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Job Safety Analysis (JSA) Template

A job safety analysis, also called a job hazard analysis, breaks a task into steps and records the hazards and controls for each one before work begins. This template turns your answers into a signed JSA that your crew can review at the pre-job briefing.

Fill in

Company

Job or task

Location

Date

JSA number

Crew and roles

Required PPE

Permits or procedures

Step 1

Hazards for step 1

Controls for step 1

Step 2

Hazards for step 2

Controls for step 2

Step 3

Hazards for step 3

Controls for step 3

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Job Safety Analysis (JSA) Template

Job Safety Analysis

Company: Acme Precision Ltd JSA no.: JSA-0231 Date: 2026-10-20 Job: Replace conveyor drive belt Location: Packaging line 3 Crew: 2 maintenance technicians, 1 line lead

Requirements before starting

Required PPE: Safety glasses, cut-resistant gloves, safety shoes Permits and procedures: LOTO-031, work order WO-448120 The crew has discussed this JSA, understands the hazards and agrees to stop work if conditions change.

Steps, hazards and controls

Job step	Potential hazards	Controls (eliminate, substitute, engineer, administrative, PPE)
1. Isolate and lock out the conveyor drive	Unexpected start-up, stored energy in tensioner	Apply LOTO, verify zero energy, release tension spring slowly
2. Remove guard and loosen belt tensioner	Pinch points, awkward posture, sharp edges	Two-person lift, gloves, use correct tools, keep hands clear of rollers
3. Install new belt, retension and replace guard	Pinch points during tracking, missing guard on restart	Check alignment by hand, confirm guard fitted, clear area before removing locks
4.
5.

Crew acknowledgement

Name	Role	Signature	Time

Approvals

Prepared by / Date

Supervisor / Date

Safety representative / Date

A starting point, not legal advice. OSHA describes job hazard analysis in four steps: select the job, break it into steps, identify hazards, and determine controls. Review the JSA when the job, tools, crew or conditions change. Prefer controls higher in the hierarchy over PPE.

Attach JSAs to ERP work orders

An optional review of linking hazard analyses and permits to maintenance jobs.

Optional. The tool and every export work without this. No spam.

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How to use this template

Choose the job, then walk it through with the people who actually do it. Enter the job details, crew, PPE and any permits. Fill in up to three steps in the fields and add more in the exported table. For each step, name the hazard in specific words, such as pinch point at tensioner, rather than a generic word like injury. Write the control as an action someone will take. Export the document, print it, and have every crew member sign after a short discussion.

Method and hierarchy of controls

The recognised approach is four steps: select the job, break it into sequential steps, identify the hazards at each step, and decide on controls. Rank controls using the hierarchy: eliminate the hazard, substitute something safer, apply engineering controls such as guarding, use administrative controls such as procedures and training, and only then rely on PPE. Jobs with a history of injuries, high potential for severe harm, new or changed tasks, and complex jobs with many steps should be analysed first.

Keep steps short and in order
Write who does what, not just what
Cross-reference LOTO, permit and work order numbers
Include emergency steps such as stop work and first aid

Worked example

For a conveyor belt replacement, step one is isolation and the hazard is unexpected start-up and stored tension energy. The control is LOTO with verification plus slow release of the tensioner. Step two exposes pinch points and awkward posture, so the crew uses a two-person lift and keeps hands out of roller zones. Step three covers restart: the control that matters is confirming the guard is back before locks come off.

Common mistakes

The usual failures are copying last year's JSA unchanged, listing hazards so generically that they cannot be acted on, using PPE as the only control, and having the supervisor complete the form alone. Another is filing the document after the job. A JSA is only useful if reviewed before the work and revisited when conditions change. Link JSAs to the work order so they are retrievable during an investigation.

Frequently Asked Questions

Is a JSA the same as a JHA?

In most workplaces the terms are used interchangeably. Job hazard analysis is the term OSHA uses. Some companies say JSA for a task-level document completed before each job, and JHA for a broader analysis of a job class.

Is a JSA required by OSHA?

OSHA does not have a single standard requiring a JSA for every job, but several standards require hazard assessments, such as PPE under 1910.132, and OSHA recommends JHAs. Customers and site rules often require them.

How many steps should a JSA have?

Enough to capture each distinct action that could expose someone to a hazard, typically 5 to 12. If you need many more, the job is probably too large and should be split into separate JSAs.

Who should sign the JSA?

Everyone doing the work, plus the supervisor who approves it. Signatures show that the crew reviewed it, so collect them after the discussion, not before.

If you plan maintenance in an ERP, we can set up a flow that attaches the right JSA and permits to each work order automatically. Ask for a short review.

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