Job Safety Analysis
Job Description:
Date:
Student Name:
Student Sign:
Job Site:
Site Supervisor:
Site Supervisor Sign:
PPE Requirements:
Tools Equipment:
Hazardous Materials:
METHODOLOGY:
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Description
Job/Task Step – What am I
about to do?
Existing Potential Hazard –
What can go wrong?
Consequence – Realistic
consequence of something
going wrong.
Likelihood – How often does
the consequence happen when
job performed.
Risk Score – Use risk table.
Controls – Prevent it from
going wrong.
Responsible – Person
implementing controls.
Completed – Control
implemented.
A
B
C
D
E
1
11
7
4
2
1
2
16
12
8
5
3
3
20
17
13
9
6
4
23
21
18
14
10
5
25
24
22
19
15
Consequence
5
Catastrophe
4
Major
3
Moderate
2
Minor
1
Insignificant
NOTES:
A
B
C
D
E
Likelihood
Almost Certain
Likely
Occasional
Unlikely
Rare
Extreme – STOP work and
contact Sup
High – Immediate Action
Required
Moderate – Action Required
Low - Monitor
Potential Health & Safety Hazards
Work at Heights
Radiation
Manual Handling
Lighting
Chemical
Transport of Wastes
from site
Spills to
Water/Stormwater
Occupational Dust, Fumes
People
Occupational Noise
Pressure
Other
Potential Environmental Hazards
Potential to Spread Weeds
& Pests
Release of emissions to air
Electrical
Heat
Gas Releases
Access & Exit
Spills to Ground/Land
Contamination
Inefficient use of fuel,
water, electricity
Removal of vegetation
Noise/Vibration
Disturb plants/animals
Disturb cultural heritage
sites
Waste generation and
disposal required
Potential for fire
Use of
pesticides/insecticides
Other
Step
#
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Process Steps
Potential Hazard/s
List the steps required to perform the task in
the sequence they are carried out.
Against each step list potential hazards that
could cause injury when the task is performed.
No
Control
With
Control
Risk
Score
Residual
Risk
Hazard Control Measures / Procedures
For each hazard identify the control measures required to eliminate or
minimise the risk of injury.
Responsible
Person/s