Form No.

VEB/QH/L3-F/142
VELESTO ENERGY BERHAD

FORM Rev. 07 Date 21/06/2020

JOB SAFETY ANALYSIS

Page 1 of 4

01.01
JSA No.: ** N4 - H2S -004 (v. 05) ** [RIG : Nx ] [ DEPT : MR-Marine, DR – Drilling, MC – Mechanical, EL – Electrical, CT – Catering, SC – Service Co, OT – Others ]
RIG - DEPT NO (REV) [NO – xxx ] [ REV – (V.xx) e.g. N2-MR-045(V.03) ]

01.02
Job/ Task Description: DISCONNECT/REPOSITION/PULL/RUN CABLES
(If applicable, refer to work instruction for guidance)

02.01
02.02 02.03 02.04 02.05
STE
DESCRIPTION OF STEPS HAZARDS RISK & CONTROL MEASURES BY WHO
P
-MISCOMMUNICATION -APPLY COLD PERMIT -SOLAR ALERT CREW
1 PRE JOB MEETING -CLASH WITH OTHER OPERATION -CLEAR COMMUNICATION WITH PERSON
-PERSON INVOLVED NOT UNDERSTAND -PJSM
-CONGESTED AREA -HARD BARRICADE OPEN HOLE -SOLAR ALERT CREW
APPROACH WORK SITE AND -OPEN HOLE -BE VIGILANT
2
SITE PREPARATION -PPE
-SHARP EDGES
-SHUT DOWN POWER SOURCE -SOLAR ALERT CREW
DISCONNECTING CABLES
-ELECTRICAL SHOCK -WEAR PPE
-SHARP EDGES -COVER SHARP EDGES
-SLIP AND TRIP -PROPER BODY POSITION
3 -MISCOMMUNICATION -DISSCUSSED CABLES PATH
-ERGONOMIC -PROPER LIFTING TECHNIQUE
-FALL FROM HEIGHT -WEAR FULL BODY HARNESS IF WORK AT HEIGHT
-SUSPENDED LOAD -WATCH THE CRANE MOVEMENT

-CABLES COULD CAUSE INJURY IF WRAPPED AROUD BODY -NEVER WRAP CABLE AROUND YOUR ARMS OR BODY -SOLAR ALERT CREW
-SHARP EDGES -WEAR PPE
4 -SLIP & TRIP HAZARD -PROPER HAND AND FOOT POSITION
PULL/RUN CABLES
(min) -MISCOMMUNICATION -DISCUSS CABLES PATH AND EXECUTE PROPERLY
-ERGONOMIC -PROPER MANUAL LIFTING
-WORKING AT HEIGHT WEAR FULL BODY HARNESS
-SHARP EDGES -SOLAR ALERT CREW
-WEAR PPE
-CUTS
5 -PROPER BODY POSITION
HOUSE KEEPING -PERSONAL INJURY

-ENSURE CREW PARTICIPATE IN DEBRIEF -SOLAR ALERT CREW

-SPEAK IN DUAL LANGUAGE
- MISCOMMUNICATION
6 -RECORD AND UPDATE NEW WAYS OR OPTION TO IMPROVE
REVIEW JSA, DEBRIEF -CREW NOT PARTICIPATE IN DEBRIEF SESSION
-SMOOTHER JOB FLOW IF ANY FROM THE CREW OR
SUPERVISORS

7
 Form No. VEB/QH/L3-F/142
VELESTO ENERGY BERHAD

FORM Rev. 07 Date 21/06/2020

JOB SAFETY ANALYSIS

Page 2 of 4

8
(max)

01.01 JSA No.: ** : ___________________________

03.00 JOB SAFETY ANALYSIS CHECKLIST & PROMPTS. THIS SECTION MUST BE MANUALLY FILLED EACH TIME THE JSA BEING USED

03.01A 03.01C
TEAM LEADER: MAHENDRA W. 03.01B POSITION: H2S ENGINEER INITIAL:
03.02A TEAM MEMBER NAME 03.02B POSITION 03.03C INITIAL 03.02A TEAM MEMBER NAME 03.02B POSITION 03.02C INITIAL
1. JEFRI 4.
2. 5.
IMPORTANT : Only those participated in the pre-job safety meeting can participate in performing the task. If new member joining the
3. task halfway, a fresh pre-job safety meeting shall be conducted. If more than five member, use empty spaces on this page to write the
names.
 Form No. VEB/QH/L3-F/142
VELESTO ENERGY BERHAD

FORM Rev. 07 Date 21/06/2020

JOB SAFETY ANALYSIS

Page 3 of 4

04.00 HAZARD / RISK (Tick √ boxes) PROMPTS

SUPERVISION
04.01A 04.01FMECHANICAL CHEMICAL
04.01J
 Team leader will maintain line of sight active supervision?  Live object at workplace identified?  Related SDS available on site?
 Pre-use inspection carried out?  Method of ensuring live objects were secured identified?  Chemical hazards explained by supv / Mud Engineer?
NOTE :  Crew asked & made aware of live objects that cannot be  Emergency shower / eye wash checked?
locked away?  PPE available, in good shape, and inspected by supv?
DROPPED
04.01B  Line of fire identified?  Storage & compatibility hazard understood and acted upon?
 Equipment / workplace checked for loose / improperly NOTE :  Ventilation adequate?
secured object? NOTE :
 Tool and equipment at height logged and accounted for? ACCESS / EGRESS
04.01G
 Drop safe tool required and available?  Escape route identified and cleared? TRAPPED ENERGY
04.01K
NOTE :  Potential entrapment considered and eliminated?  Electrocution risks considered and eliminated?
 For working at height and confined space, rescue plan  Risk of pressure release considered and eliminated?
BIOLOGICAL
04.01C made?  Line of fire considered?
 Risk of viral/bacterial exist? NOTE : NOTE :
 Risk of infection managed to ALARP?
NOTE : MANUAL HANDLING
04.01H PHYSICAL PHYSIOLOGICAL CAPABILITY
04.01L
 Object weight is known?  Individual physically suited for the task?
FIRE & EXPLOSION
04.01D  Safe lifting plan agreed upon?  No extended hours or fatigue issue?
 Fire-watch assigned on both sides of hot work wall? NOTE :  No high work rate?
 Flammable verified? NOTE :
NOTE : OCCUPATIONAL RISK
04.01I
 High Noise? HOUSEKEEPING
04.01M
ENVIRONMENT
04.01E  Limb vibration?  Tool & material are at their designated places?
 Risk of pollution considered and managed?  Luminance? NOTE :
 Risk of Loss of Primary Containment (LOPC) considered and  Temperature extreme?
managed? NOTE :
NOTE :

05.01A
05.01B 05.01C
Name of dept head who reviewed and KONG / Barge Master 22/8/2020
Date Approved / Revised : Signature:
endorsed this JSA:

06.00 REQUIRED SAFETY EQUIPMENT & PPE FOR THE JOB / TASK (Tick √ boxes) THIS SECTION MUST BE HAND WRITTEN EACH TIME THE JSA BEING USED

 A. Hard Hat  E. Life Vest / Work Vest  I. Respirator Protector  M. Gas Detector  Q. Permit To Work  V. NHOL tool
 B. Safety Glass  F. Safety Boot  J. Hearing Protector  N. Walkie-Talkie  R. Lock Out/Tag Out  W.

 C. Face Shield  G. Coverall  K. Fall Protector  O. Scaffolding  T. Safety Sign  X.

 D. Goggle  H. Special glove  L. Fire Extinguisher  P. Ladder  U. SDS  Y.

07.00 DEBRIEF / LESSONS LEARNED CHECKLIST (Tick √ boxes) THIS SECTION MUST BE HAND WRITTEN EACH TIME THE JSA BEING USED
 Form No. VEB/QH/L3-F/142
VELESTO ENERGY BERHAD

FORM Rev. 07 Date 21/06/2020

JOB SAFETY ANALYSIS

Page 4 of 4

07.01 DEBRIEF ELEMENTS

 Debrief performed  Best practices discussed (Plan, Brief, Execution)  Areas for improvement discussed (Plan, Brief, Execution)

07.02 LESSONS LEARNED / PROPOSED IMPROVEMENT

07.03 DEBRIEF ATTENDANCE RECORD

07.03A NAME 07.03B INITIAL 07.03A NAME 07.03B INITIAL 07.03A NAME 07.03B INITIAL
1. JEFRI 4.

2. 5.

3.
IMPORTANT : By signing this participants confirmed they were individually asked for their feedback on the task performed

08.00 ENDORSEMENT AND JSA RECORD

08.01 OIM NAME & SIGNATURE  Approved as submitted  Approved with Changes  Rejected DATE :

 Revision Was Updated  No update made to this JSA DATE :

08.02 QHSE ADVISOR NAME & SIGNATURE
In Rig JSA register