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  • JSA Form

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    Rian Kurniansyah
    14 views4 pages
    This job safety analysis document outlines the personal protective equipment, sequence of job steps, potential hazards, and recommendations for a work activity. It requires safety shoes, work gloves, safety glasses, a work vest, a safety harness, fire extinguishers, and lock out/tag out equipment. The document lists the basic job steps and identifies potential hazards at each step, then provides recommendations to eliminate or reduce the risks.

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    This job safety analysis document outlines the personal protective equipment, sequence of job steps, potential hazards, and recommendations for a work activity. It requires safety shoes, work gloves, safety glasses, a work vest, a safety harness, fire extinguishers, and lock out/tag out equipment. The document lists the basic job steps and identifies potential hazards at each step, then provides recommendations to eliminate or reduce the risks.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    14 views4 pages

    JSA Form

    Uploaded by

    Rian Kurniansyah
    This job safety analysis document outlines the personal protective equipment, sequence of job steps, potential hazards, and recommendations for a work activity. It requires safety shoes, work gloves, safety glasses, a work vest, a safety harness, fire extinguishers, and lock out/tag out equipment. The document lists the basic job steps and identifies potential hazards at each step, then provides recommendations to eliminate or reduce the risks.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 4

    DATE: JOB SAFETY JSA TEAM MEMBERS

    ANALYSIS
    WORK ACTIVITY (JOB):
    LOCATION:
    Rev.:
    SUPERVISOR: Date:

    PERSONAL PROTECTIVE EQUIPMENT AND SYSTEM REQUIRED TO PERFORM THIS JOB


    Helm Sarung Tangan Kulit Alat Selam Izin Kerja
    Sepatu Safety Rompi / Baju Kerja Penghalang ( Palang ) Sarung Tangan Listrik
    Kacamata Safety Safety Harness Pemadam Api ( Apar ) others
    Sarung Tangan Kerja Pelindung Wajah Lock Out/ Tag Out
    Urutan Pekerjaan Potensi Bahaya Rekomendasi untuk Remark
    menghilangkan atau mengurai
    potensi bahaya
    2 of __
    Sequence of basic job Potential hazards Recommended to eliminate or
    steps reduce potential hazards

    3 of __
    Sequence of basic job steps Potential hazards Recommended to eliminate or reduce
    potential hazards

    4 of __

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