Sample Job Hazard Analysis Form

Figure 15-1 Sample job hazard analysis form for cleaning inside surface of chemical tank. Adapted from United States Department of Labor, OSHA Job Hazard Analysis, OSHA 3071, 1998 (revised), public domain.

Once all of the steps have been identified, then the hazards for each step must be identified. Focus on anything that could potentially cause harm, for example those items fisted earlier in this chapter. Along with the hazards, you ll also determine the outcome that would occur should an employee be exposed to the hazard (consequence). For example, what could happen if an employee s hand came into contact with an unguarded pulley This wfil help determine severity and probability when selecting hazard controls. Note See the Toolbox chapter for a sample Job Hazard Analysis form. 

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