Job Hazard Analysis (JHA) Builder

Break a task into steps. Identify hazards. Document controls. Print for the crew.

JHA Number

Date

Project Name

Task Being Analyzed

Performed By (Crew Lead)

Supervisor Approval

PPE Required

checklist

Hazard Analysis

Step 1

Medium

Step 2

Low

Step 3

High

Step 4

Low

Task

JHA #:

Date: 2026-05-28

Project: —

Performed by: —

Supervisor approval: —

PPE Required

Hard hat, ANSI Z87.1 safety glasses, hi-vis Class 2 vest, hard-soled boots, work gloves

#	Job Step	Potential Hazards	Hazard Controls	Risk
1	Set up work zone and barricade hazards	Struck-by vehicles, public access to work area, falls from drops	Place cones/barricades 25 ft minimum from work; assign flagger if traffic; cover or fence open holes; post signage per MUTCD	Medium
2	Stage tools and materials	Manual lifting injury, dropped materials, trip hazards	Use mechanical lift over 50 lb; clear travel paths; stack materials below 6 ft; team lift for awkward loads	Low
3	Perform primary task	Tool injury, eye/face exposure, noise, dust	Inspect tools pre-use; ANSI Z87.1 safety glasses; hearing protection if >85 dB; wet methods or HEPA vac for silica per 29 CFR 1926.1153	High
4	Clean up and demobilize	Sharp debris, residual energy, leaving hazards exposed	Sweep all debris; verify lockout/tagout cleared per 29 CFR 1910.147; remove barricades only after final walk; sign off site condition	Low

Performed By

Name — 2026-05-28

Supervisor Approval

Name — Date

warning

Template only. Not a substitute for your company's safety program. Comply with OSHA requirements.