JOB SAFETY ANALYSIS

Ref: – JSA-…….

Facility / Site: CPF Location within Site: Chemical storage Permit No: 25459 Permit Type: COLD Date: 21.05.2019
area
 Task Description: Visual inspection and ultrasonic thickness measurement on pressure vessels

REQUIRED REFERENCES JSA REVIEW

Have the relevant Procedures, Standards, Guidelines,
or Safe Work Practices been reviewed? Yes N/A
Pending confirmation by the Task Leader of site conditions, I agree that the attached JSA identifies the
significant Task Steps, Hazards, and Controls.

JSA REVIEWER (Supervisor or Designate):

RISK ASSESSMENT
Must existing Procedures or Work Practices be
Yes No Name / Signature: HBIB BOUSABBEH Company: MSBI
modified to perform this work?
After mitigation, are there any hazards that continue to WORK SITE VERIFICATION
present a potentially significant risk? (Scenario-Based Yes No
Risk Assessment required)
The Work Team has assessed the worksite conditions and confirms:
 The JSA addresses the applicable hazards and necessary controls.
PPE REQUIRED DURING THIS TASK
 The Team has the appropriate resources (people and equipment) to do the job safely.
HARD HAT SAFETY GLASSES
 Others that could be affected by the work have been informed.
FACE SHIELD TASK LEADER:
SAFETY SHOES / BOOTS
GOGGLES

Name / Signature: Company:MSBI

FALL PROTECTION
FALL RESTRAINT
COMPLETE THE SECTION BELOW IF THIS JSA IS NOT PART OF A PERMIT PACK
GLOVES:
COTTON Work Team Declaration:
LEATHER I acknowledge that I have reviewed the attached JSA, I understand my roles
and responsibilities, and I will comply with the instructions for this task.
IMPACT PROTECTION
Name (print): Name (print):
Dust mask OTHER (specify):
Work clothes

OTHER PPE (specify):

 TASK STEPS
(Number)
1- Work permit in place
2- Preparation of pressure
vessel surface, conduct
ultrasonic thickness
measurement on pressure
vessels
3- Housekeeping
POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT
(What could go wrong?) (How can harm be prevented?) MITIGATION STATES
 PTW signed by authorised person.
 Ensure correct PPE available for task
 Procedure or task unclear  Carry out toolbox talk
 Miscommunication  Clear access to work zone.
 MSBI Emergency
 Workers involved in the tasks are not  All workers involved are competent and
 Response plan
competent They understand the scope of the work and
 Incorrect tools or PPE the hazards/risks associated with the
task.
 Clean and arrange the work area.
 Be careful when used wire brush and
equipment
 Wear adequate PPE’s
 Equipment pre-use check  MSBI Emergency
 Wire brush failure causing hand injuries
 Wash your hand after handling and response Plan
 Slip or fall before eating  First Aid kit in place
 Do not expose to extreme heat
 Make sure that all equipment are stored
in the correct place
 MSBI Emergency
 Slips trips and falls  Keep work area tidy and clean response Plan
 Unsafe access  Regular Housekeeping and keep all  First Aid kit in
 Obstacles in work area area free from hazards place
 Spill kit in place

Name Position Date Signed

Prepared By Area Supervisor

Checked By Area HSSE Supervisor

Approved By PTW Coordinator