JOB SAFETY ASSESSMENT DOC. No.

Rev
Project Interfacing Facilities with New 115/13.8kV Substation JSA Reference No. JSA-JGC-04 00
Approved Method Statement 00
Contractor JGC Gulf International Co. Ltd.
Reference:
S-000-1610-013
Sub-Contractor Modern High Speed General Contracting EST. (MHS) Work location AL KHAFJI AREA (BESIDE KJO-PME TSF)
Description of
Activity /JSA Title
Temporary Facilities Works Area Classification GREEN FIELD  BROWNFIELD 
S.N
JSA Participants’ Name: Position Signature Contractor’s Review & Approval
o
1 Reviewed By
2
Name: Benjamin Abad
3 Contractor HSE Engineer:
4 Approved By

5
Name: Salman Turki
6 Contractor Project Manager:
Note: Contractor’s JSA participants team shall comprise of DISCIPLINE engineers, supervisors, and safety personnel
Hazards, Risks & Control Measures provided in this JSA shall be communicated to all personnel involved in this job execution and shall sign the communication sheet - (responsibility supervisor /foreman)
PCD PMT Review PCD Safety Review Area Authority Approval Verified & Issued By:

Name: Name: Name: Name:

Position: Position: Position: PCD Project Manager
Date: Date: Date: Date:

CHECK ( ) REQUIRED PPE, SAFETY EQUIPMENT, AND CONTROLS REQUIRED

Hard Hats  Welding gauntlets  Respirator  Signs  Life Jacket/Work Vest  Permit to Work 
Safety Glass /Goggles  Face Shield  Air Supplied Hood  Barricades  Life Rings  Gas Test 
Safety Shoes/Boots  Hearing Protection  SCBA  Fire Extinguishers  Other PPE (Specify)  CSE 
Safety gloves  Full Body Harness  Rescue Equipment  Spill Control  Disposable coverall  Isolation / LOTO 
Other Gloves (Leather/PVC)  Self Retracting Lifeline (SRL)  Air Blower fan  Gas tester (3 in one)  Rubber boots  Excavation/Road Closure. 

PCD JSA Format Issued on 05 October 2015


Sl. No.
RISK TO WHAT
JOB STEPS HAZARDS IDENTIFIED
P E
Preparation and handling of
1 tools and equipment prior to
 Sharp edges of tools and
start work. equipment that are not
easily spotted.
 Hot and humid weather
resulting to heat stress
and dehydration
 Improper lifting resulting
to ergonomic injuries.
INITIAL RISK RESIDUAL
ACTION
RISK CONTROLS RISK
L BY
(S) RATING RATING
A R R S L R
Job Supervisor
3 3 9  Provide guards to sharp edges 3 3 9
of all equipment.
PTW Receiver
 Secure appropriate work permit
prior to start of work (if
required).
 Tie barricade tapes provide
warning signs on sharp
materials to make it visible for
all employees present in the
worksite.
 Provide proper personal
protective equipment to all
employees assigned for the
activity.
 Basic Personal Protective
equipment shall comply with
KJO aside from other PPEs that
shall be use on a specific task.
Ensure all employees are Covid
19 vaccinated with at list one
booster shot. A single person
must only lift a maximum load of
25kg. Ensure LUP (Land use
permit) is applied and available
prior to mobilization
Job Supervisor
2 3 6  Provision of cool drinking water 2 3 6
and shaded rest place.
Supervisor shall monitor their PTW Receiver
work force by looking for signs
of dehydration.
 Maintain proper back posture Job Supervisor
2 3 6 2 2 4
and body position during
manual lifting of materials.
Position body where less effort PTW Receiver
is exerted and less strain
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
Manual handling of materials  Use correct lifting technique to Job Supervisor
2 3 3 9 1 2 2
 Frequent, forced or avoid any strain on the back; do
awkward movement of not lift a load if you doubt its
weight or adequacy of the PTW Receiver
the body
equipment.
 Ensure the load is resting on a
stable support before releasing
the load off the lifting
equipment.
 Ensure there are enough crew
members before lifting the load.
 Use the following technique
while lifting manually:
 Check for any obstructions
before lifting.
 Check out the area where the
load will be placed before lifting
the load.
 Place feet - apart, leruling leg
forward.
 Bend your legs and not your
back to lift any load.
 Keep a firm grip and keep load
as close to the body.
 Don't jerk or make any awkward
movements.
 Keep the load down and then
adjust as necessary.
 Use buddy system during lifting
or by any mechanical mean.
Use proper access and do not
do shortcut. Re phrase control
with- Ensure access are clear
from any obstruction to prevent
slip trips and fall during manual
lifting.

3 Loading and unloading of 4 3 12  Check wind velocity prior to 1 2 2 Job Supervisor

Temporary Facilities  Unstable grounds / lifting and ground stability for
strong winds. outriggers. Fully extend PTW
outriggers with wood matting Receiver
prior to lifting.
 Lift shall not be made in winds Rigger/crane
that exceeds that operator
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
manufacturer's
recommendation or in wind 20
MPH.
 Avoid swinging a load on a
working area Make sure that the
swinging area of the crane is
free of structures, equipment
and workers.
 Observed double check for long
loads to prevent slip.
 Use appropriate rigging
hardware
and chin blocks or pullers.
Inspect
and check for wear and tear
and
safe working load of all
equipment to be use.
 Loading and unloading the
temporary facilities is too
general. Identify what is to be
loaded and unloaded which
need the aid of mechanical
equipment. Include the following
on Hazards Identified; Damage
to nearby existing facilities,
Crane collapse/topple, personal
or severe injury. Re phrase
control; All lifts shall comply with
KJO Safe Working Practices
Manual. Lifts shall be
suspended with the wind speed
of 32 km/hr, 20 miles, 17.5
knots or 7 m/s. Include in
controls; Lifting equipments and
materials shall be third party
certified by KJO approved
certifying body. Crane operators
and riggers must be competent
and third party certified. Lifting
materials shall be periodically
inspected and color coded as
per KJO color coding scheme.
4 3 12  Avoid swinging a load on a 1 2 2 Job Supervisor
 Unsecured loads during working area Make sure that the
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
swinging area of the crane is PTW
lifting free of structures, equipment Receiver
and workers.
 Lift shall not be made in winds Rigger/crane
that exceeds that operator
manufacturer's
recommendation or in wind 20
MPH.
 Observed double check for long
loads to prevent slip.
 Use appropriate rigging
hardware
and chin blocks or pullers.
Inspect
and check for wear and tear
and
 safe working load of all
equipment to be use.
4 3 12  Avoid lifting a load that exceeds 1 2 2 Job Supervisor
 Poor crane lifting practices the capacity of the crane and
over reaching the load. PTW
 Avoid swinging ofloads on a Receiver
high speed manner. Use tag
lines to control loads. Rigger/crane
 Personnel are not allowed to operator
ride a load.
 Maintain constant
communication for all involved
personnel on the activity. Use
two-way radio if there are
obs1ructions between riggers
and operator which cause
difficulties in coordination.
 Crane's swinging radius must
be properly barricaded. Install
warning signs "Danger, Lifting
in Progress".
 Use required proper personal
protective equipment (PPB) like
FRC, gloves, safety glass,safety
shoes & hard hats as per KJO
requirements.
4 Excavation 3 3 9  Excavation plan indicating the 1 2 2 Job Supervisor
 Contact with existing size of excavation,
location,existing underground
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
facilities are made available at PTW
underground utilities the site prior to excavation. Receiver
such as cables,pipes  Underground hazards are
clearly marked with spray paint
or other highly visible
marker/s.
 Underground pipes/cables
exposed after excavation are
properly supported and
protected against physical
contact.
 Used of metal handled tools in
excavation where underground
utilities are present is strictly
prohibited.
 Equipment operators
possessed valid 3rd party
certificate on the construction
equipment they are operating.
 Cable detector must be use
prior to excavations.
Underground existing cables
must be highlighted at the
drawing after cable detection
has been done. Work shall be
carried out as per KJO
procedures on excavations.
Daily excavation checklist must
be filled up by site supervisor
with verification from the safety
officer. Excavation equipments
must be third party certified. Slit
trench and trial pit shall be
conducted prior to excavation.
3 3 9  Motor vehicles and mobile 1 2 2 Job Supervisor
 Cave-in / collapse of equipment are not permitted to
excavation wall park or operate closer on the PTW
excavated area. Receiver
 A spotter is assigned whenever
vehicles are working adjacent
to excavation.
 Vehicle operators working near
the excavation are informed on
the existing potential hazard
prior to his job.
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
 Excavations deeper that l .2m
is properly shored, benched or
sloped back to the natural angle
of repose.
 Maintain at least Im distance
from edge of excavations for
excavated materials.
 Physical barricades with
blinking lights and warning
signs reading "DANGER -
EXCA YA TION" are provided
at edges of excavation for
visibility during night time.
3 3 9  Cross-over bridges are provided 1 2 2 Job Supervisor
 Exvacation without for safe access of workers. It is
access passage in both constructed using sturdy planks PTW
sides. with handrails. Receiver
 Directional signs reading
"Access way" are provided on
both ends of the cross-over
bridge.
5 Electrical installation (e.g. 3 3 9  Ensure to provide proper 1 2 2 Job Supervisor
panels, cables)  Injury to personnel (fall working platform and access is
of personnelmaterial) if free from any obstruction. PTW
workingplatformsI  Wear approved PPE, i.e. FRC, Receiver
scaffold are not hard hat, safety shoes, safety
available. glass, hand gloves, etc.
 Maintain body position where
less strain is exerted.

3 3 9  Sufficient manpower under 1 2 2 Job Supervisor

 Distribution panel are proper supervision is required.
normally heavy, can fall  Divide the lad weight between PTW
and can be damaged. co-workers. Receiver
 Provide the required personal
protective equipment (PPE) to
all
employees assigned for the
activity.
3 3 9  Base of ladders shall be free 1 2 2 Job Supervisor
 Using unsecured ladder from gravels, oils, and other
for elevated. obstruction . Set ladders on PTW
permanent and stable ground. Receiver
 Assign one personnel to hold
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
the
ladder when in use to provide
additional support.
 Use proper personal protective
equipment.
 Ladders shall not be use in
horizontal position as platforms,
runways or scaffolds.
 Straight ladders shall be used at
an angle of75 degrees.
 Top rung of the A-type ladder is
not permitted to use.
 An extension of 36" to 42''from
the
landing or above the highest
rung
shall be observed in using
ladders.
 Top ladders shall be secured
while using.
3 3 9  Only qualified or trained 1 2 2 Job Supervisor
 Electrocution personnel will do the activity.
 Safety checklist requirements
for electrical on portable cabins
and steel container shall be
complied.
 All electrical tools must be
equipped with GFI. Power
outlet, junction boxes must be
provided with ELCB. Shall
Comply with KJO SWPM
electrical safety requirements.
6 Scaffolding (If needed to use 3 4 12  Scaffold construction shall 1 2 2 Job Supervisor
scaffold)  Personnel Fall. conform to client requirements.
 Conduct tool box talk prior to PTW
start of activity Receiver
 Use handrail when ascending
and descending from a ladder.
 All personnel who will be
working at height must be
trained and documented by the
main contractor. Scaffolders
must be 3rd party certified. Re
phrase full body harness with
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
(full body harness with twin
shock absorbing lanyard). Drop
zone shall be barricaded,
warning signs posted and a
standby man during scaffold
erection and dismantling. Re
phrase-Scaffolds shall be
regularly inspected every 14
days, tagged and recorded.
Working at height with more
than 1.8 meters requires the
use of full body harness with
twin absorbing landyard even
the scaffold is safe for use, or
any other structure which are
still under construction. Add to
hazard/re phrase; Fall of
personnel, Personal minor or
severe injury.
3 4 12  All personnel must wear full 1 2 2 Job Supervisor
 Falling Object. body harness while working at
height. PTW
 Never leave scaffold materials Receiver
left unsecured at height.
 Hand tools to be used at height
 shall be provided with retaining
string attached to the worker to
prevent from falling.
 All unnecessary materials and
tools must not be stored on
scaffold platform to prevent
overloading and from falling.
 Provide access ladder at every
25 feet apart or when
necessary.
 The scaffold must be inspected,
certified & tagged by the
competent person (Scaffold
Supervisor/Inspector).
 In case of any scaffold
modification, it has to be
reinspected & certified
 Ensure scaffold is securely
supported on a rigid ground to
prevent the scaffold from
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
sinking. Sand or made-up
ground shall be properly
compacted.
3 3 9  All scaffold components shall be 1 2 2 Job Supervisor
 Collapse of scaffolding of international standard and
shall be constructed in PTW
accordance with the client Receiver
requirements.
 Never overload the scaffold with
materials.
 The scaffold must be inspected,
certified & tagged by the
competent person.
7 Working at height (If 3 3 9  Qualified personnel to erect 1 2 2 Job Supervisor
required to work on elevated  Unsecured Platform scaffolding (standard) and
area). green tags must be attached. PTW
 Ensure availability of scaffold Receiver
platforms and ensure that they
are fit for purpose. (Working or
Load Bearing).
3 3 9  Do not overload platforms with 1 2 2 Job Supervisor
 Falling object. (tools personnel & equipment.
and materials)  Always use safe working PTW
platform and never walk on Receiver
erected structures.
 Check ladders are secured with
the correct angle.
 Ascending & descending on a
scaffolding platform shall be
done only by using the ladder.
 Check boards & guardrails are
secure and use fall protection if
necessary.
 Never alter any scaffolding, only
scaffolding crew is allowed to
make the necessary alterations.
 Use full body harness with
double lanyard and shock
absorber if three-point contact
cannot be maintained. Ensure
to secure the harness to the
anchor point area below the
under lift.
 All employees working on the
 INITIAL RISK RESIDUAL
Sl. No. ACTION
RISK TO WHAT RISK CONTROLS RISK
JOB STEPS HAZARDS IDENTIFIED L BY
(S) RATING RATING
P E A R R S L R
roof shall wear full body
harness with lifelines.
 Falls, slips, injuries and 3 3 9  Fixed type standard working 1 2 2 Job Supervisor
damage to properties platform shall be provided at the
edge of the roof to prevent any PTW
employee, materials from falling Receiver
on the ground.
 Safety shoes used shall be
durable and with good grip.
 All materials shall be secured.
 Only required quantity materials
 shall be placed on the working
 platform.
 Warning signs and barricades
shall be placed on the ground
level indicating that there are
employees working on the roof.
 Ladders used for access to the
roof, working platform shall be
secured and extended at least 1
meter above the landing place.
8 Reinstatement of Works &  Tripping Hazards 2 2 4  Tidy up area at each end of 1 1 1 Job Supervisor
Housekeeping. work shift. Maintain good
housekeeping. PTW Receiver
 Remove all debris from site
before and after activity as
minimum and maintain.
 Arrange all materials in it’s
designated location only,
grouped into types, uses, and
neatly stocked pile.
 Designate housekeeping crew
and equipment for collecting
and removing waste and
segregating different materials.

LEGEND: (P) – People: (E) – Environment: (A) – Asset: (R) – Reputation: (S) – Severe of Consequence: (L) - Likelihood of Occurrence
 Form No: OND-4200-02-02/1
RISK ASSESSMENT MATRIX

SEVERITY OF CONSEQUENCE (S) LIKELIHOOD of OCCURRENCE (L)

1 2 3 4 5
Scale No.
Severity

Environment (E) Unlikel

Reputation (R)
Personnel (P)

Very y Possibl Likely Very

Asset (A)
Unlikely (Could e (Probably Likely
(Only in occur at (Might occur in (Expected
exceptional some occur at normal in normal
circumstance future some time circumstance circumstan
s-0.01%) time – – 1%) s – 10%) ces-100%)
0.1%)
Insignificant injury Slight
Slight Slight
1 or health effect (Less than 1 2 3 4 5
(<5K) (local)
(First Aid Case) 10barrels)
Minor
Minor injury or
Minor (< $5K
health effect Limited
2 (10 to 25 but less 2 4 6 8 10
(Medical Treatment (provincial)
barrels) than
Case)
$100K)
Medium Medium
Moderate injury or
(Localized) (<$100K
health effect Considerabl
3 (>25 but less 3 6 9 12 15
(Restricted Duty e (Regional)
but<2,500 than
Case)
barrels) $1M)
Major
Major
Major injury or ($1M or
(2,500 barrels
4 health effect (Lost more but National 4 8 12 16 20
but <5,000
Time Incident) less than
barrels)
$10M)
Catastrophic injury
Massive Extensiv
or health effect
5 (>5,000 e International 5 10 15 20 25
(Single/Multiple
barrels) (>$10M)
Fatality)

SEVERITY OF CONSEQUENCE (S) X LIKELIHOOD of OCCURRENCE (L) = RISK RATING (R)

May be acceptable, however, review task to see if risk can be reduced

1-6 LOW SEVERITY
further.
Task should only proceed with appropriate management authorization after
MEDIUM consultation with specialist personnel and assessment team; Where
7 - 14
SEVERITY possible, the job should be redefined to take account of the hazards involved
or the risk should be reduced further prior starting the job.

Task must not proceed. It should be redefined, or further control measures

15 – 25 HIGH SEVERITY put in place to reduce risk. The control should be re-assessed for adequacy
prior to starting the job.

JOB SAFETY ANALYSIS – COMMUNICATION SHEET

JSA Title Temporary Facilities Works
JSA Number 04
Job Supervisor
Job Start Date

Personnel involved in the job execution

S.No. Name Position Company Signature