APPENDIX 7-3

PROCESS HAZARD ANALYSIS WORKSHEET

1. Name the process.

2. Give the date the operations began.

3. Write a short description of the process.

4. Conduct an overview and write a narrative.  (See Appendix 7-1).  Date completed?

5. Prepare process flow chart and attach.  (See sample, Appendix 7-2).  Date completed?

6. For each step in the process as shown on your flow chart, identify and record each:

a.  hazardous substance,

b.  piece of equipment that presents a hazard, and;

c. employee operation that may be hazardous.