Work Activity (Job):HYDROTEST OF NEW PIPELINE FOR NEW MMF BACKWASH TANK

JSA Date: 20 NOVEMBER 2014 JSA Location: Waste Water Area

JSA Facilitator (Name): SYED N. SHAH JSA Facilitator (Sign):
JSA Participants: Albert, Ronald, Faizal, Rajesh, Junar
Approved By:
Shift / Area Supervisor (Name): Shift / Area Supervisor (Signature):

JSA Team to confirm for below screening criteria prior to proceeding with JSA

YES NA Screening Questions YES NA Screening Questions

 JSA Hazard checklist is available for reference. NOTE: The
completed checklist must be attached with the JSA.
 If a similar activity was performed in past, a copy of previous JSA
should be available.
 If it is a high risk activity then HSE Department must be involved.
 Visit to job location is made.
 If team is aware of any history of incident / near-miss on similar
job at Q-Chem, lesson learned report (LLR) should be available
for review.

Note: JSA shall be revalidated at maximum 30 days interval i.e. if same job continues more than 30 days.

Sequence of Basic Job Steps Potential Incidents or Hazards** Ways to Eliminate or Reduce Potential Hazards

For all job steps Slip, trip, fall hazard  Housekeeping shall be done to ensure work
place is clear all the time.
 All materials shall be removed from site to a
safe area immediately after the work.
Keep ayes on path.
 Special PPE’s (goggles) must be wearing to
Work inside the orange circle (additional PPE enter the orange circle.
required area)

 Heat stress  If heat index more than 32 degree, follow heat

stress mitigation plan.

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Job set-up including clearing at site.
Planning ,Shifting of equipment’s to site
Before Hydro-testing
(hydro test preparation)
 Noise
 Working without safety precautions / illegal
operation
 Skin irritation during cleaning the area and
dust inhalation
 Non-compliance of RLOC HSE procedures
 Falling objects while handling of equipments /
shifting of equipments and tools
 Unauthorized Personnel Entry and injury
 Defective tools/ Equipment
 Incomplete Positive isolation(LT&T) for hydro
test
 Wear double hearing protection while
operating noisy machines.
 HSE orientation/induction shall be carried out
for all personnel prior to mobilization.
 Work permit and tool box talk prior to start
the work shall be received and available on
site.
 Lead worker must be present throughout the
job.
 Use basic PPE while clearing the area
 Good housekeeping must be provided in all
working area and avoid any unnecessary pile
of debris or obstruction materials.
 Wear dust mask in dust areas.
 Refer HSE safety Procedure – Permit to work
 Obtain a work Permit & other associated permits
from permit issuer.
 Ensure working surface free from obstacles and
easy to access for fixing the blinds and gauges.
 Barricade the area with information tags where
Hydro-test is to be carried out ( 16m as per RLOC
hydrostatic procedure)
 Ensure the equipment / tool to be used for hydro
testing (such as Blinds, Hose, Pump, Coupling,
Pressure gauge, gasket etc) are free from defect
and suitable for pressure rating of the system and
proper certification.
 All equipments and tools should be inspected by
RLOC.
 Physically ensure Lines are positively isolated from
process lines (Verify LT&T). And follow RLOC
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 procedure for that.

 Remove or Isolate equipments/Instruments from
hydro test line.

 Install rated blinds and caps on required places.
( follow RLOC procedure)
 Incomplete Quality control and Inspection  Ensure all Test (NDT),and all other required
welding inspection completed before hydro test.
 Incomplete documents to permit Hydro test  Ensure and keep copy of an approved test pack by
ERG indicating test pressure and other details
 Ensure all relevant documents (Checklist signed by
stationary engineer and Maintenance supervisor).
 Slips and trips  Maintain good housekeeping throughout the job
Equipment preparation  Falling objects while handling of equipments /  Identify the hazards during TBT
shifting of equipments and tools from bottom  Secure the tools properly while lifting from ground
to top.  Use proper body postures.
 Body ergonomics  Seek assistance whenever handling the heavy
objects
 Make sure that all equipments and hoses are
certified by RLOC
 Install whip check in all hose joints.
During Hydro test  Entrapped air pockets  Make sure that all vents are open position before.
 Water should be filled in lowest point in system
Water filling
 System shall be purged of air before pressure
applied.
 Fix one calibrated pressure gauge and a vent top
of the pipe line to be hydro tested.
 Make sure that all vents are open position before
filling water
Pressurizing the pump and holding the  Disconnecting of hoses  Make sure that all hose connection are properly
pressure at the test pressure by using manual  Personnel Injury and equipment damage connected and have whip check in place.
pump or pneumatic pump
 Area to be barricaded and restrict access from
unauthorized personnel.

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  Exceeding the maximum allowable pressure  Use manual pump or pneumatic pump to increase
 Pump failure the pressure gradually.
 All equipment must be inspected by RLOC with an
inspection tag.
 Injury to workers  Keep away from the pressurized segment of the
system being hydro-tested.
 Monitor the pressure gauge from a safe distance
away from the potential source of high pressure
 Ensure the workers are wearing the required PPE
 Damage to Equipment / System caused by  Never increase the hydro-test pressure more than
exceeding the maximum allowable working the maximum allowable pressure.
pressure.  Increase pressure slowly ( 8kg/cm2 per minute)
 Maximum system test pressure shall not exceed
pressure rating of any component
 Follow RLOC pressure test procedure strictly
 Pressure gauge should be visible while pumping.
 Unattended Pressurised Tool / Equipment  Do not leave the pressurised hose or pump
unattended when the hydro- test is going on.
 Isolate the equipment from all source of energy
when not in use.
 Changing the duration of hydro test  Do not change (exceed / decrease) the duration of
hydro test without permission
Depressurising the system  Unsafe depressurisation of Hydro test water.  Ensure the safe depressurization of hydro- test
fluid.(first open vent and drain to
 Prevent any vacuum. All water should be drained
in RLOC drainage system.
 Make sure that all vents are in open position
before draining (to avoid vacuum inside pipes)
Air blowing  Disconnected of hoses  Make sure that all hose connection are properly
 Damage Hose connected and have whip check in place
 Inspect the hose for damages.
Windup &Housekeeping  Scattered Material  Ensure proper wind up & housekeeping at
worksite.

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  The accessories (hoses & pump) not
being used must be disconnected and stored
separately

Additional PPE: (Tick the box ‘√’ for YES and ‘X’ for NO and ‘NA’ for Not Applicable)
Did you refer to PPE Matrix?
Is any specialized PPE required for the job?
Are employees trained on proper inspection of PPE before use?

Goggles Dust Mask Other PPE or Equipment

Face Shield Respirator
Welding glass Air Line (Supplied Air)
Chemical Suit SCBA
Disposable Coveralls Half Face Full Face
Thermal Radiation Suit
(Aluminized Suit) Cartridge Type_ _ _ _ _ _ _ _ _

** Refer to Hazard Checklist (Annexure B: Job Safety Analysis Worksheet)

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 HSE-SAF-SFM-00-0018

Job Safety Analysis Worksheet

Annexure A – JSA Hazard Checklist
to ensure consideration of all hazards
(To be used in conjunction with the JSA Worksheet
associated with a job or task.)

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5 26-Nov-2013
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Job Safety Analysis Worksheet
Annexure B - Pre-job Confirmation Checklist
NOTE: Must be signed by the Lead Worker and Permit Issuer
Before Starting the Work:
YES NO NA
Do you notice unusual odors, vibration, noise, temperature that might be
an indication of a potential hazard?
Is hot piping and equipment insulated or guarded to reduce the risk of
burn?
Communication: Is the job properly communicated to all workers?
Has the JSA been reviewed with workers before the job begins?
Are radios available / necessary for communication during the work
process?
Life Critical Procedure: If open flame hot work, confined space, blinding,
etc needed for this job?
If yes, then all control measures implemented?
Exit/Egress Routes: Are the employees aware of emergency egress and
nearest assembly point?
Access to valves, equipment, etc.: Is the equipment, valves, nozzles,
easily accessible?
Will the worker be in unusual or cramped positions to perform the job?
Heat Exposure: Does the worker know the signs and symptoms of heat
stress such as headache, dizziness, weakness, cramping or nausea?
Do workers know methods of heat stress prevention such as adequate
water, ventilation, frequent breaks and rotation?
Has the fall hazard been identified and mitigated?
Is equipment properly isolated, tagged and locked as per LT & T
procedure?
Qatar Chemical Company Ltd.
26-Nov-2013
HSE-SAF-SFM-00-0018
YES NO NA
Are safety equipments / tools in good condition and certified? Basic PPE,
Specialized PPE, Emergency Equipment, harness, lanyard, lifting belts, hammer,
grinder, extension cords, hoses, etc
Are gas cylinders secured properly?
Chemical: Are the chemical containers proper for the material stored?
Are containers labelled properly?
Are the containers placed on the secondary containment?
Scaffold: Are scaffolds erected properly, in correct location and inspected?
Do scaffolds limit access?
Ventilation: Is adequate ventilation provided, especially in confined or enclosed
spaces?
Energized Sources: Are electric sources grounded?
Are hazards introduced by using non-intrinsically safe equipments (vehicles,
welding machine, cell phones, cameras, etc)
Health: Does the worker have any restrictions on job duties?
Are they well rested? Do they feel well?
Does the work area pose a slip / trip hazard?
Restricted area/Barricaded area: Is the work area properly barricaded and
identified?
Attachment – A: Job Safety Analysis Form Rev. 5
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 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 8/14
 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 9/14
 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 10/14
 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 11/14
 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 12/14
 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 13/14
 HSE-SAF-SFM-00-0018
Job Safety Analysis Worksheet
 Permit Issuer and Lead Worker must revalidate / sign the pre job confirmation checklist in the beginning of each shift if the job to be continued for the
extended shifts or days.

Permit Issuer: ___________________________ Lead Worker (Name / Sign): _______________________________

Qatar Chemical Company Ltd. Attachment – A: Job Safety Analysis Form Rev. 5
26-Nov-2013 14/14