Part 1: Job Particulars Page 1 of _____

JOB TITLE / AIM: JSA for the segregation and cleaning of Catalyst in Yard.
JSA DATE: 24/07/2007 JSA NO./ REVISION:
SUPERVISOR/ JSA LEADER: SCRIBE: Asad Nadeem / Nouman Liaqat
PARTICIPANTS:
LIST ASSOCIATED PROCEDURES/WORK INSTRUCTIONS OR TEMPORARY WIs:
Attach copies of any relevant documentation/ drawings.
Part 2: Job Safety Analysis
Job Steps: 1-Mobilization of Equipment (Crane), & Workers
2- Cleaning of Catalyst
4-Demobilization

Alternatives Considered: N/A

Now undertake the JSA and record in the table below. Use prompts on JSA Prompt Sheet and Hazard Checklist PA-HSEC-02-040-002-F03.
Part 3: Contingency Plans. Standard PPE,S First aid kit must be present at the area and the Hse personnel is the first response in case of emergency

Part 4: Review. After the job has been completed, JSA leader should note: any hazards, which were identified in the original JSA? Any practices that
need to be captured in the OMS? List action items, changes, and transfer any changes to the Change Management system.

File: 10.30
JSA No: JOB TITLE:
Step Describe Job Step Potential Hazards Hazard Controls
No (Copy from part 2 of form) (Use Hazard Checklist)
1 Mobilization of workers & equipment Unauthorised equipment/tools brought out to site Before mobilizing any equipment/tools make sure
that the E & P Personnel got inspected the
equipment.
Unskilled and uni inducted personnel starting the Ensure that all personnel prior to start the have been
job inducted and oriented about the hazard in the job
site.
Workers starting the job unfit to work All personnel not fit to work shall not be allowed to
work at the project site.
Workers starting the job without JSA JSA must be in place prior to work. Ensure all the
persons take part in the tool box meeting discussion.
JSA was discussed to workers and signed at the
back.
Starting Job Without Tool Box Talk All workers starting the job must be take part in the
tool box talk and a will be told about all hazards
present in the job.+

Ensure proper hauling of materials/Wear Leather

Hand Injury hand gloves.

Ensure workers are complying with the min.

Exposure of workers to various hazard like hand PPE req.Safety shoes, helmet, safety glass,
injury, dust, eye injury dust mask, reflective vest,

Take Care of other Operations in progress in the

2. Cleaning of Catalyst Lifting zone and co ordinate with other jobs
SIMOPS supervisor during the lifting all activities in the lifting
zone shall be stopped.

Ensure that all workers will be using full sleeves

shirts and trousers and grooves. So that there shall
Skin Contact “Prolong Skin contact can case be no bare skin through which skin contact shall be
irritation” observed.
JSA No: JOB TITLE:
Step Describe Job Step Potential Hazards Hazard Controls
No (Copy from part 2 of form) (Use Hazard Checklist)

Inhalation of Dust can cause irritation

Ensure that dust mask is used during the job.

Eyes Contact with eyes can cause irritation

Ensure that workers are using proper safety goggles
during the job

Note: A Sealed pack water bottle shall be available

all the time for eye washing.

Ensure one man signal man. Use tag line Ensure

potable water/sufficient shelter is available each area
Heat Stress/Exhaustion
where workers are doing he job. A first aider will be
at the area at all times with first aid kit.
Same as mobilization
3   Demobilization Same as mobilization