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JSA – Roof Rail
JSA – Scaffolding
JSA – Use of Mobile plant
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Scaffolding Handover Certificate
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Home
Vehicle Inspection Check In
Labour Hire Docket
SWMS
Job Safety Analysis (JSA)
JSA – Roof Rail
JSA – Scaffolding
JSA – Use of Mobile plant
Scaff Tags
Handover Certificates
Scaffolding Handover Certificate
Roof Rail Handover Certificate
Reporting page
Safety Meeting/Toolbox Record
Upload Job Photos
Management
Employee Forms
Timesheets
Employee Self Evaluation Form
Application for Leave
Company Policies and Employment Documents
Job Safety Analysis
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This JSA is completed in conjunction with the Safe Work Method Statement (SWMS) for Erecting, Altering and Dismantling Scaffolding.
Acknowledgement of Risk Matrix
*
I/we have read the Risk Assessment Matrix and understand it's content.
Activity - What is the task that you are doing?
*
Erecting
Alteration
Dismantling
Is a crane and bin being used for the dismantle?
Yes
No
Is Edge Protection (Rail) being installed as well?
*
Yes
No
Other than working at heights greater than 2 metres, working on or near traffic corridors, and using of mobile plant; are there any other high risk activities at this site?
*
Please select all that apply
No other high risk activities
Work carried out near live power lines
Confined spaces
Demolition works
Asbestos
Using Explosives
Diving Work
Artificial extremes of temperatures
Tilt up or pre-cast concrete
Working at depths greater than 1.5m, including tunnels or mines
Pressurised gas distribution mains or piping chemical, fuel or refrigerant lines energised electrical installations/services
Work in an area that may have a contaminated or flammable atmosphere
In or near water or other liquid that involves risk of drowning
What PPE is required for this site and task?
*
Please select all that apply
Gloves
Hard Hat
Foot Protection
Hi-Vis Clothing
Hearing Protection
Safety glasses
Fall Arrest system/Safety Harness
Face Mask
Sun Protection
Personal Floatation Device (PFD)
Client Name:
*
Client Email (if they require a copy of this JSA)
Address
*
Street Address
Date
*
Day
Month
Year
Job Owner:
*
- Please select -
Josh Prior
Scott Willis
Unknown
A toolbox talk at the start of each day should be completed to discuss any site specific safety information. Please list items toolboxed:
*
Are there any hazards or risks specific to this site?
*
What control measures will be put in place to minimise the risk of injury?
*
With these control measures put in place, what is the risk of an injury occurring?
*
Low (Proceed with work and monitor)
Moderate (Proceed with work and monitor)
High (Review and introduce more controls before starting work)
Major (Do not start work, further control measures are needed)
Control measures must be continuously monitored throughout the day to ensure they remain adequate. If an incident or injury occurrs, you must follow incident response procedures first, then control measures MUST be reviewed and amended accordingly to reduce the likelihood of the same or similar injury happening again.
Acknowledgement
*
All employees/contractors have participated in the pre-start JSA and acknowledge and agree to abide by these control measures.
This risk assessment process has been developed in consultation and cooperation with employee/workers and relevant Employer/PCBU. I/we have participated in the above risk assessment and understand its contents. I/we confirm that I/we have the skills and training, including relevant certification to conduct the task as described. I/we agree to comply with safety requirements within this risk assessment including risk control measures, safe work instructions and Personal Protective Equipment described.
AS PART OF OUR COVID 19 SAFETY MEASURES, ONLY THE LEADING HAND/MOST EXPERIENCED SCAFFOLDER IS REQUIRED TO SIGN THIS JSA, AND ALL OTHER WORKERS PARTICIPATING IN THE PRESTART MEETING CAN BE LISTED AS HAVING ATTENDED.
Person conducting this Prestart meeting:
*
Signature
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Signature locked. Reset to sign again
Workers participating in the prestart:
*
List the full names of all workers on site. To add another, click on the "+" button.
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