Job safety analysis (jsa) checklist
Warwick edwards plumber & gasfitter
What does this form include?
This form contains 9 sections:
Worksite Set-up
- Pedestrian management assessed
- Traffic Management assessed
- Appropriate signage and guarding utilised
Assess/review the job and it's surrounds
- Presence of snakes, spiders and sharps assessed
- Sufficient traffic and pedestrian access
- All appropriate PPE on site
- Weather conditions suitable
- Light sufficient for all tasks
Accessing Customer Premises
- Ground surfaces assessed for trips and slips
- Noise, electrical and chemical hazards assessed
- Presence of dogs, wasps and gases assessed
- Exposed asbestos assessed
- Breathing protection used in concealed/confined spaces
- Isolation of electrical hazards assessed
- 3rd party present for concealed/confined space access
- Working at heights assessed
- CPE assessed as safe
Additional site hazards
- Are there any additional site hazards?
- If Yes, please complete Hazards and Control
Additional Site Hazards
Additional Site Controls
Signed
Date and Time Date
Photos Attatched
Use this template