Job Hazard Analysis
Job/Activity: Backfilling
.
Department or location: Facility
Task or Step
Secure Work Order/Permit
Backfilling Activity
House Keeping
Conducted by:
Hazards
Heavy lifting, Laceration, Trip,
Fall, Inhalation of cement
dust
Laceration, Trip, Fall, Risk of
eye injury
Personal Protective
Controls
Equipment (PPE)
- Use proper lifting techniques
- Wear appropriate personal protective
equipment and footwear Safety Shoe, Fall Arrest System, Hardhat,
Eye protection
- Use gloves and dust mask while handling
cement bags.
- Wear appropriate personal protective
equipment and footwear
Safety Shoe, Fall Arrest System, Hardhat,
- Learn correct procedures for working at
Eye protection
heights.
- Select the correct ladder for the job.
Name Position Signature/ Date Name Position Signature/ Date

1. 3.

2. 4.

Reviewed by:

_______________________________________

Immediate Superior/ Safety Controller