JOB SAFETY ANALYSIS

Facility / Site: Location within Site: Permit No:PTF-19- Permit Type: Cold Date:

Task Description: Unloading, loading and placing 0F cable reels

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): High Vis Jacket

 TASK STEPS
(Number)
2-Mob of equipments
3-Preparation of equipments
and tools
4-Lorry Truck positioning
5-Unloading of cable reel
POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT
(What could go wrong?) (How can harm be prevented?) MITIGATION STATES
Adverse weather conditions *PTW/TBT *First Aid Kit
Trips/falls Adequate PPE /First aid *Safe egress at
Accident *Manual handling technique emergency
ill-health-eye problem *Speed limit *Fire extinguisher
severe injuries *Secured load
travel plan not communicated *Beacon lights
charge weight not know PIC to be onsite
Trips and falls *Permit to wok *First Aid Kit
Uncertified devices *Manual handling techniques *Safe egress at
Unqualified workers *Adequate PPE emergency
Breakdown *Toolbox talk *Fire extinguisher
Manual handling *Instruction and supervision
Eye injuries *Ensure good communication
Back strain * close Supervision
Noisy area * competent Banks man
Poor communication Ensure the soil condition
Bad soil conditions Only competent workers
Equipment and workers certification
Unqualified Lorry truck driver *Safety signs *First Aid Kit
Collision with pedestrians , fixed installation *Light beacon *Safe egress at
Uneven surface *Back up alarm installed and functional emergency
No Banks *Ensure that area is free from hazard *Fire extinguisher
Overload *Competent Banks man to be on place to
Poor communication monitor lorry truck
Crowdy area *Safety Belt must be worn
*Check truck cabin and trailer frequently
*equipment checklist
Secure the area
TBT/PTW *First Aid Kit
Overloading of forklift capacity *Forklift Radius SHOULD be free from all *Safe egress at
Nipping points personals even the authorized staff emergency
Sharp edges * PROHIBITION for the forklift operator to get out *Fire extinguisher
Heavy load from the machine during the lift
Falling Objects *All Certificates of forklift banks man of lifting
Unqualified Forklift operator operation must be displayed at work site
Collapse of the forklift *Barricade the area
 Gravity point not known *Toolbox talk to be done before shift commence
Unqualified Banks man to describe the sketch of lifting operation and to
Engine break down identify each person for his role & Responsibility
Poor communication *Check all Lifting gears before use
Mechanical failure *Pre-use check of the forklift before task
commencement
*Strictly prohibited to be under or on the fork
while manoeuvring
*Forklift operator and Banks man must know the
Signal hand means instruction of lifting operation
*Forklift operator should follows only the banks
man signals
*Banks man Wear HVJ and flags to monitor the
lifting op
*Operation should be done under HSE supervision
*STOP the work if Unsafe
6- Release Of Equipments and Damage to facilities *Ensure that the loads take their places *First Aid Kit
materials Improper position of equipments *Check Equipment are not defected , properly *Safe egress at
Accidents unloaded emergency
Bad Housekeeping *Housekeeping to be done after the shift *Fire extinguisher
*Speed limit to be respected
*Beacon light to be switched on
7-Adverse weather condition: Bites *Job rotation to be applied and share outdoors *First Aid Kit
Scorpions and snakes Poisonous insects activities between all workers *Safe egress at
Slip, trips and fall *Big and fresh quantity of water to be displayed emergency
Dehydration *Manual handling technique *Fire extinguisher
Heat struck *Awareness session to workers to aware them
Dizziness about 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
Checked By
Approved By