Job Hazard Analysis (JHA) Worksheet

OSHA Recommended Practice — Hazard Identification & Control | EHS Community Template

SECTION 1 — JOB INFORMATION

Job / Task Title

Department / Work Area

Date

JHA Prepared By

Workers Consulted (Names)

Reviewed / Approved By

Required PPE for This Task

Tools / Equipment Used

Permits Required (LOTO / CS / Hot Work)

How to complete this JHA: (1) Break the job into discrete sequential steps. (2) For each step, identify all hazards that could cause injury. (3) Describe specific controls to eliminate or reduce each hazard, using the hierarchy: Elimination → Substitution → Engineering Controls → Administrative Controls → PPE.

SECTION 2 — HAZARD ANALYSIS

Risk Rating: H = High (stop work, control before proceeding) M = Medium (control before next task) L = Low (monitor, standard controls apply)

#	Job Step (Sequential)	Hazard(s) — What could go wrong?	Risk (H/M/L)	Control Measures (specific actions)	Residual Risk
1
2
3
4
5
6
7
8
9
10

SECTION 3 — EMERGENCY PROCEDURES FOR THIS TASK

Emergency contact / assembly point:

First aid kit location:

Nearest eyewash / safety shower:

SECTION 4 — WORKER ACKNOWLEDGMENT

I have read, understood, and been trained on this JHA. I understand the hazards and controls for each step and will follow all listed controls during this task.

Worker Name (Print)	Signature	Date

SECTION 5 — ANNUAL REVIEW LOG

Review Date	Reviewed By	Changes Made?	Reason for Change / Notes

This template is provided for educational purposes by EHS Community (ehscommunity.com). Reference: OSHA Publication 3071 — Job Hazard Analysis. Retain JHAs per your facility recordkeeping policy and review annually or after any incident involving the task.