BUILDER ASCENT
Build Higher. Learn More. Earn More.
Job Hazard Analysis
Assess it. Control it. Build it. Safely.
1. Project Information
Project Name:
Location:
Date:
Time:
Trade / Subcontractor:
Foreman:
Reviewed By:
2. Task / Scope of Work
3. Hazard Analysis Break the job into steps and identify hazards and controls for each.
Step / Task Potential Hazards Control Measures Person Responsible
4. Required PPE
Hard Hat
Safety Glasses
High-Vis Vest
Gloves
Hearing Protection
Fall Protection
5. Tools / Equipment
6. Emergency Plan
What to do if something goes wrong:
Emergency Contact / Phone:
Nearest Hospital:
7. Sign-Off

By signing below, I acknowledge that I have read, understood, and will comply with this Job Hazard Analysis.

Name (Print) Signature Date
Foreman Signature:
Date: