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JSA Civil - Manual Excavation
JSA Civil - Manual Excavation
WORK ACTIVITY (JOB) TITLE: Penggalian secara Manual (Manual Excavation) Date :
WORK TEAM REVIEWED BY: JSA PREPARED BY:
1. Signature:_____________
1 7 CSTS Construction 2. Signature:_____________
2 8 Name :__________________ 3. Signature:_____________
3 9 Signature:__________________ 4. Signature:_____________
4 10 5. Signature:_____________
5 11 CSTS HSSE 6. Signature:_____________
6 12 Name :__________________ 7. Signature:_____________
Signature:__________________ 8. Signature:_____________
CRITICAL QUESTIONS:
Everyone Ready/Capable To Work? Potential Spill/Gas Release Addressed? Worst Case Discussed?
REQUIRED SAFETY EQUIPMENT
Hard Hats Goggles Safety Harness Hearing Protection Barricades Other (List): Rubber Gloves, Dust
Safety Shoes Face Shield Cotton Gloves Flame Resistant Clothing LEL Monitor masker__________________________________
Safety Glasses Work Vests Leather Gloves Fire Extinguisher H2S Monitor _____________________________________________
APPLICABLE SAFE WORK PRACTICES/SPECIAL PRECAUTIONS
Hot Work Permit Special Pre-Job Safety Discussions Confined Space Entry Permit Pollution Prevention Measures
Energy Isolation Review Emergency Action Plans Use of Specialized PPE Redundant Protection Measures
Written Procedure Site/Job Orientation Overhead/Underground Utility Lines Simultaneous Operations
POTENTIAL HAZARDS
Lifting Hazards Short Service Employees Elec. Shock/ Flash (includes utility lines) Dropped/Falling Objects Low Lighting Ionizing Radiation
Fall Potential Water/Drowning Hazard Haz. Chemical Exposure (includes H2S) Tripping/Slipping Breathing Hazard Other:_________
Skin Irritants Mech. Equip. Hazards Sharp Edges or Hot/Cold surfaces Excavation Hazard Environmental ________________
Confined Spaces Fire/Explosion Potential Pinch/Crush/Striking Hazards Confined spaces Extremes ________________
Elev. Load/Work High Noise Levels Potential Release of Energy Elevated load or work Vehicle Operations
BASIC JOB STEPS POTENTIAL INCIDENTS OR WAYS TO ELIMINATE OR CONTROL HAZARDS PIC
HAZARDS
Work preparation, and transfer tools Back Pain, Body Injury Follow manual Handling Procedure (worker has been
and equipment’s by manual handling Sakit Pinggang, terluka/ tersayat training safety manual handling)
Persiapan & transfer peralatan, Ikuti prosedur pengangkatan manual (pekerja sudah
material kerja terlatih cara pengangkatan manual)
Manual excavation Back Pain, Body Injury Ensure safe position during task execution
Penggalian tanah secara manual Sakit Pinggang Pastikan posisi tubuh aman selama melakukan pekerjaan
Heat Stress/Dehydarsi Persedian air minum yang cukup & cukup minum air
Potable water supply & enough drinking water