JOB SAFETY ANALYSIS – WORKSHEET

SABIC
JOB DESCRIPTION: Acoustic Eye DATE: March 28, 2016 JSA number: P620-009

 NEW  REVISED
JOB SAFETY ANALYSIS WP No:009

JOB LOCATION (Plant): Sabic (IBNSINA) MEOH PLANT AREA: MEOH PLANT
Risk Level
No BASIC STEP POTENTIAL HAZARDS MITIGATION PLAN RESPONSIBILITY Significant (S)/Moderate (M)/
Low (L)
Scaffolding not adaptable to guard rails shall
require the use of safety harnesses with
double shock absorbing lanyard attached to
a secure substantial object.
Scaffold supervisor to ensure all scaffolds
are inspected and tagged safe for use prior LOW
to the use thereof and weekly thereafter by
1. Working at height climbing on scaffolding Fall of personnel due to incomplete working platform. TCR Site In - Charge
a competent scaffold inspector.
A proper scaffold inspection and tagging
system, which is consistent with OSHA and
universally recognized industry standards,
shall be utilized and maintained.
Unsafe scaffolds will be tagged unsafe and
rectified immediately.
A safe means of entry and exit shall be
provided and used whenever the elevated
work area is .6 meters above or below LOW
Unavailability of access to working platform. TCR Site In - Charge
working surface.
Means of exit shall be provided at least every
100 ft. or 30 meters.
Toe board shall be installed around the
working platform to prevent the tools or
materials from falling. LOW
Falling materials, tools. TCR Site In - Charge
Barricade the area below into which objects
can fall and not permitting workers to enter
the hazard area.
Personnel shall not be on any elevated
working platform if the wind is more than 65
High wind. TCR Site In - Charge
KHP unless working area is indoor or not LOW
affected by high winds.
All personnel working at high elevation must
2. Using appropriate PPE Improper use PPE. be trained in the use, inspection, and TCR Site In - Charge LOW
maintenance of fall arrest systems.

REQUIRED AND/OR RECOMMENDED P.P.E. 1. Safety Shoes, Helmet, Safety glass, Cotton Hand gloves, Full body Harness.

______________________________________________________________________________________________________
All recommendations suggested in JSA have been implemented at site: (Maintenance Supervisor)

Prepared by: JSA Team Leader Acknowledged by: Manager/Shift Supervisor

Name:______________ Signature:__________ Badge#: __________

Name: Reviewed and acknowledged by Operation Sr. Manager In case of Major / Significant Risk (Critical
Activity).
JSA Team Members
Name ID # Department Signature Date Name:______________ Signature:__________ Badge#: __________

Comment: …………………………………………………………………………………………………

Approved by Maintenance Manager / Supervisor …………………………………………………………………………………………………………………………………………………………………

Name:_____________________ Signature:__________ Badge #:________

……………………………………………………………………………………………………………
INSTRUCTIONS FOR COMPLETING THE JOB SAFETY ANALYSIS FORM

Job Safety Analysis (JSA) is an important incident prevention tool that works by finding hazards and eliminating or
minimizing them before the job is preformed, and before they have a chance to become accidents. Use JSA for job
clarification and hazard awareness, as a guide in new employees training, for periodic contacts and for retraining of senior
employees, as a refresher on jobs which run infrequently, as an incident investigation tool, and for informing employees of
specific job hazards and protective measures.
Set priorities for doing JSA’s: jobs that have a history or many accidents, jobs that have produced disabling injuries, jobs
with high potential for disabling injury of death, and new jobs with no accident history.
Select a job to be analyzed. Before filling out this from, consider the following:
The purpose of the job-What has to be done? Who has to do it?. The activities involved: How is it done? When is it done? Where is it
done?
In summary, to complete this form you should consider the purpose of the job, the activities it involves, and the hazards its presents. If
you are not familiar with a particular job or operation, interview an employee who is. In addition, observing an employee performing
the job, or “walking through” the operation step may give additional insight into potential hazards. You may also videotape the job and
analyze it. Here’s how to do each of the three parts of Job Safety Analysis

RESPONSIBLE
SEQUENCE OF BASIC JOB STEPS POTENTIAL HAZARDS RECOMMENDED ACTION OR PROCEDURE
PERSON

Examining a specific job by breaking it down into a series of
steps of tasks, will enable you to discover potential hazards
employees may encounter.
Each job operation will consists of a set of steps or tasks.
For example:
The job might be to move a box from conveyor in the receiving
area to a shelf in the storage area. To determine where a steps
begins or ends, look for a change of activity, change in direction
or movement.
Picking up the box from the conveyor and placing it on a hand
truck is one step. The next step might be to push the loaded
hand truck to the storage area (a change in activity). Moving the
boxes from the truck and placing them on the shelf is another
step. The final step might be returning the hand truck to the
receiving area.
Be sure to list all the steps needed to perform the job. Some
steps may not be performed each time; an example could be
checking the casters on the hand truck. However, if the step is
generally part of the job it should be listed.
A hazard is a potential danger. The purpose of the Job Safety Analysis is
to identify all hazards, both those produced by the environment or
conditions and those connected with the job procedure.
To identify hazards, ask yourself these questions about each step:
1. Is the danger of the employee striking against, being struck by, or
otherwise making injurious contact with an object?
2. Can the employee be caught in, by or between objects?
3. Is there potential for slipping, tripping, or falling?
4. Could the employee suffers strains from pushing, pulling, lifting,
bending, or twisting?
5. Is the environment hazardous to safety and/or health (toxic gas,
vapor, mist, fumes, dust, heat, or radiation)?.
Close observations and knowledge of the job is important. Examine
each step carefully to find and identify hazards; the actions, conditions
and possibilities that could lead to an accident. Compiling an accurate
and complete list of potential hazards will allow you to develop the
recommended safe job procedures needed to prevent accidents.
Using the first two columns as a guide, decide what actions or procedures Who is responsible? Write the person
are necessary to eliminate or minimize the hazards that could lead to an (receiver) responsible (Supervisor/Work
accident, injury, or occupational illness. Permit Issuer receiver/contractor) to
implement the control measures
Begin by trying: identified.
1. Engineer the hazard out: 2. provide guards, safety devices, etc.; 3.
provide personal protective equipment; 4. provide job instruction training;
5. maintain good housekeeping; 6. insure good ergonomics (positioning
the person in relation to the machine or other elements in such a way as
to improve safely).
List the recommended safe operating procedures. Begin with an action
word. Say exactly what needs to be done to correct the hazard, such as,
“lift using your leg muscles”. Avoid general statements such as “be
careful”.
List the required or recommended personal protective equipment
necessary to perform each step of the job.
Give a recommended action or procedure for each hazard.
Serious hazards should be corrected immediately. The JSA should then be
changed to reflect the new conditions.
Finally, review your input on all three columns for accuracy and
completeness. Determine if the recommended actions or procedures have
been put in place. Re-evaluate the job safety analysis as necessary.