Page 49 - Safety Memo

Job Hazard Analysis Evaluation Form

The purpose of this two-page form is to allow Superintendents to
effectively and efficiently validate the acceptality of a subcontractor’s

Job Hazard Analysis submittal

Evaluator: Print Signature

Date Evaluated:

Job Site name /number:

Subcontractor Name:

Work Scope:

Projected Work Start Date:

Subcontractor’s JHA Name / Number:

Approval Signature Approver Name Approval Date

THE FOLLOWING “ CONSTRUCTION SUPERINTENDENT JHA CHECKLIST” SUMMARIZES
THE FINDINGS OF THE SUBCONTRACTOR JHA THAT IS NOTED ABOVE.