Blank JSA Template
Document Control Company: [COMPANY NAME] · Logo: [COMPANY LOGO] · Address: [COMPANY ADDRESS] Prepared by: [RESPONSIBLE 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 this analysis with the crew before the task. List the task steps, identify the hazards in each step, and document the controls. Review it on site and update it if conditions change.
Job Hazard Analysis
Task / Job: [DESCRIBE TASK] Location: [LOCATION] Date: [DATE] Supervisor: [NAME]
Use this blank Job Safety Analysis (JSA) to break a task into steps, identify the hazards in each step, and record the controls before work begins. Complete it with the crew doing the work.