Wes 3.2 job safety analysis (jsa) form checklist
Daily tailboard discussion
What does this form include?
This form contains 12 sections:
1.0 check applicable anticipated or potential hazards
- Activities in or near traffic areas
- Live Electrical work, including high test voltages or current
- Lifting heavy objects
- Other (specify) :
2.0 critical procedures: where work involves any of the following hazards must be incorporated into JSA
- Work at heights above 6ft
- Confined space entry
3.0 Training Requirements
- OSHA Safety and Health
- MSHA Safety and Health
- CPR and First Aid
- Site Specific
4.0 Site Safety Checklist
- Safe Ladder procedures
- Hazardous Materials - MSDS
- Lockout / Tagout
- Grounding Procedures
- Condition of tools & cords
- First Aid Station / Hospital location
- Fire extinguisher location
- Strap & Tie down safety checks
5.0 Tools / Equipment ( list of tools and equipment and their storage on site
6.0 Personal Protective Equipment
- Hard Hat, eye protection, safety boots required?
- Hearing protection required?
- Fall protection required?
- Fire Retardant clothing required?
- High Visibility Vest required?
- Portable gas monitor required?
- Breathing Apparatus required?
Other
Client Representative (when required)
List all WES personnel onsite
JSA approved
date Date
Use this template