ATTACHMENT 03 JHA Template.xlsx
XLSX spreadsheet 40 KB Posted
- Attached to
- WWV/WWVB UPS Battery Replacement and Annual Preventative Maintenance Federal contract opportunity
- Solicitation number
- 1333ND24QNB190380
About this file
The provided document is an ATTACHMENT 03 JHA Template, which is a Pre-Job Hazard Analysis form used at the National Institute of Standards and Technology (NIST) to identify potential hazards and control measures prior to performing work. The template covers various environmental, ergonomic, work-at-height, and activity-related hazards, as well as required permits and personal protective equipment (PPE). Employees are required to complete this form before starting each task or when conditions change. The related federal contract opportunity is for the WWV/WWVB UPS Battery Replacement and Annual Preventative Maintenance at the NIST Fort Collins site. This is a solicitation for ongoing UPS preventative maintenance and battery replacement services at the facility.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1333ND24QNB190380 AMD 0002 WD and RFIs.pdf | ||
| 1333ND24QNB19038 00001 Reschedule Site Visit and Due date.pdf | ||
| 1333ND24QNB190380 UPS PM Fort Collins.pdf |
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Text version
Sheet1
| Safety is Everyone’s Responsibility! | |||||||
| OFPM | |||||||
| Pre-Job Hazard Analysis | |||||||
| Please complete this Pre-JHA prior to start of each task or change in conditions. | |||||||
| BMSS | |||||||
| Shop/Group | Date | Time | Work order # | ||||
| Grounds Shop Maintenance | NIST | ||||||
| Project | Task location | ||||||
| Prior to performing the job, identify tasks and hazards. Use the checklist to help find hazards or list hazards | |||||||
| not identified in the checklist and record results in the Table. | |||||||
| Environmental Hazards | Ergonomic Hazards | Permits Required | |||||
| 1. Spill potential | 26. Working in a tight area | Confined space # _________ | |||||
| 2. Weather conditions | 27. Parts of body in line of fire | Excavation | |||||
| 3. MSDS (chemical handling) | 28. Working above your head | Impairment | |||||
| 4. Ventilation required | 29. Pinch points identified | Hot Work/Burn | |||||
| 5. Heat stress/cold exposure | 30. Repetitive motion | Penetration | |||||
| 6. Other workers in area | Work at Height Hazards | Radiation Work | |||||
| 7. Lighting levels too low | 31. Barricades, flagging, and signs | Roof Access | |||||
| 8. Housekeeping | 32. Floor holes | Scaffold | |||||
| 9. PACM-Possible asbestos containing material | 33. Protect from falling items | PPE Requirements | |||||
| 10. Radiation | 34. Powered platforms/Arial Lifts | Monogoggles/face shield | |||||
| 11. Lead paint | 35. Others working overhead/below | gloves (Kevlar, leather or specialty) | |||||
| 12. Fume hood exhaust | 36. Fall arrest | Arc Flash clothing/coveralls | |||||
| Activity Hazards | 37. Ladders/scaffolding | (fire retardant) | |||||
| 13. Operational lasers | 38. Leading edge work | Hearing protection | |||||
| 14. Welding/grinding | Personal Limitations/Hazards | Respirator protection | |||||
| 15. Burn/heat sources | 39. Clear instructions provided | Safety Glasses / or safety glasses | |||||
| 16. Compressed gasses | 40. Trained to use tool and perform task | w/side shields/face shield | |||||
| 17. Energized equipment in area | 41. Distractions in work area | Additional PPE required: | |||||
| 18. Electrical shock from cords/tools | 42. Working alone (communication) | Hard Hats | |||||
| 19. Equipment/tools inspected | 43. Lift too heavy/awkward position | Safety Vest | |||||
| 20. Critical lift required | 44. External noise levels | Chaps | |||||
| 21. Lock out/Tag out required | 45. Physical limitations | Safety Shoes | |||||
| 22. Airborne particles | 46. Other Hazards | Dosimeters | |||||
| 23. Flammable liquids | Other: ___________________ | ||||||
| 24. Slips, trips & falls | |||||||
| 25. Standing water |
Describe the tasks, hazard(s) and the related controls in the following table.
TASK HAZARD CONTROL
| Employee/Crew Members (printed): | |
| Supervisor/Work Group Leader Signature: | |
| OFPM Safety Office Signature: | 5/1/13 |
Sheet2
Sheet3
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