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About Us
Why WE
Clients
Contact
Blog/News
Safety
Installations
Equipment Installations
Conveyor Installation
Laser Alignment & Digital Layout
Service & Maintenance
Fabrication
Structural Fabrication
Clean Design
Safety Blitz Form
Job Hazard Analysis Focus:
Hand Safety & Laceration Prevention
Date:
Month
Day
Year
Job #:
Job Site:
(Required)
Time:
Hours
:
Minutes
AM
PM
AM/PM
Completed By (Competent Person)
Project Manager
(Required)
Please Select
Charles
Dan
John
Mike G
Tim
1. Job Description
(Required)
2. Required PPE Checklist
Gloves: Well-fitting, puncture- or cut-proof
Y
N
N/A
Chemical PPE: Appropriate gloves for hazardous substances
Y
N
N/A
Face Shield / Safety Glasses / Goggles
Y
N
N/A
Hard Hat
Y
N
N/A
Steel Toe Boots
Y
N
N/A
3. Hazard Identification & Safety Checklist
Safety Question
Are hands/fingers clear of pinch and crush points?
Status (Y/N/NA)
Corrective Actions
Are proper guards in place on all power tools?
Status (Y/N/NA)
Corrective Actions
Are objects being cut/worked on secured from movement?
Status (Y/N/NA)
Corrective Actions
Is the area free of sharp, spiked, or jagged edges?
Status (Y/N/NA)
Corrective Actions
Are gloves sized correctly (not too large)?
Status (Y/N/NA)
Corrective Actions
Is a neutralization solution ready for chemical contact?
Status (Y/N/NA)
Corrective Actions
4. Control Measures & Additional Info
5. Management & Competent Person Verification
Training: Workers trained on specific hand safety.
Equipment: Tools maintained and guards in working order.
6. Sign-Off
Operator:
Date:
MM slash DD slash YYYY
Competent Person:
Date:
MM slash DD slash YYYY
Send Form to Client?
(Required)
Yes
No
Client Name
First
Last
Client Email
Δ
