electricity?
7. Is excessive noise or vibration a problem?
Tools/Equipment Required:
8. Is there danger from falling objects?
Material Required:
Date:
Page:_____ of _____
Steps
Sequence of Steps
Potential Incidents or
Controls in Place
Instructions:
Hazards
Identify Controls or Combination of Controls That Are in
The Job Hazard Analysis must be completed prior to the
Place
development of the Safe Work Procedure.
Engineering
Administration
PPE
Developed by:
Reviewed by:
Revised by:
Approved by:
Comments:
Job Hazard Analysis with Safe Work Procedure
hb Working Safety Solutions
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Parent category: Business