Job Hazard Analysis Form

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OSHA 10

Job Hazard Analysis

Department:

Date:

Location:

Job Title:

Job Performed by:

Analysis by:

Page __ of __

Supervisor:

Approved by:

Work Process

Potential for Hazards/Injury Sources

Safe Action of Procedure (PPE)

Hazard Selection for the middle column: SB= Struck By, SA = Struck Against, CBY = Contacted By, CI = Caught in, CB = Caught Between, CO = Caught On, FB = Fall to Below,

EH=Electrical Hazard, C=Cuts, CW = Contacted With, O = Overexertion or Repetitive Motion, BR = Bodily reaction E = Exposure to Chemical, Noise etc.