🦺 Job Safety Analysis (JSA) Template
Free downloadable job safety analysis (JSA) template for identifying hazards, assessing risks, and developing safe work procedures before work begins.
| Resource | What It Covers |
|---|---|
| JHA Guide | How-to guide with examples, risk matrix, hierarchy of controls |
| JSA/JHA Playbook | Implementation workflow, roles, metrics, troubleshooting |
| JHA Procedure (SOP) | Company procedure — when JHAs are required, policy, compliance |
| You are here — JSA Template | Downloadable form with fill-out instructions |
Download
Format: Text (.txt - can be printed or converted to PDF)
Last Updated: February 2026
File Size: ~5 KB
Tip: Open the .txt file in Word or Google Docs, format as a table, and save as PDF for a professional-looking form.
Template Sections Explained
Job Information Header
This section identifies the specific task, location, and responsible parties.
| Field | What to Enter | Example |
|---|---|---|
| Project Name | Full project name | Riverside Medical Center |
| Project Number | Your internal project number | 2026-0142 |
| JSA Number | Sequential JSA number for this project | JSA-0142-015 |
| Date Prepared | Date the JSA was written | 02/10/2026 |
| Prepared By | Name and title of person writing the JSA | Mike Johnson, Foreman |
| Job/Task Description | Specific task (not generic) | Install guardrails on Level 3 east side |
| Location/Area | Where on site this work will happen | Building A, Level 3, Grid E-H |
| Estimated Duration | How long the task will take | 4 hours |
| Number of Workers | Crew size for this task | 4 ironworkers |
"Concrete work" is not a task description. "Place concrete for Level 2 east wing elevated slab using pump truck" tells everyone exactly what this JSA covers.
Job Steps Section
Break the task into 5–15 sequential steps. Each step gets its own hazard and control analysis.
How to fill it out:
| Column | Instructions | Good Example | Bad Example |
|---|---|---|---|
| Step # | Sequential number | 1, 2, 3... | — |
| Task Description | Start with action verb, be specific | "Position extension ladder at 4:1 ratio against parapet wall" | "Set up" |
| Potential Hazards | Specific hazard with consequences | "Fall from 14-foot ladder to concrete below" | "Fall hazard" |
| Risk Rating | Severity × Probability (see matrix) | S:4 × P:2 = 8 (High) | — |
| Controls/Precautions | Specific actions to reduce risk | "Use fiberglass ladder, secure top, 3-point contact, spotter at base" | "Be careful" |
| Responsible Person | Who ensures this control is in place | "Lead carpenter" | — |
Risk Assessment Matrix
Rate each hazard using these scales:
Severity (how bad):
| Rating | Level | Description |
|---|---|---|
| 1 | Minor | First aid only — bandage, ice, minor strain |
| 2 | Moderate | Medical treatment — stitches, sprain, minor fracture |
| 3 | Serious | Lost time — broken bone, hospitalization, surgery |
| 4 | Critical | Permanent disability — amputation, major organ damage |
| 5 | Catastrophic | Fatality or multiple serious injuries |
Probability (how likely):
| Rating | Level | Description |
|---|---|---|
| 1 | Rare | Could happen but very unlikely with current conditions |
| 2 | Unlikely | Has happened in the industry, not on our projects |
| 3 | Possible | Has happened on similar projects we've worked |
| 4 | Likely | Has happened on this project or regularly with this task |
| 5 | Almost Certain | Expected to happen without controls in place |
Risk Score = Severity × Probability
| Score | Level | Required Action |
|---|---|---|
| 12–25 | Extreme | Stop. Do not proceed. Redesign or get safety director approval. |
| 8–10 | High | Controls must be verified before work. Supervisor monitors. |
| 5–6 | Medium | Implement controls and monitor throughout task. |
| 1–4 | Low | Standard precautions. PPE and awareness. |
Personal Protective Equipment (PPE)
Check all PPE required for this specific task. Be specific about types:
| PPE Item | Specify Type When Possible |
|---|---|
| Hard Hat | Type I (top impact) or Type II (top + side) |
| Safety Glasses | ANSI Z87.1; tinted for outdoor, clear for indoor |
| Hearing Protection | Earplugs (NRR 29+) or earmuffs (NRR 25+) |
| Safety Boots | ASTM F2413 steel or composite toe |
| Gloves | Cut-resistant (Level A4+), chemical-resistant, or leather per task |
| Respirator | N95, P100 half-face, or supplied air per exposure |
| Fall Protection | Full body harness + 6' shock-absorbing lanyard or retractable |
| High-Vis Vest | ANSI Class 2 or Class 3 per location |
| Face Shield | Arc-rated (cal/cm² per incident energy) or impact-rated |
| Other | Chaps, aprons, knee pads, welding hood, etc. |
Emergency Procedures
Fill in for the specific work location — not just the general project info.
| Field | What to Enter |
|---|---|
| Emergency Contacts | Names and phone numbers (project manager, safety director, 911) |
| First Aid Location | Nearest first aid kit location from the work area |
| AED Location | Nearest automated external defibrillator |
| Emergency Equipment | Fire extinguisher, eye wash, spill kit locations |
| Evacuation Route | Route from work area to muster point |
| Nearest Hospital | Name, address, drive time |
Training Requirements
Document what training is required before any worker can perform this task:
- Fall protection training (before any work at heights)
- Confined space entry (before confined space work)
- LOTO (before lockout/tagout operations)
- Electrical safety / NFPA 70E (before electrical work)
- Scaffold user training (before using scaffolds)
- Excavation competent person (before trench work)
- Crane signaler/rigger (before crane operations)
- Silica awareness (before silica-generating tasks)
- Hazard communication (before chemical exposure)
Signatures
Who must sign:
- Every worker who will perform or be exposed to the task
- The foreman/supervisor who developed the JSA
- The superintendent or reviewer who approved it
When to sign:
- Before work begins — never after
- Workers who arrive later must be briefed and sign before joining the task
Completed Example: Roof Penetration Repair
Here's a fully completed JSA to show what a good one looks like:
Project: Eastside Commerce Center
JSA Number: JSA-0089-003
Date: 02/08/2026
Prepared By: Carlos Rivera, Roofing Foreman
Task: Repair 6 roof penetration flashings on Building B
Location: Building B roof, southeast corner near HVAC units
Duration: 5 hours
Crew: 3 roofers + 1 helper
| Step | Task Description | Hazards | Risk (S×P) | Controls | Responsible |
|---|---|---|---|---|---|
| 1 | Load materials onto truck and transport to building | Manual lifting strain (rolls, tools = 40-70 lbs each) | 2×3 = 6 Med | Team lift for items over 50 lbs; dolly for rolls; proper body mechanics | Helper |
| 2 | Access roof via fixed ladder and stage materials | Fall from ladder (20 ft) | 4×2 = 8 High | Inspect ladder before use, 3-point contact, no carrying materials on ladder — hoist materials separately | Foreman |
| 3 | Set up perimeter warning line (15 ft from edge) | Fall from roof edge while setting line | 5×2 = 10 High | 100% tie-off when within 15 ft of edge; harness + retractable; anchor verified by competent person | Foreman |
| 4 | Remove old flashing and sealant | Cuts from utility knife/old metal | 2×3 = 6 Med | Cut-resistant gloves (Level A4), cut away from body, retractable blade knife | Roofer 1 |
| Chemical exposure from old sealant | 2×2 = 4 Low | Gloves, safety glasses, SDS reviewed for old materials | Roofer 1 | ||
| 5 | Apply primer to penetration area | Chemical fumes (solvent-based primer) | 3×3 = 9 High | N95 respirator minimum, natural ventilation (outdoor), nitrile gloves, no open flame within 20 ft | Roofer 2 |
| Slip hazard (spilled primer) | 2×2 = 4 Low | Drop cloth under work area, clean spills immediately | Helper | ||
| 6 | Install new flashing collar and sealant | Pinch points during flashing install | 2×2 = 4 Low | Gloves, proper tool use, hands clear of pinch points | Roofer 1 |
| Burns from torch (modified bitumen) | 3×2 = 6 Med | Fire watch, fire extinguisher within 10 ft, hot work permit completed, no combustibles within 35 ft | Roofer 2 | ||
| 7 | Water test each repair | Slip hazard (wet roof surface) | 2×3 = 6 Med | Non-slip rubber boots, walk — don't run, clean up standing water | Helper |
| 8 | Clean up and remove materials from roof | Falling objects off roof edge | 3×2 = 6 Med | Lower materials by hoist — never throw, barricade below during lowering | All |
| Trip hazards (debris) | 2×2 = 4 Low | Clean as you go, designated walkways clear | Helper |
Required PPE: Hard hat, safety glasses, high-vis vest, steel-toe boots, cut-resistant gloves, fall protection harness + retractable SRL, N95 respirator (for primer step)
Emergency Info:
- Safety Director: Janet Walsh — (503) 555-0142
- Nearest First Aid: Roof hatch landing, Level 4 stairwell
- Nearest Hospital: Providence Portland — 4805 NE Glisan St (12 min drive)
- Fire Extinguisher: At roof hatch and at work area
Training Required: Fall protection, hot work, hazard communication
Tips for Filling Out the JSA
- Walk the work area first — Don't write the JSA from the trailer
- Involve the crew — The workers doing the job know the real hazards
- Be specific — Every hazard and every control should be actionable
- Use the risk matrix — Prioritize controls for the highest-risk hazards
- Include setup and cleanup — Many injuries happen during these phases
- One JSA per task — Don't combine different tasks on one form
- Update, don't ignore — If conditions change, update the JSA before continuing
- Keep it visible — Post the signed JSA at the work area, not filed away
- Review at pre-task meeting — The discussion matters more than the paper
- File for the record — Every completed JSA goes in the project safety file
Best Practices
Writing Effective Job Steps
- Start with an action verb (position, install, operate, connect, lift, inspect)
- Keep each step to one main action
- Include setup and cleanup steps
- Aim for 5–15 steps total — not too broad, not too granular
Writing Effective Hazard Descriptions
| Instead of... | Write... |
|---|---|
| "Hazard" | "Fall from 20-foot scaffold platform to concrete slab" |
| "Electrical" | "Contact with energized 480V conductors in adjacent panel" |
| "Struck-by" | "Struck by falling pipe fitting from overhead work (4-lb fitting from 30 feet)" |
| "Chemical" | "Skin and eye exposure to solvent-based roofing primer" |
Writing Effective Controls
| Instead of... | Write... |
|---|---|
| "Be careful" | "Install guardrails with mid-rail and toe board on all open sides" |
| "Use PPE" | "Wear ANSI Z87.1 safety glasses and Level A4 cut-resistant gloves" |
| "Stay safe" | "Spotter in position before crane movement; no workers inside swing radius" |
| "Follow procedures" | "Complete LOTO per procedure: lock all sources, verify zero energy, try-before-touch" |
Frequently Asked Questions
Q: How long should it take to complete a JSA?
A: 15–30 minutes for a new JSA from scratch. 10–15 minutes to customize a library JSA for site conditions. The pre-task meeting adds another 5–15 minutes.
Q: How many steps should a JSA have?
A: 5–15 steps. Fewer than 5 means the steps are too broad and you're likely missing hazards. More than 15 means you're too granular — consider combining related actions.
Q: Who is responsible for creating the JSA?
A: The foreman or supervisor responsible for the task, with input from the crew who will perform the work. The safety director should review JHAs for high-hazard tasks.
Q: Do I need a new JSA every day?
A: Not necessarily. If the same task continues under the same conditions with the same crew, the existing JSA stays valid. Create a new one when the task, conditions, crew, or equipment changes.
Q: What if a hazard doesn't fit neatly into one step?
A: Some hazards are present throughout the entire task (like working at heights). List them at the first step where they apply, and note "applies to all steps" or repeat them at relevant steps.
Q: Paper or digital?
A: Either works. The important thing is that JSAs get completed, reviewed with the crew, signed, and filed. Digital tools are faster once crews learn them, and they make the library easier to manage.
Related Resources
- Job Hazard Analysis Guide — Complete how-to guide with examples
- JSA/JHA Playbook — Workflow and implementation guide
- Safety Compliance Guide
- Job Site Safety Checklist
- Incident Report Template
- Hot Work Permit Template
- Toolbox Talk Library