Form Title JSA Worksheet Form No. PRIIS/SFDIF-001 Rev. No. 03 Ref. Doc. Job Safety Anelysis Doc. No. PRIIS/SFDIP-007 Rev. No. 03 afi JOB SAFETY ANALYSIS (JSA) WORKSHEET (Form No. PR/IS/SFD/F-001) Job to be Performe SA No: Date: New / Excavation of PIT TK-0101 3SA/04 20.11.2017 Revised Job Safety Analysis (Rev, No.0) Worksheet ie of Person Who Does Job: Ses ‘Supervisor: Executing Location: Department: Reviewed & Approved By : Organization CFU Project area (Section/Dept.): Name of the Contractor (company) Performing the Job: Work Order No. (if applicable) ‘Tecnimont Arabia Limited / AKON International Sequence of Job Risk/Hazard sia al Mitigation Hazard Control Measures Steps to be (Refer Hazard Checklist) | 44(5o""4_, | (Existing and Additional) to reduce the risk | Action By Performed High: Critical) to moderate or low. 1. Unauthorized work, PTW violation ‘High '* Obtain Work Permit prior to the commencement Permit 1. Obtain Permit to | 2. Inadequate Mevring | ef Work and hard copy to be kept at the Issuer / Work, and required | preparation/fallure to worksite Receiver / documents properly communicate to all + Do not start any work preparation until signed | Contractor involved personnel the permit is In the hand. necessary control measures + JSA to be made available at the site and Job ‘and approved work methods Specific hazards and control measure to be an result in communication communicated to all personnel involved in the lapses and serious incident Job each morning before commencing activities during the execution of work. + Check for underground services through P&ID‘s. 1. Ergonomics, slips, trips, * Ensure all workers wear proper PPE, Hardivt, Sab bumps, liftin oe safety glasses, safety boots, and leather Supariieoty 9 Engineer/ HSE in charge/ Page 1 of 9[ "Form Title JSA Worksheet Form No. PRIIS/SFDIF-001 Rev. No. 03 Ret. Doc. Job Safety Analysis Doc. No. PRIISISFDIP-007 Rev. No. 03 sas f® 3. Vehicular accidents 4, Personal injury + Ensure clear path to work site is delineated, of other vehicles encroaching of the area + Ensure workers have seen & identified hazards present in area, underground utilities etc, and provide spotters if required and also barricade the area. Identify assembly point at work area and also discuss in daily tool box talk about evacuation procedure with all workers in the event of an emergency. + Attached a required document approved exca~ clear of obstructions and debris, and no danger vation form, exact work location etc. ry aeisapa Work Permit] Receiver ‘ollow ‘Traffic. plan Scenrmpen 4+ TAM beck alos paver b Barricade the area @ reardie wartry Tow * Provide the appropriate fencing and/or barri= Job cades as per site-risk assessment, Supervisor/ 1. Inadequate access/egress + Conduct site inspection to ensure access/egress | Engineer/ 3. Secure Site 2. Slips, trips and falls, abra- Is adequate for the task activities. HSE in- sions, strains and sprains + Keep area clean & clear of obstacles. charge / + Apply appropriate signage and pedestrian con- | Work Permit trol Receiver {Mechanical Excove- « Aa il crevinge ale fort oen as Medium — | « As built drawings available at site Supervisor / + Survey land/ of work area identifying any cur- | Engineer / a teceeon creck 4. Underground utilities rent man holes and hard barricade Equipment ; + Heavy equioment operators to visit site before | operator / Check work aren is bring on thelr equipment .e electcal markers [HSE n-chavae ia he and cable markers (hard barricade or removal | / Work poem and reinstatement) Permit Receiver Page 2 0f 9Form Title JSA Worksheet Form No. PRIIS/SFD/F-001 Rev. No. 03 Ref. Doc. Job Safety Analysis Doc. No. PRIIS/SFDIP-007 Rev. No, 03 5. Pre job checks + Equipment should be certified and having valid inspection sticker approved by PRC third party 1. Uncertified equipment Medium inspection company. Area Check equipments } | 2. Inexperienced or incompe- + Equipment operator should be experienced and | Supervisor & Are fit, operator is | | tent operator competent and also having PRC approved third | Equipment competent and 3. Inexperienced or incompe- party competency certificate. operator experienced Check _{ | tent crew members * Pre use checks completed before operation crew are competent * Banks man must be experienced and compe- tent. + Excavation procedure/method should be done as per approved Method Statement. 1. Vibration ‘+ Mechanical equipment to be utilized at site 2. Dust Medium should be certified by approved PRC third party 3. Damage on underground Company. Hen utilities * Use cable detector before excavation on ground | supervisor/ 4. Striking underground util level. Beginner? ties identified or otherwise + Mechanical equipment shall be checked by the an 5. Uncertified equipment User prior to use to identify any fellure points | seceivery 6. Inexperienced or incompe- and daliy pre-use inspection recorded on check: | fauipmeat tent operator Hist operator 6. Excavation of PIT (Cx 7. Adverse weather 8. Man machine interface 9. Blind spot of operator + Mechanical equipment must be inspected by a ‘competent person. ‘+ Mechanical equipment shall undergo a servicing program in line with their manufacturer's guide- lines. + Full time supervision from start until completion of Job required. + Inspect equipment for visible damage. ‘+ Only persons who are trained and competent to do the job. ‘+ Appropriate PPE’s shall be worn as per work and tools specification/requirement * Use hearing protection when exposed to exces- sive noise levels (greater than 85 dBA over an 8-hour work period) Page 3 of 9Form Title JSA Worksheet Form No. PRIIS/SFDIF-001 Rev. No. 03, Ref. Doc. Job Safety Analysis Doc. No. PRIIS/SFDIP-007 Rev. No. 03, seat * Ensure frequent wetting of soil to eliminate accumulation of dust in the area * Operators rotation to minimize worker exposure to equipment vibration * Equipment should be certified by PRC approved ‘Third Party Inspection Company. * Equipment operator must be experienced and competent and also having PRC Approved third party competency certificate. * Trained flagman / Banks man to be provided to guide operators and personnel nearby. « Ensure that working conditions are safe or stop the activity. 1. Damage of underground * Operator shall be competent and experienced to use the jackhammer. and above ground services. + Before starting the job check underground and Job 2. Arm muscular stress due above ground services and also scan the area Supervisor / 7. Use of jackhammer | to vibration. Medium for detecting the live electrical cable. Engineer / to break soft rocks | 3. Hearing loss + Make alternate route for other road users and | work permit 4, Dust working area must be hard barricade. 5. Flying object + Operator must take rest frequently and use Recelwer 6, Foot Injury hand gloves to minimize the muscular stress. 7, Defective equipment. * Operator user must use ear plug to protect 8, Excessive friction from hearing loss. * Firefighting equipment must be available + Pre-use equipment inspection to be carried out 1. Hitting of air compressor ** Barricade the air compressor Job by other vehicle or equipment ‘+ Hose pipe must be inspected and must be ina | Supervisor/ 8. Air Compressor —_| 2. Bursting of hose pipe Medium good condition with hose whip arrestor. lngineer/Wor, 3. Improper hose pipe attach- * Air compressor must be grounded to protect 1 Pee ing with air compressor outlet the operator from electric shock 4. Fire * Place fire extinguisher nearby air compressor to | Receiver/ use in case of fire, HSE 5. Defective Air Compressor [2 om poroset ete * To conduct daily pre-use inspection and record ion checklist. eee Page 4 of 9Form Title JSA Worksheet Form No. PRIIS/SFD/F-001 Rev. No. 03, Ref. Doc. Job Safety Analysis Doc. No. PRIISISFDIP-007 Rev. No. 03, 1, Insufficient space for loader/bobeat to operate Medium + Ensure there must be sufficient place for Loader/bobeat to access and operate. 9. Removal of 2. Ground surface level not + Ensure ground must be compacted and leveled Job excavated soil firm enough * Check loader/bobcat should be certified and | Supervisor/ 3. Other risks in area ~ having valid third party inspection. lEngineer/Wo! (Loader/Bobcat/Dum | dropped objects, etc. + To ensure that loader/bobeat have adequate ieee p truck) 4. Uncertified loader/bobcat loading capacity and don't lt excess load from | Reteivery 5. Inadequate loading loader capacity, oe capacity + Loader/bobcat operator shall be experienced HSE 6. Inexperienced or and competent and also operators have third Incompetent operator party. 7. Inexperienced or * Flagman/Banks man crew must be trained, incompetent banks experienced and competent. man/flagman « All personnel to be clear of load before and 8. Personnel near load during movement. 9. Dropped object * Loader operator to check windows clean and 10. Loss of visibility of banks men to ensure he can be guided at all load/oanks man times. In case of poor visibility (Sand storm) or 11. Misunderstood signals high wind pressure, to stop the activity Unauthorized personnel in + Signal man to wear colored vest and use COR, area standard signals + Barriers/sentries to control access + Equipment must have beacon light & reverse alarm. 1. Fall, drowning, slip, trip, Dewatering shall be done by usindiwater Failure of equipment (water ‘TBI "PUES, Pus should be In good condition and Job 10. De-watei pump) inspected. Supervisor/ 2. Electric shock + Water tanker should maintain safe distance Engineer/ 3. Collapse of soil 4, Heavy equipment/vehicle movement near excava~ tion/vibration 5. Poor access/egress High from the edge of excavation at least 2 meters. + Restrict unauthorized person. Only qualified person can do the activity. + Hard barricade and warning sign should be placed. + Ensure proper access/egress are provided. IHSE in-charge| © WAP Aijpare72 © Caleb Preteren) Pago 5 of 9Form Title JSA Worksheet Form No. PRIISISFD/F-001 Rev. No. 03) Ref. Doc. Job Safety Analysis: Doc. No. PRIIS/SFDIP-007 Rev. No. 03 seas * Restrict entry of heavy equipment/vehicle clase to excavation edges, + Re-route roads if any close to dewatering activ- ity. + Ensure emergency response team is always ready and prepared in the event of an emer- gency. 11. Working in Confined space T, Unsafe work condition — accumulation of toxic / explo- sive gases 2. Unsafe access, slipping, tripping an falling over 3. Excessively hot tempera- tures (heat exhaustion, heat stroke, heat stress, sun expo sure) Low + Secure a confined space entry permit to be posted on the work area, Other required permits will also be provided and posted. + Secure Rescue plan + Work supervisor to complete the confined space checklist prior to start of work. + Assign a trained attendant who will remain stationed outside the confined space to monitor entry of personnel and maintain an entry. * Only trained confined space entrants with ‘Wang passport wil be allowed to enter confined space. % Conduct atmospheric test to check for oxygen deficiency (19.5% to 23.5%) and for toxic / explosive gases prior to entry and as needed while work is being performed. + Observe proper stacking of tools and materials. * Electrical cables laid/installed properly not Posing obstruction on work areas and walkways. + Access shall be cleared of any kind of tripping hazards * Personnel entering the confined space shall sign the log in/out sheet * Entry log shall be kept by the stand-by man * Only properly trained and authorized personne! shall enter a confined space + Always wear mandatory PPEs (Hard Hat, Safety Job Supervisor / Engineer / HSE/ Work Permit Receiver levargrnaisp Page 6 of 9Form Title ISA Worksheet Form No. PRIIS/SFDIF-001 Rev. No, 03, Ref. Doe. Job Safety Analysis Doc. No. PRIIS/SFDIP-007 Rey. No. 03 eos ‘Shoes with reinforced toe cap, Safety Glasses, Coverall with log cal * Ensure that adequate rest or shade must be provided and water must be present at the area. 12, Levelling, Backfilling and Compacting (compactor, loader and water taker) 1. Untrained and uncertified operators 2. Uncertified equipment 3, Personnel and equipment interface 4, Equipment failure Equipment fall over/overturn 5. Dust 6. Miscommunication 7. Exposure of workers to various hazard like hand injury, dust, eye injury Medium + Ensure that the equipment operators having Third Party Certificates «Ensure equipment having Third Party Certificates + Ensure workers/opt. are wearing dust mask * Ensure frequent wetting of soil to eliminate accumulation of dust in the area + Ensure proper supervision adhering to the drawing for road construction ‘+ Ensure workers are complying with the min PPE requirement Safety shoes, helmet, safety glass, dust mask, reflective vest, Note! Scart/Loose cloth is not allowed + Clear walkways, work areas of equipment, tools, construction debris and other materials + Mark, identify, or barricade other obstructions + Rotate compaction tasks to minimize worker exposure to equipment vibration ‘+ Use compactors with vibration dampening devices (roller compactor) and should undergone inspection by PRC approved third party Company. + Use hearing protection when exposed to excessive noise levels (greater than 85 dBA over an 8-hour work perlod) + Ensure emergency stop button Is working # Ensure safe guard on compactor Area Supervisor/E Ingineer/Wori Permit Receiver Page 7 of 9Form Title JSA Worksheet Form No. PRIIS/SFDIF-001 Rev. No. 03 i sana Ref. Doc. Job Safety Analysis | Doc. No. PRIISISFDIP-007 Rov. No. 03 \ T. Injury trom defective tools ~ All tools must be dean and free of oll and Job and inappropriate use grease Supervisor/ 2. Homemade tools Low + Workers must use the safety gloves. Tools used lengineer/HSE| 43. Using of hand —_| 3. Sharp Edges free from any defects & must be Inspected and P97 Wore tania monthly color coded oe + Inspect tools for visible damage prior to use + Homemade tools is not allowed at site Receiver + Right tools to be used 14, Emergency 1. Unclear information . ro ON eps aT es procedure and Job Response in case of | 2. Unclear direction should discuss during TBM or Training to the | Supervisor / wan Aochien®: 3. Congested areas High workers. Engineer & 4, Lack of direction & emer- + Use spotter to direct response team to scene of | "nines ie. in case of fire or | sency signage accident or incident. HSE) Work ea + Qualified people to assist v * For any emergency Permit @ emergency procedure to be followed. Receiver rat erate ee ‘All debris to be put in waste skips on a contimisiyyagy Job 15. Housekeeping + Tripping, littering, pollu- us basis to avoid debris blowing around pro- | Supervisor/ tion, rodents, insects, fire. Low je craps shall be put in dump- | Engineer ster immediately after break. NC OL Shige Rint TR ty ame, Page 8 of 9Form Title JSA Worksheet Form No. PRIS/SFDIF-001 Rev. No. 03 Ref. Doc, Job Safety Analysis Doc. No. PRIISISFD/P-007 Rev. No. 03 sas © JSA Team Members: Name Department Proponent Supervisor Executing Organization Supervisor SFD-FSS Representative Contractor Supervisor Others (Specify) 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 ellminate 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. 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