JOB HAZARD ANALYSIS

(See reverse side for examples of potential hazards.)

Project Title: Location:

Date Analysis Completed: Scheduled Start Date: Task Description: Painting with Gloss Paint
Attendees
:

Step 1: Review the scope of the job. Discuss the sequence of work and all potential hazards.

Step 2: Walk through the work area and identify possible hazards. Using the chart provided, list all the potential hazards identified and how hazard will be eliminated or controlled.
(Identify who is responsible for eliminating or controlling hazard and how it will be handled.)

Step 3: Provide a copy of the completed Job Hazard Analysis (DC-83) to the safety representative before work begins.

Sequence of Work Potential Hazards Method for Eliminating or Controlling

1. Sanding of the Surfaces 1. Hand injury 1. Wear specified hand gloves.
2. Eye Injury 2. Wear safety goggle
3. Inhaling dust particles 3. Use of appropriate nose mask (N95)
4. Fall from height (If sanding elevated objects) 4a. Use sandpaper extension pole (if available).
4b. Use Fall Protection Equipment as needed.
4c. Use scaffolding equipment
2. Painting 1. Chemical hazard 1a. Wear appropriate hand gloves to avoid
2. Repetitive injury chemical contact.
3. Eye Injury 1b. Wear safety eye goggle.
4. Slip Hazard 1c. Consult JHA on chemicals
2a. Do not move hand in same motion for
prolonged periods. Change hands or change
direction of motion periodically.
3a. Use appropriate eye protection.
3b. A portable eyewash bottle should be made
available to rinse off paint in case of eye contact
with paint.
4a. Paint spill should be cleaned up immediately
4b. Wear slip resistant shoe
3. Cleaning 1. Chemical Hazard (petrol or thinner) 1a. Wear appropriate hand gloves to avoid
2. Eye injury chemical contact.
1b. Wear appropriate respirator.
2a. Wear appropriate eye protection.
DC-83-E 8/17 Use Additional Forms as Needed
 Name of Preparer Date Safety Representative Date Reviewed by Date

DC-83-E 8/17—Page 2
 Potential Hazards and Conditions
For additional information, review the cited safety outline (DC-80) references.

ACCIDENT-PREVENTION PLAN (See A2, A8.) WORKER HABITS AND ACTIONS (See B1-5, C3.) PERSONAL PROTECTIVE EQUIPMENT (See C1-12, D2.)
Has an accident prevention plan been reviewed with crew Have safety responsibilities been reviewed with all workers? Are hard hats, safety glasses, appropriate footwear, and gloves
overseers and all personnel? Are workers given adequate training for their jobs? being used by all workers?
Has provision been made for rotating repetitive tasks? Are cotton respirators, face shields and protective clothing
EMERGENCY RESPONSE (See A5, D4, G3.) Are proper hoisting/lifting techniques being used? available?
Are emergency phone numbers posted (on a wall or other Are material handlers properly trained? Is hearing protection used as needed? Are welding helmets and
known location) for medical, fire, chemical, electrical Are welding and torching done in designated areas only? aprons worn as needed?
emergencies? Do workers know whom to call? Are workers trained and approved to wear respirators?
Have emergency evacuation procedures been discussed? HOUSEKEEPING/STORAGE (See D1, J1-2.)
Are first-aid supplies available? Have daily cleanup arrangements been discussed? LOCKOUT/TAGOUT (See F2, F12.)
Are fire extinguishers charged and in good condition? Are Is the work site free of clutter, dirt, and spills? Are personal lockout devices needed?
they checked monthly and marked? Arematerials being organized and stored properly? Are “Out of Use” tags available?
Are emergency cleanup provisions available for chemical Are tools and equipment being stored properly? Are circuit breaker lockouts in place?
spills? Are Safety Data Sheets (SDS) accessible? Are aisles, catwalks, and walkways well defined and Are extension cords and plugs under worker control?
Is an eye wash station available nearby? unobstructed? Is there any unusual congestion? Have pressure lines been bled down?
Is spontaneous combustion a danger? Are flammable or Is the pallet storage acceptable? Are valve blocks in place? Are blocks for gravity restraint in
explosive materials being used? Are stacked items stable and appropriately protected from the place?
Is there an emergency plan for refrigerant gas leaks? weather? Have valve handles been removed or chained in “off” position?
Are combustibles including rags properly stored?
PERMITS/REPORTS REQUIRED? (See F16, G4, G9.) LADDERS (See E1, E8.)
Confined space? Energized electrical work permit?
PERSONAL SAFETY/PASSERSBY (See A2, J7.) Are ladders in good physical condition?
Hot work? “Call Before You Dig!”? Do trip hazards exist? Are floor openings covered? Are sharp Are ladders designed for their anticipated use?
Fireguard report? Other? objects protected? Have workers completed ladder-safety training?
How will extension cords and hoses be routed safely?
BUILDING INTEGRITY (See F17.) Are dangerous areas barricaded and posted with warning HAND AND POWER TOOLS (See F1-17.)
Are arrangements in place to keep the building secure? signs? Are proper tools provided?
Are any collapse hazards evident? Are overhead clearances identified? Are tools and extension cords in good condition?
Have demolition procedures been reviewed? Is anything loose on parapets or ledges? Are restraining Are tools safety-checked before using?
Should the fire alarm system be disabled? devices or tiebacks needed?
EQUIPMENT SAFEGUARDS (See F3, F5.)
Do preexisting conditions require photographs? Can workers be caught in or between objects?
How will pedestrians be alerted to moving vehicles? Are Is equipment well maintained?
ENVIRONMENT (See A2, G4.) flagmen needed? Is equipment safety-checked before being put into use?
Is the physical environment in the work area acceptable? Will a crane be required? Has a master rigger been consulted? Are all guards in place and pinch points protected?
Is there adequate ventilation and illumination? Are all rotating shafts and belts guarded?
Is there excessive dust, noise, fumes, heat, or vibration? CHEMICAL AND ELECTRICAL (See A6, D3-4, G5) Are compressors and other fixed-place equipment anchored?
Are weather conditions (such as heavy rain, high wind, snow, Will hazardous substances be brought on work site?
HEAVY EQUIPMENT (See F15-16.)
or ice) safe for the task being performed? Is all electrical equipment properly grounded? Are ground
fault protected receptacles available where needed? Are operators maintaining adequate distance from other
FALL PREVENTION (See E2.) Are plywood or acrylic panels available to cover unattended workers?
Can worker fall from one level to another or on same level? energized electrical panels? Is equipment in good repair? Is there rollover protection?
Is there a need for fall protection training/refresher? Is there a danger from overhead high voltage electrical lines? Is the “Call Before You Dig!” procedure being followed?
Are safety lines and harnesses required? Are workers familiar with proper procedures for installing Are trenches properly sloped, shielded, and barricaded?
Is scaffolding needed for the tasks? natural gas piping? Are loads properly secured?
Are catwalks and elevated walkways in good condition? Are Is pressure testing and chemical flushing of pipe installations
handrails, guardrails, and toeboards in place? being done?
Are there dangers for persons below?

DC-83-E 8/17—Page 2