Jsa checklist
Job safety analysis
What does this form include?
This form contains 11 sections:
Describe task
What is the hazard Type/s? Select as many as apply Physical, e.g. moving vehicles, falling objects, stairwells Environmental, e.g. chemical exposure, extreme temperature, noise, weather Chemical, e.g. ammonia, gas Biological, e.g. fungus, virus, legionnaire’s disease Psychological e.g. stress, fatigue, relationships Ergonomic e.g. work station, equipment, locations of task and users
Hazard Assessment
- Risk Before - move slider to determined pre-control risk level
Add media
List the hazards that the contractor is introducing to site
Assigned Workers
contractor JSA
Finalised Date Date
Review Date Date
Completion Date Date
Use this template