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Job Safety Analysis: complete before commencing task
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Work Steps & Hazard Analysis
List each work step, identify hazards, rate the risk (Likelihood × Consequence), document controls and rate residual risk.
| # | Work Step | Hazards | Risk L×C | Control Measures | Residual Risk | Responsible |
|---|---|---|---|---|---|---|
| 1 | Access to work area | Ground conditions, mobile equipment, restricted access | Check ground support, confirm clearance, pedestrian exclusion | |||
| 2 | Ground support inspection | Falls of ground, loose rock, strata failure | Bar down loose, install temporary support, no-go zones | |||
| 3 | Equipment setup | Pinch points, electrical, stored energy | Lockout/tagout, pre-start check, competent operator | |||
| 4 | Task execution | Dust/silica, noise, heat stress, rotating parts | PPE, ventilation, hydration, guarding in place | |||
| 5 | Material handling | Manual handling, falling objects, mobile plant | Mechanical aids, exclusion zones, spotter | |||
| 6 | Area clean-up / make safe | Residual hazards, unstable ground, loose materials | Inspect area, barricade if required, report conditions |
PPE Requirements
Tick all PPE items required for this task.
Additional Hazards
Record any additional hazards not covered above.
| Hazard | Risk L×C | Control Measures | Residual Risk | Responsible |
|---|---|---|---|---|
Worker Sign-On
All workers must read the JSA and sign on before commencing work.
| # | Name | Company | Signed | Date |
|---|---|---|---|---|
| 1 | ||||
| 2 | ||||
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| 10 |
Declaration
I declare that this Job Safety Analysis has been completed for the task described above. All identified hazards have been assessed and control measures documented. All workers listed above have been briefed on the hazards and controls and have signed on before commencing work.