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POWER

JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
ACTIVITY OR TASK:HYDRO TESTING SPOOL PIECES AND PIPE WORK
JSA Preparation & task work team:
Competence = Relevant Training/Qualifications + Experience

Location / Project: Job Number: JSA Number: M36 Codes of Practice & Legislation that are applicable: JSA Revision:

Competence/ Qualific’n req’d to complete work safely JSA approved by person responsible i.e.
Team Leader / Tradesman

Name:

Position / Competence/ License:

Date:

2. HAZARD IDENTIFICATION
compulsory

Identify hazards that may be present by ticking items on the list below.

3. PRECAUTIONS: hard hat, safety glasses, safety boots
ADDITIONAL PRECAUTIONS
Gloves: type …………………. Goggles Full Face Shield High Visibility Vest Harness Fire Extinguishers Barricades Ventilation Lighting Erect Scaffolding to access Respirator or Dust mask Erect Warning signs Personal Locks or Tag system Group isolation Welding screen Fall Arrest systems Welding Face Shield

WORK LOCATION
Difficult Entry/Exit Oxygen Deficiency Oxygen Excess Engulfment (trench collapse) Poisonous Gas Present Temperature Extremes Defined Confined Space Explosive Gas Present

HAZARDOUS AREA
Hazardous Substances - attach MSDS to JSA Working at Heights Remote Area Motor Room Hazards Toxic Substances Potential for Difficult Rescue

HIGH RISK
Falling Objects Poor Lighting Slippery Surfaces Multiple Electrical Feeds Trip Hazards Electrical Hazards - LV Electrical Hazards - HV Manual Handling Sharp Materials Ladders used in the task Working at Heights Working near Crane & Crane Runways Rail Movement Pressurised Fluids Flamm. Materials Present

HIGH RISK
Suspended loads Poor Visibility Inhalable Dusts/Fibres High Noise Levels Use of Chemicals Elevated Work Platform Difficulty to Communicate amongst workers Moving Machinery Tools & Equipment Heat/ Sunlight/ Radiation Traffic Movement Working near Operation Processing Lines Live Rails Pneumatics

PERMITS
Hot Work Excavation Confined Space Hazardous Work Clearance Access to Area High Voltage Access Scaffolding Other?

HAZARDOUS SUBSTANCES in work area / to be used
-attach MSDS

PERMIT NUMBER:

4. ENVIRONMENTAL HAZARDS – (IMPACTS) tick those identified
Air Pollution (dust, fumes) Noise (plant & equipment) Spills to drains/waterways Spills to ground Soil Erosion Hazard to Flora /Fauna

Other:

RISK RATING TABLE
This table is used to calculate whether the hazard you have identified is Extreme: 9-10 High: 7-8, Medium: 5-6 or Low: 3-4
The objective of rating the risk is to lower the risk by initiating risk control measures. The score is

Likelihood: How likely is it to be that bad? Almost Certain Expected to Occur

Consequences: how severe an injury? Death
Serious Injuries Medical Treatment Req’d 1st Aid req’d

10 9 8 7 6

9 8 7 6

8 7 6 5

7 6 5 4 3

5. EQUIPMENT REQUIRED: Static Plant & Equipment
Mobile Plant & Equipment

Likely – could
happen sometime

Moderate – could
happen but not likely

Unlikely – could
happen but very rare

Revision Date: March 2005

………. of …………..

Rare - could happen
but probably never will

OHS-03-F01 5 4

Faulty Equipment. illness or environmental incident. PPE. PPE. slippery work area Remove bunting and signage Personal Injury resulting from uneven. Appropriate tools. Correct tools. Barriers. Logical sequence Sequence of Basic Job Steps Break down Job into steps. Correct Work Methods Obtain correct PTW. supervision.. Equipment Damage. PPE. incomplete fittings Personal Injury resulting from High Pressure Hose Bursting. injury. Indicate who is to perform the action where applicable against each action Identify the hazards (health and safety or Use table on environmental) associated with each step. Correct lifting techniques. PPE. be aware of hazards Correct Lifting Techniques. PPE. NAME OF TASK: HYDRO TESTING SPOOL PIECES AND PIPE WORK JSA Number: Risk Rating M36 Rev: Risk Rating Of the risk following corrective action Step No. the previous examine each to find all possible risk factors page to score risk 1 2 3 4 5 6 7 8 Discuss scope of work and work method Personal Injury resulting from with workforce working with hand tools and lines under pressure Obtain PTW Injury / damage as a result of incorrect information Identify work area Risk of injury due to low awareness of work environment Fit blanks and fittings into spool pieces Personal Injury resulting from incorrect work methods and incorrect tools Hydro Testing Personal Injury resulting from incorrect work methods. Sentry to control entry to work area. Personal Injury resulting from Blow out of equipment under test. Inspect PSV for condition and correct setting Ensure equipment drained and depressurized prior to removing fittings. Incorrect work methods. OHS-03-F01 . The risk must be reduced or controlled to a level that is acceptable before work commences. Each step should accomplish a major task and be logical. Take 5. Training in PTW system. Supervision Inspect hoses and fittings prior to use. of …………. Supervision Inspect fittings for compatability & condition. slippery work area Toolbox Meeting. PPE. Signs. Supervision. PPE Barriers. Revision Date: March 2005 ………. Signage. Correct lifting techniques. Removing Blanks and Fittings Personal Injury resulting from trapped pressure escaping Clean up work area Personal Injury resulting from uneven. correct torque-ing techniques. supervision. Environmental Aspects Potential Safety & Environmental Hazards/Impacts Recommended Corrective Action or Procedure Determine what actions are necessary to eliminate or minimise all hazards that could lead to an accident.POWER JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT Safety / Emergency Equip’t noted in the JSA risk score column on the next page – both before & after risk control measures have been nominated. inspect pressure unit and safety device prior to use.

of …………..POWER JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT Revision Date: March 2005 ………. OHS-03-F01 .

JSA NAME JSA No: Rev: DATE NAME (Please print) SIGNATURE THIS SAFE WORK BRIEFING / TRAINING WAS CARRIED OUT BY (responsible person at that location) : Name: Signature: Date: Client sign off (where applicable) Site / Project Manager sign off (document reviewed) Revision Date: March 2005 OHS-03-F01 . I confirm that copies of the relevant Permits. that I have attended a briefing on the requirements of the attached Job Safety & Environment Analysis and agree to perform the work in the manner detailed on it. Isolation Plans etc.POWER JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) CONSULTATION & SIGN-OFF RECORD I confirm by my signature below. have been reviewed. MSDS's.