Field sheet

Job Safety Analysis Sheet

A JSA form that makes the crew name the real energy that can hurt them, not a slogan.

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A JSA is a decision document. It names the energy, the people in the line of fire, the control that changes that energy, and who can stop the work. It is written for the crew that will do this job this shift.

A JSA that exists to survive an audit will get people hurt on a Tuesday.

I am Ryan L. Rinehart of EHS Concepts, based in southwest Missouri and serving Springfield, Branson, and the Kansas City area from a second base in Independence. I have written more of these on the floor than in a conference room. This sheet is the version I hand a supervisor when the last form was copied from last year and nobody can say the control out loud.

Who this is for

The person who has to brief the task before the work starts. A supervisor who inherited a packet of generic hazards. An EHS lead who is done watching crews sign a page they did not write. A contractor coordinator who needs the job named, not the company slogan.

If you need a risk matrix that no one can explain, stay with the form you have.

The five lines that have to be true

The job. One task. Not the whole work order.
The energy. Gravity. Motion. Electricity. Pressure. Chemical. Heat. Stored. Write the one that can take a life or a hand on this cycle.
The people in the line of fire. Operator. Helper. Bystander. The person walking the aisle. Name them.
The control that changes the energy. Isolation. Guard. Position. Sequence. Time. Distance. PPE is last, not first.
Stop and restart. Who can stop. Who restarts. Those are different people on a serious job.

How to write one in fifteen minutes

Stand at the task. Watch one cycle or talk the cycle out loud with the person who does it. Write the steps they actually take. For each step ask what energy is live. Write the control you can put a hand on. If the control is “be careful,” you do not have a control.

Brief it like you mean it. Read the energy and the stop. Ask the newest person to say the control back. If they cannot, the JSA failed before the work started. Sign after that conversation, not before.

What to kill on the form

Generic hazards copied from last year
Employee awareness as a control
A sign off block with no names
A date older than the crew
A risk score that no one can explain
A box that says PPE and nothing else on a high energy step

What this is not

It is not a 12 page corporate template. It is not a behavior based observation. It is not a substitute for isolation or a permit when the energy requires them. It will not save a job you refuse to stop.

If you want to test whether today’s job matches yesterday’s paper, use the 7 minute walk first. That page is free. This sheet is for writing the job you are about to run.

Order by email · $9.99 Try the free walk sheet first

Ryan L. Rinehart, M.Ed. EHS Concepts. Southwest Missouri and the Kansas City area.