CS JF Job Safety Analysis Web Page

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Chase Job Briefing · ACE

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Chase Job Briefings Pre‑Brief / Job Hazard Analysis

Chase Job Briefings

Pre‑Brief / Job Hazard Analysis

Submitted By	Job Title	Facility Phone	Date Completed	Nearest Medical Facility	Created On	Equipment Needs	Status	Actions
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IN CASE OF EMERGENCY, DIAL 911

Safety Pre-Brief / Job Hazard Analysis

Date Completed MM-DD-YYYY

Customer/Project * Work order / job # Loading jobs...

Job Category * Select a category from the list Select a category for this job

Nearest Medical Facility

Facility Phone

Nearest Medical Facility

Required & Recommended PPE

Head Protection Eye Protection Hand Protection Foot Protection Body Protection Fire Resistant Safety Vests Other (Please Note)

Other PPE / Safety Equipment Notes

Equipment Needs

Scope & Potential Hazards

Scope of Work Potential Hazards (Safety is MY Responsibility!)

Hazard	Note	Resolution
Physical Obstacles
Electrical Hazards
Slip/Trip/Fall
Weather Conditions
Personnel/Pedestrian
Ground Guard/Backup
Geographic/Enviro
Overhead Hazards
Spill Response
Flat Tires
Equipment Breakdown
Other daily deficiency
Other #1
Other #2
Other #3

Attended By (Crew)

Fill in the crew members who attended this briefing.

Crew 1

First Name

Last Name

Company

Position

Crew 2

First Name

Last Name

Company

Position

Crew 3

First Name

Last Name

Company

Position

Crew 4

First Name

Last Name

Company

Position

Crew 5

First Name

Last Name

Company

Position

Crew 6

First Name

Last Name

Company

Position

Supervisors in Charge (Form Completed By)

Supervisor

First Name

Last Name

Company

Position

Documents & Sign‑off

File Upload

Email (copy of report) Receive a copy

Signature (draw with mouse or touch)

Sign above using your finger or mouse.

⛔ IF THE JOB CANNOT BE PERFORMED SAFELY, STOP! AND SEEK HELP!
Contact your Crew Foreman and/or Direct Reporting Manager before continuing.