Job Safety Analysis Worksheet
Job Description: Erection, Modification & Dismantling of Temporary Scaffolding
JSA Date: 06/ 02 / 2019
JSA Facilitator (Name):
JSA Participants:
Review/Approval:
Work Group Supervisor (Name):
Permit Approver (Name):
Sequence of Basic Job Steps Potential Hazards
Refer to Hazard Checklist
*Poor communication
1. Site preparation and language barrier
movement of personnel and *Defective PPE
materials. *Ignorance
*Lack of Training
*Manual handling
*Failure of forklift
*Injury from physical
movement of materials or
2. Material selection, preparation equipment.
& stacking (manually or by *Cumulative back injuries
forklift) *Hand Injury
*Strained muscles and torn
ligaments.
*Hand injury abrasion,
nip/pinch points.
3. Erection, modification & *Fall of person
dismantling of scaffolding. *Fall of materials
Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
JSA Location: All Area
JSA Facilitator (Sign):
Work Group Supervisor (Signature)
Permit Approver (Signature):
Precautions / Controls Responsible
Refer to Hierarchy of Control (Section 2.5 of JSA Procedure)
 Ensure pre-task briefing is given out in a language understood by the work force. Ask
questions regarding the briefing to get feedback from the staff, ensures the
understanding.
&  Ensures person are competent for the job and close supervision until the work is
completed. Supervisor
 Ensure that the area is barricaded and only authorized person is allowed inside the Safety Officer
barricade.
 Work area should, access, egress should be free from any obstructions.
 Ensure that all personnel are aware of the potential hazards & emergency procedures.
 Ensure that valid permit is to be obtained prior to start of the work.
 Follow manual lifting procedures.
 Adopt correct posture.
 Obtain help if load is too heavy.
 Use mechanical means where possible.
 Maximum weight should not exceed more than 25kg/person in optimum conditions.
 Twisting and stooping to be avoided at all times.
 Ensure proper mechanical risk hand gloves are worn for hand protection.
Supervisor
 Wherever possible, loads shall be covered or packed in such a way as not to harm the Workers
carrier.
 Inspect the hand forklift before start of work.
 Ensured forklift has Third Party Certificate and is operated by certified forklift operator.
 Ensure that the materials are properly barricaded with appropriate signage
 Ensure that all materials are in good condition.
 Do not mix material of two different manufacturers.
 Scaffold shall be erected by certified and experienced scaffolders under a competent Supervisor
supervisor. Workers
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  Working area should be barricaded with proper signages.
 The scaffold should be aligned and levelled using spirit level/water level.
 For ladders minimum of 200mm clearance shall be maintained in vertical and
horizontal area behind ladder rung.
 Scaffolding planks should be non-slippery and the gap between planks shall not be
more that 1”, It shall extend 6-12” over the end supports.
 Platform shall be equipped with guard rail system, toe board, top rail at 1.05M height
and mid rail in the centre between top rail and toe board.
 Scaffolders should use full body harness while working above 1.6m height and follow
100% tie off procedure.
*Scaffolding collapse
 Red tag should be provided on access ladder during erection till inspection is carried
*Incompetency
out.
*Slip/trip/fall
 Scaffolders should use tool bag/belt for carrying and using tools at height.
*Unsafe access/egress
*Openings  While passing materials from ground level to height have proper/ positive
*Incomplete scaffolding communication and ensure the materials is held by other person and then release
your hands.
 Clamps should be transported to heights using pulley block (tested by third party),
rope and approved lifting bag.
 In case of suspended scaffold, ensure safe access to reach a pipe rack is provided.
Use lifeline.
 Each drop tube should be fitted with check/lock fitting to prevent slipping.
 After completion of scaffold (erection or modification) , it should be inspected by a
certified scaffolding inspector and then GREEN tag shall be provided.
 All loose materials should be removed first before starting dismantling.
 Good housekeeping shall be maintained during erection, modification or dismantling.
 Scaffold inspection shall be carried out by third party certified scaffold inspector.
 If all the checks are satisfactory and the scaffold meets the requirements GREEN tag
shall be provided. Scaffold tag shall be placed on access ladder such that it is visible
*Incompetency
for each user. Scaffolding
4. Inspection of Scaffolding. *Fall of person
 The scaffold inspector should sign the tag and put inspection date. Inspector
* Slip/trip/fall
 Scaffold shall be re-inspected after every 7 days by scaffolding inspector and shall
sign the scaffolding tag.
 Scaffolding shall be re-inspected after each modification.
 Keep the work area neat and clean.
 Do not accumulate waste at job site.
*Slip/trip/fall Supervisor
5. Housekeeping  Provide hazardous and non-hazardous waste bins with proper labelling.
*Environmental pollution Workers
 All hazardous and non-hazardous waste generated is to be disposed off separately
as per the RLIC guidelines.
6. End of activity *Poor housekeeping  Ensure that the permit is properly closed and signed by designated person. Supervisor
 Ensure that the condition stated at the closing of permit is being undertaken such as
proper housekeeping.

Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
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  Ensure that the closed out permit will be duly hand over to QSTec designated person

1. Worksite / Work Environment Hazard Adverse weather condition (rain, high winds, X Nitrogen Rich Atmosphere
X
YES No high temperature /humidity) X Inadequate lighting
X Oxygen Deficient Atmosphere X Inadequate ventilation

Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
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 Cave-in/collapse of inadequately X Damaged utility hose
X
shored/battered/stepped excavation X Damaged cylinder
Restricted mobility due to poor access or Incorrect pressure regulator fitted to gas
X X
confined space cylinder
X Slip/trip & falls hazard/Poor Housekeeping X Improper bonding/grounding
High noise (due to job location or use of X Damaged/uncertified lifting equipment
X
tool/equipment) X Unsecured load which could move
X Fire & explosion hazard 5. Ergonomic
2. Tools & Equipment X Manual handling of heavy objects
X Damaged/sub-standard tools X Awkward/cramped posture
X Improper tools for the job X Excessive force
X Uncertified equipment (e.g. crane, forklift) X Repetitive motion
Use of Non-intrinsically safe equipment in X Fatigue
X
classified area
X Line of Fire 6. Work at Height / Dropped Object
X Pinch/Nip Point X Dropped objects from height
X Use of substandard/damaged ladder Dropped object into excavation / pit or through
X
hole opening in floor structure.
3. Chemical X Damaged harness
X Exposure to substances hazardous to health, X Improper anchorage
through inhalation, ingestion, absorption, or X Substandard/damaged ladder
subcutaneous routes:
X Welding fumes 7. Pressure
X Exhaust fumes YES NO
X Corrosive substance Line breaching or potential hydrocarbon
X Pyrophoric material X
release
X Toxic substances X Working with equipment under pressure
X Asphyxiant X Damaged/inadequate hose
X Objects under compression e.g. spring
4. Physical/Mechanical Stored/residual pressure after isolation of
YES NO X
equipment
X Moving vehicle, forklift X Incorrect pressure regulator
Contact with high velocity ejected particles / 8. Electrical
X
objects. Struck-by hazard X Damaged/sub-standard cord, plugs
Contact, caught in or between machines with X Energized electrical system
X
moving parts, due to inadequate guards. X Static Electricity
Equipment with moving or rotating parts e.g. X Lack of grounding/earthling
X
grinding machine X Underrated electrical equipment
X Contact with sharp blade/edge
X Contact with excessively hot/cold surface 9. Miscellaneous Hazard
X Source of ignition X Lack of/inadequate procedure
Excessive exposure to vibration generated by Individual roles & responsibilities with regard to
X X
equipment. a job not clear / understood.
X Exposure to ionizing/ultra-violet radiation X Untrained or incompetent personnel (including

Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
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 vendors, subcontractors, etc,). X Lack of experience Unclear interface arrangements i.e. conflicting
X
activities

Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
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 Equipment trip due to safety interlock
X
unintended activation.
X Poor communication
X Lack of Supervision

Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
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Emergency Response: In case of an Emergency or plant alarm situation all works must be stopped, equipment to be switched off and all personnel must report to the safest muster point considering wind direction.
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