Form – RA 002
JSA – Job Safety Analysis
SWMS Title:
Submitted by:
Contractor:
Contact Name
Contact Signature:
Project Details & JSA Task Description:
Project:
Task / Activity:
Trades Involved:
Major Equipment to be used
for this task:
List any Hazardous
Substances, Materials or
Dangerous Goods to be used:
Cushman & Wakefield
JSA No: 10
Cable Drums Installations Revision : 000
INFINITI BUILDING SOLUTIONS PVT LTD Prepared by: BALAJI BODA
Mr.NAVEEN C Contact Position: PROJECT MANAGER
Contract Phone No: 0-9989434440
M/s. SATTVA KNOWLEDGE CITY PARCEL-II, Location: BUILDING AT Hi-tech CITY,
HYDERABAD
STORAGE OF THE CABLE DRUMS Bldg/Area
Level:
Zone/Room
Cotton Hand gloves, Hardhat, goggles, Full body
Soft barricading, Warning Lights, Wooden Pad, Harness, Safety shoes, High visibility jackets,
ladder, tagline, Safety Latch, Wheel Choker, List PPE required for this task: welding Aprons, welding face shield, leather
reverse Horn, Traffic Cones, Road Block hand gloves, fire extinguisher (CO2), Sand/water
*All equipment listed has has been cleared for use on site and is maintained in
accordance with the manufacturers recommendations. buckets.
Induction training, Height work training, Hot
List Permits to Work required to work training, Manual Handling Training
commence this Task:
Regional Template. Revision A. 10/02/2014
 Form – RA 002

Risk Matrix & Ranking

Likelihood / Probability
Level Description of Consequence or Impact Consequence L M U
Likely Moderate Unlikely
H (1) Potential death, permanent disability or major structural failure/damage. Off-site environmental H (1)
1 1 2
(High level of harm) discharge/release not contained and significant long-term environmental harm. (High)
M (2) Potential temporary disability or minor structural failure/damage.
M (2)
(Medium level of On-site environmental discharge/release contained, minor remediation required, short-term 1 2 3
(Medium)
harm) environmental harm.
Incident that has the potential to cause persons to require first aid.
L (3) L (3)
On-site environmental discharge/release immediately contained, minor level clean up with no 2 3 3
(Low level of harm) (Low)
short-term environmental harm.
Level Likelihood / Probability
Likely Could happen frequently
Moderate Could happen occasionally
Unlikely May occur only in exceptional circumstances

Hazards Identification & Control Measures

Risk Class Responsibility
Item Job steps Hazards Controls
Refer risk matrix Who will do it
S.No Break the job down into sequential steps List what can harm you How can you make the job as safe as possible
• Ensure Area should be barricaded by
Barrication Tape Workers
• Ensure Area, Ground Level & over head involved
Lines should be checked
1 Area Preparation • Slip & Trips
• Ensure that Tool Box Task has been given safety in
before starting the work charge, Site
• Ensure that Authorised person to be supervisor
allowed to working area

Cushman & Wakefield Regional Template. Revision A. 10/02/2014

 Form – RA 002

Hazards Identification & Control Measures

Risk Class Responsibility
Item Job steps Hazards Controls
Refer risk matrix Who will do it
S.No Break the job down into sequential steps List what can harm you How can you make the job as safe as possible
 Person may fall due to  We ensure that the Vehicle fitness,
slip or improper license, Crane Boom, Limit, Switches Workers
gripping. fitness, Third Party inspections are involved safety
2 Crane Positioning & Checking  Fall from height. checked in charge, Site
 Ensure crane Positioning are has been supervisor.
levelled & Compact properly
 Ensure overload chart shall be provided
and maintain as per the norms
 Ensure that all the oil Leakages shall be
checked Workers
 Crane Topple  Ensure 300 to 600 kgs shall be lifted and involved safety
tagline shall be provided in charge, site
 Follow the load Chart supervisor.
 Ensure tagline to be provided for both
ends.

 Out riggers base plates should be rested Workers

 Out rigger failure/ on on the proper & Level Sheet Plates involved safety
soft ground which are placed on the properly levelled in charge, site
and checked ground area.
supervisor.
 Truck shall be Placed at 5mt distance for
moving of crane boom. Workers
 Slip , Trip & Collapse
 Ensure wheel checkers should be involved safety
3 Truck Positions
provided to all wheels in charge, Site
supervisor.

Cushman & Wakefield Regional Template. Revision A. 10/02/2014

 Form – RA 002

Hazards Identification & Control Measures

Risk Class Responsibility
Item Job steps Hazards Controls
Refer risk matrix Who will do it
S.No Break the job down into sequential steps List what can harm you How can you make the job as safe as possible
 Ensure check the vehicle fitness, license,
and documents
 Ensure third party inspection to be done. Workers
 Vehicle Failure
 Ensure Slings and D shackles to be involved safety
inspected in charge, site
 Ensure nobody should be allowed to the
supervisor.
lifting area
 Signal man should give the signal.
 The swing area should be clear for the
swing of the boom(360 degrees)
 The crane positioning should be done in
such a way that all the adjacent existing
Unloading of Cable drums  Hit on adjacent existing
facilities should be out of the crane swing
facilities area.
 Ensure that a signal man is allotted to
 Slip & trip, cut injuries,
give signal for the crane operator.
Fall of Material &  Ensure all oil leakages shall be checked workers involved
4  Ensure no person will stand under the safety in charge,
Persons
suspended load site supervisor.
 Lifting Gears Failure  Ensure only Skilled & experienced
operators are allowed to operate the
 Crane failure
crane.
 Improper Operations  Ensure that safety orientation is given to
the operators before starting the work.
 Only Authorised persons should be
allowed to the working area.

Cushman & Wakefield Regional Template. Revision A. 10/02/2014

 Form – RA 002

Hazards Identification & Control Measures

Risk Class Responsibility
Item Job steps Hazards Controls
Refer risk matrix Who will do it
S.No Break the job down into sequential steps List what can harm you How can you make the job as safe as possible
Workers
 Suitable ladder provided and ties off with involved,
rope at both ends site
 Fall from height & Slip
5  Use full body harness supervisor,
Removing of Slings & Trip
safety in
charge.

JSA Induction Verification. To be signed by all participants in the task prior to commencement.
I have read this SWMS, understand its content and acknowledge its conditions and my responsibilities :

Print Names: Title / Trade Classification Signatures: Dates:

JSA Review & Approval to Proceed.

Cushman & Wakefield Regional Template. Revision A. 10/02/2014

 Form – RA 002

Review Date
Status

Rejected Resubmit Approved

Commnets:

This JSA has been reviewed and the works may proceed based on compliance with the requirements outlined in this SWMS , respective permits to work issued, applicable
EH&S legislation, codes and specifications.

Reviewer: Company: Title: Signed: Date: Time:

Cushman & Wakefield Regional Template. Revision A. 10/02/2014