Process Hazard Analysis (PHA) Checklist
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This Template was installed 3 times.
Process Description & Scope
Ensures a complete and accurate understanding of the process being analyzed.
Process Name
Process Description (Detailed)
Process Capacity (e.g., Units/Hour)
Raw Materials Used (List)
Process Flow Diagram (PFD) Description & Location
Process Flow Diagram (PFD) - Uploaded File
Equipment List & Key Operating Parameters
Process Phase (e.g., Mixing, Reaction, Drying)
Boundaries of the Analyzed Process (Start & End Points)
Hazard Identification
Identifies potential hazards associated with the manufacturing process, equipment, and materials.
Describe the process flow and key equipment involved.
Identify raw materials used in the process. (Select all that apply)
List any potential deviations from normal operating conditions (e.g., pressure, temperature, flow rate).
Identify potential energy sources present in the process. (Select all that apply)
Describe any known hazards associated with the chemicals used in the process (refer to SDS/MSDS).
Identify any potential ignition sources in the area. (e.g., open flames, sparks, hot surfaces)
Describe any potential release scenarios (e.g., spills, leaks, explosions).
Upload relevant process diagrams and layouts.
Risk Assessment (Severity & Probability)
Evaluates the potential consequences (severity) and likelihood (probability) of the identified hazards.
Severity Rating - What's the worst possible consequence?
Probability Rating - How likely is this consequence to occur?
Severity Score (Assign a numerical value based on the severity rating)
Probability Score (Assign a numerical value based on the probability rating)
Justification for Severity Rating
Justification for Probability Rating
Risk Matrix Category (Based on Severity & Probability Scores)
Notes/Comments
Existing Controls & Safeguards
Documents the controls already in place to mitigate the identified hazards.
Are safety interlocks present and functioning on critical equipment?
Describe the existing alarm system and its response procedures.
What type of pressure relief devices are in place?
What is the frequency of inspections for critical safety devices?
Describe any Standard Operating Procedures (SOPs) related to this process.
Are lockout/tagout procedures in place and followed?
Which of the following Personal Protective Equipment (PPE) is required for this process?
Date of last inspection of fire suppression system.
Recommended Risk Reduction Measures
Identifies and prioritizes additional measures to reduce the risk to acceptable levels.
Detailed Description of Proposed Mitigation
Estimated Cost of Mitigation (USD)
Target Completion Date for Mitigation
Responsibility for Implementation
Relevant Departments to Notify
Rationale/Justification for Chosen Mitigation
Supporting Documentation (e.g., drawings, vendor specs)
Status of Mitigation
Management of Change (MOC)
Addresses how changes to the process, equipment, or materials will be reviewed and approved.
Describe the proposed change to the process, equipment, or materials.
Justification for the change - Why is this change necessary?
Type of Change (Select one)
Estimated Cost of Change (USD)
Proposed Implementation Date
Potential Hazards Identified due to this change (Select all that apply)
Reviewer Name
Reviewer Signature
Training & Competency
Verifies adequate training and competency of personnel involved in the process.
List the core competencies required for personnel involved in this process.
Number of personnel trained on this process.
Date of last training session for this process.
Describe the content of the training program.
Training Method Used
Upload copies of training records/certificates.
Verification of Competency Method
Describe the method used to verify individual competency.
Emergency Response & Procedures
Ensures adequate emergency response procedures are in place and personnel are trained.
Describe the established emergency shutdown (ESD) procedure for the process.
Which emergency response teams are available and notified during an incident?
Estimated evacuation time to designated assembly areas (in minutes).
Describe the communication methods used to alert personnel during an emergency.
Are emergency drills conducted regularly?
Date of last emergency response drill.
Summary of findings and corrective actions from the last emergency response drill.
Are emergency procedures posted in accessible locations?
Attach a copy of the emergency response plan.
Review & Documentation
Covers the necessary review, approval, and documentation of the PHA process.
PHA Completion Date
PHA Revision Number
Summary of PHA Findings & Conclusions
PHA Report File
PHA Review Status
Reviewer Name
Next PHA Review Date
PHA Lead Signature
Compliance & Regulatory Requirements
Confirms adherence to applicable regulatory requirements and industry standards.
Applicable OSHA Standards?
Relevant EPA Regulations?
Documentation of Permit Requirements (e.g., Air Permits, Wastewater Permits)
Last PHA Review/Update Date (per Regulatory Requirements)
Frequency of PHA Review (as per regulation or company policy)
State-Specific Regulations?
Upload Copies of Relevant Permits
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