Document No: JSEA Template HVM-HAS-FM0006 -

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JOB SAFETY & ENVIRONMENT ANALYSIS WORKSHEET (HVM-HAS-FM0006)

NOTE: JSEA can only be executed once. Not to be reused again.
Zero Harm – “INJURY FREE WORKPLACE”
Date: Department: Equipment type:
Work Order #: Area / Location:
Job description
(Scope of the job)
Is there a SWI/SWP for this task? No Yes If yes, name of the SWI/SWP:
Personnel [Please specify and list]:
Tools Required [Please specify and list]:
High Risk Task? Yes No Superintendent / BUM endorsement required if Residual Risk Value M(21) – M(10) or High Risk Task is present in JSEA
Use of Cranes Yes No If Yes, ensure you have a LIFT PLAN for the work activities to be carried out. NOTE: One Lift Plan per task!
Permits and Isolations Required.
Working at Heights – *Contact ERT for Rescue Plan if working >5 meters Confined Space Entry – *Contact ERT for Gas Test & Rescue Plan
Isolation Level 1 Isolation Level 2 Permit to Work Hot Work Excavation & Penetration
High Voltage Grid Mesh Removal Radiation OLC Hot Work
Others [Please specify]:
Personal Protective & Safety Equipment
Rubber boots Full face shield Mono-goggles Respirator-Half / Full / BA Dust mask Hearing protection
Fall arrest equipment Acid suit Disposable overalls Life jacket Signs Portable Safety Shower
Extinguishers Fire Blanket Extraction Fans Gas Tester Hard Barricading Caution Tape
Fall Injury Prevention Requirements per SDS Others [Please specify and list]:
Team members that developed the JSEA
No. Team member name Your Role
1.
2.
3.
4.
5.
Periodic Reviews As A Result Of Change
Date Time Reason for Review Description Of Change Changes Made By Changes Approved By

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Residual Risk Review & Sign Off

LOW – L(22) – L(25)
MEDIUM OR CRITICAL
CONTROLS – M(21) – M(10)
I have reviewed this JSEA and I am satisfied that the job scope is clearly defined, all job
steps listed are correct, all hazards have been identified and appropriate control measures Superintendent
are stated within this JSEA.
I have reviewed this JSEA and I am satisfied that all hazards associated with this task have BUM /
been identified and appropriate control measures stated within this JSEA are satisfactory. Superintendent

As Site General Manager, I am satisfied that all hazards associated with this task have been
HIGH – H(9) – H(1) General Manager
identified and appropriate control measures stated within this JSEA are satisfactory.

Behavioural & Environmental Risk

Consider the potential behavioural risks
Untrained or inexperienced personnel
Person not fit for work, under the influence of alcohol / drugs or fatigued
Person rushing into the job without planning, hurrying to finish the job
Unauthorised use of equipment, no trained, competent and authorised.
Going ahead with the job when in doubt
Continuing with the job no matter what happens
Complacency - job done regularly, no planning and risk assessment.
Ignoring at risk behaviour in other work team members.
Consider Potential Community & Environment Impact
Land – Excavation outside authorised zone, land slip, erosion, damage to existing
tracks/roads
Air – Dust, Smoke, Engine exhaust
Water – Sediment build up due to erosion, hydrocarbon spill from plant and motorised
equipment
Local community – Noise, Traffic hazard, Traditional activities, Religious activities,
Garden plots
Waste – Packaging, lunch wraps Industrial waste etc.
Heritage – Intruding on cultural significant sites
Ecology – Disturbance to wildlife and its habitat
Potential behavioural controls
Check that all personnel have the training and experience required to do the job safely
Monitor all work team members for signs that they are not fit for work
“STOP” Plan the job with LLBs, JSEA & SOP/SWP review.
“STOP” All personnel must have the training and licenses required before starting the job
“STOP” the job and consult with the Supervisor when in doubt
“STOP” Review the JSEA when job conditions change
“STOP” use planning and risk assessment tools for every job, every time we do it
“STOP” and correct at risk behaviour immediately
Community & Environment Impact controls
Identify boundaries, Geotechnical advice, Compaction after ground disturbance, drainage
and water management
No unauthorised Fires, Fit for purpose equipment, Water carts
Silt traps, Spill Kits, Bunding and Containment, No unauthorised river crossing by
equipment
Consultation with Community via Community Affairs
Waste segregation, Housekeeping
Consult community via Community Affairs, Restrict work activities & workers within the
authorised work boundary
Assess environment, Prohibit removal of flora and fauna, relocate wildlife

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Simultaneous Operations [SIMOPS]

Work Group #1 Area/Location: Plant/Equipment:
Work Order No.: Job Supervisor Name: Job Supervisor Contact No:
Job/Task Description:

Is SIMOPS managed: YES NO

Work Group #2 Area/Location: Plant/Equipment:
Work Order No. Job Supervisor Name: Job Supervisor Contact No:
Job/Task Description:
Is SIMOPS managed: YES NO

Residual
High Risk Tasks Critical Control
Risk

WHAT CAN
KILL ME?

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Page:
Inherent Residual
Describe the Job Step Potential Hazards Risk Controls for the Potential Hazard Risk
Step (Describe what has to happen but not (If NO What controls do I need to put in place to protect my team and (If ALL
What can harm my team and me?
how to do it, include photo if available) controls are me? controls are
in place) in place)
Manual Handling 1. Apply proper manual handling techniques 2. Use mechanical aid or extra
M(18) L(22)
manpower for loads over 15KG 3. Wear Mechanical Gloves
Back Strain 1. Maintain proper body position and posture. 2. Do not stay in strained position for
M(18) L(22)
more than five (5) mins
SITE MOBILIZATION, JSA & PTW Pinch points, cuts & bruises 1. Maintain site alertness 2. Wear mechanical gloves
M(18) L(22)
1 SIGN-OFFS - LOTO
Slip, Trip & Fall 1. Maintain site alertness 2. keep work area tidy and clear of obstructions
M(18) 3. Coil Hoses and cables neatly
L(22)

Person in charge of this step: Comments: ENSURE TO LOCK-ON TO OLC ISOLATION PRIOR TO JOB START Initial:
1. All safety gear and consumables to be worn 2. DCP Extinguisher to be available
Hot Works - Arc, Heat & Sparks M(12) 3. Inspect all equipment prior to use. 4. Only competent personel to perform L(22)
Hotwork
1. Wear dust Masks & ensure proper ventilation 2. Wear Earplugs
Hot Works - Dust, Fumes, projectiles and Noise M(12) L(22)
3. Wear adequate eye protection as required
1. Apply proper manual handling techniques 2. Use mechanical aid or extra
CUT OFF & MODIFY OLC Manual Handling, Pinch-points, cuts & Bruises M(18) L(24)
manpower for loads over 15KG 3. Wear Mechanical Gloves
HANDRAIL TO CREATE ACCESS 1. Inspect all equipment prior to use 2. ensure leads are tidy & all conections are
2 FOR CPU-2 Power tools, leads, genset M(19) secure 3. only competent personnel to use tools 4. wear approriate PPE L(22)
5. Keep tools & lead conections out of rain/water

1. Competent scaffolder construct and tag scaffold 2. Barricade exclusion zone

Working at heights H(9) 3. check scaffold stability 4. Use Fall Restraint and confirm anchor point suitability. M(14)
5. Ensure 3 point fixture on ladders & A-frames 6. review PTW do LLB's
Fatigue & Dehydration L(24) 1. Take regular breaks and drink plenty water L(25)
Person in charge of this step: Comments: ENSURE SCAFF-TAG IS SIGNED & UP TO DATE Initial:
1. All safety gear and consumables to be worn 2. DCP Extinguisher to be available
Hot Works - Arc, Heat & Sparks M(12) 3. Inspect all equipment prior to use. 4. Only competent personel to perform
L(22)
Hotwork
1. Wear dust Masks & ensure proper ventilation 2. Wear Earplugs
Hot Works - Dust, Fumes, projectiles and Noise M(12) 3. Wear adequate eye protection as required
L(22)
INSTALLATION OF SUPPORT 1. Apply proper manual handling techniques 2. Use mechanical aid or extra
FRAMES: Manual Handling, Pinch-points, cuts & Bruises M(18) L(24)
manpower for loads over 15KG 3. Wear Mechanical Gloves
-WELD CPU-2 SUPPORT FRAME 1. Inspect all equipment prior to use 2. ensure leads are tidy & all conections are
3 -WELD SENSOR 5&6 JB FRAME Power tools, leads, genset M(19) secure 3. only competent personnel to use tools 5.Keep tools & lead conections L(22)
-INSTALL SENSOR 5&6 CANOPIES out of rain/water
1. Competent scaffolder construct and tag scaffold 2. Barricade exclusion zone
Working at heights H(9) 3. check scaffold stability 4. Use Fall Restraint and confirm anchor point suitability. M(14)
5. Ensure 3 point fixture on ladders & A-frames 6. review PTW do LLB's
Fatigue & Dehydration L(24) 1. Take regular breaks and drink plenty water L(25)
Person in charge of this step: Comments: ENSURE TO INSPECT ALL TOOLS/EQUIPMENT/MATERIALS TO BE FIT FOR PURPOSE Initial:
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 Document No: JSEA Template HVM-HAS-FM0006 -
Revision 2023.docx
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Date: 5 of 9
Page:
Inherent Residual
Describe the Job Step Potential Hazards Risk Controls for the Potential Hazard Risk
Step (Describe what has to happen but not (If NO What controls do I need to put in place to protect my team and (If ALL
What can harm my team and me?
how to do it, include photo if available) controls are me? controls are
in place) in place)
Manual Handling 1. Apply proper manual handling techniques 2. Use mechanical aid or extra
M(21) L(24)
manpower for loads over 15KG 3. Wear Mechanical Gloves
Back Strain 1. Maintain proper body position and posture. 2. Do not stay in strained position for
M(21) L(24)
more than five (5) mins
Pinch points, cuts & bruises M(21) 1. Maintain site alertness 2. Wear mechanical gloves L(24)
TOUCH UP PAINTING HOUSE Slip, Trip & Fall 1. Maintain site alertness 2. keep work area tidy and clear of obstructions 3. Coil
M(21) L(24)
KEEPING & DEMOBILIZE Hoses and cables neatly
4 1. Wear respiration protection & ensure proper ventilation 2.Wear Safety Glasses
Hazardous Chemical - Fumes, projectiles, fire
M(19) L(22)
or Face Shield 3.Ensure SDS is available 4. keep DCP Extinguisher near works
1. Competent scaffolder construct and tag scaffold 2. Barricade exclusion zone
Working at heights H(9) 3. check scaffold stability 4. Use Fall Restraint and confirm anchor point suitability. M(14)
5. Ensure 3 point fixture on ladders & A-frames 6. review PTW do LLB's

Person in charge of this step: Comments: Initial:

Person in charge of this step: Comments: Initial:

Person in charge of this step: Comments: Initial:

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Inherent Residual
Describe the Job Step Potential Hazards Risk Controls for the Potential Hazard Risk
Step (Describe what has to happen but not (If NO What controls do I need to put in place to protect my team and (If ALL
What can harm my team and me? controls are controls are
how to do it, include photo if available) me?
in place) in place)

7.

Person in charge of this step: Comments: Initial:

Post JSEA Review (Review completed JSEA for Positives, Negatives, improvements, suggestions, safety shares)

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Work Group Sign On Sheet

By signing on here, I acknowledge that I am aware of, understand and agree to abide by the conditions of this JSEA
No: Date: Name ID# Signature No: Date: Name ID# Signature
1. 16.

2. 17.

3. 18.

4. 19.

5. 20.

6. 21.

7. 22.

8. 23.

9. 24.

10. 25.

11. 26.

12. 27.

13. 28.

14. 29.

15. 30.

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RISK MATRIX
STEP 1 What is the maximum Reasonable Consequence?

Consequence Level
LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 LEVEL 5
LOW (1) MINOR (2) MODERATE (3) MAJOR (4) CATASTROPHIC (5)
Type

HEALTH AND * Injury or illness which results in low
SAFETY level short-term inconvenience or
symptoms (e.g. minor laceration,
bruise, headache, nausea). First aid
treatment or minor medical treatment
ENVIRONMENTAL * Isolated exceedances of low level
EFFECTS permit conditions
* No lasting environmental effect.
COMMUNITY / * Low-level social or cultural impacts.
CULTURAL * Low-level repairable damage to
HERITAGE commonplace structures.
* No compensation required.
MEDIA / * 1 - 2 public complaints from one
REPUTATION definable event.
LEGAL / * Non-conformance with internal
COMPLIANCE / standards and/or policies.
* Injury or illness that requires
medical treatment by a medical
professional and/or results in
alternative duties.
* Multiple exceedances of low
level permit conditions
* Minor impacts (<1 year) to land,
biodiversity, ecosystem, water
resources or highly valued
species
or habitat.
* Minor medium-term social
impacts on local population.
* Minor damage to
structures/items of some cultural
significance which are mostly
repairable.
* Minor infringement of cultural
heritage.
* Damage or loss of community
asset.
* Formal community complaint.
* Some compensation required.
* Minor, adverse local public or
media attention.
* Reputation is adversely affected
with a small number of site-
focussed people.
* Minor delay in gaining
approvals.
* Minor or technical non-
compliance with licence/permit
conditions or regulations that has * Notification, investigation or
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* Injury or illness that results in
a lost time injury (LTI).
* Multiple breaches of permit
conditions
* Moderate impact (>1 year) to
land, biodiversity, ecosystem,
water resources or highly
valued species
or habitat.
* Ongoing social issues.
* Moderate permanent damage
to structures/items of some
cultural significance.
* Moderate infringement of
cultural heritage.
* Strong community complaint/
reaction which is a threat to
operations.
* Significant compensation
demanded or required.
* Injury to a community
member to a level where they
cannot work.
* Adverse State/Provincial
media attention. Criticism by
NGOs.
* Multiple public complaints
from one or many definable
events.
* Moderate delay in gaining
approvals.
* Breach of licence/permit
conditions or regulations.
Print Date: 8/08/2023
* Injury or illness that results in a
permanently disabling injury to one
or more people
* Serious breach of permit
conditions resulting in show cause
or legal proceedings
* Major impacts (>5 years) to land,
biodiversity, ecosystem, water
resources or highly valued species
or habitat.
* Ongoing serious social issues.
* Significant permanent damage to
structures/items of cultural
significance.
* Significant infringement and
disregard of cultural heritage.
* Aggressive community reaction
which causes a stoppage of
operations while compensation or
redress is negotiated.
* Police action and/or external
arbitration required.
* Community member suffers a
permanently disabling injury.
* Significant adverse national
media / public / NGO attention.
* Significant difficulty in gaining
approvals or project approval
threatened.
* Company credentials tarnished.
* Serious/major breach of
licence/permit conditions or
regulations.
* Injury or illness that results in a
fatality.
* Permanent impairment to more than
10 persons
* Permit revoked due to repeated
serious breach of permit conditions
* Serious or extensive widespread
environmental impacts (>20 years) or
to the point of eradication of a highly
valued species, habitat or ecosystem.
* Very serious widespread social
impacts.
* Destruction of highly valued
structures, items or locations of
cultural significance.
* Highly offensive infringements of
cultural heritage.
* Community outrage which results in
government intervention and a stop to
operations/ production for > three
months.
* Community fatality.
* Adverse International media or
public outcry.
* Damaging NGO campaign.
* Licence to operate threatened.
* Company reputation seriously or
permanently tarnished.
* Share price may be affected.
* Extreme response from regulators
such as very significant fines and
Prosecutions, loss of licence to
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RISK MATRIX
STEP 1 What is the maximum Reasonable Consequence?

Consequence Level
LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 LEVEL 5
LOW (1) MINOR (2) MODERATE (3) MAJOR (4) CATASTROPHIC (5)
Type
REGULATOR * Regulators do not need to be limited impact (e.g. submission of report to regulators is required * Potential Investigation by operate.
RESPONSE notified. a late report to government). which could result in ongoing authorities which could result in * Multiple litigation including significant
* Regulators may need to be scrutiny /attention, warning, or major fines, operating restrictions, class actions.
notified. minor fine. or significant prosecution/litigation. * Custodial sentences for company
* Possibility of custodial sentences Executives
* Prolonged closure of operations by
authorities
OPERATIONAL * Easily addressed or rectified by * Minor or superficial damage to * Moderate damage to * Major damage to facility requiring * Future operations at site seriously
IMPACT / immediate corrective action. equipment and/or facility. equipment and/or facility. significant corrective / preventative affected due to significant damage to
EQUIPMENT * No loss of production or damage to * Minor stoppage (i.e. shift) of * Loss of production < one action. property/infrastructure
DAMAGE equipment. production. week. * Loss of production < one month. * Loss of production > one month.
TOTAL ESTIMATED < AUD $10,000 AUD $10,000 to $50,000 AUD $50,000 to $500,000 AUD $500,000 to $5M > AUD $5M
COST*
STEP 2 What is the Reasonable Likelihood of the Consequence? STEP 3 What is the Risk Rating?
1 2 3 4 5
Likelihood Description Matrix
Likelihood
Almost Certain (5) Could occur any day - Impact is sure to occur imminently
5 M(18) M(11) H(6) H(3) H(1)

Likely (4) Greater than once per month - Balance of probability will occur
4 M(20) M(14) H(9) H(4) H(2)

Possible (3) Greater than once per year - May occur shortly but a distinct probability it won't
3 L(22) M(19) M(12) H(7) H(5)
2
Unlikely (2) Greater than once per 10 years - May occur but not anticipated L(24) M(21) M(15) M(13) H(8)
1
Rare (1) Could occur as a "100-year event" - Exceptionally unlikely, even in the long-term future L(25) L(23) M(17) M(16) M(10)

It is very important, for ALL persons completing JSEAs, to understand that controls put in place influence the likelihood / probability of the
accident or incident happening, but if it happens, the consequence remains the same.

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