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    All templatesRisk Assessment · 2 pages · Updated 25 September 2026

    Job Safety Analysis (JSA / JHA) Template

    Two-page JSA: job details, a step-by-step hazard and control table scored on a 5×5 matrix, the hierarchy of controls and a worker, supervisor and EHS sign-off. The method follows OSHA publication 3071 (not reviewed by OSHA).

    What's inside

    1. Job information — task or job title, location or area, date, supervisor, participants, JSA reference number
    2. Task breakdown, hazards and controls — six rows of step, hazard, risk (L×S) and controls, plus one filled example row
    3. 5×5 risk matrix — likelihood 1 Rare to 5 Almost certain against severity 1 Negligible to 5 Catastrophic; bands 1-4 Low, 5-9 Moderate, 10-15 High, 16-25 Extreme (stop work)
    4. Hierarchy of controls — elimination, substitution, engineering, administrative, PPE
    5. Sign-off — worker, supervisor and EHS reviewer, each with name, signature and date

    What requires or shapes this record

    No US or UK regulation prescribes a JSA form. What exists is a duty to assess the risks of the work and, for some hazards, to certify that you did. These are the provisions this template is built to help you meet, and what each one asks of the record.

    • OSHA 3071, Job Hazard Analysis (2002, revised)

      OSHA's guidance puts first the jobs with the highest injury or illness rates, jobs that could cause severe or disabling harm even without an accident history, jobs where one simple human error could lead to a severe injury, jobs that are new or have changed, and jobs complex enough to need written instructions. It says to watch the employee do the job, list each step, and avoid a breakdown so detailed it becomes unnecessarily long or so broad it misses basic steps. It also says to review the analysis after an injury or illness on that job and to train everyone affected by a revision.

    • 29 CFR 1910.132(d)(1)–(d)(2)

      US general industry employers must assess the workplace for hazards that call for PPE, select and communicate the PPE, and verify the assessment with a written certification naming the workplace evaluated, the person certifying, the date(s) and that the document is a certification of hazard assessment. If your JSA doubles as that record, it needs all four elements; the template's job block and sign-off cover the first three, so add the certification wording yourself.

    • Management of Health and Safety at Work Regulations 1999, reg. 3 and Schedule 1

      In Great Britain, regulation 3(1) requires a suitable and sufficient assessment of the risks to employees and others, 3(3) requires review when it may no longer be valid or the work has changed significantly, and 3(6) requires employers with five or more employees to record the significant findings. Schedule 1 lists the principles of prevention, including avoiding risks, combating them at source, replacing the dangerous by the less dangerous and giving collective protection priority over individual protection: the principles behind the controls column.

    • ISO 45001:2018, clauses 6.1.2 and 8.1.2

      In a certified system, task-level JSAs are one way to evidence clause 6.1.2 (hazard identification and assessment of risks and opportunities) and clause 8.1.2 (eliminating hazards and reducing OH&S risks). The standard does not name the JSA format.

    Each source checked on 25 September 2026. Not legal advice; check the text in force for your site.

    Field by field

    JSA reference #
    Why: Lets a permit, toolbox talk or incident report cite the exact version the crew worked to.
    Common mistake: Keeping the same number after a revision, so nobody can tell which version was signed.
    Task / job title and location
    Why: OSHA 3071 treats a hazard as the relationship between worker, task, tools and environment, so the same task in another area is another analysis.
    Common mistake: A generic title such as "maintenance" that fits every job and describes none.
    Participants
    Why: OSHA 3071's first step is to involve the employees who do the job; they know the shortcuts.
    Common mistake: Listing only the supervisor who filled the form in at a desk.
    Step
    Why: One observable action per row, in the order the worker does it.
    Common mistake: Steps so broad ("fix pump") that basic steps disappear, or so fine that the form runs to pages.
    Hazard
    Why: OSHA 3071 asks for a scenario: where it happens, who or what is exposed, the trigger, the consequence.
    Common mistake: Writing a category ("ergonomic") instead of a scenario ("lifting an 18 kg housing from floor level in a tight bay").
    Risk (L×S)
    Why: Ranks the rows so controls go to the worst first, using the matrix on page 2.
    Common mistake: The form has one score column; mixing before-control and after-control scores on one sheet. State which it is.
    Controls (hierarchy)
    Why: Forces elimination, substitution and engineering to be considered before procedures and PPE.
    Common mistake: A controls cell that says only "PPE, take care", which is the bottom of the hierarchy.
    Sign-off: worker, supervisor, EHS reviewer
    Why: The worker's signature shows the pre-task briefing happened; the reviewer catches scoring drift between crews.
    Common mistake: Signing before the briefing, or one person signing all three lines.

    Worked example

    IllustrativeReplacing a pump seal (invented job and site)

    StepHazard scenarioL × SControls
    1. Isolate and lock out pump P-12Pump restarted from the control room while the fitter's hands are in the casing2 × 5 = 10 HighLock at the motor isolator and both valves, try-start test, one personal lock per fitter
    2. Drain and flush the casingResidual caustic splashes the fitter's face when the drain plug is opened3 × 4 = 12 HighFlush to drain before opening, check pH at the drain point, face shield and chemical gloves
    3. Lift the old seal housing (about 18 kg) to the benchLower-back strain lifting from floor level in a tight bay3 × 3 = 9 ModerateUse the bay's lifting davit; two-person lift only if the davit is out of service
    4. Refit guard and remove locksCoupling left unguarded at restart2 × 4 = 8 ModerateGuard refitted before any lock comes off; supervisor checks before hand-back

    Scores are before the listed controls. Rows 1 and 2 are High. The risk assessment matrix template's action for High is controls required before proceeding, so those controls are in place before the job starts, not added during it.

    When a spreadsheet stops being enough

    A paper JSA works while one crew does one job. It stops being enough when the same task is analysed at several sites and nobody can see that one site scored the lockout step 4 and another scored it 10, and when a permit or an incident report has to point at the exact JSA version the crew signed.

    A software record keeps a shared hazard library, versions each JSA and links it to the permit or observation that relied on it. Offline access matters because JSAs are signed where the work is. The profiles below document a JSA workflow in their vendor sources.

    Same rule for every product: tagged “Risk Assessment”, “Hazard Management”, “Safety Management”, “EHS Management”, “EHS”, “Construction Safety”, “Permit to Work”, “Permits to Work (PTW)” or “Control of Work”, with a sourced job safety analysis (JSA/JHA) or pre-task planning capability in its record, or one the vendor stated to us, labelled as vendor-stated. Documented and conditional capabilities qualify; check the linked scope before treating a module as included.

    Tekmon pays for a sponsored placement (above); its place in this list follows the same rule as every entry. How lists are ordered

    All 15 matching profiles are shown. Documentation review, not hands-on testing or a claim of compliance.

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