JOB SAFETY ANALYSIS

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

Task Description: ACID BATTERY FILLING

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:MSBI

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 POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT
(Number) (What could go wrong?) (How can harm be prevented?) MITIGATION STATES
1. Permitting work  Work condition unsafe  HSE team to assess continuously the  PTW system
 Procedures and tasks not clear conditions of work in the assigned area  Tool Box Talk
 Lack of supervision  One person responsible for PTW  inspection of all
 Miscommunication  Toolbox talks activity hazards
 PPE does not fit for the activity  Competent and qualified person
 Define hierarchy and reporting flowcharts
 Define proper PPE to be used for the work
 Check inspection certificates of equipment
for the job
 Check the status of the floor and mobile
scaffolding

 Standard PPE must be worn  MSBI Emergency

 MSDS communicated during the TBT response Plan
 Apply the manual handling techniques for  Proper fire
 Acid spill manual handling extinguisher
2. Transportation of  Fire  Spill kit in place
electrolyte  Vehicle crash  Only authorized person in the pick up
 Respect speed limit on site
 Pick up to be escorted
 Adequate Retention tray in the pick up

 Standard PPE must be worn  MSBI Emergency

 MSDS to be communicated to all workers response Plan
 Apply the manual handling techniques for  Spill kit
 Chemical handling manual handling  Eye wash
 Mobile scaffolding not stable  Ensure that the mobile scaffolding is stable  Fire extinguisher
 Inhalation before battery filling  First aid kit
 Ingestion  Adequate ventilation
3. Acid battery filling
 Eyes irritation  Adequate retention tray before proceeding
 Environmental impact for work
 Death  Spill kit, eye wash and detector to be in place
 Asphyxiated  Regular breaks
 Safety signs
 Safe access to be provided
 plan for rests & breaks
 Good housekeeping & waste management
  Only authorised person on battery room
 Presence of watchman obligatory
 MSBI Emergency
response Plan
 Acid spill kit in place  MSBI Emergency
 Keep work area tidy and clean response Plan
 Slips trips fall
 Regular Housekeeping and keep all area free  Spill kit
 Environmental impact
4. Housekeeping from hazards  Eye wash
 Fire extinguisher
 First aid kit

Name Position Date Signed

Prepared By HSSE Site Manager

Checked By Area HSSE Supervisor

Approved By PTW Coordinator