Job Safety Analysis Worksheet Date:

Title of Job/Operation: Chemistry Laboratory Operation Log Number:

Employee Name and Job Title: Chemistry Laboratory Analyst Analyst/ Date:

Division/Bureau/Section: Approved By/ Date:

Bureau of Laboratories
Personal Protective Equipment Recommended or Required: Lab coat, rubber gloves, protective eyewear, heat
resistant gloves, wrist rests, respirators, shoes.

Sequence of Basic Job Steps
Computer Data Entry
Sample Receipt
Chemical Analyses
Microbiological Analyses
Potential Accidents or Hazards Recommended Safe Job Procedures
Repetitive strain disorder, general Ergonomic training, office safety
office hazards training, wrist rests.
Overexertion, contact with hazardous Safe lifting training, rubber gloves,
samples, lifting coolers with samples.
protective eyewear, lab coat.
Contact with hazardous samples, Protective eyewear, rubber gloves,
contact with laboratory chemical, lab coat, chemistry laboratory safety
operation of electrical instruments, training, electrical safety training,
handling laboratory glassware. proper disposable of broken
glassware, first aid training, anti-
fatigue mats, hazard communication
training, heat resistant gloves.
Contact with hazardous samples, Protective eyewear, gloves, lab coat,
contact with chemicals, contact with chemistry laboratory safety training,
bacterial cultures, autoclave anti-fatigue mats, hazard
operation. communication training, and heat
resistant gloves.

*Codes for Potential Hazards:

Struck By (SB) Caught On (CO) Fall To Below (FB)
Struck Against (SA) Caught In (CI) Overexertion
Contacted By (CB) Caught Between (CBT) Exposure (E)
Contact With (CW) Fall - Same Level (FS)

Rev. 5/06