TYPICAL JHA FORM

Company name

Client name

JHA PROCEDURE NAME

JHA NO.: 01XXXXXXX

REVISION NO.:0

AREA:

Job Description: Manual Excavation for cable trench

Activities (Job
Steps)
Work Permit

DATE:

Hazardous Area Classification: Zone 0 , Zone 1 , Zone 2 , Non Hazardous

Job Ref (Project No./Work Order No.:

S/N

JOB LOCATION:

Potential Hazard

Unauthorized commencement of works

May result in exposing people and/or
potential to harm or danger.

Permit Type & No. :________________

Risk Rating
Before
Mitigation
Medium= C2

Controls/Mitigation Measures

Authorized work permit holders shall ensure obtaining and

Residual
Risk /
Rating
Low=C1

maintaining valid work permits.

The supervisor responsible for this activity has to check the
PPE of his staff to ensure that all required items are
available and properly used.

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_____________

Action Party /
Remark
Site Supervisor
and
Safety Officer

 Inform all people regarding permit conditions before work

starts.

Supervisors must conduct daily toolbox talk about nature of

work and associated potential hazards and their essential
precautionary measures.
Gas test

2
Using of hand tools

HSE check list

Lack of safety awareness

May found toxic gas or H2S gas leak or

extreme oxygen limit in air

Body pain
Risk of injury due to use of hand tools
Risk of striking hand
Risk of striking others
Risk of eye injury from metal chips
Cuts From Sharp Objects
Fall, hit and strip

Medium= C2

Carryout gas test by Authorized gas tester time to time if

required.

All groups working in different area inside station shall have H2S
personal gas monitor/Toxic clips

Medium= C2

Medium= C2

All operatives shall be trained for proper handling of tools.

Appropriate tools only have to be used and its requirements
All operatives shall wear their PPEs without fail.
Keep only required amount of tools at site.
All tools shall be kept clean for easy use.
Ensure other personnel are well clear.
Beware of sharp edges on tools
The right tool for the job should always be used to decrease
the chances of injury, incidents, or damage to a tool through
improper use
Obtain work permits/ All personnel shall be H2S trained
Comply with all general job requirements mentioned on
PTW
Toolbox Talk on possible emergency and response
procedure and work activities.
All safety requirements stated on the work permit must be
fulfilled
Survey the work area and check utilities that need to turn off
Ensure equipment is maintained in good working order and
properly used .check equipment before use.
Ensure that proper barricade and sign have been placed
around the working areas
Provide drinking water at the jobsite according weather
condition.
work and rest procedure shall be followed.
Each employee should be instructed in safe working
procedure/technique and emergency procedure and what
they should to do in case of emergency .inform every one
about the emergency exit and assembly points and
emergency contact numbers.
Follow the summer time procedure and law
Provide proper access and ladders

&Prior to
commencing
mobilization to site

General
safety/Emergency
condition

Faulty Equipment
Health Hazards / Heat Stress
Back-strain
Emergency condition

Medium= C2

Low =C1

Site
Supervisor/PT
W

Low= C1

Site Supervisor
and
Safety Officer

Low= C1

Site supervisor
& safety
officer

Low =C1

All

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 HSE check list

Lack of safety awareness

Medium= C2

&Prior to
commencing
mobilization to site

Arrange scanning certificates before start the job

Obtain work permits/ All personnel shall be trained
Comply with all general job requirements mentioned on

Low= C1

Site supervisor
& safety
officer

Low= C1

Site supervisor
& safety
officer/ALL

Low= C1

Site
Supervisor,
and
Safety Officer

PTW

Toolbox Talks on possible emergency and response

procedure.

Market the area where existing cable found

All safety requirements stated on the work permit must be
fulfilled
Barricading and setting
warning sign

Accidents and incidents may take place as a result

of lack of attention.

Excavation

Medium= C2

shall be restricted.
Use safety cones bounded by safety caution tape to cordon
the working area.
Warning signs will be settled in place of work for attention

Debris embedded in eyes.

Back strain
Personal injury
Body pain
Risk of striking hand
Risk of striking others
Cuts From Sharp Objects
Fall, hit and strip
Electric shock.
High Water Table.
Damaging Buried Utilities
Blocking of emergency access
Blacking of emergency equipments or
operation equipments access
Debris stones or excavated materials
around excavation

Trenches, excavation area shall be barricaded and access

Medium= C2

Use proper PPE

All operatives shall be trained for proper handling of task.
Appropriate tools only have to be used and its requirements
All operatives shall wear their PPEs without fail.
Beware of sharp edges on tools
Wear full Required PPE at all times,
Provide proper fitting and safety requirements for air hoses.
Continuously checking of hoses for damaged or leaks
Provide proper access to emergency equipment
Dont try to block access for operational purpose.
Dont block any road or access unless not authorized by
station authority.
Dont stock excavated materials near excavation maintained
on daily bases
Continuously checking of compressor
Arrange scanning certificates before start the job
Area cordon off.
Follow Route marker.
Excavation certificate and permits
Remove soil/ stock pile material maximum away from edge.
Steps Slop, Shoring after 4' depth as per soil condition.
Fire extinguisher
Thoroughly Inspect Equipment Before Use. Make Sure All
Safety Devices And Guards Are Intact And Operable.

Page.

 Use Extreme Caution Around Existing Utilities,

10

11

12

Post Excavation

Environmental
Conditions

Manual unloading and

offloading works

House keeping.
13

Medium= C2

Medium= C2

All work shall terminate and each employee shall move to a

Unattended trenches
Trenches left open for extended period

Lightning
Rain
Strong winds
Darkness
Sand storms /dust storms

Low =C1

Barricade the trenches

Use warning signs & lights
Close the trench, backfill and compact the area.
Close the permit after making the site clean & tidy.

Low =C1

place of safety when environmental conditions create a

hazard for the employee.
All peoples must to use proper PPE according weather
condition.
Work will be not allowed in extreme whether condition

Site
Supervisor,
and
Safety Officer
Site supervisor
& safety
officer& all

Improper handling of material.

Fall.
Hit.
Slip.
Lifting of excess load.
Material Unloading ( Back
Strains, Cuts From Sharp
Objects)

Medium= C2

Appropriate Supervision.
Access from the storage to the Loading site must be clear.
Skilled manpower to shift the load.
Proper procedure to be adopted during manual lifting.
Sufficient break to rest.
Use proper PPE
Materials stored on site will be limited to those that are
necessary for the current work

Low =C1

Site
Supervisor,
and
Safety Officer

Debris causing Slips, trips and falls.

Fire risk due to presence of

Medium= C2

Regular housekeeping at site shall be performed.

Adequate and correct stacking of materials.
Regular inspection and immediate corrective action. Keep

Low= C1

Site
Supervisor,
Workers
and
Safety Officer

combustible materials / debris.

always clear of obstruction.

Regular clearing of work site shall be implemented.

TEAM MEMBERS & ENDORSEMENT

NAME

POSITION /REF
INDICATOR

SIGN

S/N

NAME

POSITION /REF
INDICATOR

Page.

SIGN

JHA Team Leader Authorization:

Ref Indicator:

Sign:

JHA Approval (Permit Authority / Asset Holder):

Ref Indicator:

Sign:

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