Job Safety Analysis (JSA)

Severity

Date:

05-09-2013

JSA #:

03/JSA-13

AHT. SWIBER
Vessel: ANNA
Page #

of

Band
Labels

FSO Intan cargo hose repair

Review / Revision #
Barricade

Fall Harness

Face Shield

Goggles

Likelihood

Hard Hat
Hearing Protection

Safety Glasses

Permit__________________________________________

Leather Gloves

Steel-Toed Footwear

Other __________________________________________

Date:

PPE
/ Permits
Job:
Cotton
Gloves Required For
FireThis
Extinguisher

Severity:
1 = Slightly Harmful
2 = Harmful
3 = Extremely
Risk
Criteria Harmful
High
Moderate
Lockout/Tagout Tolerable Work Vest

Deck and Engine crew

To Be Performed By:

Descriptions

Likelihood:
A = Highly Unlikely
B = Unlikely
C = Likely

Formal JSA Review

______________________________________
Completed Prior to Job
(Masters signature)
Task To Be Performed:

Air Hose

Compressed Gas Hose

Hammer Wrench

Scaffold

Portable Lighting

Other ____________________________________

Chain Fall

Cutting Torch

Impact Gun

Sledge Hammer

Welding Lead

Other ____________________________________

Come-along

Electrical Cord

Ladder

Tag Line

Escape Route ____________________________________________________

Equipment / Tools Required For This Job:

Rigging
/ Rigging
Required
For This Job:
Nylon Sling
______Points
______
______
Wire Rope Sling ______
Size

SWL

Qty.

Size

______

______

Shackle ______

______

______

SWL

Qty.

Size

SWL

Qty.

Nylon Sling ______

______

______

Wire Rope Sling ______

______

______

Shackle ______

______

______

Nylon Sling ______

______

______

Wire Rope Sling ______

______

______

Shackle ______

______

______

Nylon Sling ______

______

______

Wire Rope Sling ______

______

______

Shackle ______

______

______

Choking

Existing Padeye

Field Burned Hole

Vertical

Field Installed Padeye

Field Drilled Hole

Est. weight of load

What is the Weak Link for this rigging plan?

_____________________________________________

Basket

KOM-SOPM-10 Revision : 1

Page 1 of 2

Job Safety Analysis

L = Likelihood

Sequence of Job Steps

Operating towing winch.

Mooring line stopper.

Open old shackle.

Prepared By:

Potential Hazards

1. Rolling drum may harm hand

and fingers.
2. Unmanned switch or lever
may make drum rolling by
itself.
1. Lines might be broken.
2. Lines may cast off
accidentally.
1. Rust and shell may injure to
eyes and hand.
2. Using grinder may harm to
eyes and hands.

EDI H. / CHIEF MATE

KOM-SOPM-10 Revision : 1

Reviewed By:

S = Severity

R = Risk (see table)

Recommended Safe Procedures / Hazard Protection

1. Always use proper PPE especially leather glove or anti-impact glove.

2. Ensuring an operator for each machinery to be operated.
M

1. Ensuring to check lines condition prior use.

2. Periodically inspect lines positions.

1 & 2. Always use a proper PPE for eyes and hands protection.
M

Approved By:

Capt. HASAN ALHABSYI / MASTER

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