JOB HAZARD ANALYSIS (JHA) WORKSHEET

JOB HAZARD ANALYSIS [JHA] WORKSHEET

DATE
PTW
NO
JHA NO
WORK SPECIFIC
FACILITY /
PERMIT HOT WORK BEKOK C WORKST CELLAR DECK
LOCATION
TYPE ATION
EQUIPME WORK
V-840 & V-890
NT NO. DESCRIPTION TO PERFORM PHOTO TAKING ACTIVITY NEAR WORKING AREA
NOTE
1. JHA shall be applicable for all work activities which requires PTW.
2. The pre-prepared JHA and JHA prompters will be used as a reference/guide during the development of JHA.
3. Personnel carrying out the work shall be fully familiar with the written Work/Operating Procedures developed for the job. The Work/Operating
Procedures shall describe, in step-by-step instructions, the correct method of executing the specified work.
4. Prior to commencement of work (after PTW has been approved), the task-specific JHA shall be discussed amongst all personnel involved in the
execution; and requirements contained therein shall be fully understood and agreed by all involved personnel.

CONTROL BARRIERS ACTION MONITO RECOVERY ACTION MONIT

JOB PARTY RING BARRIERS PARTY ORING
DESCRIPTION OF POTENTIAL POTENTIAL
STE
JOB STEP HAZARD Consequences
REQUIR REQUI
P EMENT REMEN
(Y/N) T (Y/N)
1 Prepare H.25.01 Manual - Back pain - Assign enough - Team - N - First aid Medic N
equipment tools materials manpower (buddy leader onboard
required to the handling / system)
work area *Pengendalian - Agronomic
barang secara awareness training
manual - Proper handling
technique

2 Assess the H.25.08 - Personal injury - Do not rush - Team - N - First aid Medic N
weather Workstations - Watch where you leader onboard
/Tempat kerja are stepping
- Look surrounding
- Secure camera with

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 JOB HAZARD ANALYSIS (JHA) WORKSHEET

hand strapped
3 Access to worksite H.25.08 - Personal injury - Do not rush - Team - N - First aid Medic N
Workstations - Watch where you leader onboard
/Tempat kerja are stepping
- Look surrounding
- Secure camera with
hand strapped
4 Bringing tools to H.26.11 Work - Personal injury - Secure camera with - Team - N - First aid Medic N
the worksite Environment hand strapped leader onboard
/Persekitaran
Kerja
5 Survey area to the .26.11 Work - Personal injury - Do not rush - Team - N - First aid Medic N
photograph Environment - Watch where you leader onboard
/Persekitaran are stepping
Kerja - Look surrounding
- Secure camera with
hand strapped
6 Switch the camera H.15.04 Lightning - Spark - Turn off the flash - Team - N - Medical Medic N
on discharge - Fire mode leader treatment onboard
/*Pelepasan kilat - Do not perform - Medivac if
battery replacement required
at site
7 Photo taking H.15.04 Lightning - Spark - Turn off the flash - Team - N - Medical Medic N
discharge - Fire mode leader treatment onboard /
/*Pelepasan kilat - Avoid device from - Medivac if HSE
falling to avoid required
spark/shock
- Perform gas test
(action by
operation/AGT)
8 Housekeeping H.25.18 - Personal injury - Be vigilant (watch - Team - N - First aid Medic N
Improper you are steps) leader onboard
housekeeping - Barricade the work
/pengemasasn area
yang tidak betul

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 JOB HAZARD ANALYSIS (JHA) WORKSHEET

JHA APPROVAL DURING PTW APPLICATION

REVIEWED BY APPROVED BY
NAME NAME

DESIGNATION WORK LEADER DESIGNATION PRODUCTION SUPERVISOR /MAITENANCE SUPERVISOR /BASE

SUPERVISOR/FUNCTIONAL SUPERVISOR
SIGNATURE SIGNATURE

DATE DATE

AFTER PTW HAS BEEN APPROVED

WORK TEAM (CONFIRMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PRE_JOB/TOOLBOX MEETING _ AFTER PTW HAS BEEN APPROVED)

Name (S) Designation Signature Signature Signature Signature Signature Signature Signature Name (S) Designation Signatur Signature Signature Signatur Signature Signatur Signature
e e e

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