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 : Company:SOCOBAT 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: SOCOBAT
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): High-Vis Jacket
TASK STEPS POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT (Number) (What could go wrong?) (How can harm be prevented?) MITIGATION STATES
1- Mob of equip -Posture / repetitive movement PTW/TBT ENI Emergency response
- Dropped objects Inspect and visual Check plan ( medical treatment + Manual handling Maintain good house keeping ambulance ) Trips and falls Use of proper PPE’s Proper tools shall be provided. Check the RPM of disc & machine Proper PPE (Gloves + Mask). Correct installation of Grinder Wheel Only qualified workers to use the equipment.
2- cutting -Posture / repetitive movement PTW/TBT ENI Emergency response
- Dropped objects Inspect and visual Check plan ( medical treatment + Rotating equipment sparks. Maintain good house keeping ambulance ) -Damaged grinding disc Use of proper PPE’s -Electrocution. Proper tools shall be provided. -Flying object/eye injuries Inspect the grinding discs prior to -fire starting work (ring test) -Burn Make sure that disc is compatible with Non competent workers the grinding machine Noisy area Check the RPM of disc & machine Proper PPE (Gloves + Mask). Correct installation of Grinder Wheel Only experienced workers to use the equipment. Wear a face shield while grinding
4-Release of ENI Emergency response
-Posture / repetitive movement Equipment’s and handling sensitization plan (medical treatment + Fatigue: back injury strained muscles materials Qualified workers ambulance) -Manual handling: back injury hand injury / dropped Arrange materials from site objects Job rotation to be applied and share outdoors activities between all workers ENI Emergency response Big and fresh quantity of water to be plan (medical treatment + displayed ambulance) Bites Manual technique Poisonous insects Awareness session to workers to aware Slip, trips and fall them about hazards associated with 5-Adverse weather Dehydration poisonous insects condition: Heat struck First aid kit and first aider should be Scorpions and snakes Dizziness available MSD Frequent breaks to be taken for Fatigue recovery Working in extreme temperature Workers should wear adequate coverall Time management culture among work force