Title:

Halliburton Management System

Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 1 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

JOB TITLE/TASK: DATE: SECTION

SAND CLEAN OUT 16-Jun-2018
JOB SAFETY
ANALYSIS SUPERVISOR: ANALYSIS BY:
refer to GD-GL- NEW REVISED
David G HPS CREW
HAL-HSE-0103,
section 3.8.3 for
instructions

R.P.C.: (RISK PLANT/LOCATION: DEPARTMENT: REVIEWED BY:

PRIORITY CODE)
NB 108 (PHM) HPS

REQUIRED AND RECOMMENDED PPE APPROVED BY:

(PERSONAL PROTECTIVE EQUIPMENT)

SEQUIENCE OF HAZARD HAZARD BEFORE R RISK REDUCTION AFTER R

BASIC JOB STEPS EFFECT Severity/Probability P MEASURES Severity/Probability P
C C

Correct Snub and

Pull Test kit to be
utilised, appropriate
gripper pressure
Dropped
applied for rated
object,
Carry out pull pull. Signs and II/D
Pull test CT equipment
test, pressure II/D 3 barriers to be 3
Connector damage,
test used.Only certified
personnel
equipment, which
injury/fatality
must include pad
eyes, shackles,
lifting slings/bridles
and cranes

Pressure 1. Failure of 1. Personal I/D 2 1. Toolbox Talk I/D 3

testing equipment and injury. prior to any testing
components. 2. Damage to operations.
2. Failure of equipment 2. Certified and
high pressure tested equipment
components must be used for
and testing.
connections. 3. Ensure BOP is
3. Over secured to test
pressure Stand.
4. Ensure all other
Flange Connections
are properly
tightened.

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 2 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

5. Ensure Test Bar

fits inside BOP and
close slip ram on
bar above nubbin.
Fit top safety plate
and secure.
6. Ensure test pump
connections are
tightened.
7. Ensure Barriers
are around work
area.
8. All non-essential
personnel are clear
of test area.
9. Personnel
completing test to
make sure no non-
essential personnel
wander into test
area during test.
10. Ensure Low and
High Pressure test
criteria is
established prior to
pressure testing
operations.
11. Only one
person is to be
designated to
operating Test
Pump and valves

Open up the Pressure Personal I/D 2 Complete pre –RIH I/D 3

well release of injury. Fire checklist. Ensure
hydrocarbons. explosion stripper pressures
Tubing are sufficient,
movement Injector hydraulic
system pressures
are adequate.
Permit to work.
Including
precautionary
measures.TBT
involving all

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 3 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

involved personnel

Caution should be
taken when pulling
the BHA back
Tagging tubing Damage to
RIH CT IV/D 3 through tubing IV/D 3
restrictions equipment
restriction i.e.
Tubing End,
Nipples, SSSV etc

Prior to POOH,
complete pre POOH
checklist. With the
Tagging Coil at 500ft stop &
surface set hydraulic
equipment too pressures to the
hard with a minimum
possibility of (Skate/Beam
jamming or pressures &
Damage to
losing the hydraulic speed
Pulling out of equipment.
BHA. Possible II/C 2 control pressures. II/D 3
hole Explosive
depth From 500ft POOH
atmosphere
correlation speed should be set
problems. at a maximum of
Fluid or gases 20ft per/min & set to
escaping stall.
through the From 100ft POOH
stripper speed should be set
to a maximum of
10ft per/min & set to
stall

Monitor weight
indicator,

CT Weight CT failure Run CT with low

drops because too speed at area with
CT tag at TOS III/C 3 III/D 3
exceeding its much min restriction,
limit buckling
Be aware to make
CT running weight
not exceed its limit

Pumping fresh High Pressure, Personal II/B 1 Ensure that all II/D 3
water through injury, personnel adhering
CT CT burried by to Manual handling

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 4 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

procedure,

Monitor weight
indicator,

Clear area under

sand, suspended load,

Wrong Tools Check validation

configuration, date on lifting
certificates and
Pressurize fluid ensure available at
expose in CT stuck,
loaction,
environment
Damage to
during function Visually check lifting
equipment,
test, gear,
CT Burst
Overhead Barricade work
crane, area,

Poor Used competent

Communicatio personal to do the
n task,

Use proper tools,

Verify Radio
communication
condition

Pumping High Pressure, Personal II/B 1 Ensure that all II/D 3

injury, personnel adhering
Hi-Vis Contact with to Manual handling
eye/skin, Damage to procedure,
equipment,
Wrong tools Check validation
configuration, Environment date on lifting
al spillage, certificates and
Pressure fluid ensure available at
expose in CT burst loaction,
environment
during function Visually check lifting
test, gear,

Liquid spill, Barricade work

area,
Overhead
crane, Used competent

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 5 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

personal to do the
task,

Use proper PPE

(especially for
pumping crew),
Poor
Communicatio
Use proper tools,
n
Verify Radio
communication
condition,

Clear area under

suspended load
Monitor weight
indicator,

CT Weight CT failure run CT with low

drops because too speed at area with
CT tag at TD III/C 3 III/D 3
exceeding its much min restriction,
limit buckling
be aware to make
CT running weight
not exceed its limit

Ensure there’s no
Hydrocarbon leaking in
Personal
(condensate) connection of
injury,
to surface, flowback system,
Damaged
Check return Outburst III/C 3 Use gas detector, III/D 3
equipment,
because high
pressure fluid Use complete PPE,
Environment
return on top
al spill
of gas buster Avoid standby
nearby gas buster

Rig down all Trapped Personal II/B 1 Bleed of all II/D 3

equipment pressure, injury, pressurized line
Wrong lifting , Damage before
Drop object, equipment, disconnecting,
Pinch point, Tools Practice proper
Work at height, malfunction, lifting technique,
Lack of Delay of job, Use hard hat,
lighting, Environment Use glove,
Sleepy feeling al spill Use safety body
when rig down harness when

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 6 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

working at height,
Make sure enough
lighting when doing
rig down at night,
Ensure that all
personnel adhering
to Manual handling
procedure,
Clear area under
suspended load,
Check validation
date on lifting
certificates and
ensure available at
location,
Visually check lifting
gear,
Use safety platform
to disconnect CT
Connector to
minimise risk of
at night
personnel injury due
to falling/dropped
object,
Barricade work
area,
Use competent
personal to do the
task,
Use proper tools,
Use safety platform
to Disconnect Riser
to minimise risk of
personnel injury due
to falling/dropped
object,
Use safety harness
when working at
high,
Verify Radio
communication
condition

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 7 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

Job Title / Task: SAND CLEAN OUT

Remarks: JSA is to be reviewed and signed off by all personnel before performing the task.

STOP WORK AUTHORITY (SWA) Briefing to be Conducted with all Personnel before performing the
task.

NAME EMPLOYEE NUMBER DATE & SIGNATURE

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.
 Title:
Halliburton Management System
Job Safety Analysis (JSA) Form
FO-GL-HAL-HSE-0103F
Owner:
Region/Function: Category 1 - Standard 0103
Director, Global HSE
Global Health, Safety & Environment (HSE)
Standards & Performance
APPROVED BY: REVISED BY: REVISED: REV. NO.
Page 8 of 8
VP, HSE & SQ Ed Devol 16-Feb-2016 4

JOB SAFETY ANALYSIS MATRIX

Potential Consequences Probability Rating
Hazard Descriptive Personnel Equipment Environmental A B C D E F
Severity Word Illness/Injury Loss(s) Frequent Reasonably Occasional Remote Extremely Impossible
Category Probable Improbable

Fatality or Long term (5 years or greater)

I Catastrophic
Permanent
Disabling Injury or
Illness
>$1,000,000
environmental damage or
requiring $1,000,000 or more to
correct and/or in penalties
1
Medium length (1-5 years)
$200,000
II Critical
Severe Injury or
Illness
to
$1,000,000
environmental damage or
requiring $200,000 - $1,000,000)
to correct and / or in penalties
2
Short term (less than 1 year)
$10,000
III Marginal
Minor Injury or
Illness
to
$200,000
environmental damage or
requiring $10,000 - $200,000 to
correct and / or in penalties.
3
Minor environmental damage that
No Injury or can be readily repaired or
IV Negligible Illness
<$10,000
requiring less than $10,000 to
correct and / or in penalties
NOTE: the number 1, 2 and 3……. These numbers represent the “RISK PRIORITY CODE (RPC)”
Probability Rating Risk Priority Code (RPC) Target
Level Description: Code Action Required P Personnel
A FREQUENT: Likely to occur repeatedly during 1 HIGH RISK: Imperative to suppress risk to lower E Equipment
activity / operation level DT Downtime
B REASONABLE PROBABLE: Like to occur several 2 MEDIUM RISK: Operation may require waiver DC Data
times endorsed by management ENV Environmental
C OCCASIONAL: Likely to occur sometime 3 LOW RISK: Operation Permissible I Interface
D REMOTE: Not likely but possible
E EXTREMELY IMPROBABLE: Probability of NOTE: Risk Priority Code of less than 3 is NOT
occurrence cannot be distinguished from zero ACCEPTABLE for hazards that target
F IMPOSSBILE: Impossible to have contact with the personnel
hazard

Date Issued Rev. No. Summary of Key Revisions

DD-MM-YYYY 0 New document

02-APR-2015 3 Unknown

16-FEB-2016 4 Reviewed. No Updates

This guideline included examples of how the performance criteria can be completed, satisfying the objective.
This guideline is not mandatory, but is included as a guide to the user.