longjob hazard analysis template

7/28/2019 LongJob Hazard Analysis Template

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Job Hazard Analysis (JHA) Template

Site / location: Permit to work (PTW) or contractnumber:

Prepared by: Date prepared:

Job description:

Environment Energy (Hazard) GroupsTargets Aspects ImpactAir Dust, fumes Air pollutionWater Spills of Oil, chemicals Water pollutionLand/Soil Erosion, spills Soil pollutionFlora & Fauna Damage CulturalHeritageWaste disposal Location,recycling Resource usageNoise Equipment noise, operations NoisepollutionFire Hot work Bush fire

Energy ExplanationManual handling Li fting a chain or sl ingMach inery & too ls Unguarded bench gr inderVehicles & mobile equip Impact from vehicle, forklift,cranePressure Compressed AirFalling objects/people Welding rod, people, open pitSound & vibration Noise/vibrat ion f rom

jackhammerElectricity Extension cord, overhead lines

Energy ExplanationRadiation Welding, NDT testing, SunHeat & cold Oxy Cutting, hot workChemicals Solvents, fumes, dustFire & explos ion Gases in confined spacesBiological organisms Hepatitis B, cooling towersPsychological/Social stress Witness a death,excessive hoursPhysical environment Weather, confined space

CONSEQUENCE (Impact)

LIKELIHOOD1.

Insignificant2.

Minor3.

Moderate4.

Major5.

Disaster6.

Extreme

A.Almostcertain

High High Extreme Extreme Extreme Extreme

B.Likely Moderate High High Extreme Extreme Extreme

C.Possible Low Moderate High High Extreme Extreme

D.Unlikely Low Moderate High High Extreme Extreme

E.Rare Low Low Moderate High High Extreme

F.Extremely

rareLow Low Low Moderate Moderate High

Company Procedures PPE Required

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Asbestos management SWP 10.1Chemical Cleaning SWP 10.6Concealed Services SWP 7.3Confined Spaces SWP 7.5Cranes and Lifting SWP 11.5Diving Permit SWP 7.6Electrical Safety SWP 12.2Emergency Planning EMPLIA-05First Aid SWP 5.5Flammable LiquidsGas Storage and Transport SWP 11.4Hazardous Chemical Control SWP 10.6Hot work SWP 7.4

Hydraulic Spanner SWP 11.5Lead/ Mercury SWP 10.6Manual Handling SWP 10.3Oil transfer SWP 10.6Painting SWP 11.2Permit to Work/Lockout Tag-out SWP 7.1Personal Protective Equipment SWP 10.2Portable Electrical Equipment SWP 12.2Scaffolding, Ladders, Mobile Platforms SWP

12.1 Transport Plan SWP 13.5Working at Heights SWP 12.1

Mask

Safety Glasses

Safety Helmet

Boots

Gloves

FumeExtraction

Clothing

Dust

Face Shield

Hair net

Steel caps

Riggers

Fans

Welding Jacket/Hood

P1 P2

Goggles

WeldingHelmet

Gumboots

Welding

Heaters

DisposableOveralls

Respirator

Chemical

Rubber

ChemicalOveralls

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LIKELIHOOD - The probability that the identified consequence will occur, taking into account proximity and exposure to the hazardA. Almost certain The most likely and expected result. Up to 1 in 10 chance.B. Likely Would not be unusual. Up to 1 in 100 chance.C. Possible Unusual but possible sequence or coincidence. Up to a 1 in 1,000 chance.

D. Unlikely Has happened somewhere. Up to a 1 in 10,000 chance.

E. Rare Has never occurred after many years of exposure, but is conceivably possible. Up to a 1 in 100,000 chance.

F. Extremely rare Has never happened before. Up to a 1 in 1,000,000 chance

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CONSEQUENCE (impact) - The most likely result of contact with the hazard Hierarchy of Controls

Consequence(impact)

Injury topeople Environmental impact

Financialloss

Productionloss on

system or toclient

Control Examples

1.Insignificant

First-aidtreatment -minor cuts,

bruises, bumps

Negligible or no environmental harm or environmentalnuisance, e.g.- contained oil spill


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Controlled Risk Level Action TableLevel Low JHA Moderate JHA High JHA Extreme JHA1. People2. Plant, Environment3. Product ion

Proceed. Ensure identified controlmeasures are applied as required

(Competent) Accountable personapproval required to proceed

Do not proceed. Manager approvalrequired

Do not proceed. Responsible officer to addressthe problem

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Job Steps Hazard and Risk Descriptions Uncontrolled Risk Level Control MeasuresControlledRisk Level

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Additional Hazards Identified on Site

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Job Steps Hazard and Risk Descriptions Uncontrolled Risk Level Control MeasuresControlledRisk Level

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longjob hazard analysis template

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