DATE:

JOB PLANNING TOOL Control no.:

STEP 1- Job Details: Complete all sections

JPT Team leader:
JPT Team Members:
Job Description:
Job Location/ Equipment
Working at Heights Hot Work Confined Space Excavation
Permit required?
Working Near Water Lifting

Isolations Required?
(State which equipment or refer to isolation documents)

List any specialized

(skills, people, equipment, tools, PPE required)

List (drawing, document, work instruction, reference)

Additional Information
Identify and document hazards and their control to reduce their risk to an acceptable level.
STEP 2 - Record Planning Outcomes Risk control should be applied where possible in order of:
(Elimination, Substitution, Isolation, Engineering, Administration, PPE)
Job
Step Description Hazards Controls By whom
Steps
 Job
Step Description Hazards Controls By whom
Steps

STEP 3 - Highlight any potentially fatal or

JPT Team leader to highlight above any hazards likely to result in death or seriously injured
significant hazards and their controls
STEP 4 - Communicate this form JPT Team leader must ensure this form is discussed with the worker's supervisor
JPT Team Leader
I have consulted with the relevant people and have identified hazards and their controls necessary for this job to conducted safely
I have highlighted any hazards likely to result in death or seriously injured
I have snured the Job supervisor or Worker's supervisor are familiar with this JPT.

NAME AND SIGNATURE DATE TIME