← All templatesPrints landscape on letter paper.Fill it out on screen
Job hazard analysis

Job Hazard Analysis

Free Safety Report
Project 
Location / area 
Date 
Company 
Supervisor / competent person 
Prepared by 
Permits required 
Weather / conditions 

Job steps, hazards, and controls

#Job stepHazardsControlsBeforeAfter
1     
2     
3     
4     
5     
6     
7     
8     
Risk = likelihood × consequence (1 to 5 each).1 to 2 Negligible3 to 4 Low5 to 9 Moderate10 to 16 High20 to 25 Extreme

PPE required

Hard hat
Safety glasses with side protection
High-visibility vest
Work gloves
Safety-toe boots
Hearing protection
Face shield
Full-body harness and lanyard
Respirator
Cut-resistant gloves

Equipment in use

Ladder
Scaffold
Scissor lift
Boom lift
Forklift or telehandler
Crane
Excavator
Skid steer
Power tools
Powder-actuated tools
Torches or welding
Concrete saw
Generator
Air compressor

Emergency information

Nearest hospital 
Muster point 
Emergency contact 

Crew review. By signing, I confirm I reviewed this JHA before starting work.

#NameTrade / companySignature
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Prepared by 
Email 
Phone 
Signature
Made with the free JHA builder at FreeSafetyReport.comRun this JHA on a phone and send it to Procore: responsevault.com