Ground Mount JHA/JSA

Ground Mount JHA/JSA

Complete this form every time you are working on a ground mount solar site.
Name*
Date*

MonthDayYear
Date
Jobsite*
Construction Manager*
Electrical foreman*
Description of Daily Work*
Check potential hazards

FloodingSkin IrritantsFall PotentialToxic MaterialsLifting HazardsTrafficVibrationConfined spacesHigh Noise LevelExcavation HazardInadequate VentilationWater HazardIonizing RadiationEnvironmental HazardFire HazardHot or Cold SurfacesLead ExposureChemical ExposureSharp EdgesCompressed GasesCrush/Strike Hazards
Check all special precautions that apply.*

Simultaneous OperationsPollution PreventionRedundant ProtectionPre-job Safety DiscussionsLifting HazardsNear Miss ReportsDangerous Waste DisposalOverhead or Underhead Power LinesOverhead Power Lines Near the Job SiteDig Alert
Check all Personal Protective Equipment (PPE)*

Hard HatsEye ProtectionFace ProtectionSafety FootwearEar ProtectionCoverallsSCBAAir Lines/HoodPersonal GroundsHot Work PermitOperating Procedures
Signature

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