JOB SAFETY ANALYSIS (JSA) WORKSHEET

Rabigh Refining & Petrochemical Company

JOB SAFETY ANALYSIS (JSA) WORKSHEET

Job to be Performed: JSA No: Date:
Revision No:
JSA for Excavation of Cable Trench Excavation UOD/LTP/2017/004 January 25, 2017
Job Safety Analysis and Repair 0
Worksheet Title of Person Who Does Job: Section: Supervisor:
Mr Vijayan LTP
Organization: Location: Department: Reviewed & Approved By :
M/S Sanai Contracting Co CT-3 Area UOM
Risk Rating
Risk/Hazard (Low, Mitigation Hazard Control Measures
Sequence of Job Steps to be
Moderate, Action By
Performed (Refer Hazard Checklist) (Existing and Additional) to reduce the risk to moderate or low.
High,
Critical)

1) Preparations Low Consult the proponent.

a) Site survey and Physical injury Make sure all the identified work spots are correct.
identify all
work spot and Traffic incident
provide Follow scope of work, methodology statement and the contents of this
identification JSA.
mark. Execute the job in a safe manner. Supervisor/
Establish the job sequence. Work Permit
Receiver/Safety
Inspector/ Safety
b) Work A joint site inspection by Issuer & Receiver is to be conducted while issuing Officer
execution Work Permit to identify hazards.
Be aware of conflicting work scopes in area prior to commencing work
task.
During the toolbox talk the WP Receiver shall highlight the key hazards
and associated controls identified in the JSA.
Keep the worksite clean and tidy and free of trip hazards (housekeeping).
 Type of work permit identified from JSA shall be issued and available at
worksite.
WP Issuer must demonstrate integrity of isolation to WP Receiver before
work commences.
Inform all personnel in the vicinity of the planned work. All non-essential
personnel shall vacate the area of the work.

c) Tools & Incorrect tool for the Low Temporary equipment must be inspected and tagged with a valid PRC
equipment job Inspection Sticker prior to use.
Ensure a complete inspection of tools and equipment is performed prior
to start of work.

Provide good and appropriate PPE.

Safety helmet, glass, shoes, ear plug, face mask with chemical cartridge,
dust mask, face shield, working gloves, FRC coverall and others are
required.
Supervisor/
Materials should hold out with the strength rate accordingly. Work Permit
Prevent from damage. Receiver/Safety
Check the manufacturer’s rating specification safety data sheet for all Inspector/ Safety
materials before placing on it. Officer

Assign qualified and experienced supervisor and foreman.

Inappropriate and Low Competent & qualified workers to be assigned.
d) PPE damaged PPE

Work permit receiver shall be Petro Rabigh certified

Validity of certificate is updated
Obtain work permit and to be countersigned by PR.
Inappropriate Low
e) Materials materials Any damage to plant or equipment must be reported to shift supervisor.
Care to be taken when working near to electrical equipment.
Care to be taken when working near to instrument tubing.
Lack of work Pipework or equipment should not be used for access.
f) Arrangement experience could Low
of workforce make mistake or
accident / incident

g) Work permit Non- qualified work Low

receiver permit or expired
 work certificate
Low
Damage to Plant and
Equipment
Fire hazard  Area must be barricaded to avoid unauthorized entry.
 Certified hoses to be used for the Jack Hammer.
Personal injury
 Jack hammer and air compressor must be inspected and certified
3)Breaking the Asphalt Dust explosion hazard by PR inspection agency
using pneumatic  Whip check arrestor must be provided on all disconnect joints of
Pressure energy
jackhammer, bobcat air compressor and jack hammer hoses.
and JCB Damage to existing  Equipment should be certified and tagged by PRC approved
facilities inspection agency.
Supervisor/
 Provide flagman for co-ordination.
Work Permit
Vehicle/ Heavy Moderate  Any defective hoses shall be immediately removed from the work
equipment site.
Issuer/Receiver
movement  Use fire extinguisher certified by fire department.
 Use cable detector before starting the job.
 Perform each work safely with the use of proper tools & with
right work permit.
 Always wear proper & complete PPEs.
 If in case damage on underground services, immediately stop the
work and proponent shall be notified. Underground services shall
be isolated.
4) Manual Excavation Presence of  Obtain work permit and follow established PR work permit Supervisor/
(Depth< 1.2 m) underground utility Moderate system. Work Permit
lines  Follow established PR excavation procedure (PR/IS/SFD/GI-034). Receiver/Safety
 Obtain excavation approval form. Inspector/ Safety
Soil collapse  Follow all the requirements mentioned on the excavation Officer
approval form.
Slip, trip and fall  All utilities and lines shall be properly identified and appropriate
parties notified before beginning any digging or clean-up work.
Fire/ Explosion  Use cable detector before starting the job.
Static charge  All hazards to personnel and underground installations shall be
noted on the Work Permit.
Vehicle/ Heavy  Never store materials or park/position equipment near the edge
equipment of the excavation.
movement  Install hard barrier made of scaffold tubing surrounding the
excavation to protect individuals and mobile operating equipment
Equipment damaged above the excavation or if the excavation is left unattended
including hoses overnight.
 Install traffic signs, blinking warning lights at night where there
are personnel or vehicle movement.
  Assign flagman to direct traffic if necessary.
 Allow only competent and qualified person to execute the job.
 Excavated soil shall not be stored closer than 0.6 meters from the
edge of the excavation.
 Determine the type of soil prior to entry (i.e. stable rocks, type A,B
and C soil)
 Ensure heavy equipment / cranes shall not be operated or parked
closer than 1.3 meters from the edge of the excavation.
 A qualified person shall make daily inspections of excavation prior
to the start of work shift.
 Equipment should be certified and tagged by PRC approved
inspection agency.
 No hot permitted above 0% LEL.
 Provide FPD certified fire extinguisher.
 Conduct gas testing before entering the pit.
 No mechanical excavator within 3m of any excavation or other
obstruction.
5. Backfilling and Injury to personnel Moderate  Area must be barricaded to avoid unauthorized entry.
compaction  Use the mandatory PPE’s.
Fall Hazard
 Provide FPD certified fire extinguisher.
 Obtain work permit and follow established PR work permit
system.
 All equipment and vehicles must be inspected and certified by
PRC approved agency.
 Perform each work safely with the use of proper tools & with right
work permit.
8. Asphalt Paving Exposure to asphalt Low  Explain the safety Precaution outlined on the work to ensure Safety
Burn injury Awareness.
Traffic incident  Proper hand Tools should be used.
 Proper PPE should be used by the workers during the work.
Supervisor/
 N-95 mask should be use while handling the concrete works.
Work Permit
 Area should be properly barricaded.
Receiver/Safety
 Housekeeping should be done after completion of
Inspector/ Safety
the job.
Officer
 Use heat resistance gloves.
 Area must be barricaded to avoid unauthorized entry.
 Obtain hot work permit for vehicle entry.
 Provide flagman for co-ordination.

9. Housekeeping / Personal Injury Low  Disposed waste in an approved disposal area. Supervisor/
Demobilization No Proper use of PPE  Perform each work safely with the use of proper tools & with Work Permit
 right work permit. Always wear proper & complete PPEs. Receiver/Safety
Inspector/ Safety
Officer

JSA Team Members:

Name Department Sign

CT-3 Area

MSSD-FMT

FSSD

Contracter / SANAI

IMPORTANT:
 This JSA must be available at the place where the activity is being performed and all personnel involved must be informed of the hazards associated with the
activities and the control measures to eliminate or minimize the hazards.

 This JSA must be reviewed if the scope of work changes or if any other major contingency occur.

 In case the plant emergency alarm is sounded, all work must be stopped, all permits will become automatically cancelled and Emergency Response Plan to be
followed.

 Ensure the availability of contractor Supervisor during the activity, continuously

 ATTACHMENT 3:
PETRO RABIGH RISK ASSESSMENT MATRIX

** ADDITION NEW INSTRUCTION  COMPLETE REVISION 