LADDER SAFETY GUIDE

JOB SAFETY ANALYSIS GUIDEVersion1DateMay, 2015CommentsInitial Job Safety Analysis GuideA. INTRODUCTIONJob Safety Analysis (JSA) is a procedure that focuses on individual job tasks to identify hazardsand prevent injury or exposure by employing appropriate engineering, administrative, physicalcontrols, as well as personal protective equipment (PPE). The JSA process focuses on therelationship between the worker, the task, the tools, and the work environment. JSA document steps thatmust be taken to eliminate or reduce workplace hazards to an acceptable risk level. This Guide is basedupon Occupational Safety and Health Administration (OSHA) publication 3071 Job HazardAnalysisB. SCOPEUniversity supervisors are responsible for determining which jobs/tasks performed by theiremployees require JSA. The JSA is a step by step process that requires employee involvement,review of any hazards associated with work tasks, and identification of controls can mitigatehazards.The Environmental Health and Safety Office (EHS) will provide training and consult withsupervisors regarding the applicability of JSA in the workplace and will assist with completionof JSA upon request.Work tasks which have JSA priority are those: With high injury or illness rates;With a potential hazard that can to lead to or cause severe injuries and/or illnesses;That have undergone changes in procedure and/or processes;That are new to the operation; orThat are complex and require written instructions.C. RESPONSIBILITES EHS is responsible to conduct training for supervisors on how to complete and manageJob Safety Analysis Forms.Supervisors are responsible for completing Job Safety Analysis Forms for tasks deemedhazardous in their work area/activities.Supervisors must review Job Safety Analysis Forms annually with employees.Employees must review Job Safety Analysis Forms prior beginning a job task.Environmental Health and Safety OfficeJob Safety Analysis Guide05/20151

Supervisors must maintain Job Safety Analysis Forms, make them available toemployees, and submit completed JSA to EHS.D. STEPS1. Obtain Job Safety Analysis Form (Appendix A): The Job Safety Analysis Forms isavailable online at ehs.gmu.edu or from EHS upon request.2. Select a Work Task: Select the work to perform the JSA based upon priority and actualor potential hazards.3. Fill out the JSA form: Fill out all sections of the Job Safety Analysis Forms.4. Submit the JSA Form: Send completed Job Safety Analysis Forms to EHS atsafety@gmu.edu.5. File JSA for Reference: File Job Safety Analysis Forms in a conspicuous location foremployees to access and reference as necessary.E. REVIEW AND MODIFICATIONSEHS Safety Officers will review each submitted Job Safety Analysis Form for accuracy andthoroughness. Incomplete JSA will be returned to the supervisor with questions or comments.Completed JSA should be reviewed on an annual basis with employees for accuracy. If JobSafety Analysis Forms are updated or new tasks are documented using the JSA process, updatedJob Safety Analysis Forms must be submitted to EHS at safety@gmu.edu.F. RECORD KEEPINGSupervisors are responsible for maintaining Job Safety Analysis Forms in an accessible locationfor employees to reference as needed. EHS maintains copies of completed JSA and posts themon the EHS website.G. EHS INSPECTIONEHS will coordinate a review of Job Safety Analysis Forms on a routine basis with supervisorsand update Job Safety Analysis Forms as necessary and whenever an incident or injury occursduring a task documented by a Job Safety Analysis Forms.The information contained in this Guide is not inclusive of all OSHA regulations. Please contact EnvironmentalHealth and Safety Office at (703) 993-8448 or visit www.OSHA.gov for more information regarding workplacehazards, safety precautions, and regulations.Environmental Health and Safety OfficeJob Safety Analysis Guide05/20152

Appendix A: JSA FormEnvironmental Health& Safety OfficeJob Safety Analysis FormSECTION 1 - WORK TASK INFORMATIONWork Task:Reference#:JSA Completed By (Name):Date last updated:Unit(s):FacilitiesHousingAthleticsCampus RecFreedom CenterStudent CentersUniversity PoliceSchool of Art and DesignHousekeepingPlumbingCarpentryHVACUtilities and TradesGeneral MaintenancePaintElectricalWaste and RecyclingGroundsAuto bodyN/ACHCPWarehouseOthers:Other (please define):Shop(s):YN May work be performed alone?Work task process - List work task into steps in the order they occur.1.2.3.EHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015PAGE 1 of 7

SECTION 1 - CONTINUED4.5.6.7.8.9.10.EHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015PAGE 2 of 7

SECTION 1 - CONTINUEDSpecial Instructions/Notes:SECTION 2 - WORK ACTIVITIES INFORMATIONAbrasive blastingCleaningDemolitionForklift operationLifting 40 lbsBattery ChargingCompressed gas orair useElectrical or hydraulicworkGenerator workNon-portable water,sewageChemical useCutting, drilling,sawingConstructionCutting concreteExcavationFlammable materialsJackhammer useLandscapingPouring, mixing,siphoningPaintingTree trimming,loggingWelding, soldering,brazingPower tools useSandingVehicle useWaste disposalWork in a confinedSpaceWork with sharpobject (ex: glass, saw)Work in a mechanicalspaceWork in labWork outdoorsOther:Utility workWork at heights( 4ft),aerial liftWork occuring aboveworksiteSECTION 3 - REQUIRED TRAINING (check all that apply)Aerial LiftArt SafetyAsbestos AwarenessChainsawConfined Space EntryHazardCommunicationFall ProtectionBloodbornePathogensFire ExtinguisherHearing ConservationLab Safety AwarenessSafety RefresherPowered IndustrialTrucks (Forklift/ManLift)General SafetyLockout/TagoutRespiratory ProtectionEHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015PAGE 3 of 7

SECTION 3 - CONTINUEDEquipment -specific Training (please list):List all applicable SOPs:SECTION 4 - PLANS, MANUALS, AND GUIDES (check all that apply)Confined Space PlanLockout/Tagout PlanChainsaw SafetyGuideExposure Control PlanFire Safety PlanHazardCommunication PlanMedical SurveillancePlanChemical, Hazardous,and Universal WasteManagement GuidePersonal ProtectiveEquipment PlanArt Safety ManualJob Safety AnalysisGuideChemical InventoryRequirements GuideFire Watch GuideCompressed GasSafety GuideElectrical Safety GuideEmergency Showerand Eyewash FlushingGuideFlammable and Combustible Liquid SafetyForklift Safety GuideHand and Power ToolSafetyHot Work SafetyLadder Safety GuideMachine and MachineShop Safety GuideHazardousMaterials Shippingand Receiving GuideMaterial HandlingGuideOil and Chemical SpillResponse GuidePesticide and HerbicideApplication SafetyGuideSkidsteer LoaderSafety GuideWalking and WorkingSurfaces GuideSECTION 5 - HAZARD INFORMATION (check all that apply)Whole bodyHazardRequired personal protective equipmentChemical (vapor orsplash)Electrical shockApronHeat/coldHot surfaces/burnsFall protectionPoisonous plants/InsectsSparksFallFlying objectMoving vehicleSlips, tripsMusculoskeletal/ergonomicOther:Coveralls (chemicalresistant)High visibilityclothingArc flash protectionFlame resistantclothingCoveralls (cloth)Rain gearOther:EHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015PAGE 4 of 7

SECTION 5 - CONTINUEDEyes, Face, HeadYNNA Can the hazard be eliminated without PPE?If hazard can be mitigated describe how:HazardRequired personal protective equipmentBlood or OPIMElectrical shockFace shieldFlying particlesUV lightSafety gogglesProtective helmetClass E - ElectricalClass G - GeneralClass C - ConductiveEarsYNNA Can the hazard be eliminated without PPE?If hazard can be mitigated describe how:HazardNoisy environmentNoisy toolsOther:Required personal protective equipmentEar muffsEar plugsOther:YNNA Can the hazard be eliminated without PPE?If hazard can be mitigated describe how:Hand & ArmsHazardBlood or OPIMChemicalsElectrical shockCut, bruise, orscrapePinch pointsSparksVibrationExtreme cold or heatRequired personal protective equipmentAbrasion/cut/puncture resistant glovesLinemen’s glovesTemperature resistantglovesChemical resistantglovesEHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015Anti-vibration glovesLifting glovesWelding glovesDisposable (ex:nitrile) glovesPAGE 5 of 7

SECTION 5 - CONTINUEDHands & ArmsHazardRequired personal protective equipmentLiquid resistantglovesChemical resistantsleevesOther:Slip resistant glovesCut resistant sleevesYNNA Can the hazard be eliminated without PPE?If hazard can be mitigated describe how:LungsHazardRequired personal protective equipmentAsbestosChemical (gas, vapor)Dust mask (N-95, P-95, etc.)Half facePesticidesSilicaAirlineLow oxygen ( 19.5%)ParticulateFull faceOther:Welding fumesOther:YNNA Can the hazard be eliminated without PPE?If hazard can be mitigated describe how:Feet & LegsHazardChemicalElectric shockPinch pointsSlippery surfaceHeavyequipmentOther:Impact from objectRequired personal protective equipmentChapsChemical resistantshoesMetatarsal protectionLeggingsImpact resistantshoesWater resistant shoesEHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015Knee padsNonconductive shoesSteel or composite toesshoesAnti-slip shoesLogging bootsOther:PAGE 6 of 7

SECTION 5 - CONTINUEDYNNA Can the hazard be eliminated without PPE?If hazard can be mitigated describe how:SECTION 6 - ACKNOWLEDGEMENTSupervisor Name:Signature:Date:Superintendent Name:Signature:Date:Safety Office/Facilities Safety Coordinator Name:Signature:Date:Notes: Forms must be submitted to safety@gmu.edu for review and posting to the JSA website at ehs.gmu.eduJSA Training is required for all new supervisorsJSA must be reviewed annually by supervisorsAll employees should review and have access to JSA that are applicable to their work tasksAny exposure to hazardous materials or injuries must be reported to Human Resources and Payroll Worker’sCompensation using an Employer’s First Report of Accident Form.All accidents, property damages, or emergencies that do not result in employee injuries or exposures mustbe reported using the university Incident Report Form.All forms, safety manuals, and safety procedures are available on line at ehs.gmu.edu.EHS Phone: 703.993.8448 Fax: 703.993.8996 safety@gmu.edu Last Updated: 08/2015PAGE 7 of 7

Environmental Health and Safety Office Job Safety Analysis Guide 05/2015 2 Supervisors must maintain Job Safety Analysis Forms, make them available to employees, and submit completed JSA to EHS. D. STEPS . 1. Obtain Job Safety Analysis Form (Appendix A): The Job Safety Analysis Forms is available online at ehs.gmu.edu or from EHS upon request.