Rev.

3, March 2015

JOB HAZARD ANALYSIS [JHA] WORKSHEET

JHA NO. PTW NO WORK PERMIT HOT/ COLD

TYPE
FACILITY LOCATION SPECIFIC
WORKSTATION
EQUIPMENT NO. WORK DESCRIPTION ACTUATOR SERVICING
NOTE
1. JHA shall be applicable for all work activities which requires PTW.
2. The pre-prepared JHA and JHA prompters will be used as a reference/guide during the development of JHA.
3. Personnel carrying out the work shall be fully familiar with the written Work/Operating Procedures developed for the job. The Work/Operating Procedures shall describe, in step-by-step instructions, the correct method of
executing the specified work.
4. Prior to commencement of work (after PTW has been approved), the task-specific JHA shall be discussed amongst all personnel involved in the execution; and requirements contained therein shall be fully understood and
agreed by all involved personnel.

JOB POTENTIAL POTENTIAL

DESCRIPTION OF JOB STEP CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
STEP HAZARD CONSEQUENCES

Tools Preparations Proper hand placement & wear Team Leader Team Leader
Pinch point Finger /hand injuries First aid
1. hand gloves. Technician Medic
-Beware of ground & surrounding. Team Leader
Slippery surface Slip trip & fall Team Leader First aid
-Use correct access pathway. Ensure Medic
Technician
safety boots in good condition.
Physical & body injuries Isolate instrument air before Team Leader
Pressure Team Leader First aid
2. Pretest valve and actuator commence service job & verify Medic
Technician
pressure fully bleed.
High noise Induced hearing lost -Wear double hearing protection at high Team Leader Team Leader
Medical rehabilitation
decibel location. Technician Medic
Dismantle Actuator and valve Team Leader Team Leader
3. Electricity Personnel electrocuted First aid
-Verify power/signal has been isolated Operation Medic
-Bleed off air pressure and verify
Pressure Physical & body injuries
pressure fully bleed from First aid Team Leader
4. Internal inspection and Team Leader
parts cleaning pressure gauge.
Technician
- Don’t stand in front of line of fire.

Pinch point Proper hand placement & wear Team Leader Team Leader
Finger /hand injuries First aid
hand gloves. Technician Medic

Open
 Pinch point Proper hand placement & wear hand First aid
Finger /hand injuries Team Leader Team Leader
gloves. Technician Medic
5. Install new repair kit into valve
and actuator and overhead -Proper technique while perform manual
crane lifting Team Leader Team Leader
Heavy objects Back pain & muscle pain handling & implement buddy system Technician First aid Medic

Be aware of sharp edges & wear

Finger & hand injuries Team Leader Team Leader
Sharp edges hand gloves First aid
Stroke test and install Technician Medic
6.
flange to the Wear chemical / rubber gloves
valve Skin irritation Team Leader Team Leader
Chemical exposure during greasing. First aid
Technician Medic
Pinch point Proper hand placement & wear Team Leader Team Leader
Preform pressure test Finger /hand injuries First aid
hand gloves. Technician Medic
-Proper technique while perform manual
7.
handling & implement buddy system
Back pain & muscle pain Team Leader Team Leader
Heavy objects . First aid
Technician Medic

Proper hand placement & wear Team Leader Team Leader

Pinch point Finger /hand injuries First aid
hand gloves. Technician Medic
8. House keeping
-Proper technique while perform manual
Back pain & muscle pain Team Leader Team Leader
Heavy objects handling & implement buddy system First aid
Technician Medic
 JHA APPROVAL DURING PTW APPLICATION

REVIEWED BY APPROVED BY

NAME NAME

DESIGNATION WORK LEADER DESIGNATION PRODUCTION SUPERVISOR / MAINTENANCE SUPERVISOR/ BASE SUPERVISOR/
FUNCTIONAL SUPERVISOR

SIGNATURE SIGNATURE

DATE DATE

WORK TEAM (CONFIRMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PRE-JOB/TOOLBOX MEETING - AFTER PTW HAS BEEN APPROVED)
Please add column/row if required.

Name(s) Designation Signature Signature Signature Signature Signature Signature Signature

& Date & Date & Date & Date & Date & Date & Date