JOB SAFETY ANALYSIS
Ref: – JSA – 007
Facility / Site: ……………………………………………… Location within Site: ……………………….. Permit No: ………………………. Permit Type: ………………. Date: ……………………
Task Description: Righ of Way ……………………………..
REQUIRED REFERENCES JSA REVIEW
Have the relevant Procedures, Standards, Guidelines,
Yes N/A
or Safe Work Practices been reviewed? 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
Name / Signature: Company:
FALL PROTECTION
FALL RESTRAINT
GLOVES: COMPLETE THE SECTION BELOW IF THIS JSA IS NOT PART OF A PERMIT PACK
COTTON
Work Team Declaration:
LEATHER
I acknowledge that I have reviewed the attached JSA, I understand my roles
IMPACT PROTECTION and responsibilities, and I will comply with the instructions for this task.
Dust mask OTHER (specify): Name (print): Name (print):
Work clothes
OTHER PPE (specify):
TASK STEPS POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT
(Number) (What could go wrong?) (How can harm be prevented?) MITIGATION
STATUS
1. Mobilization and Driving • Collision with other vehicles. • Pre-deployment checklist to be issued 24 hours Seatbelt On all the
• Overturning vehicle with driving off road. before mobilization. time driving
• Driver fatigue
• Ensure drivers travel at safe speeds for Cars equipped with
conditions-passengers to have input. first aid kits
• Use identified roads and tracks. Fire extinguishers
• Travel at suitable speed for the surface available in cars
conditions. Satellite phone and
• Ensure drivers take breaks GPS locator are
available
• Use of all CONTRACTOR safe-driving
procedures. Observe all speed limits. Vehicle to Phones and contact
be checked before the start of any journey to list available in all cars
ensure safe operation. Cars equipped by IVM
• Rest breaks to be taken every 2 hours (15min) system
Journey Management Plan and convoy system in
force
• Drivers to should have defensive driving
certificate prior to mobilization to project
location
• The use of mobile telephones (including hands
free is not permitted whilst the vehicle is in
motion
• Emergency contact list to be posted in cars
2. Site Preparation • Musculoskeletal – From erecting hoardings, traffic • Training regarding good lifting techniques and Trained First aiders
barriers, barricades and posting safety signage. how to recognize your own limitations. onsite
• Team work if it looks like two or even three Adequate PPE for all
workers would do the job more effectively and personnel
safer than one, then that is probably true. Good lifting practice
• Use adequate body position while lifting or Safety signs are posted
carrying equipment onsite for personnel
• TBT in place
• Body fitness and medical check before starting
the job
3. Use of grader /bulldozers to • Personnel struck by moving machinery • One person to be dedicated to safety watch Warning flash light is
clear right of way • Underground services and have good communications with workers. ON once the
• Exposure time to be limited to as low as machinery is operating
• Overhead services (if applicable)
reasonably practical. First aid kits and first
• Roll over of machinery
• Banks man is to lead the moving machinery aiders in place
• Road Crossings
• Competent persons only to perform the job Communication
• Interfering with other moving vehicles system in place
• CONTRACTOR PTW is in force, personnel to be
• Soil disturbing Adequate PPE to be
trained on the PTW system
• Careless movement and storage of soils can cause used
• Machinery to be daily checked and inspected by
serious damage to the structure and future use of the Safety signs to be
competent person
soil. marking services
• Machinery is only to be operated by trained,
above ground
experienced and competent personnel
Flags to be used when
• Project cars to be equipped with IVMS system
needed to redirect
At distance control is in place other cars or vehicles
• Speed limit to be respected all the time Correct hand signals
• All Cars are equipped with Roll bars and
necessary first aid kits
• Fertile topsoil is to be kept separately from
mineral soil to allow reinstatement of the ground
to its best advantage for future use.
• Any soil movement or ground disturbing to be
done basing on the Method of statement
4. Refuel of Machinery • Contamination of ground and possible • Only trained and competent personnel will Trained personnel on
environmental impact on flora and fauna carry out refueling of machinery on project firefighting (operator,
• Fire and explosion locations. driver)
• All necessary precautions to prevent spills will Communication
be taken and any resulting spills will be system in place
immediately cleaned. (radios, phones)
• Any Spill to be reported and contained quickly Correct hand signals
• All needed personnel or equipment to be First aid kits and first
mobilized to contain the spill aiders in place when
• Spill report to be issued to CONTRACTOR
• All refueling operations to be performed by
competent persons
• HSSE supervisors to check after refueling
operation
• Ensure workers understand the hazards and
controls by doing a pre-job tool-box talk.
• Area to be barricaded.
• Electric Pump to be equipped with earthing
system.
• Refueling operation should be performed with
engine OFF. needed
• Park within 2m of pump. Liners to be used to
contain spills
• Operator/End User must shut the engine of the
Vehicle/Plant & Equipment prior to refuelling
• Ensure that there are No Naked Flames in the
area.
• Refueling must take place in a well-ventilated
area.
• Avoid spilling fuel by protecting the ground
with Fire retardant impermeable blanket & clean
up any fuel run off.
• Full inspection of equipment before to be used.
Smoking is prohibited while fuelling engines.
5. Cleaning & Housekeeping • Musculoskeletal from repetitive motion including • Training for good work practices to be held on Good lifting practice to
bending, stretching, reaching etc. site be applied
• TBT in place before job, housekeeping issue to Provide all needed
be mentioned in all TBT equipment to perform
• Personnel to end the day by cleaning, good housekeeping
inspecting equipment and good housekeeping. (trash bins, skips,
containers for waste)
• Waste management plan is in force during
project
• Waste to be removed in time as per
CONTRACTOR waste management plan
• Personnel to perform cleaning and
housekeeping without abuse to their bodies
6. Working in desert Biological hazards such as reptiles Use of PPE •MSBI Emergency
Close supervision response plan (medical
Poison from the scorpions & snakes
Long sleeve coverall treatment +
Personnel missing or lost in the desert
Safety boots
ambulance)
Personnel Protests Communication
Terrorist Attack GSM
Sat phone
Security accompanying
Provide sat phone, security spot and radio for
personnel working at uncovered area by
phone.
Assess the situation as quick as possible and
announcing the state of the emergency
(Emergency or Alert).
At any security threats call first the ERT leader
mentioned in back of access badge and
emergency contact list.
In case of any Terrorism threats call first the
ERT leader or the IMT Leader and the
COMPANY Field Security Liaison Officer
mentioned in back of access badge and
emergency contact list
Delegate someone to make sure that the area
is evacuated.
Name Position Date Signed
Prepared By
Checked By
Approved By
