Job Hazard Analysis and Mitigation Form

Task Hazard Analysis and Mitigation Form

Task or Employee: Inspecting an attic with pull down stairs Routine Non-routine

Basic Job Steps Potential Hazards Controls & Recommended Actions 1. find the areas where you will conduct the  Notify homeowner inspection  walk area prior to set-up or service to familiarize 2. put on your safety glasses  trip/slip/fall  identify and remove trip/slip hazards and bump cap  unlevel surfaces  stand to the side and watch overhead as you pull the 3. pull down the attic hatch  objects falling from overhead and inspect the ladder ladder down

 climbing surface  use proper ladder use techniques 4. Ascend steps  overheard hazards  wear bump cap  fall from ladder  use flashlight

5. visually inspect the  head injuries from sharp walking surface in the  Determine your clear path of travel objects attic  wear eye protection and bump cap  foreign body in eyes  use proper ladder use techniques  fall from ladder

 sharp objects  eye protection 6. inspect  falling objects  bump cap  falls through ceiling  hand protection  flashlight Job Hazard Analysis and Mitigation Form page 2 of 2 Basic Job Steps Potential Hazards Controls & Recommended Actions

Acknowledgements

Print Name Signature Date

Supervisor: 1/16/2015

Participants: