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JOB HAZARD ANALYSIS
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JHA CONTROL & PROJECT DETAILS
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JHA numberRevisionStatusWork dateShift
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Project name
Project number
Company
Crew / Foreman
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Task titleTrade
Exact work location
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Planned start
Planned finish
Effective date
Review dateApproved by
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TASK, CONDITIONS & CREW
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WORK STEPS, HAZARDS, CONTROLS & RESIDUAL RISK
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StepWork StepHazard CategoryHazard DescriptionExisting ControlInitial LInitial SInitial RiskElimination / SubstitutionEngineering / AdministrativeRequired PPEResponsible PersonDeadlineVerifiedResidual RiskProceed?
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PERMITS, TRAINING, EQUIPMENT & EMERGENCY REQUIREMENTS
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CREW ACKNOWLEDGMENT
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EmployeeCompany
Classification
Status
Acknowledgment Date
Questions / Comments
Signature
Supervisor Initials
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STOP-WORK, CHANGED CONDITIONS, INCIDENTS & CORRECTIVE ACTIONS
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FINAL REVIEW & CLOSURE
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Prepared byForeman
Competent person
Approved by
Final review date
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Closed by
Closure date
Closure notes
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