Hazard Analysis

Using the format below, identify hazards and safety precautions/procedures to mitigate hazards. Use as many sheets as necessary.

Description of Work: _____________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________
________________________________________________________________________

Step/Phase of Job

Safety Hazard

Precautions/Safety Procedures

 

   

 

 

   

 

 

   

 

 

   

 

Accepted: _______________________________ Date: _____________

Supervisor/Task Manager

 

 

My supervisor has reviewed this hazard analysis with me and I understand the hazards and required precautionary actions. I will follow the requirements of this hazard analysis or notify my supervisor if I am unable to do so.

Name (please print)

Signature

Date