FORM REVISION

JOB SAFETY ANALYSIS / RISK ASSESSMENT FORM HALLIBURTON MANAGEMENT REVISION NO:
DATE:
01 MARCH 2012
DOCUMENT NO: 001 SYSTEM A
Pages:
4

Job Title/Task: JSA/RA Document No: Revision Date: Risk Priority Code:
Offload cement 0 28-May- 2015
JSA-VN-HAL-CMT-1000 Allocated after Risk
Department: Plant/Location: Category: Prepared By: Approved By: Reduction Measures in place
Vung Tau Khanh Le PETER YATES RPC =
Cementing Viet Nam Cementing service Hai Pham
Dan Tran

REVIEWED BY WORKGROUP PRIOR TO PERFORMING WORK

Required and Recommended PPE Hard Hat, Safety Glasses, Coveralls, Safety Boots, Gloves, Hearing Protection; Dust Mask/Respirator

Before After
Sequence of Basic Risk Reduction Measures
Hazard Hazard Effect
Job Steps

SEVERI

SEVERI
PROBA

PROBA
BILITY

BILITY
RPC

RPC
TY

TY
Tool box meeting, Poor communication Injury people, damage EQ III C 2 Make sure everyone involved in the III D 3
review JSA operation understands their roles and
responsibilities.

RISK ANALYSIS MATRIX Page 1 of 4

Hazard Severity: I = Catastrophic, II = Critical, III = Marginal, IV = Negligible
Probability Rating A = Frequent, B = Reasonably Probable, C = Occasional, D = Remote, E =Extremely Improbable, F = Impossible
Risk Priority Code, 1 = High Risk (Not permissible STOP THE JOB), 2 =Medium Risk (May require waiver endorsed by management), 3 = Operation Permissible
 FORM REVISION
JOB SAFETY ANALYSIS / RISK ASSESSMENT FORM HALLIBURTON MANAGEMENT REVISION NO:
DATE:
01 MARCH 2012
DOCUMENT NO: 001 SYSTEM A
Pages:
4

III D 3

Check forklift extension Visible cracks Injury to personnel, dropped objects III C 2 Proceed if all is well III D 3
and forks

Using forklift(s) Driving backwards, Injury to personnel, property III C 2 Certified drivers only, seatbelts used, one III D 3
moving fast damage banksman used if multiple forklifts are
operating

Lifting operations Broken bags of III C 2 Insure only one bag at a time is lifted by III D 3
cement forklifts.
Injury to personnel,
damaged product
Visible damage on Injury to personnel III C 2 Reject damaged bags. III D
Received lifting straps. damaged product 3
product

Rain conditions Forklift slipping Property damage, injury to Suspend operations until rain stops. III D
personnel, water entering 3
product.

Reviewed By: Supervisor: Date: Plant / Location

PETER YATES Khanh Le 28-May- Vung Tau
2015

RISK ANALYSIS MATRIX Page 2 of 4

Hazard Severity: I = Catastrophic, II = Critical, III = Marginal, IV = Negligible
Probability Rating A = Frequent, B = Reasonably Probable, C = Occasional, D = Remote, E =Extremely Improbable, F = Impossible
Risk Priority Code, 1 = High Risk (Not permissible STOP THE JOB), 2 =Medium Risk (May require waiver endorsed by management), 3 = Operation Permissible
RISK ANALYSIS MATRIX
Potential Consequences Probability Rating
Hazard Descriptive Personal Illness/ Equipment Environmental A B C D E F
Severity Word Injury Loss(s) (Any incident that…) Frequent Reasonably Occasional Remote Extremely Impossible
Category Probable Improbable

Potentially harms/adversely affects the general

Fatal/ public & has the potential for widespread
permanent public concern of Halliburton operations. Can
I Catastrophic
disabling
>$1,000,000 have serious economic liability on the
operation.
1
injury/ illness
Potentially harms/adversely affects trained
$200,000 employees & the environment at our facility.
Severe Injury/
II Critical
illness
to
$1,000,000
Requires specialised expertise/resources for
correction.
2
>$10,000 Presents limited harm to the environment &
Minor Injury/ requires general expertise & resources for
III Marginal
illness
to
$200,000
correction 3
Presents limited harm to the environment &
No Injury/
IV Negligible >$10,000 requires minor corrective actions (CPI).
illness
Note the number 1, 2 and 3… these numbers represent the “Risk Priority Code”
Targets:
Probability Rating P Personnel
Level Description E Equipment
A FREQUENT: Likely to occur repeated during activity/operation. DT Downtime
B REASONABLY PROBABLE: Likely to occur several times. DC Data
ENV Environment
C OCCASIONAL: Likely to occur sometime. I Interface
D REMOTE: Note likely, but possible.
E EXTREMELY IMPROBABLE: Probability of occurrence cannot be distinguished from zero
Risk Priority Code (RPC)
Code Action Required
1 HIGH RISK: Imperative to suppress risk to lower level.
2 MEDIUM RISK: Operation may require waiver endorsed by mgmt. Operation Permissible

3 Note: RISK PRIORITY CODE OF LESS THAN 3 IS NOT ACCEPTABLE FOR HAZARDS THAT TARGET PERSONNEL

Page 3 of 4
 INSTRUCTIONS FOR USING RISK ANALYSIS MATRIX

STEP1: After identifying a significant hazard, first consider the POTENTIAL CONSEQUENCES. For example, what happens if
the accident occurs?

STEP 2: After considering the POTENTIAL CONSEQUENCES, such as Sever Illness of Injury, identify the Hazard Severity Category (for
example, II).

STEP 3: Now consider the PROBABILITY RATING. If it is Reasonably Probable that the accident would occur, the rate would be “B”.

STEP 4: Follow the Hazard Severity Category (II) across the line until it dissects with the PROBABILITY RATE (B). This shows a RISK
PRIORITY CODE (RPC) of 1.

STEP 5: RPC 1 is unacceptable. STOP THE JOB! Institute controls to reduce the risk to an acceptable level with an RPC of 3.
Contact your manager if the risk cannot be reduced to RPC 3!

STEP 6: When the RPC is 2 and the hazard impacts people, this is still an unacceptable level of risk.

Page 4 of 4