Embed Size (px)
DESCRIPTION
Worksheet to use with Job Safety Analysis
Citation preview
SAFETY ANALYSIS SHEET
JOB_______________________________________________ DATE_____________________
OPERATION_______________________________________ DEPT______________________
OCCUPATION_________________________________________________________________
INJURIOUS CONTACTS
POSSIBILITIES WHAT PART OF OPERATION HOW TO ELIMINATE
CAUGHT BETWEEN: __________________________________ ________________________
____________________ __________________________________ ________________________
____________________ __________________________________ ________________________
____________________ __________________________________ ________________________
STRIKE AGAINST: __________________________________ ________________________
____________________ __________________________________ ________________________
____________________ __________________________________ _______________________
____________________ __________________________________ _______________________
STRUCK BY: __________________________________ ________________________
____________________ ___________________________________ ________________________
____________________ __________________________________ _________________________
____________________ ___________________________________ _________________________
RECOMMENDED PROCEDURE FOR THIS OPERATION: _______________________________
SIGNATURE
