Job Hazard Analysis Form - PDF Templates

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Wednesday, February 19, 2025

Job Hazard Analysis Form

Comments

Hazard Control &Pr

otection Measures

Ensure power is turned off

before starting work. Alw

ays test before beginning

work to verify that power

is off

Remove tools and other met

als from body

Wear appropriate personal

protective equipment (PPE

per Required NFPA 70E clas

sification) such as insula

ted gloves, safety glasses

, and non-conductive footw

ear

Inspect tools before use.

Verify that guards are wor

king properly. DO NOT put

hand near blades

Keep tools in good conditi

Keep cords away from work

area

Make sure you have a good

center of gravity and alwa

ys maintain control

Wear goggles and dust musk

if applicable

Use appropriate cutting to

ols and handle them safely

Wear cut-resistant gloves

when handling sharp object

s or materials

Inspect ladder before use

Use ladder at proper heigh

Make sure the ladder in as

sembled, locked and on lev

el ground

DO NOT exceed weight limit

for ladder

DO NOT stand on the top or

top rung of ladder and ma

ke sure a co-worker is hol

ding ladder if any higher

than a stepladder

Use proper lifting techniq

ues, including bending at

the knees and lifting with

the legs rather than the

back

Seek assistance from anoth

er worker when lifting hea

vy or awkward objects

Vehicle Inspection: Assess

ing potential hazards rela

ted to vehicle condition,

such as faulty brakes, tir

e wear, and fluid leaks

Road Conditions: Evaluatin

g risks associated with di

fferent road types, weathe

r conditions, and traffic

patterns

Driver Behavior: Identifyi

ng hazards linked to distr

actions, fatigue, impaired

driving, and aggressive b

ehavior

Emergency Procedures: Revi

ewing protocols for respon

ding to accidents, breakdo

wns, and other unforeseen

incidents

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Job Hazard Analysis Form

Site ID & Site Name

BUKBU01381, Bungoma_Khaoya

Emergency Evacuation Plan

Site Name

Bungoma_Khaoya

Emergency Response Team

First Aider

Jimmy Sinokho 0717658045

Fire Marshal

Francis Odour 0721708009

Contact Person

Njoki Kimari 0722125366

Contractor contact Person

FrankLin Musili 0726515304

PPE Matrix

Task

	Saf ety He lme t	Saf ety Sh oes	Vis ibi lit y V est	Dus t M ask	Saf ety Gl ove s(D epe ndi ng on tas k)	Ear Pr ote cti on	Eye Pr ote cti on	Ove ral l
Sit e s et out an d e xca vat ion
Bac kfi lli ng
Con str uct ion of pl int hs and pe rim ete r w all
Cab lin g
Mov ing Eq uip men t
Loa din g & Off loa din g m ate ria l
Ele ctr ica l W ork s
Wel din g/G rin din g a n H ot wor ks
	Saf ety He lme t	Saf ety Sh oes	Vis ibi lit y V est	Dus t M ask	Saf ety Gl ove s(D epe ndi ng on tas k)	Ear Pr ote cti on	Eye Pr ote cti on	Ove ral l
Use of Po wer to ols
Sit e c omp let ion wo rks
Sit e C lea n u p
Thr ead ing

Tool Box Talk Sheet

Team Name

Jimmy

Site

Bungoma_Khaoya

Project

RMS Installation

Date

19/2/25

Instructor

Jimmy

Topic Discussed

	Yes	No	N/A
Exact s cope of work d iscusse d assoc iated r isks an d mitig ation m easures
Absolut e site rules a nd EHS commitm ent
Equipme nt Insp ection
	Yes	No	N/A
PPE Ins pection
Results of ris k asses sment a nd fall protec tion pl an
Emergen cy resc ue proc edures, evacua tion pr ocedure s and f irst ai d brief ing
Plant,E xacavat ions,Ba ckfilli ng,Towe r riggi ng and electri cals wo rks dis cussed
Safety moment Topic
Others

Comments

COMMITMENT

''We have participated in todays safety meeting and agree with the topics discussed and the way necessary safety measures have been taken into consideration in the planning of activities.''

Employees Present

Technician Name

Jimmy Sinokho

Assistant Technician Name

Francis Otieno

Technician ID Number

24593544

Assistant Technician ID Number

12839006

Technician Signature

Assistant Technician Signature

Vehicle Inspection Checklist

Vehicle Registrati

KDA 399L

Drivers Name

Francis Otieno

Current Mileage

290257

General Condition

of the vehicles

	Yes	No	N/A
Are the window s in go od cond ition a nd do t hey ope n prope rly?
Do the doors o pen and close properl y?
Are the windsc reen an d the r ear win dow in a good conditi on?
Do the wipers front a nd rear operat e prope rly and are th e blade s in go od cond ition?
	Yes	No	N/A
Is the rear vi ew mirr or in p lace an d in go od cond ition
Is the side mi rrors i n place and in good c onditio n?
All the four t ires in good c onditio n inclu ding a spare t ire
Are the airbag s intac t?
Is the air con ditioni ng func tional?
Vehicle fluid levels okay?(o il,brak e fluid , power steeri ng flui d coola nt)
Are the door l ocks fu nctiona l?
Do all sits ha ve seat belt? A re the seatbel ts func tioning proper ly?
Does th e horn operate proper ly?
Is the battery in goo d condi tion?
Do the brake l ights i llumina te when the br ake ped al is d epresse d?
Does th e headl ights o perate properl y?
	Yes	No	N/A
Does th e parki ng /han d brake work p roperly when e ngaged?
Do the turn si gnal in dicator s blink front and rea r
Do the headlig ht oper ate pro perly?
Are the chevro n refle ctors i n place and in good c onditio n?
Does th e vehic les hav e any d ents or scratc hes?

General Vehicle E

quipment

	Yes	No	N/A
is ther s an ad equate and wel l suppl ied fir t aid k it?
Is fire exting uishers in pla ce, pro perly c harged and cur rently inspect ed?
SIs the re a wh eel spa nner in a good condit ion?
Is ther e a whe el jack in a g ood con dition?
Are the life s avers i n place and in a good condit ion?