JSA library / Electrical & Mechanical

Equipment Maintenance (Lockout/Tagout) JSAJob Safety Analysis template

Repairing or servicing machines, pumps and equipment. Use it as-is or change it to fit your job, then walk the site and add what's different today.

Make this JSA on your phone →

Free · no account · the crew signs on the same phone · prints a professional record

Date

Location

Person in charge

Company

Nearest ER / address

Muster point · Emergency: 911

Job steps, hazards & controls

#	Job step	Hazards	Controls
01	Identify all energy sources	Missing a source: electric, pressure, spring, gravity, heat	Walk the equipment; list every energy source
02	Shut down and lock out	Someone restarting the equipment	Normal shutdown; tell affected people Every worker puts on their own lock and tag
03	Release stored energy	Pressure, springs, raised parts or heat releasing	Bleed pressure, block raised parts, let it cool Verify: try to start it; check gauges read zero
04	Do the work	Pinch points, sharp edges Heavy parts	Right tools; get help with heavy parts Keep guards and parts organized for reassembly
05	Return to service	Starting with people or tools inside	Guards back on, tools out, everyone clear Each person removes their own lock; test run while watching

Don’t forget to check

Hand & Power ToolsChemicals & SDS

Today’s site-specific hazards

Hazard	Control

Crew sign-in: I reviewed this JSA and I can stop work

Name	Company / role	Signature	Time

How it works on your phone

1 · Pick itTap the button above. This JSA loads with the checks crews most often forget already suggested.

2 · Walk the siteAdd where you are, who's in charge and the nearest ER. The first person on site adds today's hazards.

3 · Crew signsPass the phone. Each person reads every step and signs. Print or save the PDF.

This JSA is a starting point built from common field practice. Your job, your site and your company's procedures come first: change anything that doesn't fit, and follow your permits and regulations.