INSTRUCTIONS
This form may be used to prepare a job hazard analysis for
a general work area or for a particular classification of employees. It may also be used to prepare a safety work
plan for a multi-step project.
1. In column #1 list typical tasks associated
with the general work area or the employee classification. For project safety work plans list the major
steps in the order of occurrence.
3. Survey the work area(s) and, opposite
each task or project step in column #1, list all real or potential hazards in
column #2.
4. Opposite the hazards identified in
column #2, list methods for preventing or controlling hazards in column
#3. Consider safe work conditions, work
practices, and personal protective equipment.
5. Use safety reference materials to
develop hazard prevention steps:
USFS Health and Safety Code
Handbook
Title 8 Safety Orders
CDF Health and Safety Procedures
Handbook 1700
State Comp Insurance Fund
Materials
6. After completing the Job Hazard
Analysis / Project Safety Work Plan, discuss it with workers and ask them for
suggestions to improve the hazard prevention steps.
7. The Hazard Prevention Steps (column 3)
may be used to develop a Code of Safe Practices [IIPP-3] for the general work
area, employee classification, or project.
Use the IIPP-2 or the IIPP-3 to provide safety training or orientation
to employees. Document training or
orientation on CDF Form IIPP-6 or IIPP-7.
8. Make work assignments according to the
ability and training of each employee.
9. Ensure that necessary tools and
equipment are available and in good working order, and that employees receive
adequate instructions in their safe and proper use.
10. Use the IIPP-3 or column 3 of the IIPP-2
to develop a Job Safety Survey [CDF Form IIPP-4]
11. To ensure compliance, periodically
inspect employee work practices and document on the Job Safety Survey [IIPP-4].
12. Ensure that a copy of this document is
available to employees at the worksite.
Keep on file for a minimum of three years.
CHECKLIST OF THINGS TO CONSIDER
IN DEVELOPING JOB/PROJECT HAZARD ANALYSIS
TYPES OF
HAZARDS
[ ] Atmospheric - dusts, vapors, mists,
gases, fumes
[ ] Physical - noise, puncture, radiation,
weight, illumination, strike, fall
[ ] Electrical
[ ] Hazardous liquids or substances
[ ] Insects and animals
PERSONNEL
[ ] Physical
Condition - workers warmed up to perform arduous work
[ ] Adequate Personnel to perform identified
tasks.
[ ] Adequate
supervision
[ ] First aid facilities/materials available
PERSONAL
PROTECTIVE EQUIPMENT
[ ] Gloves
[ ] Eye Protection
[ ] Chaps
[ ] Hearing Protection
[ ] Hard Hats
[ ] Thermal Protective Clothing
[ ] Chemical Protective Clothing
[ ] Approved Respirators
[ ] Lifelines or Harnesses
[ ] Special Equipment
WORKING
ENVIRONMENT
[ ] Housekeeping - clear work areas, storage
facilities
[ ] Perimiter Controls - barricades, covers,
flagging, posting
[ ] Adverse Weather Precautions
[ ] Ladders, Shoring, or Scaffolding
[ ] Security - after hours or overnight
[ ] Sanitary Facilities - washing, cleaning,
drinking
[ ] High Voltage Lines - identified,
de-energized
[ ] Adequate Lighting
[ ] Fire Extinguishers
TOOLS,
EQUIPMENT, and MATERIALS
[ ] Proper tools and equipment available
[ ] Electrical tools properly grounded
[ ] Tools and equipment in good operating
condition