Metal Crafts Constructors Pvt Ltd
HPCL-Mittal Energy Ltd, GGSR, Bathinda
Job Safety Analysis Sheet
Permit No:
Main Activity: Erection of spool by chain block / rope pulley
Sl. No. Sub Activities Hazards (Both Existing as
(List the tasks well as potential) Against
required to perform each task list the hazards that
the activity in the could cause injury/damage to
sequence they are people, equipment or the
carried out environment.
Fall of person due to slip, un
balance, failure of systems
Arrangements of
lifting equipment’s.
1 Fall of Materials due to failure
Hooking of Chain
of system.
pulley block
obstruct to the emergency
route/ways due to improper
stacking of materials
Fall of load/material
physical injury & Damage of
equipment’s due to hit by load
2 Lifting of material
Back injury due to bad
postures
Injury due to fall of material
3 General
Name Designation
Approver-1 (Manager or above both
issuer & requester)
Note:
JSA to be done by issuer and accepter of work permit, in case required, representative from other discipline can also join the team for JSA
Location: CPP
JSA No. MCCPL/HMEL/JSA-16.Rev.02
Control Measures.
(List the control measures required to eliminate or
minimize the risk of injury arising from the identified
hazard.)
Provide proper lifeline with full body harness.
Deploy only trained & experienced workforce.
Avoid moving on the slippery platform.
Use safe access like ladders.
Use rope pulley with safety latch to lifting chain block to the
hanging object.
Ensure the object is capable to manage the load.
All fitting tools and tackles should be TPI certified and
colour coded.
Ensure the physical condition of the tools & tackles before
use.
Do not stack any material on the walkway or emergency
Cordon off the area & provide warning/sign boards.
Follow all control measures of sr. 1 B
Use guide rope to control the unwanted movements of the
load.
Ensure sufficient clearance to uppering/lifting the load.
Provide physical means of Barricade nearby area.
Use mandatory PPE's
Persons should keep the safe distance from the lifting load.
Maintain suitable posture and correct techniques, while
handling the material
Place the materials in arranged manner in safe condition
Avoid the throwing the materials and escape on the pile
Housekeeping should be maintained.
Proper communication to be maintained.
Signature Date
 JOB SAFETY ANALYSIS FORM
JSA Sheet No._______________
Checklist of common Hazards
This should be used as an aid to identifying hazard. This is the list for the most common hazards but is not a definite list.
Mechanical/Equipment Thermal Ignition sources Electrical
Entanglement Hot surface Electricity Electrical shock
Shearing Steam Static electricity Static electricity
Crushing Refrigerants Hot work Power failure
Striking Stored Energy Lightening Pressure
Cutting Falling material Sparks Release of energy
Mechanical failure (e.g. by overloading) Springs under tension/compression Frictions Implosion
Chemical Counterweights Flames Compressed air
Flammable Radiations Auto ignition Steam
Toxic e.g. ionizing radiation (X-rays) Pyrophoric material Hydraulics
Harmful Place of work Vehicles Process
Irritant Obstructions Fork lift Wrong material
Oxidising Access/egress Tankers Missed steps
Pyrophoric Work at height Reversing vehicles Instrument failure
Corrosive Falling objects Speed Interlocks
Dangerous to environment Slip/trip/fall People Control system failure
Dust explosions Housekeeping Unsafe behavior Alarms
Gases Temperature Human errors Nature
Fumes Ventilation Training/competence Weather
Vapours Confined space Method of work Winds/Storms/lightening
Dusts Hazards of other tasks being done Manual handling (lifting, carrying, pushing
Asphyxiants Simultaneously. and pulling)
Stress/workload
Biological (e.g. legionella) Noise/Vibrations/Hot work

Name Designation Signature Date

Approver-1 (Manager or above both Issuer

& requestor)
(Note: 1. JSA to be done by issuer and acceptor of work permit. In case required, representative from other discipline can also join the team for JSA.

2. JSA to have approvals for Hot Jobs, confined space entry & Work on equipment in service