PROCESS SAFETY MANAGEMENT SYSTEM Doc No: PSM/FR/9.9B
Ref Doc : PSM/PR/9 WORK PERMIT SYSTEM Rev. : 1 FORMATS Date of this Rev : January, 2013 Page 1 of 1 JOB HAZARD ANALYSIS
DIVISION/ DEPT NAME Maintenance / Onsite
PROJECT/ WORK REQUISITION Excavation TITLE PROJECT/ REQUISITION NO JOB DESCRIPTION Excavation ACTIVITY ACTIVITY IDENTIFIED HAZARDS CONTROL/ MITIGATION TYPE OF NO. DESCRIPTION MEASURES PERMIT REQUIRED Chipping at job area Striking of live electrical wires at the Electrical clearance to be taken prior to Cold A1 area may cause harm to workers start of job. Electrical to sign on permit. Working inside Slippage of loose sand/mud from walls Shoring to be compulsorily provided for A2 Cold excavated pit of pit may bury workers pits more than 1.2 mts in depth Working inside Loose sand inside pit may cause Gum boots usage is mandatory A3 excavated pit slippage to workers Chipping with crowbar may hit live Insulated crowbars to be used. Chipping inside A4 electrical wires resulting in harm of excavated pit workers Sign Prepared By Name Designation Executing Supervisor Sign Approved By Name Designation Executing Manager