Method Statement Submittal Form

TRS-CN-FRM-0019

General Information
R08-HE4-C20-3050-Shura
Project Name Shura Hotel (HE4) Project Code
Hotel (HE4)
Submittal No. R08-HE04-C20-3050-TSR-MS-C-03 Date 8-Dec-22
Contract No. R08-HE4-C20 Shura Hotel (HE4)
Contract Description Concrete Package

Contractor
Contractor Name TAMEAR Subject MS - Blinding Concrete
Specification No. 031000 & 033000 Drawing Ref. NA
Discipline Civil Other (please specify) NA
Planned Date of Work 15-Dec-22 Submitted For: ☒ Approval ☐ Information
Contractor Authorized Representative

Ali Maarouf 8-Dec-22

Name Signature Date

Design Consultant - Comments

Comments:

Name Signature Date

Engineer’s - Comments
Comments:

Name Signature Date

Status Code

☐ Accepted ☐ Accepted with Comments ☐ Revise and Resubmit

☐ Rejected ☐ Review not Required

Method Statement Submittal Form (TRS-CN-FRM-0019)

Revision 00, Rev. Date 05-May-2019 Page 1 of 1
 Method Statement

BLINDING CONCRETE
Prepared for

Project

R08-HE4C20 Shura Hotel (HE4)

Concrete Package Project

Method Statement No. TSR-MS-C-03, C0

 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

REVISION HISTORY

Prepared by
Reviewed by Reviewed by
REV. Date Description Construction
QA/QC Manager Project Manager
Manager
08 Dec. Mohamed
C0 For Approval Mohamed Gad Ali Maarouf
2022 AlTaweel

TSR-MS-C-03, C0 Page 2 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

REVISION RECORD

Rev Date Description for Modification Remarks

C0 5 Dec. 2022 Initial Release

TSR-MS-C-03, C0 Page 3 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

TABLE OF CONTENTS

SEC. DESCRIPTION

COVER PAGE
REVISION HISTORY
TABLE OF CONTENTS
1. SCOPE OF WORK
2. PURPOSE
3. ACRONYMS & ABBREVIATIONS
4. REFERENCES
5. RESPONSIBILITIES
6. MANPOWER / EQUIPMENT / MATERIAL
7. METHODOLOGY
8. QHSE PROCEDURE
9. ATTACHMENTS

TSR-MS-C-03, C0 Page 4 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

1. SCOPE OF WORK

The scope of this method statement is to define all the procedures and inspections to be followed
during Blinding Concrete Works in TAMEAR construction site according to Approved Drawings and
TRS Requirements at Shura Hotel (HE4) – Concrete Package. This work includes all the activities
pertaining to the execution of Blinding Concrete that includes surface preparation, erection of
formwork, placement and finishing of the blinding concrete.

2. PURPOSE

The purpose of this method statement is to describe the methods to be implemented and the
resources to be utilized for Blinding Concrete Works and procedure to be followed during the activity
at the mentioned project.
Moreover, to ensure that all the required resources are provided to carry out the activity as stipulated
in the TRS Requirements. All works will be in accordance and conformance to TRS / ATKINS
surveillance, witness, and approval.

3. ACRONYMS & ABBREVIATIONS

· TRS – The Red Sea Development Company.

· TSR – TAMEAR.
· ATKINS – Supervision ATKINS.
· ACES – Testing Laboratory.
· HSE – Health safety & Environment.
· JSA – Job Safety Analysis.
· MSDS - Material Safety Data Sheet.
· PPE – Personal protective Equipment.
· QHSE – Quality, Health, Safety & Environment.
· ITP – Inspection & Test Plan.

4. REFERENCES

· TRS Employer’s Requirements.

· Project Quality Management Plan.
· Project Health & Safety Management Plan.
· Approved Mix Designs.
· Project Specification 033000.

TSR-MS-C-03, C0 Page 5 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

· ACI 347.
· ASTM C94.
· Approved Drawings.

4.1 PERMITS

Work permits shall be issued as per attached Job Safety Analysis and Safety considerations.

5. RESPONSIBILITIES

5.1.Project Manager

· Ensures that the content of this method statement is understood and implemented at all
times.
· Coordinate with the Construction Manager to ensure that the necessary resources to
implement the approved Method Statement have been allocated to the task.
· Determine all the requirements needed in order to comply with quality and safety standards
and regulations as required.
· The Project Manager is responsible to appoint site supervisory personnel to organize,
coordinate, and oversee the execution of the work detailed in this method statement.

5.2.Construction Manager

· Responsible for the organization and coordination of the work detailed in this method
statement.
· Responsible to provide all resources (Manpower, Materials, and Equipment…etc.) to the site
required to execute the job.

5.3.QA/QC Engineer

· Responsible to assist/advise the construction team to ensure all works comply with specified
requirements.
· Ensure that the materials being delivered and used are in accordance with the project
specifications and approved material submittals.
· Ensure that all related instruments used to put levels for the concrete have valid calibration
date, and the activity is carried out as per approved ITP.
· Hold inspections to verify work is implemented properly prior to TRS inspection.

TSR-MS-C-03, C0 Page 6 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

· Responsible for the inspection, preparation of all documents and compiling them for the
inclusion in the final documentation packaged.

5.4.Site Engineer

· Shall be directly involved in the planning and execution of the activities contain formwork and
concrete pouring.
· Monitor and coordinate activities of concrete pouring to ensure compliance with quality,
schedule, and sequence requirements.
· Coordinate inspection requests to QC Engineer.
· Ensure that all relevant inspections are completed and approved.
· Ensure that release for concrete pouring is secured.
· Arrange with the batch plant in-charge for the location required for concrete pouring, timing,
quantity, and specifications.

5.5.Site Foreman

· Responsible for day-to-day construction activity at site.

· Ensure works carried out correctly and in a safe manner.
· Acts as direct link between site engineer and workers.
· Arrange all construction material to be available on time at site.

5.6.Site Land Surveyor

· Setting out lines and grades for the installation of shuttering.

· Verifying bottom of concrete prior to placements.
· Establishing the top of concrete elevations.

5.7.HSE Manager

· HSE Manager is responsible to establish and implement an effective HSE management

system in accordance with TRS HSE requirements.
· Ensures the HSE management system requirements are implemented and maintained.
· Coordinates with the Site HSE team and the Construction Management team to ensure
effective implementation of the HSE Procedures.
· Assist risk assessment team to formulate Method Statement and JSA for specific
construction activities.

TSR-MS-C-03, C0 Page 7 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

· He may lead the entire team, maintaining HSE awareness and to create safe culture and
working environment through innovative ideas.
· Planning and coordinating the HSE Trainings for the project.
· Issue necessary directives to Safety Officer / Supervisor and render advice to the Project
Manager, as required.
· Prepare and submit HSE reports to, TRS's / TRS Safety Executives whenever required.
· Carryout HSE inspections at construction sites with reference to all HSE issues
· Liaise with TRS and ATKINSs HSE Departments.
· Take part in incident investigation and reporting of all Incidents.
· Take part / attend in TRS's HSE meetings.
· Monitor and assess HSE measures on visits to sites.

5.8.HSE Officer

· He will ensure that all the activities related to the specified task followed safely and all
workers are wearing PPE.
· Identify hazards and take measure control those hazards and follow JSA/risk assessment.
· He is responsible for monitoring and assessing hazardous and unsafe condition / situations.
· Developing measures to assure personnel safety.
· Correct unsafe acts or conditions through the regular line of authority.
· May exercise authority to prevent or stop unsafe acts when immediate action is required.
· Participate in planning meetings to identify any health and safety concerns inherent in the
operations daily work-plan.
· Inspects the site to ensure it is a hazard-free environment.
· Conduct toolbox meetings.
· Verify that all tools and equipment are adequate and safe for use.
· Promote safe practices at the job site.
· Enforce safety guidelines.
· Trains and carries out drills and exercises on how to manage emergencies.
· Watches out for the safety of all workers and works to protect them from entering
hazardous situations.
· Respond to employees’ safety concerns.
· Advise and instruct on various safety-related topics (noise levels, use of machinery etc.).
· Conduct risk assessment and enforce preventative measures.
· Initiate and organize OHS training of employees and executives.
· Inspect premises and the work of personnel to identify issues or non-conformity (e.g., not
using protective equipment)

TSR-MS-C-03, C0 Page 8 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

· Stop any unsafe acts or processes that seem dangerous or unhealthy.

· Prepare reports on occurrences and provide statistical information to HSE Manager.
· Carry out PTW Monitoring and review.

5.9.Laboratory Technician

· Conduct all concrete tests (Slump & Temperature).

· Report to PQM for any issues about testing.

6. MANPOWER, EQUIPMENT AND MATERIALS

6.1.Manpower

1. Land Surveyors.
2. Assistant Surveyor.
3. Site Engineer.
4. Site Foreman (Civil).
5. QC Engineer.
6. Laboratory Technician.
7. Equipment Operator.
8. Safety Personnel.
9. Labor.

6.2.Equipment

1. Vibrator.
2. Total Stations.
3. Auto Levels.
4. Concrete Pump.
5. Concrete Mixer Truck.
6. Hand Tools.
7. Tower Lights (in case of night work).
8. Testing Equipment for Concrete Slump & Temperature.

6.3.Materials

1. Blinding Concrete (approved mix designs).

TSR-MS-C-03, C0 Page 9 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

2. Polyethylene Sheet (Vapor Barrier).

3. Curing Compound.

7. METHODOLOGY

7.1. Ordering

· Once the initial requirement of concrete has been assessed by site engineer, a preliminary order
will be sent to the batchplant production engineer with all necessary information including the
mix design.
· The order will state the date required, approximate start time, approximate quantity and pour
location. These will be recorded on the batch plant daily shipping sheet.

7.2.Mixing & Transporting

· The concrete will be batch mixed in accordance with the relevant approved mix design and
requirement of TRS specifications.
· Once the first truck mixer has departed and dependent on the requested delivery rate, the batch
plant foreman will decide as per the given time interval on the start time for the batching of the
subsequent loads of concrete to commence, unless otherwise instructed by TSR site engineer.
· Once the mixer arrives at site / designated testing area, QC Engineer will ensure that the
concrete of the correct specifications has been delivered.
· Concrete slump and temperature must be recorded on ACES record sheet.
· Rejected concrete shall be taken out of site and disposed of as per local laws and regulations.

7.3.General

· The area to receive the blinding concrete shall be well compacted and field density should not be
less than the required percent as per Specification for Earthwork specifications.
· Site engineer shall ensure the termite control is applied and protected with polyethylene sheets
as indicated on drawings.
· All benchmarks and control points shall be properly established and secured throughout the
entire duration of works.
· Based on these established data, control points Surveyor with the supervision of Site Engineer
shall locate the exact coordinates of the area for Blinding Concrete base on the approved
drawings.
· For verification of coordinates, TSR shall raise WIR to ATKINS.

TSR-MS-C-03, C0 Page 10 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

· Prior to the placing of blinding concrete, Site Engineer & QC Engineer must ensure that the area
to receive the concrete is clean and free from foreign matters.

7.4.Formwork

· Prior to the placing of concrete, the Site Engineer & QC Engineer must ensure that the forms are
clean and placed in accordance with relevant approved drawings.
· Surveyor should set the location of formwork as per drawings.
· Surveyor shall mark the level for top of concrete on the formwork.

7.5.Placement of Blinding Concrete

· The concrete mixer must be stopped at the designated testing area for inspection of slump and
to obtain samples of concrete testing specimens for compressive strength.
· Cast the concrete within 90 minutes (ASTM C94 Clause 11.7) from the batch plant loading time.
Expired concrete will not be used.
· Concrete will be placed at its locations by direct pouring or concrete pump depending on the
access and as decided by TSR Site Engineer.
· Allowable drop height of concrete is 1.0 m.
· The thickness of blinding concrete shall be as per approved drawing.
· The blinding concrete shall be protected from external damages once the placement is finished.
· The placed blinding concrete shall be levelled properly to achieve neat and smooth finish.
· Curing of Blinding Concrete will be by water or by approved curing compound.

8. QHSE PROCEDURE

8.1.QUALITY

8.1.1. General

· All works will be undertaken in compliance with the quality requirements of the Contract, and the
Quality Management Plan.
· Site inspections will be based on approved ITPs and approved drawings.

8.2.SAFETY

· All personnel to join safety induction prior to commencement of site.

TSR-MS-C-03, C0 Page 11 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

· Conduct toolbox talk on routine basis.

· Complete Safety Task Assignment (STA) by using TRS Form (TRS-HS-FRM-0002) by the activity
foreman along with his team before to start of work.
· Hazards with regards to the activity and around to be communicated to personnel working at site
· Safety officers to ensure safe condition of the workplaces.
· Foreman / supervisor must ensure to rectify all observations indicated by the safety officer/s,
personnel working at site and or observed by anybody.
· Foreman /Supervisor always ensure safe working condition, hazard identification and control
measure implementation.
· Ensure to have all required Works permits before to start activity.
· All hand tools and power tools will inspect before to use and will be color-coded.
· Safety officers will be available in the work area until the work is completed.
· PPE will be provided and all personnel at site must wear at all times.
· Method statements, STA, JSA for all steps of activities to be in place and discussed with workers.
· Suitable access roads for equipment shall be provided by TSR.
· Banks man shall be deployed with the Equipment’s during heavy equipment movement.
· Equipment/operators licenses and equipment daily check reports and verified.
· Follow site speed limit, instructions, and warning signs.
· All engine powered mobile plant and equipment shall be equipped with an audible reversing
alarm device will have 360° vision available.
· All equipment shall hold suitable fire extinguisher.
· The responsible supervisor will periodically check the condition of the barriers, and where
necessary refurbishment will be conducted.
· It will ensure the personnel engage on the activity will have relevant experience, further
refresher trainings will be conducted on site at routine basis.
· Emergency response team for any emergency at site will be available further emergency contact
numbers will be displayed at various locations and also TRS given emergency number will be
maintained and display at site.
· If there will need to carry out work after normal hours, it shall ensure to comply and follow TRS
Extended Hours, Night Work and Holiday Work Control (TRS-HS-COS-0015) permit system.
· All hazardous waste shall be collected in separate bins; it will be disposed separately through TRS
& GAMEP approved contractor. Record of all waste disposal will be maintained and avail for any
future reference.

8.2.1 Environmental Policy Implementation

TSR-MS-C-03, C0 Page 12 of 13
 METHOD STATEMENT
BLINDING CONCRETE
PROJECT NAME: Shura Hotel (HE4) – Concrete Package

CONTRACT NO: R08-HE4C20

It is important that everyone involved in the project is aware of the environmental policy and
environmental plan and bound by their requirements. Approved documents should make clear the extent
and standard of environmental performance and assessment that is required as well as requirements for
monitoring and reporting. These requirements need to be cascaded down throughout the entire Project
management.

9. ATTACHMENTS

· ITP & Checklist.

· Job Safety Analysis.

TSR-MS-C-03, C0 Page 13 of 13
 APPROVED
INSPECTION & TEST PLAN ITP NO
DATE
DISCIPLINE:

BLINDING CONCRETE TSR-TRSDC-ITP-03 CIVIL

PROJECT TITLE: CONTRACTOR/SUBCONTRACTOR

R08-HE4C20 Shura Hotel (HE4) TAMEAR

INSPECTION RESPONSIBILITY
ITEM PROJECT PHASE & ASSIGNMENTS
TASK / ACTIVITY REMARKS
NO. ACTIVITY CODE
TSR TRS ATKINS

1.0 DOCUMENT REVIEW

KCC - "RH" of Documents and "H" for Material

Raw Materials Sampling, Testing and Sampling and Testing.
1.1
Concrete Mix Design Approval
RH/ H RH/ H RH/ H TRSDC/Consultanats- "RH" of Documents and "H"
for Material Sampling and Testing.

MATERIAL
2.0
RECEIVING

2.1 Concrete, Polythylene Sheet H W W

3.0 INSTALLATION

Blinding Concrete concrete Formwork

3.1
Inspection
I W W

Blinding Concrete Sampling, Testing

3.2
& Placement Inspection
I W W TSR to Provide Applicable MEP clearance

3.3 Concrete finishing & curing Inspection W S S

PRE-
4.0
COMMISSIONING

4.1 Not Applicable

GENERAL NOTES

The first three incidents of each Inspection or testing activity listed require 100 % participation by TRS/Consultant Site Inspection Personnel. After this
1 period, TRS/Consultant Inspection may adjust the levels of TRS/Consultant participation based upon the Contractor’s performance.

2 Surveillance: QA/QC organization to monitor work in progress without notice from Construction Organization
Witness: QA/QC organization shall be notified of the timing of Inspection or test in advance. However, the inspection or test shall be performed as
3 scheduled if the QA/QC organization representative is not present.
Hold: QA/QC organization shall be notified of the timing of inspection or test in advance. Inspection or test shall not be carried out without the QA/QC
4 organization representative in attendance.

5 If TSR delegates the assigned responsibility to the Subcontractor, then the TMR will have the same degree of responsibility as assigned to TRSDC.

LEGEND
H Hold Point for QC Inspection/ Test R Review of Documents
W Witness Inspection/Test RH Review and Approval of Documents
S Surveillance I 100% contractor's Inspection

Page 1 of 1
CHECKLIST Checklist No. Approved Date WIR NUMBER

Blinding Concrete TSR-TRSDC-IC-03 CIVIL-

PROJECT TITLE CONTRACTOR / SUBCONTRACTOR
R08-HE4C20 Shura Hotel (HE4) TAMEAR
LOCATION

LAYOUT DRAWING NUMBER REV. NO. PURCHASE ORDER NUMBER

SCHEDULED INSPECTION DATE & TIME ACTUAL INSPECTION DATE & TIME QUANTITY INSP.

ACCEPTED
REJECTED

No. ACCEPTANCE CRITERIA REFERENCES PASS FAIL N/A Comments

A General

A1 Surveyor shall set out the points for the location of work area Approved Drawing

Layout and leveling shall be done in accordance with the approved

A2 Approved Drawing
drawings.
Method statement &
A3 Polyethylene sheet is installed after termite control
Specification 313116

B Formwork Inspection

B1 Dimension (Shape, Position & Level ) Specification 031000

B2 Visual check of Strength and Stability Specification 031000

B3 Visual Check of Form tie Specification 031000

B4 Visual Check of Coating for release agent Specification 031000

C Concrete Placement Inspection

The Concrete received on site should be of same grade and properties
C1 Specification 033000
as approved in mix design.
Discharge of the concrete shall be completed within 90 minutes from
C1 ASTM C94 section 11.7
batching time.
All concrete arriving at site is received by QC Engineer and 3rd party
C2 technician for slump and temperature testing before proceeding for PQP
placement.
The thickness & top level of blinding concrete shall be as per approved
C3 Approved Drawing
drawing

C4 Workmanship to obtain proper vibration and efficient curing Specification 033000

C4 Highest freely drop height for concrete not more than 1.0 m Method statement

REMARKS:

REFERENCE DOCUMENTS:
ASTM
Approved Drawing
Specification for Cast in Place Concrete

TSR / Third-Party TRS / ATKINS

Construction Representative*
Name, Initials and Date:
PMT Construction Representative
QC Record Reviewed Work Verified
Name, Initials and
Work is Complete and Ready for Inspection:
Date:

QC Engineer TRS / ATKINS Engineer

Performed
Work / Rework May Proceed QC Record Reviewed Work Verified
Inspection Name, Initials and
Name, Initials and Date:
Date:

QC Manager

Name, Sign and Date: Quality Record Approved:

Page 1 of 1
Job Safety Analysis
TRS-HS-FRM-0001

Instructions for completing Job Safety Analysis (JSA) form

Section I -Enter general information about the site and job task.
Section II - Determine whether any of these operations apply to the job task to be performed. Make note of any special training, permit, certification, and risk assessment
requirements.
Section III - Identify any human/organizational factors that could impact the ability to perform the work safely.

1. Break the job down into steps - Be as specific as possible. Write each job step in a new row of column A (Activity/Step). It’s a good idea to leave an extra row between
steps in case you need them later. Add additional rows to the table as needed, or if completing the JSA on paper, print additional copies of the sheet to accommodate
all job steps.
2. Determine the hazards associated with each job step and write them in column B (Hazards). Use the examples of hazards provided below to trigger your thinking
about different types of hazards and energy sources.
3. List any control measures that will be taken to ensure that step is done safely in column C (Control Measures). Use the control measure examples and hierarchy
provided to trigger your thinking about different types of controls and their effectiveness at reducing risk. Controls toward the top of the table tend to be more effective
at minimizing the severity and/or likelihood of an event than the controls toward the bottom of the table. If this job involves a Life Crucial Operation, continue to step 4.
Otherwise, repeat steps 2-3 for each of the job steps identified, then proceed to step 8.
4. Considering the hazards involved and the control measures that will be in place, determine the worst credible severity of an incident that could result from this job step.
Use the severity table provided. Write the severity number in column D (Severity).
5. Considering the hazards involved and the control measures that will be in place, determine the likelihood that an incident will result from this job step. Use the likelihood
table provided. Write the likelihood number in column E (Likelihood).
6. Multiply the severity number by the likelihood number and enter the product in column F (Risk).
7. Consider the risk rating against the thresholds provided in the Overall Risk Ratings.
i. Very low and low risk ratings of 1-3. This level is generally considered acceptable provided that all control measures are applied.
ii. Medium risk ratings of 4-6. Medium risk requires a planned approach to control the hazard and applies additional controls if required. Action taken must be
documented on the risk assessment form.
iii. High and Very High-Risk ratings of 8-24. For all high and very high risk, Column G (Additional control measures) must be implemented to further reduce the risk to
a medium or low level. Such activities shall not be proceeded until applying additional control measures. The Construction Director/Manager or facility Manager must
personally review the activities with a High or Very High residual risk score and approve additional control measures by signing off the JSA.
8. Repeat steps 2-7 for each of the job steps identified.

Section IV - Provide the name, company, and title of those who prepared and reviewed/approved this form in the signature box provided. The Construction Director/Manager or
facility Manager must review and approve the additional control measures that have a High or Very High-Risk rating before proceeding the task. Additional space is also provided
for crew members to sign the JSA if desired.

Reference Table in completing Section III – Job Safety Analysis (Column B – Hazard)
Biological & Environmental Electrical Chemical Gravity/Height Mechanical & Motion
Altitude Arc Flash Air Emissions Equipment Tipping/Collapsing Being Thrown Off/Under
Animal Bite/Sting Buried Utilities Chemical Products Excavation/Trench Equipment
Blood-Borne Pathogens Damage to Leads/Cables · Carcinogenic Falling Objects Disintegration of Moving
Contaminated Food/Water Damage to Switches · Combustible/Flammable Floor Openings/Edges Components
Insect-Borne Disease Energized Circuits/Conductors · Explosive Grating Removed Driving/Vehicle Traffic
Pests Inadvertent Energization · Toxic Inadequate Support Ejection of Workpiece/Debris
Poisonous Plants Lack of Isolation/Grounding · Corrosive Lack of Access Ladders/Stairs Entanglement
Precipitation Missing/Damaged Insulation · Reactive Suspended Load Friction
Temperature/Humidity Overhead Lines Client/Process Chemicals Unstable/Insecure Materials Movement/Shifting
Unsanitary Conditions Overload of Circuits Lack of Containment Work Above/Below Others Moving Parts
Weather Stored Energy Leakage/Spills Work at Height/Fall Hazards Pinch/Crush Points
Wind/Turbulence (Batteries/Capacitors) Material Incompatibility Walking/Working Surface Projectiles
Pressure Water Near Electrical Produced/Disturbed by Work · Slippery Rotating Equipment
Abrasive Blasting Conductors · Asbestos · Uneven Sharp Edges, Corners, or Points
Compressed Gases Work Environment
· Lead · Obstructed Shearing
High Pressure Fluid Cluttered
· Silica · Steep Stored Energy
Pressure Testing Confined Space · Moving/Swaying/Pitching (Springs/Accumulators)
· Welding Fumes
Pressure Washing/Blasting Damaged Tools/Equipment · Insufficient/Unstable Striking
Radiation Entrapment · Dust Trapped Between Equipment and
Water Discharges Ergonomic
Intense Light Erosion Awkward Postures/Movement Fixed Structures
Lasers Hazardous Atmosphere Wastes Generated Unexpected/Uncontrolled
· Hazardous Excessive Force/ Exertion
Microwaves · Oxygen Rich/Deficient Heavy/Awkward Load Movement
Naturally Occurring · Contaminants · Non-Hazardous
Sound Repetitive Motion
Radioactivity Radioactive Ignition Sources Same Position
Material Inadequate Ventilation Continuous Noise
Intermittent Noise Vibration
X-Rays Poor Lighting/Glare
Restricted Access/Egress Extreme Noise
Runoff Impact Noise

Reference Table in completing Section III – Job Safety Analysis (Column C – Control Measure)
Most Effective Controls Examples

Job Safety Analysis (TRS-HS-FRM-0001)

Revision 01, Rev. Date 29-July-2020 Page 1 of 9
Job Safety Analysis
TRS-HS-FRM-0001

Elimination Ø Make connections at ground level before erecting Ø Remove a dangerous machine from service
(Remove the hazard altogether) a structure to eliminate work at height Ø Provide power outlets to avoid trailing cords
Substitution Ø Use latex rather than oil-based paints
(Replace the material/process Ø Reduce energy, such as speed, force, amperage, pressure, and temperature
with a less hazardous one) Ø Use water-based detergents instead of organic solvents
Engineering/Isolation Ø Ventilation Ø Isolate hazardous energy sources
Ø Secondary containment
(Design effective control Ø Machine guarding Ø Interlocks
Ø Barriers
measures to protect people and Ø Enclosures Ø Platforms and guardrails
Ø Improve lighting
the environment) Ø Circuit breakers Ø Exclusion zones
Warning Ø Signs Ø Horns Ø Labels
Ø High visibility paint
(Alert people to the hazards) Ø Backup alarms Ø Beepers Ø Tags
Administrative Ø Work rotation to minimize exposure
(Provide training, procedures, Ø Inspect safety equipment Ø Training and supervision
etc.) Ø Good housekeeping practices
PPE Ø Safety glasses Ø Fall harness and lanyards Ø Respiratory protection
Least Effective
(Personal protective equipment) Ø Hearing protection Ø Gloves Ø High visibility vests

Reference Table in completing Section III – Job

Reference Table in completing Section III – Job Safety Analysis (Column D –Severity)
Safety Analysis (Column E – Likelihood)
Impact On Likelihood Chances of
Severity Level Probability
People Environment / Community Equipment / Property Level Occurrence
Ø Long-term (multi-year) impacts to air, Ø Extensive losses of high value
surface/ground water, or soil; or equipment/property
Expected to occur
Critical / Single / Multiple Ø Widespread areas including offsite Ø Loses exceeding $1,000,000; Very
6 4 in most 1 in 100
Catastrophic fatalities area/community affected; or or Likely
circumstances
Ø Some adverse publicity/media Ø Major unplanned impact on
coverage project budget and schedule
Ø Lasting (up to one year) impacts to air, Ø Losses of equipment/property
Injury or illness surface/ground water, or soil; or that cannot be readily
resulting in Ø Offsite area/community affected; or replaced; or
Strong possibility
Major 4 permanent total Ø Events that are reportable to Ø Losses exceeding $100,000; Likely 3 1 in 1,000
the event will occur
or partial regulatory authorities; or or
disability Ø Potential for adverse publicity/media Ø Significant unplanned impact
coverage on project budget
Injury or illness Ø Temporary (up to one month) impacts
resulting in to air, surface/ground water, or soil Ø Loss of equipment that can be
medical limited to the project site; or readily replaced; or
The event might
Moderate 2 treatment or Ø Breach of regulatory requirement or Ø Losses exceeding $10,000; or Possible 2 1 in 10,000
occur
temporary limit; and Ø Minor impact on project
disability/loss of Ø No potential for adverse budget
function publicity/media coverage
Ø No direct impact to air, surface/ground Ø No impact on equipment
Injury or illness water, or soil; or functionality Highly unlikely but
requiring first- Ø Effects restricted within buildings or Ø Minor, cosmetic damage; or may occur in
Minor 1 Unlikely 1 1 in 1,000,000
aid treatment containment structures; and Ø Repair costs easily covered exceptional
only Ø No potential for adverse by normal project operating circumstances
publicity/media coverage budget

Reference Table in completing Section III – Job Safety Analysis (Column F – Risk)

Risk Matrix Overall Risk Ratings

Likelihood
Very Low Low Medium High Very High
Severity
Unlikely Possible Likely Very Likely 1 2-3 4-6 8-18 24
1 2 3 4

Critical - 6 6 12 18 24

High and Very High-Risk ratings of 8-24.

Additional control measures must be implemented to further reduce the High and very
Major - 4 4 8 12 16 high risk to acceptable level.
Note: The Construction Director/Manager or Facility Manager must personally review
the activities with a High or Very High residual risk score and approve suitable additional
Moderate - 2 2 4 6 8 control measures by signing the JSA.

Minor - 1 1 2 3 4

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Section I – General Information

Emergency Procedures
Emergency Contact Name Emergency Contact Phone Number
Primary Contact Mohamed AlTaweel Primary Contact 0504989920
Secondary Contact Shady Shawkat Secondary Contact 0572546310
Details
Program Number. R08-HE4C20 Shura Hotel (HE4) Company Name TAMEAR
Project Name R08-HE4C20 Shura Hotel (HE4) Date 12/05/2022
JSA /Risk Assessment Title Blinding Concrete Category ☒ New ☐ Revised
Specific Location Shura Hotel (HE4) Building
Concrete Pumps, Concrete Truck Mixers, Concrete Vibrators, Slump
Plant Tools & Equipment Required Test Apparatus, Temperature Gauge, Measuring Tape, Cubes for Area
Sampling

Work Scope/Description Blinding Concrete

Section II – Does this job require any of the following operations?

ü = Requires formal/special training n = Requires certification or Competent/Qualified Person designations

= Requires a permit/form/report ∆ = Life Crucial Operations = Requires full Risk Assessment

Description Yes Description Yes

Aerial Lifts ü ∆ ☐ Cranes - Critical lift ü n ∆ ☐

Confined Space ü n ∆ ☐ Hot Work ü ☐
Dismantling and Demolition n ☐ Loading/Unloading Material ∆ ☐

Electrical Hazards ü n ∆ ☐ Noise Exposure ü ☒

Excavation/Trenching ü n ∆ ☐ Powered Industrial Trucks ü n ∆ ☐

First Line Breaks ü n ∆ ☐ Radiation Area Work ü n ☐
Grating/Floor Plate/ Guardrail Removal ∆ ☐ Respiratory Hazards ü ☐
Hazardous Energy Control ü n ∆ ☐ Roof Work ü n ∆ ☐
Hazardous Materials
Asbestos & Lead Work
ü n ☐ Scaffolding ü n ∆ ☐
Hazardous Materials
Crystalline Silica & Cadmium
ü n ☐ Site/Vehicle Traffic ∆ ☒
Hazardous Waste Operations ü ☐ Steel Erection n ∆ ☐
Heavy Equipment ü n ∆ ☒ Work at Height (> 6 ft) ü n ∆ ☐
Rigging, & Cranes ü n ∆ ☐ Other ☐

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Section III – Job Safety Analysis Risk Assessment (Post Control Measures)
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J)
Activity/Step Hazards Control Measures Severity Likelihood Risk Additional Control measures Severity Likelihood Risk
Provide Induction to all site
personnel, safety briefing before start
Un-familiar to site rules
of job to be ensured, Awareness 1 2 2
and regulations
trainings on routine basis to be
conducted
Ensure provision of basic site
Preparation for Concrete
Lack of site facilities facilities, drinking water, rest 1 2 2
shelters, toilets & etc.
Wear PPE, Ensure provision of first
kit, arrange lighting arrangement if
Insects bite 2 2 4
there will need to work in dark time,
do not work in the darkness
Adopt safe/buddy manual lifting
practices; Mechanical lifting shall
be used for heavy lifts.
Formwork shall be adequately
constructed.
Inspect formwork prior to pouring.
Lifting formwork may
Keep continuous watch during
cause back pain
pour also
Formwork may strike
Wear appropriate PPE and no
personnel and cause
Form Work Personnel shall are allowed to work 2 2 4
injury while de-shuttering
below while shuttering activities
Nails left in formwork
are in be removed after use.
leading to injury
Designated de-nailing area to be
Use of Damaged Tools
deployed.
Do not use damaged or
homemade tools
Use appropriate tools.
Damage tools to be removed from
site.
Wear required PPE, brief people
Contact to Chemical before activity, follow TRSDC 1 2 2
Instructions
Use drip Trays or resistant sheet
Testing of concrete
underneath, ensure provision of spill
Concrete Spill kits, personnel to be trained for to 1 2 2
control and use of emergency spill
kit,
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Wear PPE, Post Warning Signs,

Slippery surface Barricade the area, and ensure 2 2 4
regular housekeeping of the area.

Ensure induction of all drivers /

operators, Brief before start of
activity, ensure training in regular
Movement of Concrete intervals, Follow site traffic rules and
2 3 6
Trucks regulations, park in the designated
area, do not over take in blind points,
use flagman on site and avoid
reversing without flagman

Assign Operator with valid license,

Maintain validity record maintain in
Drivers / Operator without
the site office, Renewal of license 2 3 6
valid license
must ensure, Do not allow driver /
operator with expired license to work
Ensure equipment inspection before
to mobilize on site, Use TRSDC forms
and checklist, ensure daily inspection
Uninspected Equipment of equipment before to use, do not 2 2 4
Concrete Casting
use defective equipment on site,
ensure to rectify or remove from the
site
Ensure induction of drivers before to
move on site, Conduct awareness
Not following Speed Limit training, and Follow speed limits, site
or Using Mobile phone rules and regulations, safety briefing 2 2 4
during driving to be ensured before to start of
activity. Stop vehicle at safe place to
answer the call ( if necessary )
Assign flags man, barricade the area,
ensure proper supervision of the
Collision of equipment 2 1 2
activity, coordinate the nearby
activity,
Ensure safe parking on site for the
truck, vehicles and ensure access for
Improper Parking of trucks equipment and people near to the 2 2 4
activity, ensure to assign flagman,
install safety sings,

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Job Safety Analysis
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Poor maintenance of
equipment
Oil leak / oil spill
Fire into plan or machinery
Incompetent Operator
Failure of Equipment
Out riggers of concrete not
fully extended
Uneven ground or
uncompacted ground
Job Safety Analysis (TRS-HS-FRM-0001)
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Ensure preventive / regular
maintenance of equipment, use daily
equipment inspection checklist, do
2 2 4
not use defective equipment, and
Remove defective equipment from
the site for service.
Use drip tray or resistant sheet
during refueling, ensure preventive
maintenance, provide spill kit in
2 2 4
nearby location, ensure emergency
contact numbers and emergency
response team
Ensure provision of firefighting
equipment, Inspect regularly, train
site people for the use of fire
extinguishers, Ensure updated 2 2 4
emergency response plans, ensure
provision of emergency contact
numbers,
Operator will assign with valid
license, Validity record will maintain
in the site office, Renewal of license
2 2 4
will ensure from the site office,
Operator with expired license shall
not be allowed to work
Ensure preventive maintenance of
equipment, use equipment checklists
before to operate for the day activity, 2 2 4
Do not stay near to equipment
radius, use flagman
Equipment checks thoroughly by
driver before to mobilize at site.
Pump out riggers shall be fully 2 2 4
extended. Supervisor must ensure
entire activity
Ensure provision of leveled
ground for concrete pump
positioning by activity supervisor.
2 2 4
Further Equipment working
position must ensure by driver. use
equipment checklists before to
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Job Safety Analysis
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operate for the day activity, Do not

stay near to equipment radius, use
flagman
use equipment checklists before to
operate for the day activity, Do not
stay near to equipment, only relevant
personnel may present at work area.
Concrete pipe burst 2 1 2
Post safety signs, ensure to have
emergency contact numbers,
personnel must brief before to start
of activity
Monitor site continuously, remove all
unnecessary material and people
from the area, Ensure emergency
exits, train people for emergency
Slippery surfaces 2 1 2
response, brief employees for the
activity, ensure updated emergency
response plans, team and contact
numbers.
Use drip tray or resistant sheet
underneath of concrete pump.
Ensure availability of spill kits,
maintain emergency contact
Concrete Spill 2 3 6
numbers, brief site personnel for
environmental emergency response,
and ensure to update environmental
emergency response team.
Monitor site conditions, do not work
Abnormal Weather
in abnormal weather condition, 2 4 4
condition
follow TRSDC work instructions
Use ear plugs / ear muffs, post safety
signs, brief personnel before the
High Noise 2 2 4
activity, train personnel in regular
intervals
Emergency contacts numbers to
be available onsite.
Lack of awareness in
Emergency response
case of emergency
Emergency Procedure to be discussed by site
Workers are not fully 2 2 4
Response supervisor prior to
trained/personal
commence the job
injuries
Stand by Emergency vehicle
to be available on site

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First aid kit/trained first

aider must be available on site
during works
Never allow a worker to
work alone by him in
remote places unless
proper communication and
emergency

Proper transportation, use,

handling and disposal of
hazardous substances
(spill/contamination) must
be observed Strictly
Concrete waste to be
disposed in designated skip
waste collection area as per
TRSDC recommendations.
Uncontrolled waste Ensure Proper dust
generation & suppression method and
improper determine the frequency of
Environmental handling & Disposal work to be done by water
Hazards (Air, Leaks / spills of tankers
2 2 4
Ground, Water, hazardous liquid Declare the whole site as
Dust, Noise) dust suppression “No Burning” zone for all
measures Air types of waste materials
Pollution Ensure engineering /
Ill-health Administrative controls for
operatives working around noisy
areas / machines above the
workplace exposure limit for 8
hour work.
Avoid concrete
contamination in soil, carry
out concrete mixing work in
bunded area/designated
area to prevent it from spreading.
Slip , trip fall Dust
Conduct TBT
Being hit by falling
Use of proper PPEs
objects
Follow waste management
House keeping Striking against 2 1 2
procedure
projecting poorly
Provide adequate waste bins at
stacked items or
site.
misplaced

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materials Clear the waste on regular

Intervals from the site.
Clean up during the shifts
Day to day clean before
entering the work
removal of unused
materials
Inspections to ensure cleanup
is complete walk
ways should be neat and
tidy
Note: Insert additional rows or print additional sheets as necessary to accommodate all job steps.

Section IV – Approval and Signatures

Prepared by Company Position
Mohamed AlTaweel TAMEAR CM

Mohamed Yusufaldeen TAMEAR Corporate HS Manager

Reviewed and Approved by Company Position
Ali Maarouf TAMEAR Project Manager

High and Very High residual risk rating (8-24)

Note: All High and Very High residual risk ratings (8-24) require review and approval by Construction Director/Manager or Facility Manager before starting work to ensure that the additional controls are adequate to execute the task safely.
Reviewed and Approved by Company Position
Construction Director/Manager or Facility Manager
Reviewed by Crew Company Position

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