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.