JOB HAZARD ANALYSIS

Risk Assessment Code Matrix Accident severity Expected frequency / occurrence High to Low (4 = High, 1 = Low) 4 3 2 1 4 H H C L 3 H C M L 2 C M L R 1 M L R R
Task: Description of job Required PPE: Hardhat, Safety toe Boots, Safety Glasses, Rescue Harness List additional PPE as required. Required Equipment: List required safety and work equipment	Location: INNER BELT RD, THIRD AVE Date: Reviewed by:
Tasking:	Hazard:	RAC	Hazard Controls, Safety Precautions To Take:
Select Risk Assessment Code
Select Risk Assessment Code
Select Risk Assessment Code
Select Risk Assessment Code
Select Risk Assessment Code
Select Risk Assessment Code
Select Risk Assessment Code
Signatures of On-Site Personnel verifying the review of Potential Hazards and Hazard Control methods:
Print Name	Signature	Print Name	Signature