Classification: Internal Use

OPERATIONS MANAGEMENT SYSTEM OMS No. SHEM02.02

Rev. # (1) Date July 2021

SAFER - Health and Safety Risk Assessment Attachment 5.1: JSA Next review Date June 2024
Format
Page 1 of 3

 JOB SAFETY ANALYSIS (to be filled out by Operations/Maintenance Staff or Group Leader together with JSA Team Members)

Area: Job Description: To do work JSA number: Requester name:

on Concrete mixer, Concrete pump,
vibrator, De-watering pump.

Job Location: Mention Applicable Procedures:

Team Leader: Dept: Use additional sheets if necessary.
Name & ID: Date: Attachments: Yes / No If Yes state number of pages:

No. Job Steps Potential Hazards Risk Level Steps to Reduce Hazard Remaining Risk Level
1. Ground for mixture ma-
chine should be leveled
a) Tilting of mixture properly so that the ma-
machine. chine can rest firmly.

2. All rotating parts like

1 Manual concreting gears, chains & rollers
should be guarded or bar-
b) Workers may come
ricaded.
in contact with the
rotating parts of
the machines Fall of mixture hopper
hoist & anchoring break
will be checked & ad-
justed.
2 Concreting with ready mix Injury due to unsafe 1. Speed limit should be
concrete driving of transit more than 15 kmph.
mixture 2. Proper ramp for concrete
unloading in bucket/pump
should be provided.
Classification: Internal Use

OPERATIONS MANAGEMENT SYSTEM OMS No. SHEM02.02

Rev. # (1) Date July 2021

SAFER - Health and Safety Risk Assessment Attachment 5.1: JSA Next review Date June 2024
Format
Page 2 of 3

No. Job Steps Potential Hazards Risk Level Steps to Reduce Hazard Remaining Risk Level
3. One signal man should be
deputed for proper signal-
ing.
Adequate turning area
and end stoppage for
transit mixer should be
provided.
a) Worker may come 1. All rotating parts should
in contact with the be barricaded /guarded.
3 De-watering rotating parts of 2. Earthing & other electrical
machine. line should be checked
b) Electric Shock before operation.
Vibrator shall be properly
4 Use of Vibrator Electric shock earthed and cable joints
should be avoided.
1. Trained person should be
deployed for vibration ac-
tivity.
Excessive vibration 2. Proper supervision should
5 Placing of Concrete directional charge be ensured.
Technical specification
should be strictly fol-
lowed.

Section A: JSA Preparation /review Section B: JSA Approval

Classification: Internal Use

OPERATIONS MANAGEMENT SYSTEM OMS No. SHEM02.02

Rev. # (1) Date July 2021

SAFER - Health and Safety Risk Assessment Attachment 5.1: JSA Next review Date June 2024
Format
Page 3 of 3

1- Team Leader (PK maintenance / execution Supervisor): I have led the JSA team 5-Approved by Maintenance \Technical Manager
during the preparation phase and I have agreed to the highlighted risks, mitigation
Name & ID: Dept:
actions and listed steps of this JSA
Sign: Date:
Name & ID: Dept:
Sign: Date:
2-Contractor/Operator/Technician: I have reviewed and agreed with all steps of this 6-Acknowledged by Area Operation \ Owner Manager
JSA
Name & ID: Dept:
Name & ID: Dept:
Sign: Date:
Sign: Date:
Name & ID: Dept: 7-Approved by Department Sr. Manager: (Only required if any of the remaining
risks is higher than Insignificant)
Sign: Date:
Name & ID: Dept:
Name & ID: Dept:
Sign:
Sign: Date:
3-Operation Supervisor: I have reviewed and agreed with all steps of this JSA 8- Acknowledged by Director (Only required if any of the remaining risks is either
Significant or Major).
Name & ID: Dept:
Name & ID: Sign: Date:
Sign:
4-EHSS representative: I have reviewed and agreed with all steps of this JSA 8- Approved by President: (Only required if any of the remaining risks is either
Significant or Major).
Name & ID: Dept:
Name & ID: Sign: Date:
Sign: Date: