JOB SAFETY ANALYSIS FOR THE PREPARATION & APPLICATION OF

GROUTING TO PUMP SKIDS
COMPANY/ PROJECT NAME or ID/ LOCATION ( City, Stt!" DATE NE#
February 20, 2014 REVISED PAGE $ o% 

#ORK ACTI'ITY (D!)ri*tio+"

Concrete is scored to provide a friction surface for other appications such a s epo!y and "rout# $he surface is ch ipped by a pneu%atic "un caed a chippin"&
ha%%er# 'n encosure (i be erected to create a te%perature controed environ%ent condusi ve to storin"
storin " "routin" %ateria so that an acceptabe te%perature
can be achieved to %i! and appy the "rout %ateria# )ateria (i then be %i!ed usin" a concrete %i!er (hich (i be ventiated outside of the encosure# $he
"routin"
"routin " %ateria (i then be poured and appied to create a bond to the pu%p s*ids#

DE'ELOPMENT TEAM POSITION / TITLE RE'IE#ED BY POSITION / TITLE

+ayne ope*a Safety Coordinator )i*e 'der%ann V## -perations
Dave Ru.ich Safety Coordinator
at Robinson Supervisor  
MINIMUM RE-UIRED PERSONAL PROTECTI'E E-UIPMENT ( SEE CRITICAL ACTIONS FOR TASK.SPECIFIC RE-UIREMENTS"
REF/EC$IVE VES$   -/ES 'IR 6RIF3I /-VES /eather& )ateria
'RD '$ F'CE SIE/D RESIR'$-R andin"
/IFE/IE  'RESS E'RI R-$EC$I-& Ear &78 Vountary
Vountary 6se Respirator  -ptiona &
S'FE$3 /'SSES u"s E C/-$I&Re9uired
C/-$I&Re9uired on&site
S'FE$3 $-ED 5--$S
(Defined ees
JOB STEPS 0POTENTIAL HA1ARDS 2CRITICAL ACTIONS TO MITIGATE HA1ARDS
1. Set-up jo
job /ine of fire, Struc* by vehice or air 5e a(are of surroundin"s
a# osition hose under pressure, %usce 6se safe on&site drivin" practices
co%pressor strains, sprains, trip ha.ards, fas 6se spotter;s< for bac*in" and positionin" of co%pressor and a vehices
do(n(ind fro% fro% adder deiverin" toos, e9uip%ent and %ateria to (or* ocation
(or* area erfor% safe iftin" techni9ues
b# Choc* (hees 6se buddy syste% to ift and carry ite%s =8> bs#
c# Strin" hohoses Inspect hose connections and (hip chec*s at start of each shift
d# in hose Ensure safe adder instaation and usa"e
connections ractice "ood house*eepin" habits
e# InstInsta
a (hip
(hip chec
chec*s
*s 5e a(are of surroundin"s at a ti%es
at co%pressor :
chippin" ha%%er
f# Inst
nsta
a and
and ci%
i%b
adders

4# Chip concrete usin"
concrete usin" chippin"
"un to appro!i%atey 1? depth
Fyin" concrete debris,
forei"n ob@ects in eyes,
inhaation, co%pressed air
;acerations<,
+ear proper E for tas* incudin" faceshied
6se A(et contro? %ethods to *eep airborn siica dus t to %ini%u%
+hen en"ineerin"
e n"ineerin" contros cannot be i%pe%ented
i%pe%ented an &78 dust %as* or
I-S approved respirator is reco%%ended to be (orn
erfor% proper body positionin" to ei%inate static po stures
ractice "ood house*eepin" habits

8# Erect enclosures usin"
enclosures usin" Fas, pinchpoints, acerations, strains, Inspect and perfor% safe fa protection techni9ues
scaffod %aterias sprains, struc* by, eectric shoc* ractice safe iftin" techni9 ues : use the buddy syste% to ift and carry ite%s
a# 'ttach =8> bs#
tarpvis9ueen to +ear proper E (hen handin" toos and %aterias
scaffod Ensure safe adder instaation and usa"e
b# Ci%
Ci%bb ad
adders
ders,, erfor% safe aeria : scissors ift techni9ues
c# -per
-pera ate and
and (or
(or** 6se spotters
fro% aeria : 6se safe hand : po(er too practices incudin" inspection of toos, chords and
scissors ift FCIBs
d# 6se hahand an
and 6se ri"ht too for @ob
po(er toos ractice "ood house*eepin" habits
  JOB SAFETY ANALYSIS FOR THE PREPARATION & APPLICATION OF
GROUTING TO PUMP SKIDS
10# Install forms around area to be Strains, sprains, pinch&points, eectric Ensure proper iftin" techni9ues
"routed shoc*, puncture (ounds, acerations 6se buddy syste% to ift : carry ite%s =8> bs # 6se safe hand : po(er too
a# 6se hand : po(er practices incudin" inspection of toos, chords and FCIBs
toos, dri hoes 6se ri"ht too for @ob
into concrete : +ear proper E (hen handin" toos and %aterias
attach (ire nais, ractice "ood house*eepin" habits
prep "rout (or*
area
12# Mixing grout  Strains, sprains, pincn&points, Ventiate %i!er e!haust directy outside of encosure
a# /ift : position ba"s inhaation, in"estion, s*in irr itation, Continuousy use a four "as %onitor to ensure carbon %ono!ide eve
: paes to pour eye in@uries re%ains beo( the action eve
%aterias into %i!er  ractice safe iftin" techni9ues
b# our finished "rout 6se buddy syste% to ift and carry ite%s =8> bs#
into (hee barro( 6se A(et contro? %ethods to *eep airborn siica dust fro% resin to a %ini%u%
to transport +hen %i!in" hardener and resin, area %ust be (e ventiated usin" oca
c# Shove "rout into e!haust ventiation
paes +hen en"ineerin" contros cannot be i%pe%ented an '& I-S approved
respirator is reco%%ended to be (orn
+ear proper E (hen handin" toos and %aterias
+ear nitrie&eather "auntet "oves
+ear safety "asses : face&shied (hen %i!in" : pourin"
ractice "ood house*eepin" habits

14#  Applying grout, Strains, s*in irritation, static +ear proper E
postures 6se "ood body %echanics : chan"e body position often

1. !e-mobe from "or# area Strains, sprains, pinch&points, +ear proper E (hen handin" toos and %aterias
a# Re%ove struc* by ractice safe iftin" techni9ues
tarpsvis9ueen and 6se buddy syste% to ift and carry ite%s =8> bs#
scaffodin" 6se spotter;s< for bac*in" a vehices, re%ovin" toos, e9uip%ent and %ateria
%aterias fro% (or* ocation
b# Re%ove any ractice "ood house*eepin" s*is
unused %aterias
c# Re%ove toos
d# Re%ove e9uip%ent

 Each ob or -peration consists of a set of steps# 5e sure to ist a the steps in the se9uence that they are perfor%ed# Specify the e9uip%ent or other detais
to set the basis for the associated ha.ards in Cou%n 2

0  ' ha.ard is a potentia dan"er# +hat can "o (ron" o( can so%eone "et hurt Consider, but do not i%it, the anaysis toGCo+t)t & victi% is struc* by or
stri*es an ob@ectH C345t & victi% is cau"ht on, cau"ht in or cau"ht bet(een ob@ectsH F66 & victi% fas to "round or o(er eve ;incudes sips and trips<H E7!rtio+
& e!cessive strain or stress  er"ono%ics  i ftin" techni9uesH E7*o3r! & inhaations*in ha.ards# Specify the ha.ards and do not i%it the description to a sin"e
(ord such as Cau"ht

2  'i"nin" (ith the first t(o cou%ns, describe (hat actions or procedures are necessary to ei%inate or %ini%i.e the ha.ards# 5e cear, concise and specific#
6se ob@ective, observabe and 9uantified ter%s# 'void sub@ective "enera state%ents such as, be carefu or use as appropriate#