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JOB SAFETY ANALYSIS FORM

SEQUENCE OF BASIC ACTIVITY


STEPS/ PRESSURE LEAKAGE TEST POTENTIAL HAZARD HAZARDS CONTROL
1) Check pipe length Trip hazard Watch your steps
2) Check mech. joints & pipe joints Trip hazard Proper handling of tools

Follow safety procedure for small tools


3) Check manual pump Parts defect/ Malfunction requirement inspection
4) Inject water pressure w/ manual pump Bursting of rubber hose Pump gradually/ constant observation
5)Water pressure established, repeat #2 Bursting of main pipes body and
procedure its joints Initial backfill of trench
6) Check end caps Detachment where installed Secure support/ tightly installed
7) Release of water pressure Hit by pressurized water Complete PPE suits and stand clear
AFETY ANALYSIS FORM
RESPONSIBLE PARTY
Site supervisor
Site supervisor

Site supervisor
Site supervisor

Site supervisor
Site supervisor
Site supervisor
REVISION:
Concrete Batching Plant Requirements
Description unit Qty
1) Design Mix 20N/mm2 or 3000 psi ( 28 days ) ea 1
2) Design Mix 28N/mm2 or 3500 psi ( 28 days ) ea 1
3) Test Certificate
a. Cement ea 1
b. Sand ea 1
c. Gravel stone ea 1
d. Water ea 1
e. Admixture ea 1
4) Batching plant calibration certificate ea 1
5) Testing equipment calibration certificate ea 1
6) Concrete cylinder sample
a. 3000 psi ( 28 days ) ea 3
b. 3500 psi ( 28 days ) ea 3

Note: All of the above, need to be submitted today to CTJV


MANHOLES TABULATED DATA Width x 2 Width x 2
SURVEY ORDINATES Top wall Bottom slab Wall & slab Height ( outside- ( inside
Description Northing Easting finished elev finished elev. Thickness ( meters ) mtrs ) -mtrs )
Manholes # 1
Manholes # 2
Manholes # 3
Manholes # 4
Manholes # 5
Manholes # 6
Manholes # 7
Manholes # 8
Manholes # 9
Manholes # 10
Manholes # 11

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