JHA WORKSHEET

-HOW TO USE THIS FORM:

1) Crew performing task reviews ALL generic JHA considerations.
2) Review previous JHA update(s) for useful information which will help this task.
3) Create new JHA update with generic form and ALL considerations for this task.
4) Carry out task as per plan. If any conditions changeSTOP & RE-ASSESS.
5) File JHA update for future reference.
WORK ACTIVITY
To spool out/in slick wire
Job
Step

Description of Job Step

Installation/Facility
Location
Associated Work Permit Type
Associated Work Permit Number
Electrical Isolation Certificate Number
Physical Isolation Certificate Number
JHA Cross Reference Number
Date

Potential Hazard/s

Control / Recovery Measures

Deleum Oilfield & Services Sdn Bhd

Open Yard/ W.House
Nil
Nil
Nil
Nil

Result

acceptable

Ready all team and equipment for work

Unsuitable tool and

equipment for the job

Safety briefing and tool box talk

Unattended safety
violation

Urges all team to participate in safety briefing

acceptable

Reminded all team leader to follow safety steps

and procedure/ready fire watcher and fire
extinguisher. Barricade area. Wear full PPE.

acceptable

Wear appropriate PPE / follow instruction

acceptable

Work commencing (procedure applied)

To spool out slick wire job (use power
pack ,RSU & spooling device)

4.

House keeping work area

-High pressure
-High tension wire,
personnel step
through the tension
wire
-Wire break and
injured personnel
Trip /slip and fall /
finger injury

L LIKELIHOOD
CATEGORY

S - SEVERITY

DEFINITION

LOW

MEDIUM
HIGH

Use the right tools and equipment

CATEGORY

RESULT
DEFINITIONS

Remote

LOW

No injury

Possible

MEDIUM

First Aid Injury

Probable

HIGH

Lost Time Injury

69

Unacceptable

No pollution

34

Tolerable

Minor Damage

Minor Pollution

1-2

Acceptable

Major Damage

Major Pollution

No Damage

IS THERE A SAFER WAY TO COMPLETE THE JOB? ARE THERE ALTERNATIVES WITH LESS RISK?

Prepared By ( Maintenance Supervisor / Team Leader / Crew)

Verified By (Base Supervisor / Maintenance Supervisor)

Seen By (Safety Manager, Operation Manager, Safety Focal

Point)

Name
Designation
Date
Signature

Name
Designation
Date
Signature

Name
Designation
Date
Signature

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DOSSB-F11-1/Revision No.1

JHA WORKSHEET

DOSSB-F11-1/Revision No.1