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JOB SAFETY ANALYSIS FORM
JOB DESCRIPTION #JSA #:
NEW JOBLOCATIONNEWCUSTOMERREVISEDTASKSCHANGES TO REVIEWED MSDS (CHEMICALS)PRIME CONTRACTOR:DATE
SHIFT START
YESNONASUPERVISOR:HAZARDSRECOMMENDED CONTROLS
A
A
A
A
A
A
RANK
B
B
B
B
B
B
BC
C
C
C
C
C
CRANK:
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How to fill out job safety analysis
How to fill out job safety analysis
01
Identify the job or task to be analyzed.
02
Break down the job or task into individual steps.
03
Identify potential hazards associated with each step.
04
Determine all possible control measures to eliminate or reduce the risks.
05
Document the findings and review with workers performing the job.
Who needs job safety analysis?
01
Employers in any industry where workers are exposed to potential hazards on the job.
02
Safety managers and supervisors responsible for ensuring a safe work environment.
03
Workers who want to understand the risks associated with their job and how to mitigate them.
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What is job safety analysis?
Job safety analysis is a process used to identify and reduce risks in the workplace by breaking down tasks into steps, identifying hazards, and implementing control measures.
Who is required to file job safety analysis?
Employers are required to conduct and file job safety analysis for all tasks that have potential hazards.
How to fill out job safety analysis?
Job safety analysis can be filled out by breaking down tasks into steps, identifying hazards for each step, and implementing control measures to mitigate risks.
What is the purpose of job safety analysis?
The purpose of job safety analysis is to prevent workplace accidents and injuries by identifying potential hazards and taking steps to eliminate or reduce them.
What information must be reported on job safety analysis?
Job safety analysis should include a description of the task, steps involved, potential hazards, control measures, and the individuals responsible for implementing the control measures.
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