Job Hazard Analysis (JHA) Checklist

Use this Job Hazard Analysis to fully understand all the hazards created or encountered and the plan to mitigate them.

Question Response Type
1. Please indicate the area of work. Text Answer
2. Please indicate any potential hazards created by performing this task. Text Answer
3. What measures will be taken to safely perform this task? Text Answer
4. Will this task create a hazard to personnel working in the area? Yes No N/A
5. If so, what are the measures provided to ensure the safety of all nearby personnel? Text Answer
6. Does this task require any special PPE to ensure the safety and protection of all personnel involved in the task? Yes No N/A
7. If so, what PPE will be utilized? Text Answer
8. Has this plan been reviewed with the onsite safety manager or superintendent? Yes No N/A

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