Free mining JSA template

• The MapTrack mining JSA template contains 6 checks.
• Task details: mine/site name, date, operation type (surface/underground), task description, location/panel/level, assessor and supervisor.
• Work steps and hazard analysis: numbered work steps with hazards, risk rating (L × C), control measures, residual risk and responsible person.
• Pre-filled mining steps: access to work area, ground support inspection, equipment setup, task execution, material handling, area clean-up and make safe.

Learn more about compliance and inspections in MapTrack.

• Systematic hazard identification: break each task into steps and identify mining-specific hazards before work begins.
• Regulatory compliance: meet Australian Mining Regulations and state-based Mines Safety legislation requirements for risk assessment documentation.
• Risk-ranked controls: document control measures for each hazard using the hierarchy of controls, with initial and residual risk ratings.
• Worker engagement: the sign-on section ensures every worker has reviewed the JSA and understands the hazards and controls before starting work.
• Accountability: the JSA records who assessed the task, who supervised, and who signed on , creating clear responsibility.
• Audit trail: a completed JSA provides documented evidence for safety audits, incident investigations and regulatory inspections.

• Task details: mine/site name, date, operation type (surface/underground), task description, location/panel/level, assessor and supervisor.
• Work steps and hazard analysis: numbered work steps with hazards, risk rating (L × C), control measures, residual risk and responsible person.
• Pre-filled mining steps: access to work area, ground support inspection, equipment setup, task execution, material handling, area clean-up and make safe.
• PPE requirements: hard hat, safety glasses, hi-vis, steel caps, hearing protection, dust mask/respirator, gloves, self-rescuer (if underground).
• Additional hazards: blank rows for site-specific hazards not covered in the main table.
• Worker sign-on: 10-row register with name, company, signature and date.
• Declaration and signatures: assessor and supervisor sign-off.

1. Complete the task details: mine or site, date, operation type, task description, location and personnel.

   Record the mine or site name, the date, whether the operation is surface or underground, a clear description of the task, the specific location (panel, level, pit area) and the names of the assessor and supervisor. This header ties the JSA to a specific task and location on the mine.

2. Break the task into sequential work steps. Use the six pre-filled steps as a starting point and add or modify as needed.

   Start with the pre-filled steps (access to work area, ground support inspection, equipment setup, task execution, material handling, area clean-up and make safe) and adjust them to match the actual task. Add steps for any additional activities and remove steps that do not apply.

3. For each step, identify the hazards. Consider ground conditions, mobile equipment, dust, heat, electrical and atmospheric hazards.

   Think about mining-specific risks at each step: falls of ground, mobile equipment interaction, dust exposure (silica, coal dust, diesel particulates), heat stress, electrical hazards in potentially explosive atmospheres, inrush risks and noxious or oxygen-deficient atmospheres underground. Consult experienced operators who know the area.

4. Document control measures using the hierarchy of controls (eliminate, substitute, isolate, engineer, admin, PPE). Rate the initial and residual risk.

   For each hazard, apply controls starting from the top of the hierarchy. Record the specific control measure, the responsible person and the residual risk rating after controls are applied. If the residual risk remains high after all practicable controls, escalate to the site senior executive or safety manager.

5. Check the PPE requirements section and tick all items required for the task.

   Review the PPE list (hard hat, safety glasses, hi-vis, steel caps, hearing protection, dust mask or respirator, gloves, self-rescuer if underground) and tick all items required for the specific task. Add any additional PPE not listed, such as fall arrest harness or chemical-resistant clothing.

6. Brief all workers on the JSA. Each worker signs the sign-on register to confirm they understand the hazards and controls.

   Gather the crew at the work area and walk through the JSA step by step. Allow workers to ask questions and raise additional hazards. Each worker must sign the register with their name, company and date before commencing the task.

7. The assessor and supervisor sign to authorise the task.

   The assessor confirms the JSA accurately reflects the task, hazards and controls. The supervisor confirms the controls are adequate and authorises the work to proceed. Both sign and date the form. File the completed JSA as part of the mine safety records.

Practical answers about the form, record keeping and using MapTrack.

This form is a starting point. Check the current requirements that apply to your equipment, work and location. The form alone does not establish compliance.

• WHS (Mines) Regulations
• Mine Safety and Inspection Act 1994 (WA)
• WHS Act 2011
• Safe Work Australia - Code of Practice: How to Manage Work Health and Safety Risks

• Model Codes of Practice (Safe Work Australia)
• Model Work Health and Safety Act (Safe Work Australia)

MapTrack publishes this template. The linked authorities publish their own guidance; they haven't endorsed this form.

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