Job Safety Analysis and Isolation Record Form
v3.0
Purpose. Workers complete this form before starting any job to identify hazards, agree controls and record isolation points, locks and test for dead results.
1.When to complete
Complete this form on site before work starts, for every job, and review it whenever the task, the site or the people change. Every worker on the task, including apprentices, signs it. The completed form is attached to the job record.
2.Identifying hazards
Walk the work area and list every hazard: electrical sources, height, refrigerant, confined spaces, asbestos, traffic, weather, manual handling and other trades. Rate the risk before controls and after controls.
3.Controls
Record the specific controls you will use, not generic statements. Name the isolation points, the edge protection, the gas detector or the exclusion zone. Confirm the personal protective equipment and the emergency contact for the site.
4.Isolation record
List each isolation point, who fitted a lock, the instrument used for the test for dead and the result. This section must be completed before any electrical work starts.
5.Sign off
The licensed electrician or supervisor in charge signs to confirm the controls are in place, and every worker signs to confirm they understand them. At the end of the job the supervisor signs to confirm locks are removed and the site is safe.