POSITION RECRUITMENT JOB HAZARD EVALUATION FORM

Please provide detailed information regarding the position. If you have questions, please feel free to contact Risk Management & Environmental Health & Safety at (305) 348-2621  

  

Hiring Manager Panther ID: 
Hiring Manager First Name :   
Hiring Manager Last Name:
Position Title:
Position Type:
Position Number:
Approximate Hire Date:
Direct Supervisor Name:  
Direct Supervisor Telephone: 
Direct Supervisor Email:   

OSHA Guide to Employer Safety Training Responsibilities At-A-Glance University Safety Training Chart
Click on this icon for additional information regarding the Tool/Hazard/Exposure 

              Note: With respect to positions that require employees to perform any of the functions identified below, supervisors are responsible to verify qualifications, and to assure that appropriate screening questions are incorporated at the appropriate phase of the recruitment process.

 
TOOL/HAZARD/EXPOSURE WORK APPLICATION Please check ALL that apply) COMMENTS
Confined Space Entry
Hazardous Chemical 
Loud Noise FromEquip/Machinery/Vibration 
Laboratory Work 
Access/Inspect Construction Sites 
Bio-Hazardous/Infectious Materials 
Power Tools 
Registered/Suspected Carcinogens 
Compressed Gases
Food Handling & Preparation
Fieldwork or Surveys Off Campus 
Boating & Scientific Diving 
Roof Work & Scaffolds 
Industrial Vehicles & Mobile Equipment
Operating University Vehicles (All types)
DEA Regulated Controlled Substances
Manual Materials Handling
Needs personal protective equipment for the job
Required to spend 50% or more of their time operating a computer? 
Lasers 

Ultraviolet/Infrared Generating Equipment

Utilities & High Voltage Equipment 

Radioactive Materials & Equipment 
International Travel

Live Animals for Research 

Other (Please specify in the comments box)