Format

Job Safety Analysis Form

HSE Department

JSA NO: TMX-2/2018/PRJ/57

JOB SAFETY ANALYSIS FORM

Section 1: State description of job.

Grinding to be done on FRVE(100kl) tank for repair work.

S/No Describe sequence of job to Potential Hazard(s) Precautionary measures &

be carried out. control
1  Grinding activity  Injury to hand  Wearing necessary PPEs
i.e. cotton hand gloves,
Safety goggles, Safety
shoes as mentioned in
PTW
 Skilled workman to be
engaged to carry out the
activity.

 Fire hazard
 Hot work Permit to be
taken prior to work.
 Follow PTW instructions
and wear PPE’s as
mentioned in PTW
 Running water hose to
be provided
 Toxi Rae meter should be
used to check the area
for presence of any
flamable gases and the
same should be
monitored continuously
throught the work.
 Fire extinguisher to be
kept near the area of Hot
Work continuously till
the work is completed.
 Experinced team to do
the job.

 Dust pollution  Dust mask to be worn.

HSE-FRM-205/Rev.00 (Associated PR: HSE-PR-205) INTERNAL USE ONLY Page 1 of 2

 Format
Job Safety Analysis Form
HSE Department

 Electrocution  Certified electrical

Equipment, extension
boards to be used.
 Self Inspection checklist
of portable electrical
equipments to be filled
and signed off.
 Check the earthing
connection for tightness
of all electrical
euipments to be used.

JSA done by: (team members from all functions involved in the job)

Rahul
Name & Signature of Permit issuer / Shift leader / area owner:

Date:

HSE-FRM-205/Rev.00 (Associated PR: HSE-PR-205) INTERNAL USE ONLY Page 2 of 2