Method Statement With Job Safety Analysis For Road, Drains, Culverts, Road Crossover (Final) (16!07!2019)

Conex Petroleum Refining Company
Project Name 10,000 BPD PETROLEUM REFINERY AT FREE PORT MONROVIA
Site Contractor LUTECH ENGINEERING FZ LLC Issued For Review and

Approval
Document No. Rev. 0 Date
METHOD STATEMENT WITH JOB SAFETY ANALYSIS

FOR ROAD, DRAINS, CULVERTS, ROAD CROSSOVER
PROJECT
10,000 BPD Petroleum Refinery at Free Port

Monrovia
July, 2019
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Lutech Engineering FZ LLC
Title Method Statement with Job Safety Analysis for Road, Drains, Culverts, Road Crossover
Document No.
Project 10,000 BPD Petroleum Refinery at Free Port Monrovia
Contract No.
Client Conex Petroleum Refining Company
Contractor Lutech Engineering FZ LLC
Total No. of Sheets:
0
Rev Remarks Prepared By Prepared Checked By Checked Approved By Approved
No. Date Date Date
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TABLE OF CONTENTS
Sr. No. Description

1.0 PURPOSE
2.0 SCOPE
3.0 REFERENCE DOCUMENTS
4.0 GENERAL
5.0 METHODOLOGY
6.0 JOB SAFETY ANALYSIS & MITIGATION MEASURES
7.0 FALL PROTECTION SYSTEM
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1.0 PURPOSE
Lutech Engineering is going ahead with construction of 10,000 bpd petroleum refining
for their Client M/s. CONEX Petroleum Refining Company At Monrovia Free port,
Liberia consisting of OSBL tankages, ISBL tankages, Piping, Pump house, Dyke wall,
Refinery Civil construction, Erection of Refinery Columns, Heat exchangers, Heaters,
Boilers along with necessary Control Room / Office Building, Road, Drains, Culverts,
Cross overs etc. All related necessary job of integration with existing CONEX terminal
facility to that of proposed Refinery facilities including Tankages, Pumping to be
carried out to facilitate Export of product through existing Shipping line and local
delivery by BRVs.
Now, it has been felt that the need for a Method Statement with job safety analysis
for civil / structural work that covers Road, Drains and Cross Over’s. Accordingly, the
related Method Statement is being made.
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2.0 SCOPE
This document explains the required activities to carryout Civil work of Road, Drains, ,
Culvert and Road Cross over which involves the following:
• RCC Work (Drains, Culvert, Road Cross Over foundation)

• Road Work (Bituminous Road)
• Structural work (Road Cross over)
All excavation works are equivalent to Hot Work. Excavation Permit needs to obtained
from Terminal Manager for Excavation and all other Cold Work. Electrical Clearance is
also necessary for any possible Electrical Cable or possible Earthing Network, on a
one-time basis. Similarly, Custodian will issue Clearance for any possible Sewerage
line in proposed Road, Drain and Culvert area.
Fire screen of 3 M high has been provided after the existing Tank Farm to isolate the
Proposed New Tank Farm. All ignition sources shall be kept off as far as possible. Tool-
Box Talk is a must before start of the job on a daily basis, as the situation, working /
operating condition may change overnight or changes in shift.
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3.0 REFERENCE DOCUMENT
1. Contract Document
2. Lay Out covering Drains, Roads and Culvert in ISBL and areas under integration of
OSBL to ISBL
3. Civil Drawing for all the above including section drawing
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4.0 GENERAL
The following schedule will be followed:
• RCC Work (Drains, Culvert, Road Cross Over foundation)
1. Identification of Location / coordinates

2. Bar Bending & RCC Mix Design
3. Excavation of earth based on Drain, Culvert, Road Cross Over Foundation design
4. Removal of earth from site
5. Shoring as necessary
6. Hard soling
7. PCC
8. Form Work & Installing Steel Reinforcement
9. Casting of RCC wall / flooring / foundation
10. Curing
11. Back filling
12. Retention of embankment, as necessary
• Road Work (Bituminous Road)
1. Surface Preparation
2. Road Embankment
3. Sub Grade
4. Laying of Kerbstones (as need)
5. Sub-Base
6. Aggregate Base Course
7. Prime coat
8. Bituminous Base Course or Binder Course
9. Tack / Seal Coat
10. Joints
11. Compaction of Mixtures
12. Thickness of Cores & Testing
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Bitumen shall be heated to a temperature between 146 °C and 156 °C at mixing

time. The temperature of bitumen mix shall be monitored at the time of
application. All bituminous mixtures shall leave the paver at a temperature not
less than 150 °C.
• Road Cross over (Structural work)
Structural work main components are as under:
o RCC Foundation Work as per Drawing, design and specification

o Erection of Steel Structure that includes Hoisting & Rigging, Structural steel
assembly, Column anchorage, Beam & Columns, Open web Steel Joists, System
Engineered Metal Buildings, Laying of piping as per approved drawing / GA
drawing, Design & specification
o Laying of piping as per GA / Isometric Drawing, Design & Specification
• Traffic Management Plan: It is proposed to use the Emergency exit of the Terminal
for Incoming / outgoing traffic related project related material movement and
other mobile equipment like Excavator, Hydra, Mobile Crane, Concrete Mixer
Truck, Other material trucks, Staff / Contractor men vehicle etc. However, as the
proposed route is not in good motor able route, it is suggested to use the existing
main Entry route to Terminal for these Project related Vehicle / Mobile
equipment’s, which is passing by the side of existing Tank Farm to the Project site
with a another separate Entry and Exit at the area contiguous to Tank Farm end
leading to Terminal Exit gate.
• Security: All vehicles / Mobile equipment’s will pass through Terminal Security
with appropriate Gate Pass (Entry / Exit).
• Materials: All materials pertaining to Project will be stored in designated area as
earmarked by the Site Engineer. Site Engineer need to consult Terminal Manager in
this respect, as needed.
• Any surplus earth out of excavation, will be disposed off, by Site I/C to create
enough space to accommodate Project Materials and to provide adequate space for
carrying out jobs, movement of Mobile equipment’s etc.
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• In view of ongoing monsoon all approaches to Project site and within Site shall be
made motor able or at least WBM / WMM type.
• All safety and security arrangement shall be in place and Terminal Operations shall
not be hampered.
• At least 2 X 9 Kg DCP Fire Extinguishers, Sand buckets (dry sand) and one running
water hose near work area will be in readiness to meet Emergency.
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5.0 METHODOLOGY
5.1 RCC WORK (DRAINS, CULVERT, ROAD CROSS OVER FOUNDATION)
a. The following Methodology will be adopted for Concrete / RCC work:
• Concrete components
• Concrete mixing
• Concrete testing
• Formwork for foundation elements
• Formwork for Skelton elements;
• Work sequence for all elements.
b. Procedure:
• Drawing Approval
1. All shop drawings for the elements to be executed shall be approved in

advance to the proceeding of that element preparation and casting
procedures;
2. Shop drawings shall be submitted on sufficient time to allow the Engineer to
check / comment / approve the drawings and to be ready before the start
of the activity on site.
• Excavation
1. Excavation shall follow the excavation sequence based on the site

availability;
2. Excavation slopes shall follow safe slopes, proper Shoring or Benching to be
done
3. Foundation levels shall be checked as per the final approved shop drawings.
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• Materials:
o BS 5328 (C 30)
o ASTM C94, C227, C295, C1152
o BS 8102, 8000-4
o ASTM A 615 (Steel)
Laboratory tests shall be carried out on the Concrete mix materials to ensure
that the course of concrete mixing and preparation, materials comply with the
requirements defined in Technical Specification and Code
• Cement:
a. Shall be Portland Cement

b. Cement type for Skelton and other members will be as specs and drawings.
c. Source of cement shall be consistent for each individual element;
d. Source shall be approved by the Engineer as part of the concrete mix design
procedure;
e. Cement shall be stored in silos at the central batch plant.
• Aggregates:
a. Corse and fine aggregates shall be obtained at locations as per the approved
design mix documents;
b. Aggregates shall be tested as per the project specifications and codes to
satisfy the requirement individually and within the mix design.
• Steel (reinforcement):
As per ASTM A 615
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• Water:
a. Water source shall be the one defined and approved in the design mix
approved documents;
b. Water cement ratio shall be the one as per the approved mix design
document. Maximum shall be 0.45.
• Mixed Concrete:
a. For foundation works, concrete type (A) shall be used with a maximum 20
mm aggregate size and 38.25 Mpa strength after 28 days (Otherwise
Specified).
b. Cement content shall be not less than 370 kg/m³, using Portland Cement.
• Concrete mixing
Concrete mixing shall be done in one of the central batch plants approved by
the Engineer; it shall be transported in Truck mixers fulfilling the
Specifications, codes and approved design mix requirements.
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• Pouring and Compaction
a. Concrete pouring shall be placed evenly in layers.

b. Layers shall be compacted using vibrators;
c. Before pouring fresh concrete, temperature shall be checked to be of a
minimum value of 12 °C, and a maximum value of 32 °C
d. Slump of fresh concrete shall be checked to meet the specifications and
codes.
e. Slump for foundation elements shall be between 80 mm ±5mm; 90 mm
±5mm for Columns and 100mm ±5mm for Ceilings (Otherwise Mentioned)
f. During casting cylinder / Cube concrete samples shall be taken for further
compression tests after 7 days to reach the 67% (25.5 MPa) strength
requirements and for 28 days compression test to the required 100% (38.25
MPa) strength (Otherwise Specified).
• Formwork and False work:
a. Shop drawings shall be submitted showing the details of form and false
works for the different foundation / wall types and dimensions for the
Engineers review / comments / approval;
b. Removal of formwork shall be related to concrete strength as per specified
minimum period and Engineers approval.
• Concrete Curing:
Concrete curing shall follow the approved quality plan.
• Equipments:
Number of equipment mentioned in this section is minimum, exact number

shall be defined based on the exact quantities to be poured per day or per
item.
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Description of Equipment Number

Batch Plant 1
Truck Mixers 2-3
Mobile Pump Need based
Vibrators 2 or more
Slump Cone 2
Concrete Cube Moulds (150 mm X 150 mm) 24
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FIG: TYPICAL RCC BOX CULVERT DWG.
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Figure: CULVERT WITH HUME PIPE
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Figure: STORM WATER DRAIN
5.2 ROAD WORK (BITUMINOUS ROAD)
The Methodology will be adopted as under:
The Site Engineer will be responsible for Bituminous Road laying. Necessary Work
Permit to be obtained.
Equipment:
• Shovel
• Compaction Roller Machine
• Spreader
• Trucks
• Sprit Level
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• Plumb bob
• Electric air blower / Air Compressor for cleaning
• Drilling Machine
• Hammer
• Measuring Tapes
• Markers
Methodology
• Surface Preparation
o The surveyor shall mark the road center line and width of the embankment
prior to starting of any road works; The Site Engineer shall make detail survey
of the existing services (If any) by the side of the road or crossing the road.
o Surveyor shall make a survey report for the existing levels prior to filling or
cutting and engineer should make sure for the same.
o All the road works and road crossings must be executed as per the approved
drawings and as per project specifications.
Road embankment:
• Embankment shall be installed on top of the existing natural ground, thickness of

this layer shall be at least 30 cm.
• Material to be used for road embankment shall be A-1-a OR A-1-b or A-2-4 in
accordance with AASHTO classification.
• Every layer should be compacted with heavy compactor and the compacted density
of the soil shall be equal to or greater than 95% of modified Proctor M.D.D., with
no single value below 92%.
Sub Grade:
• Ensure that approved sub-grade material is used and the material sample shall be
collected and tested as per project specifications upon receiving of material at
site.
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• Sub-grade material shall be placed above embankment filling

• The approved Sub-grade material shall be backfilled to the thickness of 300mm
and it should backfilled in two layers (each layer 150 mm).
• Compaction of sub-grade shall be facilitated by means of a 10 – 12-ton vibratory
roller, rolling shall be continue to achieve the MDD of 95% as per approve drawings
and project specifications.
• Thickness of sub-grade shall not be less 300 mm or as specified in the approved
drawings
• The formation shall be shaped and graded to an even and uniform, well filled
surface, shaped similarly to the finished surface of the road.
• Compaction test shall be done by approved laboratory for the Sub grade.
Laying of Kerbstones
As needed and as per approved drawing. The kerbstone laying shall be inspected and
approved by Site Engineer.
Sub-Base:
• Ensure that approved, well graded, sub-base course material is used and the
material sample shall be collected and tested as per project specifications upon
receiving of material at site.
• Thickness of sub-base course shall be 200mm as specified in the approved
drawings, and it shall be placed in two layers.
• Sub-Base material spreading shall be started after receiving the compaction test
results of Sub Grade.
• Sub-base material loads shall be spread outside area on which it is spread to
ensure that no segregation occurs, and it shall be spread evenly.
• Each layer shall be must be compacted to an average of 100% of MDD with no
single value below 98%
• Minimum field density tests shall be one test for every 100 Sq.meter of granular
sub-base laid
• Minimum material test requirement shall be one sample for every day materials
arrived. Test shall be as follows grading, plasticity index, sand equivalent, MDD,
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and CBR, loss by abrasion by the approved laboratory as per the project
specifications.
Aggregate Base Course
• Ensure that approved sub-base course material is used and the material sample
shall be collected and tested as per project specifications upon receiving of
material at site.
• Thickness of sub-base course shall be 150 mm as specified in the approved
drawings.
• Aggregate base course material spreading shall be started after receiving the
compaction test results of Sub Grade.
• Aggregate base course material loads shall be spread outside area on which it is
spread to ensure that no segregation occurs, and it shall be spread evenly.
Prime Coat
• Ensure that approved material is used and each consignment test certificate for
prime coat (MC 70) shall be provided.
• Prime coat shall be tested as per project specifications.
• Prime coat shall be applied between road base course and bituminous base course
as per approved drawings.
• The same shall be cured for a curing period of 48 hours prior to laying of
bituminous base course.
• Bituminous material for the prime coat shall be applied in quantities of at least 0.7
ltr/m² not exceeding however 1.50 ltr/m².
Bituminous Base Course or Binder Course
• Ensure that approved bituminous base course material is used and each
consignment test certificates shall be provided for Bitumen used (MC 40 - 50).
• Bituminous base course shall be of thickness 90 mm or as per approved drawings.
• Bituminous base course shall not be placed during dusty, foggy and Rainy weather.
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• Bituminous base course material shall be transported in trucks from hot mix plant
& its final placement temperature shall not be less than 150 °C
• Consistency of mixture shall be checked for each 200 tons.
• Site engineer in coordination with surveyor must ensure laying of bituminous
course to the correct levels and to the specified longitudinal and cross section
profiles.
• The Bituminous base course shall be evenly placed by mechanical spreader on a
clean base in a manner that it does not become segregated.
• The seams of the bituminous base course shall be sufficiently staggered against
each other and it should be executed straights, longitudinal if necessary being
adapted to the road alignment.
• Bituminous base course shall be compacted evenly over the entire surface by using
pneumatic & steel roller.
• Gradient slope shall be maintained as per approved drawings.
• The core sample to be taken after compaction to determine the layer thickness
and the MDD as per project specifications.
Tack / Seal Coat
• Ensure that approved material is used and each consignment test results shall be
provided for Tack coat.
• Tack coat shall be tested as per project specifications.
• Tack coat shall be applied between bituminous base course and the wearing course
as per drawings, as needed.
• Tack coat shall be cured for at least 3-hour.
• Tack coat shall be applied in quantities of at least 0.4 ltr/sq. mtr, not exceeding,
however 0.60 ltr/sq. mtr.
Temperature:
• Temperature shall be checked whenever material is delivered to site.

• Aggregate ingredient shall be heated to a temperature between 160 °C to 179 °C.
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• Bitumen shall be heated to a temperature between 146 °C and 156 °C at mixing

time.
• All bituminous mixtures shall leave the paver at a temperature not less than 150
°C.
• Prime coat (MC-70) between 50 °C and 80 °C.
• Tack Coat shall be laid between 30 °C and 50 °C.
Joints:
• Longitudinal Joints in asphalt courses shall be offset by 300 mm in relation to the

longitudinal joints of the underlying course
• Transverse joints in succeeding layers shall be offset by at least 2 m. The same
shall apply when new pavement is laid in contact to an existing, which will be cut
back in steps, 2 m wide in each of its layers
• At transverse joints the previously laid work shall be cut to a vertical edge. Before
laying the material against it, the vertical edge to be painted with hot bitumen
and roughened
• Minimum number of joints to be exercised / considered during execution
Compaction of Mixtures:
• After spreading and strike-off, the rolling operation by pneumatic and steel roller
shall start immediately and shall operate as close as possible to the paver without
excessive tearing.
• Rolling will not be prolonged till cracks appear.
• The asphalt layer shall be compacted to a minimum degree of 98% of maximum
Density.
Thickness of Cores:
• Depth of each bituminous paving course shall be measured by cored samples.

• Samples shall be one sample for 600 sq. mtr.
• Cored sample shall be 10cm in diameter (nominal)
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Figure: TYPICAL ROAD DRAWING
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5.3 ROAD CROSS OVER (OVERHEAD PIPING)
• RCC Foundation Work
RCC Foundation work will be done as per approved drawing. Necessary bolt will be
anchored along with base plate on which steel structure will be erected.
o Drawing Approval
o Excavation
o Materials
 Cement
 Aggregates
 Water
 Steel
o Form Work
o Mixed Concrete
 Concrete Mixing
 Pouring & Compaction
o Concrete Curing
• Erection of Steel Structure
The Steel structure will be erected over the Road as per approved drawing,
fabrication methodology and specification. It will be Pre-fab structure need to be
erected. Necessary Work Permit including Working at Height to be obtained. The
Falling Object Protection means, and Fall Protection are to be in place.
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Methodology will be as under:
• Site Layout, Site-specific Erection Plan & Construction Sequencing

• Hoisting & Rigging
• Structural Steel Assembly
• Column Anchorage
• Beams & Columns
• Open Web Steel Joists
• Systems-engineered Metal Buildings
• Laying of Piping with guide as per approved drawing
• Piping spacing as per approved GA drawing
Equipments:
Hoisting / Rigging
• Mobile Crane / Hydra

• Mobile Telescopic Boom
• Mobile Elevated working Platform/ Man Baskets/ Scissors Lifts
• Chain Pulley
• Welding Machine
• Gas Cutting Machine
Personal Fall Arrest System:
• Safety Nets
• Beamer / Glyder / Girder Grip
• Retractable Lanyards
• Uni Strut
• Life-lines
• Safety Cable (Column attached)
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Approval to begin Steel Erection
• ASTM standard test method (concrete must be 75% of the minimum compressive
design strength): footings, piers, walls
Site Layout
• Adequate access
• A firm, properly graded, drained area, readily accessible for the safe storage of
materials and the safe operation of equipment
Hoisting & Rigging
• Crane inspections as per ANSI B30.5-1994

• Qualified operator is in charge of lifts and has final call
• Qualified rigger
• Preplan routes to minimize employee exposure to suspended loads
• Multiple lift rigging procedures….
Critical Lift
• A lift that
1. Exceeds 75 percent of the rated capacity of the crane or derrick, or

2. Requires the use of more than one crane or derrick.
Column Anchorage:
General requirements for erection stability
• Columns anchored by a min. of 4 rods (bolts)

• Each anchor rod, assembly including base plate and foundation, designed to resist
a 300# eccentric load at 18” from the column face
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• No repair, Replacement or Field Modification permitted to anchor bolts unless

approved by structural Engineer.
• 4 bolts minimum per column.
• Repair, replacement or field modification of anchor bolts must be approved by the
structural engineer of record.
• Columns set on level finished floors, pre-grouted leveling plates, leveling nuts, or
shim packs
• All columns shall be evaluated by a competent person to determine whether guying
or bracing is needed
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Beams & Columns:
• Secured with at least two bolts per connection.

• Competent person to evaluate.
• Diagonal bracing
• With bracing, secured by at least one bolt per connection.
• Double connections at columns and/or at beam webs over a column.
• At least one bolt or similar connection device is present.
Double Connection:
• Attachment method where the connection point is intended for two pieces of steel
which share common bolts on either side of a central piece.
• Double connections at columns and / or at beam webs over a column: At least one
bolt or similar connection device must be present (e.g., a beam seat, etc.)
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Diagonal Bracing:
• Solid web structural members used as diagonal bracing must be secured by at least
one bolt per connection drawn up wrench tight or the equivalent as specified by
the project structural engineer of record.
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Open Web Steel Joists:
• Addresses proper joist end attachment, erection procedures
o erection bridging requirements according to Tables A & B of AISC

o Holes in joists / bolting required for joists in 40’+ bays
• Requirements for landing and placing loads on joists

• Some requirements may be modified through a site-specific erection plan (tandem
setting of some 60’+ joists and requirements for landing decking bundles)
Anchored Bridging / Bolted Diagonal Bridging
• Steel joist bridging is connected to a bridging terminus point.

• Diagonal bridging that is bolted to a steel joist or joists.
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Figure: TYPICAL ROAD CROSS OVER (PIPING OVERHEAD)
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6.0 JOB SAFETY ANALYSIS TEMPLATE
Job Title: RCC Work (Drains, Culvert, Road Page _____ of _____ JSA No.: Date: _____ New _____ Revised
Cross Over Foundation Work)
Equipment: Supervisor: Analysis by:
Department: Approved by:
Required Personal Protective Equipment (PPE):
Job Steps Potential Hazards Recommended Safe Job Procedures

Identification of Location / coordinates Injury Obtain Cold Work Permit. Use PPE (Helmet, Safety Shoe).
Bar Bending Injury Obtain Cold Work Permit. Use PPE (Helmet, Safety Shoe,
Hand gloves). Check for the stability of the equipment. Only
trained and competent Contractor staff.
RCC Mix Design
Route Fixation for Movement of Material & Mobile Incident involving Truck / Route must be fixed / ear marked and Motor able or hard top
equipment’s mobile equipment, Injury, type. Truck / Mobile equipment speed limit - 10 KMPH within
Death, Loss of property / Project site / Terminal. Detachable Spark Arrester to be fixed
material on Mobile Plant. Competent and or having valid license to
drive / operate. Terminal Staff to follow earmarked
pathways for pedestrians.
Excavation of earth based on Drain, Culvert, Road Cross over Injury or Illness Obtain Excavation Permit. Site Engineer and other working
foundation design staff to be aware of Electrical Cables, Sewerage line, defunct
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Petroleum line passing through site. Consider enough space
for movement of Excavator in Horizontal and vertical
direction. Almost 1 - 2 M depth earth excavation needed.
Area fenced- only authorized and competent people to work.
Excavated earthed to be positioned at least 1 M away. Site
Engineer to consider condition of earth due to prevailing
monsoon, static load and dynamic load in surroundings,
Stability of Excavation. Assess any live service, proximate
water course or isolation failure could cause flooding of
excavation. Means of entry and exit from the excavation.
Dewatering pump. Any Mobile Plant must not be allowed
within 2 M from Electrical Cable and Pole within 5 M.
Removal of earth from site Injury Working / proper earth mover / dumper. Competent operator
/ driver. Site Engineer to direct the area of safe operation
considering Static and dynamic load on excavation.
Shoring as necessary Injury Shored, benched and or battered, as needed. Sloping of the
face prevent ground collapse. Benching and battering may
also be considered in absence of shoring.
Hard soling / PCC Injury Protection from earth collapse. Providing shield. Sloping of
the face prevent ground collapse.
Form Work Injury Protection from earth collapse. Providing shield. Sloping of
the face prevent ground collapse. PPEs (Gloves, Helmet,
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Safety Shoe).
Installing steel Reinforcement Injury Protection from earth collapse. Providing shield. Sloping of
Safety Shoe).
Positioning of aggregate, Concrete Mix Injury Demarcated area. PPEs.
Positioning of necessary equipment’s for casting Injury Demarcated area. PPEs.
Casting of Footing, RCC Wall / Flooring / Foundation Injury Protection from earth collapse. Providing shield. Sloping of
Safety Shoe, Dust mask). Safety shower be provided.
Curing Injury PPEs (Gloves, Helmet, Safety Shoe)
Removal of shattering and disposal of shattering materials Injury PPEs (Gloves, Helmet, Safety Shoe)
Back Filling Injury PPEs
Retention of Embankment, as necessary (for Culvert) Injury PPEs
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Job Title: Road Work (Bituminous Road) Page _____ of _____ JSA No.: Date: _____ New _____ Revised

Surface preparation Injury Obtain Cold Work Permit. Use PPE (Helmet, Safety Shoe,
Hand gloves). Check for the stability of the equipment. Only
trained and competent Contractor staff.
Road embankment Injury Certified earth mover, Competent Driver/ operator. Use PPEs
Sub Grade making Injury Certified Compactor / Roller, Competent Operator, Use PPEs,
Sub grading as per approved design and specification.
Laying of Kerbstones (as needed) Injury Kerbstone laying as per approved drawing and specification.
Use PPEs
Sub-Base making Injury On specification materials, Layer wise compaction as per
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design, Test procedure followed, Approved / certified Mobile
plants, Competent operator, Use PPEs
Aggregate Base Course Injury On specification materials, Layer wise compaction as per
design, Test procedure followed, Approved / certified Mobile
plants, Competent operator, Use PPEs
Prime Coating Injury / Burn Only Competent worker handling Hot bitumen (150 Deg C),
application as per design and specification, Use PPEs.
Bituminous Base Course or Binder Course Injury/ Burn Only Competent worker handling Hot bitumen (150 Deg C),
application as per design and specification, Evenly
Compacted, Gradient slope maintained. Use PPEs.
Tack / Seal Coat Injury / burn Approved Material used, Application as per design and
specification.
Jointing layers Injury Quality norms of Jointing Bitumen course adhered to, Use
PPEs
Compaction of Mixtures Injury Certified Compactor / Roller, Competent Operator, Use PPEs
Thickness of Cores & Testing Injury Competent employee, Adhere to Testing Standards, Use PPEs
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Job Title: Road Cross Over (Overhead Page _____ of _____ JSA No.: Date: _____ New _____ Revised
Piping)

RCC Foundation: RCC Mix design, Excavation, Materials, Form Injury Excavation Permit to be obtained, Adherence to design and
work, Concrete mixing, Pouring/ compaction, specification, Benching needed if shoring not done. Use Shield
to protect from earth cave in during activities in trench.
Certified equipment / Competent Operator.
Approval to began Steel erection Injury Certified Mobile plant, Competent Operator, work under
supervision. Approved drawing. Footings, Piers, walls to have
minimum 75% compressive strength. Erection only after
receiving Structural Engineer’s clearance.
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Hoisting & Rigging / Critical Lift Injury Crane Inspection done (ANSI B 30.5). Qualified Lift operator,
Qualified Rigger, The total load shall not exceed rated
capacity of hoisting equipment or the rigging capacity.
Controlled load lowering shall be used while the load is over
Connector / Operator. Preplan route to minimize employee
exposure to suspended loads. Use PPEs
Column Anchorage / Erection Structural stability shall be maintained at all times during
erection. Minimum 4 bolts as per design & specification.
Columns to be framed in at least 2 directions. Check for
Guying or Bracing needed. Field modification like shim pack
only with approval of Engineer. Repair / replacement of
anchor bolt not permitted unless approved by Structural
Engineer. Use PPEs
Beams & Columns erection Secured with at least two bolts per connection. Competent
person to evaluate. Any Gap or void of 12” or more to have
skylights on roof or floor, to prevent fall. Plumbing up as per
competent person, Planked / decked floor as needed. Use
PPEs- Personal fall arrest – Lifeline & Falling object
protection. Connectors / Operators must be provided and
wear equipment necessary to be able to be tied-off or be
provided with other means of fall protection.
Double Connection / Diagonal Bracing Diagonal bracing / Double connections at columns or at Beam
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Approval

webs over a Column - Standard procedure be followed.
Open Web Steel Joist Addresses proper joist end attachment, erection procedures.
When columns not framed in 2 directions by beams, Steel
joists shall be field bolted at the column. Hoist cables not
released until joists are field-bolted and the bottom chord is
restrained by stabilizer plate.
Anchored Bridging / Bolted Diagonal Bridging Anchored Bridging / Bolted Diagonal Bridging be carried out
as per Technical Digest of Steel Joist Institute. Use PPEs.
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Approval
General Personal Protective Equipments:
Type Of PPEs Remarks

Protection
Head Hard hat/ Helmet- meets ANSI Z89.1 Name should be displayed for
requirements identification
Eye & face Safety Glass – meets ANSI Z87 Person wearing prescription
requirements glass to wear over the glass
Foot Steel toed shoe/ boot Tennis shoe, sandals not
allowed
High Visibility Vest with high visibility- meets ANSI Welders excluded
Attire reflectivity requirements
Hand / Finger Appropriate Gloves People using tools/ materials
to use always
Hearing Ear plug- used for noise more than 85 Exposure not to exceed 140
dBA dBA
Activity based Eye/ Face Protective Equipments:
Activity Safety Equipment

Welding Welding Hood and safety glasses with side shields
Burning Burning Goggles with Shield
Abrasive grinding or cutting Face Shield and safety glasses with side shields
Drilling Goggles or Face Shield and safety glasses with side shields
Reaming Face Shield and safety glasses with side shields
Chemical Handling Goggles and Face Shield
Molten Materials Goggles and Face Shield
Corrosive Liquids Goggles and Face Shield
Concrete Pouring Safety glasses with side shields
Page 40 of 45

Approval
Activity based Protection Equipments:
Activity Safety Equipment Remarks

Vessel/ Confined Space Self Contained Gas/ Oxygen/ H2S test to be checked
Entry Breathing Apparatus
Working at height/ Safety harness/ Protection fall arrest system/ Proper
Operating Mobile plant Safety belt guard rail/scaffolding/ safety netting/
certified mobile Boom Lift/ Crane/
Excavator/ Front Loader/ Dumper,
ladder/2 M rule adherence
Excavation Shoring, Benching, Using shield, 1.5 M
depth Rule adherence/Proper entry-
exit
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Approval
7.0 FALL PROTECTION SYSTEM
• Personal fall Arrest System:
o Means a system used to arrest an employee in a fall from a working level.

o System consists of an anchorage, connectors, a body harness and may include a
lanyard, deceleration device, lifeline or suitable combination of these.
• Positioning Device:
o Means a body belt or body harness rigged to allow an employee to be supported

on an elevated, vertical surface, such as a wall or column and work with both
hands free while leaning.
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Approval
• SAFETY NET:
FALL ARRESTER
• Beamer, Glyder, Girder Grip:
Page 43 of 45

Approval
• Lanyards / Retractable Lanyards:
2 Lanyards Minimum for 100% FP
Page 44 of 45

Approval
Figure: GENERAL LAYOUT
Page 45 of 45

Method Statement With Job Safety Analysis For Road, Drains, Culverts, Road Crossover (Final) (16!07!2019)

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Method Statement With Job Safety Analysis For Road, Drains, Culverts, Road Crossover (Final) (16!07!2019)

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Conex Petroleum Refining Company

Project Name 10,000 BPD PETROLEUM REFINERY AT FREE PORT MONROVIA

Site Contractor LUTECH ENGINEERING FZ LLC Issued For Review and

Document No. Rev. 0 Date