Job Safety Analysis

Doc. No: TML-HSE-GEN-PR-L-108

Revision: 2
Date: June 2010
Page: Appendix 4

Job Safety Analysis Format

Job:

TO TOP-UP DIESEL

Permit No:

Work Team:

TJ OIL LAND Sdn Bhd

Date:

Performing
Authority (PA):
BASIC JOB STEPS

Issuing Authority
(IA):
RISK RATING
Cat2

POTENTIAL HAZARDS

1-Pumping Diesel

Diesel Spill/Broken hose/Slippery

floor/Fire / burning.

2-Connect hose to the welding

machine and air compressor

Slippery floor/Diesel spill/Hose leak

Cat5

3-Top Up Diesel to the equipment

Diesel spill/Eyes injury/Body / cloth

contaminated diesel fuel
Contamination diesel fuel cloth/Valve
in open position/Fuel leak

Cat4

4-House Keeping

Job Safety Analysis

Cat5

Rev. 0

RECOMMENDED CONTROL MEASURES

Check diesel hoses/Clean work area if diesel
spill/Ensure work area free from electrical source
or fire/Standby fire extinguisher/Ensure the
equipment in good condition.
Ensure work area / floor clean free from oil or
other object/Use proper glove/Ensure diesel hose
in good condition
Diesel spill/Eyes injury/Body / cloth contaminated
diesel fuel
Make sure clean the cloth from diesel
contamination/Make sure the deck floor no oil leak
or oil spill/Wash down the deck or drip pan if have
leak or spill.

Job Safety Analysis

EXPERIENCE

YES

Doc. No: TML-HSE-GEN-PR-L-108

Revision: 2
Date: June 2010
Page: Appendix 4

NO

Have you done this job before?

Are you knowledgeable with the job to be

performed?

Have you referred to technical drawing/vendor

procedure/SSP?

Is supervision/experienced assistance required?

PPE
Hard hat?
Safety Glasses?
Safety shoes?
Ear plugs?
Right type of gloves?
Safety harness?
POTENTIAL HAZARDS
Slippery floor?
Congested area?
Tripping?
Overhead work?
Working at height?
Scaffolding?
Secure ladder?
Heavy load?
Hammer strikes?
Pinch/trap finger, hand?
Back injury hazard?
Swinging object?
Falling object?
Others closeby?
Sharp object?
Eye injury?
Grating/deck opening?
Blocked drains?

Prepared By:

Job Safety Analysis

YES

NO

/
/
/
/
/
YES
/

Work vest?
Apron?
Goggle?
Face shield?
Respiratory protection?

YES

NO

YES

NO

/
/

NO

YES
Trapped pressure?
Pressurized equipment/vessel hazard?
Fire/explosion hazards?
Escape route?
Shock/electricity/static?
Breaker rack out?
Valve isolation?
Guard rotating equipment?
Power tools hazards?
High noise area, double ear protection?
Spark/hot slag?
Burn (heat/chemical)?
Near radioactive materials/sources?
Environmental spill?
Hose connection?
Windy?
Dusty?

Date:

Rev. 0

Sign:

/
/

NO

Job Safety Analysis

Reviewed &
Approved By PA:
Reviewed &
Approved By IA:

Doc. No: TML-HSE-GEN-PR-L-108

Revision: 2
Date: June 2010
Page: Appendix 4

Date:

Sign:

Date:

Sign:

Acknowledgement by Work Team

I hereby acknowledge my participation in the toolbox meeting for this job. I understand it is my responsibility to read, understand and adhere to
the control measures written in this Job Safety Analysis.
No

Name

Company / Designation

Risk Matrix for JSA

Job Safety Analysis

Rev. 0

Sign

Job Safety Analysis

CATEGORIES IMPLEMENTATION GUIDANCE

Job Safety Analysis

Rev. 0

Doc. No: TML-HSE-GEN-PR-L-108

Revision: 2
Date: June 2010
Page: Appendix 4

Job Safety Analysis

Cat 1 - Very High Risk: Work should not be started or continued until the risk has been reduced.
Cat 2 - High Risk: Work should not be started until the risk has been reduced. Work can only continue with
extreme caution. Risk must be reduced immediately.
Cat 3 - Moderate Risk: Efforts should be made to reduce the risk, but the costs of prevention should be carefully
measured and limited. Risk reduction measures should be implemented within a definite time period.
Cat 4 - Possible Risk: No additional controls are required. Consideration may be given to a more cost-effective
solution or improvement that imposes no additional cost burden. Monitoring is required to ensure that the
controls are maintained.
Cat 5 - Negligible Risk: Further consideration not required. Monitoring is required to ensure that the controls are
maintained.

Job Safety Analysis

Rev. 0

Doc. No: TML-HSE-GEN-PR-L-108

Revision: 2
Date: June 2010
Page: Appendix 4