JOB SAFETY ANALYSIS

Ref: C5+– JSA- 006

Facility / Site:……………………………………………… Location within Site:…………………….. Permit No:……………………. Permit Type: ……………… Date:…………………….

Task Description: Road Crossing with casing

REQUIRED REFERENCES JSA REVIEW

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:
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

FALL PROTECTION Name / Signature: Company:

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):            
           
 TASKS/STEPS
(Number)
1. Permitting work
2. Mobilization and Driving
3. Site Preparation
POTENTIAL HAZARDS
(What could go wrong?)
 Work condition not safe
 Procedures and tasks not clear
 Lack of supervisory
 Miscommunication
 Not correct PPE worn
 Equipment not inspected and certified
 Collision with other vehicles.
 Overturning vehicle with driving off road.
 Driving fatigue
 collusion with other gear and vehicle
 Blocked road without adequate traffic signs
 unmaintained deviation (bypass) road
 Traffic accident
 Traffic signs bad placed/defined
HAZARDS CONTROLS HAZARD PORT
(How can harm be prevented?) MITIGATION STATES
 PTW system
 All necessary permissions and authorization  Tool Box Talk
shall be obtained from the relevant  Inspection
Authorities concerned before starting any Certificates
work.
 HSE team to assess continuously the
conditions of work in the assigned area
 Toolbox talks
 Competency of personnel and supervisory for
the activity
 Define hierarchy and reporting flowcharts
 Define proper PPE to be used for the work
 Check inspection certificates of equipment for
the job.

 Travel at suitable speed for the surface  Trainings
conditions and respect speed limits.  Certifications
 In-field journey Management Plan
 Drivers to receive a course in Desert defensive
driving prior to mobilization to project
location
 The use of mobile phones (including hands
free) is not permitted whilst the vehicle is in
motion
 Seatbelt On all the time driving
 Communicate the deviation drawing and  Trained First aiders
notify staff onsite onsite
 Define the adequate traffic signs (arrow  Emergency
deviation, speed limit, stop, blocked road) Response Plan
 Block the road with adequate barriers (with  Traffic laws
red fence) and signals
 Proper placement of signs
 Restrict the work area.
 TBT in place
 Adequate PPE for all personnel
 Appropriate layout and maintenance of the
road deviation
4. Checking equipment  Punch point / hand injuries  Smart grip / 3 points of contact when climbing  Trained First aiders
 Personnel Injury onto machines onsite
 Falling from machine  Use containment cans/ plastic covers to  Emergency
 Slipping from ladder prevent spills Response Plan
 Diesel / oil spill  Wear dust mask when cleaning air filter
 Electric shock  Adequate equipment, certified will be used  Ambulance ready
 Breathing dust from filters  Competent persons will perform the job to intervene in case
 Waring must be done only after turning off of emergency
the power and confirming there is no
 Evacuation car on
electricity to prevent electrification.
work site covering
 Equipment check list should be made for all
POB working in the
new equipment coming to site
area.
 Ensure the respiratory equipment such as air
line hose pressure regulator, filter is free from
defect.
 Weekly equipment check list should be made
and kept at engine
 Wear proper PPE
 Use proper ladders / steps to go on top
5. Excavation  Damaged buried facilities  Dedicated team for the manual digging  Trained First aiders
 Person fall in the trench  Provide locate documentation (as-built, maps, onsite
 Dust goes in respiratory system drawing…) to ensure that the locations of all  Emergency
 Mishandled or poorly placed material buried facilities have been determined. Response Plan
 Excavated material or other objects falling on  Ensure that copies of locate documentation
workers are on site at all times during the ground  Ambulance ready
 Personnel hit by excavator or wheel loader disturbance. to intervene in case
 Mobile equipment incident due to unstable  Install stakes and warning tape around trench of emergency
adjacent structures  Ground personnel to wear high visibility
 Evacuation car on
 Workers go down in the trench while trenching jackets
work site covering
 Back injury when working with shovel under bad  Inspect trenches at the start of each day.
POB working in the
posture  Remove debris and excavated soil near
area.
 Personnel trip / falling hazards due to excavated excavation site
material  Wear respiratory mask if working downwind
 Excavator tilting due to bad ground stability (mud,  Place excavated material at safe distance from
sand…) the trench
 Never walk under and beside excavator
loader, wheel loader or machines
 Be aware of nearby vehicles and mobile
equipment causing soil to vibrate
 Do not go down in the trench while excavating
the trench
 Wear correct safety boots and mind steps / do
 not rush
 Check the stability of the ground below the
excavator
 Keep safe distance between the heavy
equipment and the trench edges (2m).
 Do not go down in the trench while excavating
 Wear correct safety boots and mind steps / do
not rush
 Watch for venomous animals and wear safety
boots and leather gloves
 Avoid hand and fingers injuries.
 Safety signs in place.
 Goal posts to avoid collision with overhead
power lines.
 Banksman permantly presence in mandatory.
 Area Underground utilities maps.
6. Pipe casing lowering in  Equipment / structure damage by Excavator/ Side-  Competent personnel shall be designated for  Fire extinguishers
boom when moving the operation  Emergency
 Punch point / hand or finger injuries due to  All equipment inspected (daily internal Response Plan
releasing lifting pipe inspection, and 3th party inspection) and  Ambulance ready
 Person crushed against objects by Excavator/ Side- confiscate any defective equipment to intervene in case
boom  Banksman to guide the engines movement of emergency
 Person foot crush by Excavator/ Side-boom chain  Never stand under suspended loads  Evacuation car on
 Personnel injury/Death or structure damage by  Do not exceed the SWL of the Excavator/ Side- work site covering
boom or rope boom POB working in the
 Personnel injury or structure damage by backload  Have good communication / visibility with the area.
due to excavator rotation Excavator/ Side-boom operator
 Excavator/ Side-boom tilting due to bad ground  Never insert hand / finger in between the pipe
stability (mud, sand…) and slings
 falling load  Wear leather gloves and avoid punch points
 Correct use of hand signals for lifting
 Trained First aiders onsite
 Adequate PPE for all personnel
7. Holiday test  Personnel injuries  Proper PPE must be worn  First Aid Kit
 Electrification/electrocution  TBT in place  Emergency
 Electrical sparks causing fire  Proper safety signs Response Plan
 Equipment damage by high voltage  Check the holiday detector, and substitute if  Ambulance ready
any damage (loose connection and frayed to intervene in case
cables) of emergency
 Only competent person must use the holiday  Evacuation car on
detector work site covering
 Ensure that supply is kept off during POB working in the

8. Coating/coating repairs  Worker insert his hand in the heating area
 Torch applied accidentally to face
 Body or parts burned by the torch flame
 Compressed gas bottles explosion
 Fire catching to equipment
 Manual lifting / moving of gas bottles causing back
injuries, tripping hazards
 Chemical contact with skin
 Chemical contact with eyes
 Chemical pouring on the coverall or clothes
 Chemical spill on the ground
 Fire catching chemicals
9. Cleaning &Housekeeping • Equipment and tools remain on site
• Slip trip and fall
• Trash left in the work place
intervention on the pipe area.
 Personnel must use insulate adequate hand
gloves to protect from electricity shocks.
 Inspect tools before use  First Aid Kit
 Watch for ground personnel while operating  Fire extinguishers
the heating machine  Emergency
 Clear area from personnel before spotting the Response Plan
heater  MSDS
 Do not approach heater during operation,  Ambulance ready
never insert hand in between heaters to intervene in case
 Buddy system, have a working plan according of emergency
to flame direction  Evacuation car on
 Wear face shield and leather gloves work site covering
 Handle bottles correctly, keep fire away from POB working in the
gas bottles area
 Have fire extinguisher in place
 Team carrying loads over 25 Kg
 Keep gas bottles at standing position
 Wear chemical gloves / plastic gloves long
sleeves
 Wear face shield or safety goggles
 Rinse eyes immediately with fresh water
 Refer to MSDS for immediate actions
 Wear plastic coveralls / Tyvex coveralls
 Avoid spill of chemicals, proceed carefully
 Keep fire away from chemicals, never smoke
 Warning signs in place
 Keep safe distance from trench
• Training for good work practices to be held on Plastic bags
site waste bins
• TBT in place before job, housekeeping issue to
be mentioned in all TBT
• After working day, team leader must ensure
cleaning, inspecting equipment and good
housekeeping.
• Waste management plan is in force during
project
• Waste to be removed in time as per
CONTRACTOR waste management plan
10. Working in ROW  Biological hazards such as reptiles  Use of proper PPE  Emergency
 Personal Fatigue / Heat stress  Insure periodic rest time for work force. response plan
 Personnel missing or lost in the desert  Dedicated rest area sun-shielded (medical treatment
 Close supervision + ambulance)
 Personnel Protests
 Communication means
 Assess the situation as quick as possible and
announcing the state of the emergency
(Emergency or Alert).
 At any security or terrorist threats call first the
ERT leader mentioned in emergency contact
list.

Name Position Date Signed

Prepared By
Checked By
Approved By