Blank Job Hazard Analysis (JHA) Template
Document Control Company: [COMPANY NAME] · Logo: [COMPANY LOGO] · Address: [COMPANY ADDRESS] Prepared by: [RESPONSIBLE PERSON / COMPETENT PERSON] · Date: [DATE] · Approved by (signature): _________________
| Field | Value |
|---|---|
| Category | Job Hazard Analysis / JHA / JSA |
| Recommended Industry | All |
| Document Type | JHA/JSA |
| Access Level | Starter |
| Last Reviewed | 2026-06-29 |
| Last Updated | 2026-06-29 |
How to Use This Template
Complete a JHA before a task, ideally with the crew that will do the work. Break the job into steps, identify the hazards in each step, then list the controls that eliminate or reduce each hazard. Review it on site, adjust if conditions change, and have the crew sign on. Use the hierarchy of controls — try to eliminate or substitute the hazard first, then use engineering controls, then administrative controls / safe work practices, and use PPE as the last layer.
Job Hazard Analysis
| Field | Entry |
|---|---|
| Job / task: | [DESCRIBE TASK] |
| Location / project: | [LOCATION] |
| Date: | [DATE] |
| Crew / competent person: | [NAME(S)] |
| Required permits: | ☐ None ☐ Hot work ☐ Confined space ☐ Energized ☐ Other: ____ |
| Required PPE: | [LIST] |
Step-by-Step Analysis
| # | Task Step (what you do) | Potential Hazards (what could go wrong) | Controls / Safe Work Practices | Responsible |
|---|---|---|---|---|
| 1 | [Step] | [Hazards] | [Controls] | [Name] |
| 2 | [Step] | [Hazards] | [Controls] | [Name] |
| 3 | [Step] | [Hazards] | [Controls] | [Name] |
| 4 | [Step] | [Hazards] | [Controls] | [Name] |
| 5 | [Step] | [Hazards] | [Controls] | [Name] |
| 6 | [Step] | [Hazards] | [Controls] | [Name] |
Hierarchy of Controls (reminder)
- Eliminate the hazard → 2. Substitute → 3. Engineering controls → 4. Administrative / safe work practices → 5. PPE
Emergency Considerations
- Nearest first aid / AED: [____] Emergency number: 911 / [COMPANY CONTACT]
- Rescue plan (if working at height / confined space / energized): [____]
Crew Review & Sign-On
By signing, each crew member confirms they reviewed this JHA, understand the hazards and controls, and know they can stop work if conditions are unsafe.
| # | Print Name | Signature | Date |
|---|---|---|---|
| 1 | [DATE] | ||
| 2 | [DATE] | ||
| 3 | [DATE] | ||
| 4 | [DATE] |
Prepared/approved by (competent person): ____________________ Date: [DATE]
Company Customization Needed
- Add the actual task steps, hazards, and controls for the specific job — generic entries should be replaced.
- List the PPE and permits your task requires.
- Define who is authorized to prepare and approve JHAs at your company.
- Review and customize based on applicable federal, state, local, client, and project-specific requirements.
- Re-do or revise the JHA when the task, crew, equipment, or conditions change.
Last Reviewed / Last Updated
- Last Reviewed: 2026-06-29
- Last Updated: 2026-06-29
- Next Review Due: [SET DATE]
Disclaimer
This document is a general safety template and educational resource. It is not legal advice, does not replace a site-specific hazard assessment, and does not guarantee compliance with OSHA or any federal, state, or local requirement. Employers are responsible for reviewing, customizing, implementing, training employees on, and maintaining their own safety programs and records. Consult a qualified safety professional, legal counsel, or regulatory authority when needed.
Template ID: blank-jha-template · Editable master (Markdown). Export to Word/PDF for distribution. Access level: Starter.