Document no :

JOB HAZARD ANALYSIS Page 1 of 3

Task Title : ___________________________________

Location : ___________________________________
Contractor /Department : ___________________________________
Date : ___________________________________

Method : * Group discussion/ Direct observation / Recall & check

(* Delete where not applicable)

JHA Team Members : Site Visit Details:

Name Designation Sign Date Name Sign

Equipment Involved : Workers Involved :

Item no. Type of Equipment Quantity No. of Task / Occupation
workers

1
 Document no :
JOB HAZARD ANALYSIS Page 2 of 3

PPE Requirements for Task :

Note : All equipment must conform to acceptable international standard and approved by Authorised Personnel

Item Type Compulsory Item Additional Item Type Required :

(* Delete where not applicable) (* Delete where not applicable) Please Tick
Tick Yes No
Hard Hat Dust Mask

Safety Goggles/ Specs/Visor* Safety Harness & Lifeline

Ear Plugs / muffs Welding Face Shield

Rigger / Rubber gloves* Chemical Cartridge

Respirator
Safety Shoes / Boots * Positive Breathing Apparatus

Apron

Coverall

Luminous Vest

Life Jacket / buoy *

Safety Torch

Low Voltage Handlamp

110 V Electrical Equipment

240 V Electrical Equipment

with ELCB
Welding set with centre
tapped earthing

2
 Document no :
JOB HAZARD ANALYSIS Page 3 of 3

Task Title : ___________________________________________

Location : ___________________________________________
Contractor /Department : ___________________________________________
Date : ___________________________________________

Task step Potential hazard H/S/E Assessment / Threat Hazard control (Barrier) Recovery Measure

Management Endorsement : ………………………..

( For RED Risk Job ) Authorization