ATTACHMENT 1: JOB SAFETY ANALYSIS WORKSHEET

DO IT SAFELY OR NOT AT ALL

Hazard/Risk Management THERE IS ALWAYS TIME TO DO IT RIGHT
(Check boxes that apply, read the references, & decide what to do)
Potential Hazards Job safety Analysis Process Flowchart
Hazardous Substances (SPM 7.2) Overhead (SPM 4.10) Work Crew Work Responsible Person Person in Charge
Hazardous Atmosphere (SPM 4.9) Working at Height (SPM 4.10)
Confined Space (SOP-404) Diving Operations (SPM 9.8)
Working in Noisy Area (SPM4.6) Machinery/Moving Objects Start
Environmental Impact (SPM 17.0) (SPM 8.4 & SOP-403)
Arc/Flash (SPM 4.7) Heat Stress (SPM 7.6)
Radiation Work (SPM 7.4) Power/Hand Tools (SPM 8.4) No
Ignition Source (SPM 5.3) Fire/Explosion (SPM 5.0 & 9.0) Is JSA
Slips/Trips/Falls (SPM 8.1) Prepare JSA Prepare JSA
Pressure (use permit to work system) Required
Lifting Plan Required (SOP-406 & -504) Pinch Points (SPM 8.2 & 8.4)
Manual Handling (SPM4 4.8, 8.2 & 8.4) Hot Surfaces (SPM 8.4) Yes
Additional Workers (SOP-401) Adequate Lighting (SID 12.4) Review JSA with
Over-the-side work (SOP-506) Excavations (SOP-405) PIC
Discuss with WRP
Bees/Snake Attack (SPM 7,6)
Hazard Controls Safety Equipment Required

PPE (SPM 4.1) Face Shield/Goggles (SPM 4.7) Review JSA

Physical Barriers (SPM 4.10) Hand Protection (SPM 4.8)
Safety Equipment (SPM 4.0) Chemical Gloves (read MSDS)
Ignition Source Controls (SOP-402) Chemical Apron (read MSDS) Effect Changes Effect Changes Yes No
Lockout-Tagout (SOP 403) Work Vest/Life Jacket (SPM 16)
Changes
Required Work Permits (SPM 9.0) Full Body Harness (SPM 4.10)
required
Spill Control Plan (discuss with HES) Life Line (SPM 4.10)
Fire Fighting/ERT Standby (contact HES) Safety Barricade (SPM 8.1)
Emergency Evacuation Plan Respirator (SPM 4.9, SOP 404) Review JSA at Review final JSA
(Contact HES) Fire Retardant Tarps (SOP-402) Tool box talk with Work crew
Eyewash/Safety Shower Location Hearing Protection (SPM 4.6) Accept JSA
(SPM 4.11 & SID 10.0) Spill Control (contact HES)
Material Safety Data Sheets (obtain from Fire Extinguishers (SPM 6.2)
supplier before using product) Others (specify)
Hot Bolting Procedure Sign reverse of
(contact Construction) GWP that Job task
Commence task
SPM – Safe Practices Manual SID – Safety in Designs Manual and condition are
understood
SOP – Standard Operating Procedure
GWP Number Work Location Completed By Discussed At Toolbox Talk on (date)     
      EGTL SITE , ESCRAVOS Ajith Singh.B By (name)      initial

Describe work to be Performed

Installation of Crawler Crane

Task Hazard Controls Responsibilities

Detail the steps involved in doing
the job
Inspection of worksite
Manuel handling of materials
Lifting of Boom with the crane
What could go wrong and what would the
effect be?
Slip, Trip and Fall.
Pinch Points, Waist pain
Struck by mobile equipment
Equipment tipping over due to unlevelled
ground surface .
Struck by the lifting load
Crushing by the counter weight
How can the hazard be prevented Who is going to take action
Remove all waste materials from the work Work Supervisor, Foreman
site. arrange the materials in good fashion
order.
Follow good mauel handling technique Work Supervisor, Foreman
Required PPE must be used during
material handling
Lifting area should be cordoned off to Work Supervisor, Foreman
avoid unauthorized movement. Operator and Rigger
Out rigger should be exteneded in firm
and level ground.
Trained rigger should control the
suspended load by using tag line.
Trained and competent operator should
operate the crane.     

Lifting and installation of crawler
Tightening,grinding and fixing of
plates.
Heavy object,
suspended load
line of fire
damaged slings and lifting gears
Struck by the Swinging boom
Pinch Point, Heavy object, Airborn
particles, slip,trip and fall. Electrical
shock   grease to avoid slipping and tripping
avoid line of fire Work Supervisor, Foreman
do not work under suspended load Operator and Rigger
ensure that tag lines are used to direct
and position the crawler.
ensure lifting plan is discussed and
followed.
Only qualified and certified riggers to be
used during lifting and positioning .
inspect all rigging equipment.
use signal man with reflector jacket.
adequate and smooth communication
between rigger, signal man and crane
operator mst be ensured throughout the
operation
Use proper hand gloves, faceshield. clean Work Supervisor, Foreman
the work area if there any oil spill or
hazard.
 Check all the hand and power tools
before use.
Working on Noisy and heat stress Heat stress, Noise  Drink enough cold water, use hearing Work Supervisor, Foreman
area protection all the time while on noisy zone
Working on height to assemble the Fall from height, dropping object, Entangle Full body harness to be used while Work Supervisor, Foreman
booms. between the mechanical structure. working above 1.8 m from the groung and
100% tie off procedure to be followed.
Secure the area where the chance of
falling objects are high.
Always position your body in safe
distance to avoid entanglement between
the mechnical structure.

Arranging of materials        Trip and fall All unnecessary materials should be Work Supervisor, Foreman
removed.
Do good housekeeping
                        

                       

                       

                       

                       
                       
Can all personnel in the group answer YES to all the following questions
Have all the significant hazards involved with the work been identified? Yes/No Has everyone on site been issued with appropriate PPE? Yes/No
Have control measures been identified for these hazards & implemented? Yes/No Are we aware of what everyone else is doing at the work-site? Yes/No
Has the method of communication been agreed and tested? Yes/No Does everyone know that any changes to the work plan have to be communicated to Yes/No
everyone involved in the work?

Is everyone aware of what is being done at the work-site? Yes/No Does everyone know that anyone new to the job should be given this JSA for review and Yes/No
any questions answered prior to joining in on the work

PIC Signature: WRP Signature:

Date: Date:
If the answer to any of these questions is NO, then the safety of people is at risk and additional action is required as to why the answer is NO