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JOB SAFETY ANALYSIS WORK SHEET

DATE : D / M / Y Contractor :
JSA for ripping of cable whole route J.O#10-00918-

JSA Function Name Badge #/ Iqama Phone #

Main Contractor Construction Engineer (GCC)

Main Contractor Site Safety Advisor (GCC)


Ame Site Foreman

AME Safety Officer

SAPMT Representative

Proponent Rep (P/L) (Optional)

DESCRIPTION OF TASK:

Work Location:
REFERENCES: REQUIRED SAFETY EQUIPMENT
 G.I. 2.00” Work Permit System
 Hazard Identification plan (HIP) 1. Required to wear proper PPE
 Saudi Aramco Construction Safety Manual 2. Barricades, Sign Boards, ladders, warning light and fire extinguishers.
 G.I. 2.709 “ Gas Testing procedure using 3 in 1 Gas monitor”
 G.I. 7.025 “Heavy Equipment Operator Testing and Certification”
 G.I. 7.030 “Inspection and Testing Requirements for Elevating /Lifting Equipment”
 G.I. 1021.000 “ Street and road Closure : Excavations, Reinstatement and Traffic
Control”
 G.I. 7.026 “ Crane and heavy equipment incident reporting procedure”
Prepared by: (Contractor) Reviewed by: Reviewed by: Approved by : Approved by :
AME Safety Officer : AME Construction Foreman GCC Safety Advisor : SAPMT , Representative: Operations Representative

Signature
Signature Signature
Signature Signature
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S/N SEQUANCE OF BASIC STEPS POTENTIAL HAZARDS HAZARDS CONTROLS ACTION BY

1. The permit issuer & receiver to conduct a joint


site inspection to discuss the hazards &
precaution required for conducting the job
safely.
2. Invite other entities with utilities that may be
affected by this activity
3. Obtain work permit as outlined in GI-2.100
4. A tool box meeting shall be conducted. Contractor Work Permit Receiver /
1. Injury/Incident due to falling 5. Incase of any emergency all activities shall be Proponent work Permit issuer to
1. Preliminary Site Inspection
Slipping stopped and employees should move to witness/ Safety Officer ensure
designated safe area. compliance
6. Maintain communication between supervisors
and safety personnel
7. Non-essential personnel shall be kept clear of
the work area
8. All the personnel should wear Safety shoes,
safety glass and hard hat as personal protective
equipment’s.

1. Conduct joint site inspection


1. Miss-communication 2. Highlight the potential Hazards Contractor Work Permit Receiver /
2. Obtain work permit and Counter signature /understanding 3. Highlight the Safety Precaution Required Proponent work Permit issuer to
4. Take the counter sign if required witness ensure compliance

1. Secure a hot work permit


2. Aramco Certified operator must be used
1. People struck by equipment 3. Check any existing underground facility is Contractor Work Permit Receiver /
2. Existing facilities struck by present using locators Proponent work Permit issuer to
3. Ripping by dozer
equipment 4. Rip only threw surveyed and staked path witness/ Safety Officer ensure
3. Unqualified operator 5. Valid equipment sticker / daily operator compliance
inspection check list
6. Flagman shall be used to provide signals.

1. Traffic Hazards 1. Remove all precaution signs , barricades & drums


4. House Keeping
2.Environmental Hazards 2.Clean all debris