Job Safety Analysis (JSA)

Severity

Date:

27-11-2013

JSA #:

04/JSA-13

AHT. SWIBER
Vessel: ANNA
Page #

of

Band
Labels

Cargo Hose Delivering

Review / Revision #
Barricade

Fall Harness

Face Shield

Goggles

Likelihood

Hard Hat
Hearing Protection

Safety Glasses

Permit__________________________________________

Leather Gloves

Steel-Toed Footwear

Other __________________________________________

Date:

PPE
/ Permits
Job:
Cotton
Gloves Required For
FireThis
Extinguisher

Severity:
1 = Slightly Harmful
2 = Harmful
3 = Extremely
Risk
Criteria Harmful
High
Moderate
Lockout/Tagout Tolerable Work Vest

All Crew

To Be Performed By:

Descriptions

Likelihood:
A = Highly Unlikely
B = Unlikely
C = Likely

Formal JSA Review

______________________________________
Completed Prior to Job
(Masters signature)
Task To Be Performed:

Air Hose

Compressed Gas Hose

Hammer Wrench

Scaffold

Portable Lighting

Other ____________________________________

Chain Fall

Cutting Torch

Impact Gun

Sledge Hammer

Welding Lead

Other ____________________________________

Come-along

Electrical Cord

Ladder

Tag Line

Escape Route ____________________________________________________

Equipment / Tools Required For This Job:

Rigging
/ Rigging Points
Required
For This Job:
Nylon Sling ______
______
______
Wire Rope Sling ______
Size

______

______

Shackle ______

______

______

Wire Rope Sling ______

______

______

Shackle ______

______

______

______

Wire Rope Sling ______

______

______

Shackle ______

______

______

______

Wire Rope Sling ______

______

______

Shackle ______

______

______

SWL

Qty.

Nylon Sling ______

______

______

Nylon Sling ______

______

Nylon Sling ______

______

Size

Choking

Existing Padeye

Field Burned Hole

Vertical

Field Installed Padeye

Field Drilled Hole

SWL

Qty.

Size

SWL

Qty.

Est. weight of load

What is the Weak Link for this rigging plan?

_____________________________________________

Basket
KOM-SOPM-10 Revision : 1

Page 1 of 2

Job Safety Analysis

L = Likelihood

Sequence of Job Steps

Along side to bunker ship

Transfer hose
Connecting hose

Casting off from Bunker

ship

Prepared By:

Potential Hazards

Collution due; engine failure,

loss of steerage, bad weather /
Poor visibility / Damage to
property / Fire explosion /
Human injury or loss of life
Fall due to slip and trip / hand
finger caught in between hose
and bulkwalk top
Wrong manifold;
contamination / inproper camlock coupling connection; loss of
containment / hand finger cought
between couplings; finger injury.
Fouling of propeller by line in
water / Engine failure, bad
weather; collusion / damage
property and human injury /
handling of fuel fuel in contact
with body parts.

JIMMY D. L. / 2ND MATE

KOM-SOPM-10 Revision : 1

Reviewed By:

S = Severity

R = Risk (see table)

Recommended Safe Procedures / Hazard Protection

Toolbox talk / Test engines and all related equipment prior to approach /
confirm to bunker ship ready to receive vessel / Approch slowly and
manoeuvre vessel carefully /Master to exercise discreation and good
judgments whether to continue operation or to cancel if weather
unfavaurable / Maintain Good communication with bunker ship / Ensure
vessel have good vender to avoid steel to steel contact / stop all hot work /
SOPEP equipment in placed / Contingencies preparedness.
Keep deck clean and tidy / Controlled passing of hose / Dont hold hose to
close to bulwalk top / Work orderly, dont rush concentrate on the job being
done.
Colour coding of Fuel and water manifold & hoses coupling / hose
connection to be done by competent person / connection to be double
checked by duty engineer / Keep hand fingers away from coupling when
connecting / Connecting to be done by two persons
Test engines and all related equipment prior to casting off / Confirm bunker
ship ready to release vessel / Ensure propeller is clear and all lines on deck /
good communication between bridge and deck crew / Master to exercise
good seaman ship to manoeuvre vessel clear of bunker ship / MSDS /
Gloves, cover alls, bunker procedure.

HENDRA M. / CHIEF MATE

Approved By:

RUSDY / MASTER

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