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PAEC JSA Blank Form 2003-2024 free printable template

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JOB SAFETY ANALYSIS WORKSHEET Department Job Analyzed Date Completed Task Completed By Supervisor Location Analysis By Approved By Required Personal Protective and Emergency Equipment SEQUENCE OF JOB STEPS PAEC JSA Blank Form.doc Risk/Safety Mnaual April 2003 POTENTIAL HAZARDS Reviewed By CONTROLS/ PREVENTION MEASURES Worksheet Location of Job or Task Employee performing Job or Task 1. Job or Task title 2. Training required to complete job/task 3. Detailed description of job as currently...
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How to fill out jsa form

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How to fill out a JSA form:

01
Begin by gathering all necessary information, such as the job details, the individuals involved, and the potential hazards.
02
Carefully assess the work environment and identify any potential risks or hazards that may be present.
03
Clearly define and document the steps required to complete the task safely, including any necessary safety measures or precautions.
04
Consult with workers and get their input on the identified hazards and possible control measures.
05
Fill out the JSA form by listing the job steps, potential hazards, and corresponding control measures. Make sure to provide specific details and include any necessary diagrams or illustrations.
06
Review the completed JSA form with all workers involved in the task to ensure everyone understands the identified hazards and control measures.
07
Keep a copy of the JSA form on-site and make sure it is easily accessible to all workers throughout the duration of the task.

Who needs a JSA form:

01
Any employer or organization that wants to ensure the safety of its workers and minimize workplace accidents and injuries.
02
Industries such as construction, manufacturing, mining, and oil and gas, where workers often engage in high-risk tasks and operate heavy machinery.
03
Workers who are involved in potentially dangerous activities, such as working at heights, operating equipment, handling hazardous materials, or working in confined spaces.

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Filling out a job safety analysis has been adopted by OSHA as a best practice for Safe Work procedures the JSA is a very effective means of helping reduce incidents accidents and injuries in this video we will give a brief description of what's involved as well as an example of how one is done all right we had a Marva doing our job safety analysis holding a tail board discussion our crew has a new job they had to plan out planning is essential part of our work and will go out on job site we need to look over our job site conditions and sense any hazards that we're going to encounter through our course of work and once they do that they need oars get the crew together and discuss all that now part of a job safety analysis it's more than just discussing hazards we're going to look at the scope of the work what actually is going on with the work make sure we know everyone understands work procedures, and we also assigned specific duties that way every crew member knows exactly what they have to do for the day now some hazards we encounter could be environmental we see traffic pedestrians could be weather conditions like they mentioned in an hour and I were discussing the smarted brain night before, so we have wet conditions on the ground had mud in the ditches if you're handling a lot of equipments heavy we're handling we have worried about lifting out property rigging equipment, and we're setting poles you know getting caught or pinched or between or under is this equipment, so a lot of flop factors considers it's also in this part the electrical work we deal with, and they did mention going through lockout ragout procedures which before we start working online we have to report in and make sure the land you have clearance to work on lines we's a flea and there's quite a bit goes into this, and it's an essential part of working and planning and I think crew needs to have some good training in this area to make sure we do it properly all right guys walked over the job today we're going to set 20 foot service poles over there right here behind us between those two we're going to hang transformers and hang drops to each service pole procedure today well hang five transformers starting right here on this pole second one down going all the way to the angle right there the three first one that pole this pole in this pole will be 15 KV a number six pole and number seven pole will be 25 KV a work procedure first thing we'll do is I'll get I guess Chris Brandon you to get the truck cook up the trailer get three twenty foot poles Blake and I and I guess Kenneth will go get tools material after you're done getting all the poles just pull over there, and we'll load up all the tools and material the hazards c1 that rain looks like it rained last night so be careful where we drive try not to try to stay out of the ditch slipping obviously going to be handling some pretty heavy transformers don't let them fall on you all right some precautions obviously inspect...

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What is form jsa?

This generic JSA template, or job safety analysis form, can be used by a supervisor or safety official to analyze hazards associated with performing a certain job. Begin by filling out information about the job and employee participating in the inspection. ... Preview a completed JSA example report conducted with iAuditor.

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The penalty for the late filing of JSA form is a fine of up to $1,000. Additionally, employers may be subject to civil and criminal penalties, including fines, imprisonment, and/or other sanctions for failure to comply with the JSA filing requirements.
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