JSA (Job Safety Analysis) Sheet

Ref-
Activity Name:- Fly ash brick machine maintenance
Location:- Date :

Sr.No. Sub-Activity Name Type Of Hazard Risk(s) Involved Risk Control measures
Only inducted worker shall be deputed at the work place.
Manpower Untrained worker,lack
1 Personal injury
Mobilization of skill awareness Given Tool Box Talk to all workers.

Only Trained Person should be Deployed for work.

LOCK-OUT-TAG-OUT (LO-TO) before start of the maintenance.

Personal injury,
Unskilled Worker
Property damage Work area should be barricated to avoid unauthorised entry.

2 Maintenance Work Use all PPE's.

Hand tools should be insected for any damage before they use & kept in
proper toolkit.
Faulty hand tools Personal injury Work shall be carried out under supervision.
No work and worker should be deployed near machine.
Night work permit to be taken from concern engg.and safety dept.
Ensure proper illumination during dark hours.
Darkness, fall of Personal injury, damage
3 Work during dark hours Electrical cable should lead min 2 m height. No exposed electrical
person, fall of material to property
wire.Earthing.
Route shall be illuminated.

Name & Signature of Site Engineer / Supervisor :___________

Name & Signature of Site In-charge :___________

Name & Signature of Project In-charge :__________

Name & Signature of HSE Officer : ______