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Job Safety
Analysis
Job Description:
Plant:
Environment Change
Yes
No
Equipment:
Type of JSA.
Standard
Non-standard
Date:
Implementation sheet
No.
Job Steps
Potential Hazards
Mitigation Plan
Responsibility
Dismantling of
existing structure,
Piping and
equipments
Improper Tools
Erection of Steel
structure, Piping
spools and
equipments
Equipment failure
Required PPE:
Agreement for execution that I understand the criticality of task and all hazards related to job steps. I am expected & obliged to take all measures in
job step hazards control to mitigate risk level associated with this task.
Approved by: Maintenance specialist/Supervisor:
Name:
Badge #
Signature: