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Job Hazard Analysis Form

FormControlled document
DPR-FRM-001
v2.2
Document ownerHSE and Training Manager
Version2.2
Approved27 January 2026
Next review27 January 2027
StatusCurrent

Purpose. This form records the steps, hazards and controls for a non-routine or high risk task and the sign-on of every person doing the work.

1.When to use this form

Use this form when the Take 5 and Job Hazard Analysis Procedure requires a job hazard analysis: non-routine tasks, tasks without a written procedure, working at heights, confined spaces, hot work, crane lifts, excavation over 1.5 metres, work near live services or energised plant, and any task the supervisor rates as high risk.

2.How to complete it

The crew completes the form together at the work site before starting. Break the job into steps in the order they will be done. For each step, list what could harm someone and the control that will be in place, using the hierarchy of controls. Rate the risk with the controls in place using the site risk matrix.

3.Approval

The supervisor must review the form, walk the job if it is high risk, and approve it before work starts. If the task, the crew or the conditions change, stop, revise the form and have it re-approved.

4.Sign-on

Every person on the task must read the form and sign on. A person who joins the task later must be briefed and sign on before starting. The form stays at the job until the task is finished.

5.Filing

File the completed form with the work order or the shift records. Hazards that could not be controlled at the task level must be entered in the Hazard and Incident Register.

6.Complete the form

DPR-FRM-001 v2.2 · CAQA Deepridge ResourcesUncontrolled when printed. Simulated document created by CAQA for training and assessment.