Template

Terra5 Job Safety Analysis JSA

by Ryan Hacke, from the Community

The Terra5 Job Safety Analysis template supports transmission and distribution and construction tasks through a structured daily job briefing. It includes a daily PPE check for hard hat, safety vest, safety toe shoes, safety glasses, ear protection, and gloves. Record job details such as job name and number, address, superintendent, contractors on site, rally point, emergency number, eyewash and first aid locations, and nearest medical facility. Capture permits and approvals, line voltage and circuit name, minimum approach distance, excavation locates, concrete pour card details, and equipment checklists. Document steps to perform the task, potential hazards, protective measures, and required PPE, with mid day and post break reviews. Use the safety wheel and the hierarchy of controls to identify and reduce risk.

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Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Job Safety Analysis JSA Form
This Job Safety Analysis JSA form helps teams identify job steps, assess potential hazards, and define controls before work begins. Sections cover site information, personnel, job name and task, as well as checks for OSHA and emergency postings, mobile equipment activity, traffic exposure, and integrity of critical controls. The template guides reviews of PPE requirements, working at heights, barricades and controlled access zones, scaffolding inspection and tagging, stairs, ladders, and housekeeping. Use it after training to reinforce safe practices and standardize risk assessments across construction activities.
by Brad Moyer, from the Community
Downloads: 10+
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Template
Branch 23 Job Safety Analysis (JSA) Form
This Job Safety Analysis (JSA) form helps teams document job steps, identify potential hazards, and define safety controls before work begins. It includes prompts for site information, job and department details, supervisor, and date. A hazard checklist covers chemicals, high-traffic areas, powered industrial trucks, welding and grinding, arc flash, pressure testing, and other risks. Critical procedures sections address work at heights, confined space entry, lockout/tagout of electrical or mechanical energy, heavy equipment lifting, and hot work in potentially explosive atmospheres. The form provides structured tables for sequencing job steps with corresponding hazards and controls, a tools and equipment list, and an additional PPE checklist (eye and hearing protection, fall protection, respirators, chemical-resistant gear, gloves, hard hat, gas monitor, and more). Includes approval sign-off for the site supervisor.
by Aaron Turner, from the Community
Downloads: 10+
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Template
JSA Template Free Job Safety Analysis Form
This JSA template helps teams break jobs into steps, spot hazards, and record effective control measures. Capture details for each job step, assess risks such as chemical, electrical, ergonomic, excavation, fall, fire, mechanical, noise, radiation, struck by objects, temperature, visibility, and weather. Document engineering and administrative controls, required personal protective equipment, and other preventive measures with clear explanations. Include photos, recommendations from the health and safety committee, and digital signatures to complete and verify the analysis. Use this form to standardize Job Safety Analysis, improve hazard awareness, and reduce incidents across worksites.
by Marleene Cerda, from the Community
Downloads: 0
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Template
IB Task Analysis Template
Use this IB Task Analysis checklist to break down job steps, identify hazards, rate risk, and define practical control measures. Capture site details and date, specify required PPE such as safety glasses, hard hat, gloves, or respirator, and document methods to eliminate or minimize risk. Ideal for construction teams standardizing job hazard analysis and improving safety compliance.
by Faye Meades, from the Community
Downloads: 30+
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Terra5 Job Safety Analysis JSA

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Job Safety Analysis JSA Form

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