Job Safety Analysis

Location Date Assessment Number

Task Being Assessed

Method Statement Title: Method Statement Number:

Critical Risks Present:

Confined Space (see confined Space procedure) Working at Height Electrification
Mobile Elevating Working Platforms Excavations Other
If critical risks are present then the PTW system must be implemented.

Key Risks Present:

Portable Electrical Tools Vibration Disease

Hazardous Materials Heat Waste

Manual Handling Noise Dust

Slips, Trips and Falls Plant Vibration

Radiation Other

Risk Final
Rating Risk
Task Hazards Before Control Measures Rating
Contr
S L RR S L RR

Name ID # Signature
Construction Manager

Site Supervisor

Workers