• JHA Audit Form

  • Date JHA was created*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Date of Audit*
     / /
    2 digit month, 2 digit day, 4 digit year
  • All significant task steps identified?*
  • Hazards correctly identified and assessed?*
  • Workers familiar with hazards associated with the task?*
  • Workers understood their individual responsibilities to ensure hazards are controlled?*
  • Appropriate controls identified?*
  • Required controls in place at time of audit?*
  • Workers observed following task steps correctly?*
  • All identified and required equipment is available and in use?*
  • All workers involved with task have signed off on the JHA?*
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  • Should be Empty: