Job Hazard Analysis (JHA) Template

Permit to work (PTW) or contract number: Date prepared:

Site / location: Prepared by: Job description:

Environment

Energy (Hazard) Groups

Targets

Aspects

Impact

Energy
Manual handling Machinery & tools Vehicles & mobile equip crane Pressure Falling objects/people Sound & vibration jackhammer Electricity

Explanation
Lifting a chain or sling Unguarded bench grinder Impact from vehicle, forklift, Compressed Air Welding rod, people, open pit Noise/vibration from Extension cord, overhead lines

Energy

Explanation

Air Dust, fumes Air pollution Water Spills of Oil, chemicals Water pollution Land/Soil Erosion, spills Soil pollution Flora & Fauna Damage Cultural Heritage Waste disposal Location, recycling Resource usage Noise Equipment noise, operations Noise pollution Fire Hot work Bush fire

Radiation Welding, NDT testing, Sun Heat & cold Oxy Cutting, hot work Chemicals Solvents, fumes, dust Fire & explosion Gases in confined spaces Biological organisms Hepatitis B, cooling towers Psychological/Social stress Witness a death, excessive hours Physical environment Weather, confined space

CONSEQUENCE (Impact) LIKELIHOO D

A. Almost certain B. Likely C. Possible D. Unlikely E. Rare F. Extremely rare 1. Insignificant High Moderate Low Low Low Low 2. Minor High High Moderate Moderate Low Low 3. Moderate Extreme High High High Moderate Low 4. Major Extreme Extreme High High High Moderate 5. Disaster Extreme Extreme Extreme Extreme High Moderate 6. Extreme Extreme Extreme Extreme Extreme Extreme High

Company Procedures

PPE Required

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Job Hazard Analysis (JHA) Template

Asbestos management SWP 10.1 Chemical Cleaning SWP 10.6 Concealed Services SWP 7.3 Confined Spaces SWP 7.5 Cranes and Lifting SWP 11.5 Diving Permit SWP 7.6 Electrical Safety SWP 12.2 Emergency Planning EMPLIA-05 First Aid SWP 5.5 Flammable Liquids Gas Storage and Transport SWP 11.4 Hazardous Chemical Control SWP 10.6 Hot work SWP 7.4 Hydraulic Spanner SWP 11.5 Lead/ Mercury SWP 10.6 Manual Handling SWP 10.3 Oil transfer SWP 10.6 Painting SWP 11.2 Permit to Work/Lockout Tag-out SWP 7.1 Personal Protective Equipment SWP 10.2 Portable Electrical Equipment SWP 12.2 Scaffolding, Ladders, Mobile Platforms SWP 12.1 Transport Plan SWP 13.5 Working at Heights SWP 12.1

Mask Safety Glasses Safety Helmet Boots Gloves Fume Extraction Clothing

Dust Face Shield Hair net Steel caps Riggers Fans Welding Jacket/Hood

P1 Goggles Welding Helmet

P2

Respirator Chemical

Gumboots Welding Heaters Disposable Overalls

Rubber

Chemical Overalls

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Job Hazard Analysis (JHA) Template

CONSEQUENCE (impact) - The most likely result of contact with the hazard
Consequence (impact) 1. Insignificant Injury to people First-aid treatment minor cuts, bruises, bumps Medical treatment injury Environmental impact Negligible or no environmental harm or environmental nuisance, e.g. - contained oil spill <20 litres - possible incidental and local impact on flora and fauna Material environmental harm or an environmental nuisance, but prosecution unlikely, local publicity only, local nuisance impacts on community, e.g. - technical breaches of legal requirements regardless of harm or nuisance - spills to waterways <200 litres where dispersal/cleanup is simple Serious environmental harm, possible prosecution, local state publicity eg - significant loss of oil (4000L to land, several 100L to water) - ecosystem impact such as fish kill that requires follow up monitoring and recovery with expert input and control Serious environmental harm, prosecution probable, national publicity, reputation impacts, political and licence implications e.g. - Significant ecosystem impact with residual effects likely after follow up - large loss to waterways eg 8,000 litres, esp. if drinking water affected Serious environmental harm, prosecution certain, severely affected reputation, international attention possible, probable licence restrictions e.g. - loss of 20,000L oil to water, or to sensitive land area - significant impact on regional ecosystem, with significant residual effects likely Serious environmental harm, prosecution certain with jail terms, licence restrictions, severe reputation impact, international attention e.g. - significant impact on regional ecosystem with eventual recovery impossible - catastrophic dam failure Financial loss Up to $5k Production loss on system or to client Level 1 Control 1. Eliminate

Hierarchy of Controls
Examples Repair damaged equipment; replace a chemical process with a mechanical or physical one. If this is not practical then: With a safer alternative. Break larger loads into smaller, lighter loads; use a less toxic material. If this is not practical, then:

2. Minor

$5k - $50k

Level 2

2. Substitute

3. Moderate

Serious injury permanent disability, amputation Fatality

$50K - $500k

Level 3

3. Isolate

Install barriers to restrict access to hazardous work areas, electrical isolation and permit systems. If this is not practical, then: Place a guard on dangerous parts; extract fumes, dust, use a lifting device to do all lifting in workplace. If this is not practical, then:

4. Major

Over $500K

Level 4

4. Engineering

5. Disaster

2 - 4 fatalities

n/a

n/a

5. Administrate

Rotate jobs to reduce time spent on a single task, train staff in safe work procedures, documented procedures, rules. If this is not practical, then: Use safety footwear, helmets, earmuffs etc. These rely on appropriate human behaviour to minimise the risk

6. Extreme

5 or more fatalities

n/a

n/a

6. PPE

LIKELIHOOD - The probability that the identified consequence will occur, taking into account proximity and exposure to the hazard
A. Almost certain B. Likely C. Possible D. Unlikely E. Rare F. Extremely rare The most likely and expected result. Up to 1 in 10 chance. Would not be unusual. Up to 1 in 100 chance. Unusual but possible sequence or coincidence. Up to a 1 in 1,000 chance. Has happened somewhere. Up to a 1 in 10,000 chance. Has never occurred after many years of exposure, but is conceivably possible. Up to a 1 in 100,000 chance. Has never happened before. Up to a 1 in 1,000,000 chance

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Job Hazard Analysis (JHA) Template

Controlled Risk Level Action Table
Level 1. People 2. Plant, Environment 3. Production Low
JHA

Moderate JHA (Competent) Accountable person approval required to proceed

High JHA Do not proceed. Manager approval required

Extreme JHA Do not proceed. Responsible officer to address the problem

Proceed. Ensure identified control measures are applied as required

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Job Hazard Analysis (JHA) Template

Job Steps

Hazard and Risk Descriptions

Uncontrolle Control Measures d Risk Level

Controlled Risk Level

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Job Hazard Analysis (JHA) Template

Additional Hazards Identified on Site

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Job Hazard Analysis (JHA) Template

Job Steps

Hazard and Risk Descriptions

Uncontrolle Control Measures d Risk Level

Controlled Risk Level

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Job Hazard Analysis (JHA) Template

All foreseeable hazards have been identified, risks evaluated and appropriate control measures will be applied as per this JHA worksheet Team member sign-off that JHA has been reviewed, and understood prior to starting work Team member name Signature Date Team member name Signature Date Team member name Signature Date Change of work methodology - Team member sign-off that JHA has been reviewed, and understood prior to starting work Team member name Signature Date Team member name Signature Date Team member name Signature Date

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Job Hazard Analysis (JHA) Template

Authorisation sign off for this JHA - *Line management approval required for moderate or high level risks after controls Site Manager/Supervisor Signature, Approval date Signature, Accountable person for job date Authorisation sign off for this JHA - *Line management approval required for moderate or high level risks after controls Site Manager/Supervisor Signature, Approval date Signature, Accountable person for job date Authorisation sign off for this JHA - *Line management approval required for moderate or high level risks after controls Site Manager/Supervisor Signature, Approval date Signature, Accountable person for job date

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