PMT/Contractor JSA Form - 1/12/2008

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JOB SAFETY ANALYSIS WORK SHEET

✘ New D / M / Y Contractor: Br. C.A.T. International Co. Limited.
JSA # MGS-002 Date
Revised 18 / FEB / 2015 Contract #/JO#:660003283/10-01282-0002

JSA Function Name Badge# Job Title Mobile Phone #

CAT Site Supv./ Frmn. Khalid Majeed Site Supervisor Civil 0500569118

CAT Project Engineer Omar Turkmani Construction Manager 0558080192

CAT Site Safety Supervisor Zahid Mahmood Bhatti HSE Supervisor 0504638022

SAPMT Safety Advisor Neeraj Safety Advisor 0561752243

SAPMT Representative Abdul Hai Mechanical Engineer 0503546065

Proponent Rep. (Issuer)

Proponent Rep. (Oprtn.)

DESCRIPTION OF TASK: GEOTECHNICAL INVESTIGATION

Work Location/ (Area then station numbers): KM 900 to 601, PS3 to PS6
Prepared by/ Signature: (Contract Reviewed By/ Signature: (SAPMT) Approved By/ Signature: (Client)

______________ ____________ ____________

CAT Representative. Signature Safety Advisor Signature Lead Proj. Engr. Signature

______________ ____________ Operation Rep. ____________

HSE Supervisor Signature SAPMT Rep. Signature Signature
PMT/Contractor JSA Form - 1/12/2008
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Reference GIs & SAES:
Work Permit System (G.I. 2.100), Reporting of Contractor on-job Injuries/Occupational Illnesses (G.I. 6.007), Saudi Aramco Construction Safety Manual (SACSM).Mobile Heavy
Equipment Operator Testing and Certification (G.I. 7.025), Safety Spectacles (G.I. 8.002), Protective Safety Footwear (G.I. 8.005), Inspection, Testing and Maintenance of Fire
Protection Equipment (G.I.1781.001). Control of remote area travel and search/rescue procedures (G.I. 6.025), Traffic and vehicle safety (G.I. 6.030).

Item SEQUENCE/ BASIC POTENTIAL HAZARDS HAZARD CONTROLS ACTION

STEPS BY

1. Mobilization of Equipment to 1. Interaction with Light & Heavy 1. Follow speed limit.
the site Vehicles. 2. Head lights to be turned on when on the move. Hazard lights to be turned
2. Adverse Road conditions on when vehicle is temporarily stopped along the side of the highway.
3. Commuters/Pedestrians 3. Not to take any unwanted risk during shifting.
4. Bogged vehicle 4. Plan ahead for the route and always be alert for any consequences.
5. Get a map and use alternative route for better road condition.
6. Presence of mind while behind the wheel & expect the unexpected. Make CAT/ Operation
eye contact with other commuters. SAPMT
7. Vehicle / Rig equipment check pre-start. (follow-up)
8. Ensure that service vehicle & the rig have water, fire extinguisher, first aid
kit, warning triangle, spare tire, and jack & communication device.
9. A support vehicle should be always with drill truck for immediate help.
10. Follow Traffic and Vehicle safety Manual (Chapter 8 of SA Contractor Safety
Manual) while driving in Aramco Premises

2. Work Permit 1. Violation of work permit system 1. Issue the correct permit for the job.
2. Incorrect filling of permit 2. Issuer and receiver both would have in their possession the valid work
3. Not meeting the requirements permit card certification.
4. Accident & Injury 3. Gas test will be performed before issuing work permit when required.
4. Job description and equipment to be used will be clearly stated on the work
permit. CAT/ Operation
5. All tick boxes will be correctly filled and gas readings indicated. SAPMT
6. Work permits will be issued for specific period of time required to complete 1 (follow-up)
the job.
7. To extend work permit time the oncoming shift issuer will inspect the job
site and write extended time on the permit.
8. Special precautions like fire watch, standby man, barricading, will be stated
on the work permit.
PMT/Contractor JSA Form - 1/12/2008
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Item SEQUENCE/ BASIC POTENTIAL HAZARDS HAZARD CONTROLS ACTION

STEPS BY

3.
1. Underground pipeline or cable 1. Metal detector to be utilized prior to use any cutting operation.
CAT/ Operation
damage
Cutting of Asphalt SAPMT
2. Broken cutting tool 2. Safe distance should be maintained.
2 (follow-up)
3. Pinch point 3. PPEs (steel toe safety shoes).

4. Excavation of pit to check

u/g utilities. 1. Proper PPE (safety Shoes, gloves).
1. Pinch point & cuts
2. Proper benching during excavation. Proper shoring in loose sand material.
2. Slip trip and fall
4.1 Manual Excavation down 3. Ample cold water storage should be available.
3. Heat stress
to 1.1m

1. Pinch point, cut CAT/ Operation

1. Proper PPE (safety Shoes, gloves). A standby personnel should be available
2. Slip trip and fall SAPMT
4.2 Manual work inside out of excavation, in case any emergency.
3. Heat stress 3 (follow-up)
excavation 1.2 meter deep 2. Proper benching during excavation. ii). Proper shoring in loose sand
4. Dizziness due to H2S gas
(confined space) material.
3. Confined space only permit should be Secured from work permit issuer.
4. H2S Gas detector available at site

4.3 Movement, in and out of

1. Slip trip and fall
the Excavation 1. Proper PPE (safety Shoes, gloves). Proper benching during excavation.
5. Drilling Rig set up

1. Remove tools 1. Pinch points. 1. PPE (safety Shoes).

2. Manual lifting 2. Training for manual lifting (RGF Safety Manual)

1. Ample cold water storage should be available for drinking. Heat stress CAT/ Operation
2. Dig hole for water 1. Heat stress SAPMT
training
circulation (follow-up)
1. People clear distance from machine
3. Level Rig 1. Pinch points

4. Raise Mast 1. Daily inspection and, keep clear

1. Mechanical failure
PMT/Contractor JSA Form - 1/12/2008
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Item SEQUENCE/ BASIC POTENTIAL HAZARDS HAZARD CONTROLS ACTION

STEPS BY

6. Drilling Activity

1. Drilling, retraction and 1. Moving parts 1. No loose clothing (procedure) Communication. Train new people, brake cat
sampling 2. Impact head when not in use. Keep cat head clean. Use low gear. CAT/ Operation
2. PPE (Head hut, Gloves, Ear plug) SAPMT
(follow-up)
2. Handling drill pipes 1. Pinch points. 1. PPE (Safety Shoes, Gloves).
2. manual lifting 2. Training for manual lifting (As per RGF Safety Manual), 25kg limit (for safety
person).

7.
1. Pinch points. 1. PPE (Safety Shoes, Gloves). CAT/ Operation
Remove Samples SAPMT
2. Lifting sample box 2. Training for manual lifting (As per RGF Safety Manual), 25kg limit (for safety
person). (follow-up)

8.
CAT/ Operation
1. Pinch points 1. PPE (Safety shoes, Gloves etc.) SAPMT
Clean Rods
(follow-up)

9.
1. Handling Cement CAT/ Operation
1. PPE (Gloves, safety shoes & Goggle). Fresh water available
Backfill Holes 2. Open Bentonite pit SAPMT
2. Cover overnight. Warning tape MSDS sheet should be on site.
(follow-up)

10.
CAT/ Operation
Transport to and from site 1. Road accident
1. Observe speed limits, Wear seat belts, No seat belt no ride SAPMT
(people)
(follow-up)

11. 1. Slips and trips 1. Stack and contain empty bags.

CAT/ Operation
2. Environmental damag 2. Container for rubbish. Remove rubbish and dispose in approved area.
House keeping SAPMT
3. Oil spill 3. Place contaminated material in a container remove from site and dispose in
(follow-up)
approved location.
PMT/Contractor JSA Form - 1/12/2008
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# Recommendations/Notes Assigned to Remarks

1 All site personnel are required to wear PPE/ such as safety helmet, safety glasses, gloves, and safety shoes. CAT

2 Conduct Tool Box Safety Meeting prior to work activity. CAT

3 Explain to key personnel the purpose of the JSA and enforce the implementation of content. CAT

4 Use the JSA to identify hazards and list the precautions on the work permit. CAT

5 Garbage’s shall be disposed properly on a daily basis. CAT

If an injury or near miss occurs, the JSA shall be reviewed immediately to determine whether changes are
6 CAT & SAPMT
needed in the job procedures.