SF

JOB HAZARD ANALYSIS

Date
Project number

Project title

Job description
Permit required?

JHA number
Yes

No

List other referenced or applicable documents

Sequenc

Step / Action

e Number

Permit number

Do personnel performing the work need a licence/ticket/trade skill?

Yes

No

Type of permit

(Specify)

Possible hazards

Recommended controls

Person/people responsible

(Refer to attached Hazards list)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

FO-AUST-KBR-HSE-ADM0107, Rev. 5 (01/05)

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Kellogg Brown & Root Pty Ltd

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JOB HAZARD ANALYSIS

Hazards list

Identify potential hazards for each job step

Check items

Prior to identifying potential incidents and hazardous conditions, identify the hazards
associated with the works and record below

In conjunction with the hazards list, use the following catch

phrases

When producing JHAs the following should be checked

Struckby, against

Leader is trained in JHA process

01 Electricity

18 Radiation

02 Chemicals

19 Hydrocarbon/gas release

Contactwith

People performing the job are involved

03 Rotating equipment

20 Surfaces

Contactedby

People with knowledge of the job are involved

04 Vehicles

21 Tools/equipment

Caughtin, on, under, between, against

Chemicals are identified and data from MSDS is used

05 Muscular stress

22 Human factors

Exposuretemperature, chemicals, noise etc.

Required permits, isolations and hold points are listed

06 Mental stress

23 Insect/animal bites

Slip, trip, or fallfrom heights or same level

Hazards are identified and recorded on Hazards List

07 Heights

24 Fire

Overexertion fromlifting, pushing, pulling etc. (manual

JHAs are not too long for people to remember

08 Depths

25 Introduced animals/plants

09 Confined spaces

26 Historical sites

10 Vibration

27 Bush clearing

JHA is signed by all relevant personnel

11 Moving objects

28 Excavation/earthworks

JHA details are entered into JHA register

12 Weather

29 Spills/leaks

Signed original is given to Supervisor

13 Hot/cold objects

30 Other mobile/stationary equipment

14 Lighting

31 Pressure (stored energy)

15 Driving hazards

32 Fumes, vapour or dust

16 Falling objects

Other (specify)

handling)

Applicable standards or codes are referenced where known

Escape of productoil spill, gas release etc.

Checklist is completed and attached to JHA

17 Noise

FO-AUST-KBR-HSE-ADM0107, Rev. 5 (01/05)

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Kellogg Brown & Root Pty Ltd

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JOB HAZARD ANALYSIS

Notes
Take time out prior to starting any tasks. Stand back and look for hazards. Can the job be moved to a safer location? Consider others working nearby. Is there an easier/safer way to carry out the task? Ensure all personnel wear the
correct PPE. Ensure any manual handling is carried out in accordance with Manual Handling Procedures. Consider heat stress. If job scope changes, stop work, review and amend JHA before resuming tasks. Ensure permits are
entered into JHA and they are understood.
All personnel involved in the creation of the JHA shall enter their names below and sign to confirm they have read and understood the conditions of the JHA.
JHA Team Leader
(Print name)

(Signature)

(Date)

(Company)

(Print name)

(Signature)

(Date)

(Company)

(Print name)

(Signature)

(Date)

(Company)

(Print name)

(Signature)

(Date)

(Company)

JHA Team Member

JHA Team Member
JHA Team Member
All persons involved in performing work listed in the JHA shall enter their names below and sign to confirm they have read and understood the conditions of the JHA.

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

(Print name)

(Signature)

(Date)

Originator signature

KBR supervisor signature

Contractor supervisor signature

(mark N/A if contractors not performing job)

FO-AUST-KBR-HSE-ADM0107, Rev. 5 (01/05)

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Kellogg Brown & Root Pty Ltd