Job Safety Analysis (JSA)

General Information
24 MAY 2017 08 00
DATE: TIME:
DAY MONTH YEAR H M

WORK TO BE DONE: RECTIFICATION IN DOMESTIC WATER SUPPLY LINE

BRIEF DESCRIPTION: RECTIFICATION IN WATER SUPPLY LINE

EXACT LOCATION: ROAD WAY NEAR MAIN GATE NO 2

PPE required for the Job

Hard Hat Soft Leather Gloves

Safety Shoes Chemical-Resistant Gloves
Safety Glasses Heat-Resistant Gloves
Facial Protection Cut-Resistant Gloves
Hearing Protection Long-cuff Leather Gloves
Respiratory Protection Welding Mask/Goggles
Full-Body Harness Apron and Gaiters
Use of tool-belts

Specify below if other PPE is required:

General Protection Measures required for the Job

Containment Barriers TagOut of Equipment

Spill Kit (Absorbing Material) Fire Fighting Equipment
Warning Signage Cordon-off Area

Specify below if other measures are required: