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    JHA Template Blank

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    Christopher Newby
    This document is a job hazard analysis for a project. It outlines potential hazards and risks associated with different job steps, as well as corrective actions, required training, permits, and safety equipment. Personal protective equipment, chemical hazards, emergency plans, and safety checklists are also addressed to help identify and mitigate risks for the work.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    JHA Template Blank

    Uploaded by

    Christopher Newby
    696 views5 pages
    This document is a job hazard analysis for a project. It outlines potential hazards and risks associated with different job steps, as well as corrective actions, required training, permits, and safety equipment. Personal protective equipment, chemical hazards, emergency plans, and safety checklists are also addressed to help identify and mitigate risks for the work.

    Original Description:

    Job Hazard Analysis Template

    Copyright

    © © All Rights Reserved

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    DOCX, PDF, TXT or read online from Scribd

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    This document is a job hazard analysis for a project. It outlines potential hazards and risks associated with different job steps, as well as corrective actions, required training, permits, and safety equipment. Personal protective equipment, chemical hazards, emergency plans, and safety checklists are also addressed to help identify and mitigate risks for the work.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    696 views5 pages

    JHA Template Blank

    Uploaded by

    Christopher Newby
    This document is a job hazard analysis for a project. It outlines potential hazards and risks associated with different job steps, as well as corrective actions, required training, permits, and safety equipment. Personal protective equipment, chemical hazards, emergency plans, and safety checklists are also addressed to help identify and mitigate risks for the work.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5
    At a glance
    Powered by AI
    The document discusses job hazards analysis and safety procedures for various tasks.

    The document appears to be analyzing potential job hazards and listing corrective actions/mitigations for safety.

    Potential hazards identified include contact with hazardous materials, being struck by objects, slips/trips/falls, overexertion from lifting/pulling/pushing.

    CB&I JOB HAZARD ANALYSIS

    Date: Project # and Name: 1321771104 VC PM/HSO: JHA#:


    Summer
    Work Type (Task):
    Development Team: Master Revision Rev#: 0
    (maintain hard copies on site
    for audit)
    Equipment / Tools / Materials Personal Protective Equipment Reason for JHA Revision
    Required

    Potential Risks /
    Step Job Steps Corrective Actions / Mitigation
    Hazards
    1

    CMS-710-05-FM-01700-VCS Page 1 of 5
    CB&I JOB HAZARD ANALYSIS
    Step
    Job Steps Potential Risks / Corrective Actions / Mitigation
    Hazards
    4

    Stop Work Authority All on-site personnel are empowered, expected, and have the responsibility to stop their own work and
    the work of co-workers, or other contractors if any persons safety or the environment is at risk. NO negative repercussions will
    result from this action.

    Chemicals Description/Health Hazards

    CMS-710-05-FM-01700-VCS Page 2 of 5
    CB&I JOB HAZARD ANALYSIS

    Required Training: Required Permit(s): Other Information:

    CMS-710-05-FM-01700-VCS Page 3 of 5
    CB&I JOB HAZARD ANALYSIS

    JSA Hazard Checklist


    Potential Hazards
    Chemical Exposure Ignition Sources Fire/Explosion
    Hazardous Atmosphere Pressure Spills
    Confined Spaces Lifting Slips/Trips
    Noise Overhead Chips/Slivers
    Working/Walking Surfaces Falls Pinch Points
    Environment/Weather Machinery Hot Surface
    Arc/Flash Heat Stress Simultaneous
    Open Hole
    Other -

    Hazard Controls and Emergency/Contingency Plans

    Personnel Protective Equipment Spill Control/Contingency Plan


    Physical Barriers Fire Fighting
    Safety Equipment Emergency Evacuation Procedures
    Ignition Source Controls Eyewash/Safety Shower Location
    Lock Out Tag Out Material Safety Data Sheets
    Required Work Permits Simultaneous Operations
    Fall Protection/Open Hole Policy Hot Bolting Policy
    Other
    Describe:

    Safety Equipment Required


    Hard Hats Work Vest/Life Jacket Respirator
    Safety Shoes Full Body Harness Fire Extinguisher
    Safety Glasses Double Lanyard w/ Shock Fire Retardant Tarps
    Face Shield Absorber
    Life Line Lock Out Tag Out
    Devices
    Goggles Safety Cable Gas Detector
    Cotton Gloves Safety Barricade Hearing Protection
    Leather Gloves Caution Tape Adsorbent Pads
    Rubber/Chemical Clothing Containment Pans
    Chemical Apron Work Permit Proper Tools
    Other
    Describe:

    CONTACT WITH Will the task put you in STRUCK BY Can you be struck by moving objects,
    contact with hazardous energy/materials- flying objects or falling material?
    electricity, chemicals, heat, cold radiation,
    gases or fumes, water, steam, or poor air
    quality?
    STRIKE AGAINST Can you strike your body CAUGHT IN, ON, OR BETWEEN Can you be caught in,
    against stationary, moving, protruding, sharp or on, or between anything? Look for pinch points,
    jagged objects? protruding objects, moving and fixed objects.
    SLIPS, TRIPS, OR FALL Can you slip, trip or OVEREXERTION (LIFTING, PULLING, PUSHING) Does the
    fall? Will the fall be to the same level or a task involve lifting, pulling or pushing? Is there a
    lower level? possibility for over exerting or straining yourself? Is the
    CMS-710-05-FM-01700-VCS Page 4 of 5
    CB&I JOB HAZARD ANALYSIS
    job highly repetitive?

    CMS-710-05-FM-01700-VCS Page 5 of 5

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