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Job Hazard Analysis (JHA) [select campus]

Department/Org:	Category:	[Select a primary category]
Title of person performing this job:	Supervisor:
Location(s):	Frequency:	[Select how often this job is performed.]
Approved/Certified by:	Date:	Click or tap to enter a date.

Brief Job Description:

Prerequisites specific to this job:

Knowledge, Skills, and Abilities	Training (courses and/or job/task specific)

Required Personal Protective Equipment:

Task List

Task #	Description	Known or Potential Hazard(s)	Control(s)

Add rows as needed.