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Job Safety Analysis Worksheet

Work Location
Employees

Date

Risk Control Measures Who is responsible


Activity Hazards List the control measures
Write the name of the person
List the tasks required to perform Against each task list the hazards required to eliminate or
(supervisor or above) to
the activity in the sequence they that could cause injury when the minimize the risk of injury
Impliment the control measures
are carried out. task is performed. arising from the identified
identified
hazard.

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