JOB SAFETY ANALYSIS

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

Task Description:

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

Name / Signature: Company:

FALL PROTECTION
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): Worker performing task inside to wear Double

Earing Protection (ear plugs and ear muffs), Welding gloves
 TASK STEPS
(Number)
1-Diesel transportation
2 -Fuelling engines at site
POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT
(What could go wrong?) (How can harm be prevented?) MITIGATION STATES
• Journey Management procedure to be applied. Eni ERP
Checklist to be performed on daily basis. First aider in the site
Diesel transport and storage pictograms to be pinned First aid kit available
up.
Gyrophare to be installed.
Inspection of the itinerary road before diesel
• Trapping of personnel/ vehicles transportation.
Equipment (Trailer tank) failure Itinerary To be strictly followed.
Noise / Vibration Qualified driver / valid permit
Equipment crush to personal and facilities Tool box talk to be conducted with Driver before
Personal injury, Damage to the vehicles departure.
Tank fall Night Transportation is prohibited.
Leak Gasoil on land Speed limit tractor 10 km/ h
Traffic Accident Ensure a continual communication with the supervisor
on duty
EMERGENCY contact list to be posted on the tractor.
Fire extinguishers.
SMOKING IS PRHIBITED while Diesel Transportation.
Diesel MSDS to be available and well explained by the
supervisor on duty
Tank fall Ensure workers understand the hazards and controls Eni ERP
Personal injury by doing a pre-job tool-box talk. First aider in the site
Facilities damages Area to be barricaded. First aid kit available
Engines damages Only Manual pump will be used.
Leak oil, gasoil Electric Pump is not allowed.
Fire Park within 2m of pump.
Personal injury/ Fatality Operator/End User must shut the engine of the
Damage to the facilities Allergies, damage to environment Vehicle/Plant & Equipment prior to refuelling
Fire Ensure that there are No Naked Flames in the area.
Refuelling must take place in a well ventilated area.
Ensure suitable fire extinguishers and First Aid Kit is
available in close proximity to the re-fuelling activity.
Full inspection of equipment before to be used.
Suitable PPE available. (Plastic Gloves, Eyes
protection...etc)
Smoking is prohibited while fuelling engines.
Diesel MSDS to be available and well explained by the
supervisor on duty
3-Adverse weather condition:
Scorpions and snakes
• Bites • Job rotation to be applied and share outdoors activities
• Poisonous insects between all workers Eni ERP
• Slip, trips and fall • Big and fresh quantity of water to be displayed First aider in the site
• Dehydration • Manual technique First aid kit available
• Heat struck • Awareness session to workers to aware them about
• Dizziness hazards associated with poisonous insects
• MSD • First aid kit and first aider should be available
• Fatigue • Frequent breaks to be taken for recovery
• Working in extreme temperature • Workers should wear adequate coverall
• Time management culture among work force

Name Position Date Signed

Prepared By Site supervisor

Checked By HSE
Approved By