Loading...

Job Safety Analysis Form

Scope of Work: Opening and Unloading Containers

Location: PayPal Park

JSA Reference Number:

Date Revised: 2/13/23


1. Opening container

Hazard: Risk of being hit by unrestrained items or falling loads.

Control: Consulting with site users/employees prior to placement of equipment in container. 

Ensuring there is sufficient lighting in and around the container.

Opening the right-hand door cautiously first; only when safe, proceed with the left.

 2. Unloading & closing container

Hazards: Slips, trips, and falls.

Musculoskeletal injuries, such as sprains and strains.

Physical fatigue.

Control: Ensure staff is trained with proper lifting techniques.

Keep the area around containers clear of obstructions.

Clean up spills when they occur.

Considering the environmental conditions of the site, for example, heat, rain, and ventilation; and the appropriateness for workers unpacking in these conditions.

   


First Employee Name

First Name*

Middle Name

Last Name*

Phone*
First Employee Date of Birth*
First Employee Signature*
Second Employee Name

First Name*

Middle Name

Last Name*
Second Employee Date of Birth*
Third Employee Name

First Name*

Middle Name

Last Name*
Third Employee Date of Birth*
Fourth Employee Name

First Name*

Middle Name

Last Name*
Fourth Employee Date of Birth*
Fifth Employee Name

First Name*

Middle Name

Last Name*
Fifth Employee Date of Birth*
Sixth Employee Name

First Name*

Middle Name

Last Name*
Sixth Employee Date of Birth*
Seventh Employee Name

First Name*

Middle Name

Last Name*
Seventh Employee Date of Birth*
Eighth Employee Name

First Name*

Middle Name

Last Name*
Eighth Employee Date of Birth*
Ninth Employee Name

First Name*

Middle Name

Last Name*
Ninth Employee Date of Birth*
Tenth Employee Name

First Name*

Middle Name

Last Name*
Tenth Employee Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!