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Job Hazard Analysis Checklist
Section 1: General Information
1. 1. Foreman
2. 2. Weather/Conditions
3. 3. Job Steps to be performed
Section 2: Human Performance
1. 1. First Time Evolution
Yes
No
N/A
2. 2. Lack of Experience/Apprentice
Yes
No
N/A
3. 3. Near by Work Activities
Yes
No
N/A
4. 4. Mix Up Potential
Yes
No
N/A
Section 3: PPE
1. 1. Hard Hat
Yes
No
N/A
2. 2. Safety Glasses
Yes
No
N/A
3. 3. Safety Boots / Steel Toed Boots
Yes
No
N/A
4. 4. Gloves
Yes
No
N/A
5. 5. FR Clothing
Yes
No
N/A
6. 6. Face Shield
Yes
No
N/A
7. 7. Welding PPE
Yes
No
N/A
8. 8. Face shield
Yes
No
N/A
9. 9. Arc Rated PPE
Yes
No
N/A
Section 4: Permits
1. 1. Confined Space
Yes
No
N/A
2. 2. Hot Work
Yes
No
N/A
3. 3. Excavation
Yes
No
N/A
4. 4. Line Breaking
Yes
No
N/A
5. 5. Critical Lift
Yes
No
N/A
6. 6. Permit Notes
Section 5: Emergency Equipment
1. 1. Fire Extinguisher
Yes
No
N/A
2. 2. Eye Wash
Yes
No
N/A
3. 3. Safety Shower
Yes
No
N/A
4. 4. Evacuation Route/Reporting Area
5. 5. Emergency Phone
Section 6: Hazard Recognition
1. 1. Fall Protection
Yes
No
N/A
2. 2. Fall Prevention
Yes
No
N/A
3. 3. Hole Covers
Yes
No
N/A
4. 4. Life Lines
Yes
No
N/A
5. 5. Anchorage Point
Yes
No
N/A
6. 6. Struck By/Pinch Points
Yes
No
N/A
7. 7. Visibility
Yes
No
N/A
8. 8. Slips/Trips
Yes
No
N/A
9. 9. Work Area Notes
10. 10. GFCI Required
Yes
No
N/A
11. 11. Quarterly Inspection of Electrical Tools
Yes
No
N/A
12. 12. Guards and Handles In place
Yes
No
N/A
13. 13. Tools Required for the job
Yes
No
N/A
14. 14. Adequate Lighting
Yes
No
N/A
15. 15. Flammables/Combustibles
Yes
No
N/A
16. 16. Fire Blanket
Yes
No
N/A
17. 17. Flash Shielding
Yes
No
N/A
18. 18. Lead Paint/Coatings
Yes
No
N/A
19. 19. Potential Asbestos Identified
Yes
No
N/A
20. 20. Hexavalent Chromium
Yes
No
N/A
21. 21. Other Heavy Metals
Yes
No
N/A
22. 22. Heat/Cold Stress
Yes
No
N/A
23. 23. Barricading Necessary
Yes
No
N/A
24. 24. Proper Signage
Yes
No
N/A
25. 25. Environmental Conditions to Note
Section 7: Competent Person Identified
1. 1. Rigging/Signaling
2. 2. Scaffolding
3. 3. Confined Space
4. 4. Fall Protection
5. 5. Excavations
6. 6. Electrical
7. 7. Notes
Section 8: Equipment Necessary
1. 1. Crane
Yes
No
N/A
2. 1. Crane
Yes
No
N/A
3. 2. Aerial Lift/Scissor Lift
Yes
No
N/A
4. 2. Aerial Lift/Scissor Lift
Yes
No
N/A
5. 3. Fork Lift
Yes
No
N/A
6. 3. Fork Lift
Yes
No
N/A
7. 4. Training Verified
Yes
No
N/A
8. 4. Training Verified
Yes
No
N/A
9. 5. Overhead Hazards
Yes
No
N/A
10. 5. Overhead Hazards
Yes
No
N/A
11. 6. Make sure to complete pre operational checks and document
12. 6. Make sure to complete pre operational checks and document
13. 7. Other Hazard Notation/Mitigation
14. 7. Other Hazard Notation/Mitigation
Section 9: Job Task Assessment-1
1. 1. Ladders
Yes
No
N/A
2. 1. Ladders
Yes
No
N/A
3. 2. Barricades
Yes
No
N/A
4. 2. Barricades
Yes
No
N/A
5. 3. LOTO
Yes
No
N/A
6. 3. LOTO
Yes
No
N/A
7. 4. Housekeeping
Yes
No
N/A
8. 4. Housekeeping
Yes
No
N/A
9. 5. Electrical Cords/Tools
Yes
No
N/A
10. 5. Electrical Cords/Tools
Yes
No
N/A
11. 6. Fall Protection
Yes
No
N/A
12. 6. Fall Protection
Yes
No
N/A
13. 7. Hand Tools
Yes
No
N/A
14. 7. Hand Tools
Yes
No
N/A
15. 8. Fire Extinguisher
Yes
No
N/A
16. 8. Fire Extinguisher
Yes
No
N/A
17. 9. Do check if item not applicable
Yes
No
N/A
18. 9. Do check if item not applicable
Yes
No
N/A
Section 10: Job Task Assessment-2
1. 1. Protection from falls
Yes
No
N/A
2. 1. Protection from falls
Yes
No
N/A
3. 2. Protection from electrocution/shock
Yes
No
N/A
4. 2. Protection from electrocution/shock
Yes
No
N/A
5. 3. Proper PPE for task
Yes
No
N/A
6. 3. Proper PPE for task
Yes
No
N/A
7. 4. Walkways clear
Yes
No
N/A
8. 4. Walkways clear
Yes
No
N/A
9. 5. Work area picked up and orderly
Yes
No
N/A
10. 5. Work area picked up and orderly
Yes
No
N/A
11. 6. Ladders used correctly
Yes
No
N/A
12. 6. Ladders used correctly
Yes
No
N/A
13. 7. Protection from Pinch/Crush Points
Yes
No
N/A
14. 7. Protection from Pinch/Crush Points
Yes
No
N/A
15. 8. Using tools correctly
Yes
No
N/A
16. 8. Using tools correctly
Yes
No
N/A
17. 9. Cords in good condition
Yes
No
N/A
18. 9. Cords in good condition
Yes
No
N/A
19. 10. Protection from hot work
Yes
No
N/A
20. 10. Protection from hot work
Yes
No
N/A
21. 11. Task Assessment Notes
22. 11. Task Assessment Notes
Section 11: Post Shift Review
1. 1. Was anyone injured In the cource of working today or did any unplanned event occur which could result in injury or loss? If so, explain below and ensure it has been reported to your Project Manager and Safety Manager.
Yes
No
N/A
2. 1. Was anyone injured In the cource of working today or did any unplanned event occur which could result in injury or loss? If so, explain below and ensure it has been reported to your Project Manager and Safety Manager.
Yes
No
N/A
3. 2. Explanation
4. 2. Explanation
5. 3. Suggestions for Improvement
6. 3. Suggestions for Improvement