JOB SAFETY ANALYSIS

(JSA)
 Risk Matrix and Categorization

Like liho o d/Pro bability

Risk Matrix Result Risk

1 Rating 2 Minimum Management Response
3 4 Impact/Consequence
5

Rare Unlike ly Po s s ib le Like ly Health

Alm o sand
t CeSafety
rtain
Risk deemed unacceptable. Immediate intervention required from Senior Managem ent to
15 to 25 Extreme Risk
eliminate or reduce risk by the introduction of additional control measures.
Onc e P e r 1 ye a rs Onc e pe r m onth
Environment
Continuous ly oc c urs
Onc e pe r 10 Ye a rs
or Unlike ly to oc c ur or Could oc c ur througho ut the da y
Co ns e q ue nc e
or P ra c tic a lly Im pos s ible Management
or Ha s ocplanning
c urre drequired to eliminate
e ls e whe re or or
Hareduce
s oc crisk to adlower
urre e ls elevel
whebyrethe
Onc e pe r we e k or Financial
Will oc c ur or
or Conc e iva ble , but only in Like ly to oc c ur
9 to 12 e xtre m e c ircHigh
um sRisk
ta nc e s introduction
in Mining of additional
Indus control mlaeasures
try within s t in where practicable
the Mining and try
indus montioring
in the Com m on or fre que nt
Damage and Loss
1 ye a rs la s t m on th oc c urre nc e
effectiveness of existing controls.

5 Catas5tro
5 Supervisor attention
10needed. Monitor effectiveness of existing
15 controls and determine 20 Legal Compliance
25
to p
8 hic Moderate
(Mo d e rate ) Risk (Hig h) practicable.. (Extre me ) (Extre me ) (Extre me )
corrective actions where
Reputation

1 to r4 4Low Risk 8 level. Monitor effectiveness of existing

Risk at an acceptable 12controls. 16 20
4 Majo
(Lo w ) (Mo d e rate ) (Hig h) (Extre me ) (Extre me )

3 Mo d eConsequence
rate
3 Immediate and on-going
6 intervention is required from Senior9 management to ensure 12 15
= Catastrophic
(Lo w ) (Mo d e rate ) (Hig h) (Hig h) (Extre me )
control measures are adequate, irrespective of Probability/Likelihood

2 4 6 8 10
2 Mino r
(Lo w ) (Lo w ) (Mo d e rate ) (Mo d e rate ) (Hig h)

1 2 3 4 5
1 Ins ig nific ant
(Lo w ) (Lo w ) (Lo w ) (Lo w ) (Mo d e rate )

Risk Rating Categories:

Hierarchy of Control

1. ELIMINATION
2. ISOLATION Date
3. SUBSTITUTION Dewatering Pipeline Project South, North Prepared:
Work Area: Contractor / Department: UMT/P&P Expire Date:
4. ENGINEERING Series
Review Date:
5. ADMINISTATION
Task/Activity:
6. PPE Hydro Test of Pipeline

JSA prepared by: Israr Ahmed

Type of Work Permit Required: Mandatory PPE Requirements: Tools or Equipment Required
(Indicate by marking box)
(Please enlist) (Consider such things as grinders, compressed
gas cylinders, air compressor, gas detector etc.)
None Electrical
Hot Work Excavation
 JOB SAFETY ANALYSIS (JSA) JSA #:

Lifting Instructions Cold

andWork
Application
Confined Space
Instructions: Hazardous Materials Fire / Emergency Equipment
Summary of Potential Hazards (List any hazardous materials to be used and Requirements
The Job Safety Analysis (JSA) may be either:
(See JSA Control Recommendations) attach a MSDS) (Consider fire extinguishers, Tripod, and
 Initiated for critical non-routine activities in conjunction with the permit to work protocol; or
other rescue equipment)
 Required where no other specific process or document is available to manage and control an identified hazard; or
Atmospheric Contaminant Fire/Explosion
 Required as specified in, or to support, the development of a Standard Work Instruction; or
Air Pollution
 When identified as required asHazardous Chemicals
part of completing a Risk Assessment
Biological
 JSA is valid for 7 days and can Manual
be extended for 7 days only
Handling/Ergonomics
 JSA shall be discussed with all involved workers and other individuals who can affect during the activity
Biodiversity (flora, fauna,
habitat)
Application: Noise
Tasks that require a JSA will be analyzed in accordance with the following criteria:
Electricity Pressure
 Identify the task step by step in the sequence that the work will be undertaken
Crushed/Caught
 List the between Radiation
hazards that may reasonably be expected to be associated with those task steps
 List the actions to be taken toRelease
Engulfment remove,(Gas)
reduce or effectively control exposure to the hazard
 Assess the risk of the activity with all required controls effectively implemented; and
Entanglement Slip/fall
 For each required action or control, identify the name of the person responsible for completing that action.
Others ______________

JSA SUMMARY
STEP JOB STEP POTENTIAL HAZARDS Current Controls CURRENT REQUIRED HAZARD RESIDUAL
NO RISK CONTROL RISK
List the steps Against each step list the potential All those controls which are
SCORE SCORE
required to hazards that could cause currently implemented and in-place For each hazard identified list
perform the task in injury/damage when the task step the control measures required
the sequence they is performed. to eliminate or minimize the
are carried out. risk of injury.
 Non Compliance with • Obtain Cold Work Permit & other
SECMC and Facility’s HSE associated permits
MS Procedures
1 Planning • Conduct tool box talk. L-3
 Unauthorized Personnel • Barricade the area where hydro-
test is to be carried out

STEP JOB STEP
NO
List the steps required to Against each step list the potential
perform the task in the
sequence they are injury/damage when the task step
carried out.
Hydro-test preparation
2 L-3
(water filling)
3 Hydro-Testing Activity
JOB SAFETY ANALYSIS (JSA) JSA #:
POTENTIAL HAZARDS Current Controls CURRENT REQUIRED HAZARD RESIDUAL
RISK CONTROL RISK
All those controls which are
SCORE SCORE
hazards that could cause currently implemented and in-place For each hazard identified list
the control measures required
is performed. to eliminate or minimize the
risk of injury.
• Post warning signs
• Ensure the equipment/tool to be • All equipment, pressure
 Defective used for hydro-testing (such as gauges, HT pump, generator,
hose, pump, coupling, pressure L-3
Tool/Equipment’s Electrical DB should be
gauge, spade, gasket etc.) are free inspected and tagged.
from defect and suitable for the
pressure rating of the system.
• Persons supervising
pressure/leak tests must be trained,
competent and qualified.
• Testing should be carried out
 Unsafe Practice under PTW, which is required for
each test or at least a test package Site Manager/Site
 Pinch Point for the same location. Supervisor & HSE
• Ensure the equipment tested by
the competent person, prior to
testing.
• Avoid Pinch point activity.
Properly signage at place.
 Failure of • Rating of line/gasket/flange
line/gasket/flange should be suitable for hydro-test.
 Air entrapment inside • Test spade/test blind should be as
pipeline per line rating.
Site Manager/Site
• Gradually filling of water. L-4
Supervisor & HSE
 Suddenly increase of • Pressure should be raised
pressure gradually.
 PSV failure • All hoses/gasket is with line rating.
 JOB SAFETY ANALYSIS (JSA) JSA #:

STEP JOB STEP POTENTIAL HAZARDS Current Controls CURRENT REQUIRED HAZARD RESIDUAL
NO RISK CONTROL RISK
List the steps required to Against each step list the potential All those controls which are
SCORE SCORE
perform the task in the hazards that could cause currently implemented and in-place For each hazard identified list
sequence they are injury/damage when the task step the control measures required
carried out. is performed. to eliminate or minimize the
risk of injury.
• Calibrated PSV should be
attached.
• Ensure to use allowable pressure
of HT pump.
 Air hoses & Pneumatic tool • Use Ear Plug for Noise.
failure. • Access to the test area must be
limited to essential personnel only,
 High intensity sound. barriers, warning signs, patrolling
the test boundaries.
 Contact with equipment • Persons supervising
High pressure pressure/leak tests must be trained,
competent and qualified.
 Exceeding max allowable Site Manager/Site
pressure. • Pressuring equipment should not L-4
Supervisor & HSE
be left unattended at any time
 Un-attended pressurized during the test.
tool/equipment. • When the test pressure has been
reached, the pressuring equipment
 Changing the duration of shall be isolated from the equipment
hydro-test. under test and where performable
disconnected.
 Unsafe depressurization of • Ensure the equipment tested by
hydro-test fluid the competent person, prior to
testing.
 JOB SAFETY ANALYSIS (JSA) JSA #:

STEP JOB STEP POTENTIAL HAZARDS Current Controls CURRENT REQUIRED HAZARD RESIDUAL
NO RISK CONTROL RISK
List the steps required to Against each step list the potential All those controls which are
SCORE SCORE
perform the task in the hazards that could cause currently implemented and in-place For each hazard identified list
sequence they are injury/damage when the task step the control measures required
carried out. is performed. to eliminate or minimize the
risk of injury.
• Close examination of equipment
at above maximum allowable
working pressure shall not take
place until the pressure has been
held for 30 min.
• Support of piping and equipment
exposed to the hydro-test should
have proper strength. Site Manager/Site
L-4
• Should have vent points at high Supervisor & HSE
position.
• Make sure no air trapped in line.
• Vent valves will be open after
pressure release.
• Never stand in front of the
pressure gauge during test. (Use
Face shield also)

• Ensure proper windup and

4 Windup & Housekeeping
housekeeping at worksite.
Scattered Material • The accessories (hoses & pump) L-3
Site Manager/Site
not being used must be Supervisor & HSE
disconnected and stored separately.
 JOB SAFETY ANALYSIS (JSA) JSA #:

REVIEW & APPROVAL

Obtain a cold work permit and
Initial JSA
Name Signature Date
Prepared by:
other associated permits
Reviewed by
Area Owner (DM Name Signature Date
SECMC):
Reviewed by
SECMC HSE Name Signature Date
(Manager/ DM):
Approved by:
Name Signature Date
Department Head

Extension
Reviewed by
Area Owner (DM Name Signature Date
SECMC):
Reviewed by
SECMC HSE Name Signature Date
(Manager/ DM):
Approved by:
Department Name Signature Date
Manager:

NOTES:
1. Any additional controls or changes to controls following a change to scope or other “trigger” event shall be updated in the relevant section or on an additional sheet and
the workgroup consulted. Trigger events can be considered as:
a. Change to workplace;
b. Change to workplace environment;
c. Change to workplace conditions;
d. Change to Plant, People or Procedures; or
e. Following an event / incident / near miss that has occurred whilst applying the existing JSA controls.

I hereby confirm I have read, understand, and agree to comply with this JSA.
 JOB SAFETY ANALYSIS (JSA) JSA #:

SIGNATURE SIGNATURE
EMPLOYEE NAME DATE EMPLOYEE NAME DATE

Area Representative Signature:

 JSA CONTROL RECOMMENDATIONS
Potential hazard Check questions
Will there be any air pollutants generated?
Gas, Dust, Fumes
Are there any fire alarms nearby that may be set off?
Noise Will you need to shout to be heard?
Can something be spilt or overflow?
Spills
If so, can harm happen to people, area or plant?
Electrical Is there live equipment in the area?
Mechanical Is there any crush points or moving parts?
Are there any hazardous chemicals in the area?
Chemical
Will you be handling any chemicals?
Bodies of Water Can someone or something fall / drive into a body of water?
Will the work involve lifting, carrying, pushing, pulling?
Manual handling
Will the work be in an awkward position?
Hot Work Will the work involve cutting, welding or sparks?
Can someone be struck by a dropped tool or materials?
Work at Height
Have all those involved been trained & considered competent?
Recommended control measure
- provide ventilation away from workers and restrict access
- disconnect and arrange additional warning devices
- move work away or provide hearing protection
- control flows or re-route flows
- erect bunds or barricade the area
- isolate or barricade hazard
- isolate or barricade hazard
- move work away from hazard
- isolate or minimize exposure times
- attach MSDS and wear PPE
- restrict access to work area / isolate / barricade hazard
- provide standby person at all times & conduct activity with PFD
- reduce heavy loads, use lifting teams or mechanical means
- reduce working times and share duties
- restrict access and place protective guards
- determine if a “permit to work” is needed
- ensure the area has been delineated and use lanyards on all tools
- use fall restraint as first choice