JOB SAFETY ANALYSIS

Location Date New Revised Jsa No.

Task Supervisor
Team Members Analysis By

Approved By
Pre-Job Assessment (Check all that apply in both sections)

Potential Hazards :

CHEMICAL EXPOSURE NOISE ARC/ FLASH PRESSURE FALLS FIRE/ EXPLOSION CHIPS/ SLIVERS

HAZARDOUS ATMOSPHERE WORKING/ WALKING SURFACES OPEN HOLE LIFTING MACHINERY SPILL PINCH POINTS

CONFINED SPACE ENVIRONMENT/ WEATHER IGNITION SOURCES OVERHEAD HEAT STRESS SLIP/ TRIPS HOT SURFACES

SIMULTANEOUS OPERATION OTHER :

Hazard Controls and Emergency / Contingency Plans :

PHYSICAL BARRIERS LOCK-OUT/ TAG- OUT EMERGENCY EVACUATION PROCEDURES SIMULTANEOUS OPERATIONS OPEN HOLE POLICY

SPECIAL SAFETY EQUIPMENT REQUIRED WORK PERMITS EYEWASH/ SAFETY SHOWER LOCATION HOLT BOLTING POLICY SPILL CONTROL/ CONTINGENCY PLAN

IGNITION SOURCE CONTROLS FIRE FIGHTING MATERIAL SAFETY DATA SHEETS (MSDS) FALL PROTECTION

SEQUENCE OF BASIC JOB STEPS POTENTIAL INCIDENTS AND/OR HAZARDS AT EACH STEP RECOMMENDATIONS TO ELIMINATE HAZARDS

Safety Equipment Required to do this Job. (check all applicables) :

HARD HATS SAFETY GLASSES GOGGLES FIRE ESTIGUISHER FORKLIFT

SAFETY SHOES SAFETY HARNESS WORK VESTS WORK PERMIT REQUIRED CRANE

FACE SHEILD BARRICADES LOCK-OUT/ TAG-OUT

COTTON / LEATHER GLOVES

Is there a "Weak Link" in the process sequence today? If so, what is it and what actions are necessary ?

MACHINERY MATERIAL MANPOWER METHODS WEATHER OTHER

TEAM MEMBERS SIGNATURES AND DATE BELOW
 JOB SAFETY ANALYSIS
Location Basin Oil and Gas - Seminole 123 #1 Date 5/20/20 New Revised Jsa No.

Task Flowback Supervisor David Glawson

Team Members Freddy saldana Analysis By Freddy Saldana

Approved By David Glawson

Pre-Job Assessment (Check all that apply in both sections)

Potential Hazards :

CHEMICAL EXPOSURE NOISE ARC/ FLASH PRESSURE FALLS FIRE/ EXPLOSION CHIPS/ SLIVERS

HAZARDOUS ATMOSPHERE X WORKING/ WALKING SURFACES OPEN HOLE LIFTING MACHINERY X SPILL PINCH POINTS

CONFINED SPACE X ENVIRONMENT/ WEATHER IGNITION SOURCES OVERHEAD HEAT STRESS X SLIP/ TRIPS HOT SURFACES

X SIMULTANEOUS OPERATION OTHER :

Hazard Controls and Emergency / Contingency Plans :

PHYSICAL BARRIERS LOCK-OUT/ TAG- OUT EMERGENCY EVACUATION PROCEDURES SIMULTANEOUS OPERATIONS OPEN HOLE POLICY

SPECIAL SAFETY EQUIPMENT REQUIRED WORK PERMITS EYEWASH/ SAFETY SHOWER LOCATION HOLT BOLTING POLICY X SPILL CONTROL/ CONTINGENCY PLAN

IGNITION SOURCE CONTROLS FIRE FIGHTING MATERIAL SAFETY DATA SHEETS (MSDS) FALL PROTECTION

SEQUENCE OF BASIC JOB STEPS POTENTIAL INCIDENTS AND/OR HAZARDS AT EACH STEP RECOMMENDATIONS TO ELIMINATE HAZARDS

Dump sand trap as needed Body strain, slips, trips, and falls take your time, watch body placement, don’t rush, be aware

Take hourly readings slips, trips, and falls. be alert of surroundings, get plenty of rest, footing and hand placement

check tank levels splills, leaking tank, slips, trips, and falls do walk arounds, be alert, take notes, use 3 point contact

Get water hauled off as needed spills, leaking tanks, truck drivers, backing trucks do walk arounds, good communication, use a spotter

weather heat, wind, rain, hail be aware of your surroundings, check weather regularly

Safety Equipment Required to do this Job. (check all applicables) :

X HARD HATS X SAFETY GLASSES GOGGLES FIRE ESTIGUISHER FORKLIFT

X SAFETY SHOES SAFETY HARNESS WORK VESTS WORK PERMIT REQUIRED CRANE

X COTTON / LEATHER GLOVES

FACE SHEILD BARRICADES LOCK-OUT/ TAG-OUT

Is there a "Weak Link" in the process sequence today? If so, what is it and what actions are necessary ?

MACHINERY MATERIAL MANPOWER METHODS WEATHER OTHER

TEAM MEMBERS SIGNATURES AND DATE BELOW

Freddy Saldana