Professional Documents
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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 1-2. This level is generally considered acceptable provided that all control measures are applied.
ii. Medium risk ratings of 3-9. 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 10-25. 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 & Electrical Chemical Gravity/Height Mechanical & Motion
Environmental Arc Flash Air Emissions Equipment Being Thrown Off/Under
Altitude Buried Utilities Chemical Products Tipping/Collapsing Equipment
Animal Bite/Sting Damage to Leads/Cables Carcinogenic Excavation/Trench Disintegration of Moving
Blood-Borne Pathogens Damage to Switches Combustible/Flammable Falling Objects Components
Contaminated Food/Water Energized Circuits/Conductors Explosive Floor Openings/Edges Driving/Vehicle Traffic
Insect-Borne Disease Inadvertent Energization Toxic Grating Removed Ejection of Workpiece/Debris
Pests Lack of Isolation/Grounding Corrosive Inadequate Support Entanglement
Poisonous Plants Missing/Damaged Insulation Reactive Lack of Access Ladders/Stairs Friction
Precipitation Overhead Lines Client/Process Chemicals Suspended Load Movement/Shifting
Temperature/Humidity Overload of Circuits Lack of Containment Unstable/Insecure Materials Moving Parts
Unsanitary Conditions Stored Energy Leakage/Spills Work Above/Below Others Pinch/Crush Points
Weather (Batteries/Capacitors) Material Incompatibility Work at Height/Fall Hazards Projectiles
Wind/Turbulence Water Near Electrical Produced/Disturbed by Work Walking/Working Surface Rotating Equipment
Pressure Conductors Asbestos Slippery Sharp Edges, Corners, or Points
Abrasive Blasting Work Environment Lead Uneven Shearing
Compressed Gases Cluttered Silica Obstructed Stored Energy
High Pressure Fluid Confined Space Welding Fumes Steep (Springs/Accumulators)
Pressure Testing Damaged Tools/Equipment Dust Moving/Swaying/Pitching Striking
Pressure Washing/Blasting Entrapment Water Discharges Insufficient/Unstable Trapped Between Equipment
Radiation Erosion Wastes Generated Ergonomic and Fixed Structures
Intense Light Hazardous Atmosphere Hazardous Awkward Unexpected/Uncontrolled
Lasers Oxygen Rich/Deficient Non-Hazardous Postures/Movement Movement
Microwaves Contaminants Sound Excessive Force/ Exertion
Naturally Occurring Ignition Sources Continuous Noise Heavy/Awkward Load
Radioactivity Radioactive Inadequate Ventilation Intermittent Noise Repetitive Motion
Material Poor Lighting/Glare Extreme Noise Same Position
X-Rays Restricted Access/Egress Impact Noise Vibration
Runoff
Reference Table in completing Section III – Job Safety Analysis (Column C – Control Measure)
Details
Program Number. R03 Company Name ABDUL MOHSEN ALTAMIMI Contracting Company
Project Name C02C02-Turtle Bay - Village center & Neighborhood Centers - Package05 Date 11/05/2023
JSA /Risk Assessment Title Blinding Concrete Category ✘ New Revised
Specific Location Turtle Bay Village, Red Sea Building SITE FACILITIES
Plant Tools & Equipment Required Concrete mixer trucks, concrete pump, Water Tanker, Total station, PPE’s, etc. Area CO2CO2-Turtle Bay
Work Scope/Description Blinding Concrete at site for TBV Mixed Use which includes Village Centre, Professional Neighborhood Centre, Non-Professional Neighborhood Centre
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
1. Survey Work (Survey and Ensure the work area is clear of any
Stake out). obstructions. Unnecessary materials Assigned HSE Representative to ensure
shall be removed to prevent slip and the verified ID certificates for operators
trip hazards. is valid with expiration date issued.
Work area shall be barricaded with safety Ensure the assigned signalman/rigger
warning or hard barricade whenever or flagman is always at the site for
area is exposed to traffic hazards. proper coordination.
Unplanned Traffic Flow. Debris and other construction waste shall Ensure prior of heavy equipment use
be hauled out of site. pre-checklist are being carried out.
Promotional Safety Signage shall be Ensure the approved heavy equipment
posted around the work zone. operators with valid ID third party
Unsafe Work Areas. Flagmen shall be assigned to eliminate certificate.
Traffic Hazards. Assigned HSE Representative to ensure
2 2 4 2 1 2
Traffic Management Plan shall be the sticker ID for equipment is valid
developed and submitted to for and up to date.
approval. Further, that includes Ensure prior of starts of activity, all
Slips; Trips; Fall. necessary barricading and signage is in
excavation/trenching activity and
pedestrians. place.
Ensure Buses, Equipment, Light Vehicles Ensure all involved in the activity are
shall park at designated parking area. required to stay at site while the
Communicate the designated ASSEMBLY activity is ongoing.
AREA to all workers. Assigned/dedicated flagman are
Communicate the Emergency Procedure & equipped with reflective vests and flags
Call Numbers to all employees. (green & red) to guide the operator and
assist during equipment maneuverer.
Lack of Training. Ensure all working personnel to undergo 2 2 4 Assigned HSE Team ensure all workers 2 1 2
all mandatory trainings to enhance are trained and Safety
Contact with sharp objects on site; knowledge on the activity. Inducted/Oriented prior to enter inside
work site.
Ensure all the members of the work team
HSE team to ensure all protruding
are fit for the activity. survey stake must be protected with
cap.
Ensure all PPEs are issued prior to
Short cuts Ensure prior of activity starts to
deployment of operatives to their conduct pre-start task briefings to
discuss the potential hazards.
respective areas of assignment i.e.
appropriate working gloves, safety
goggles, safety shoes, visibility vest.
Foremen/Supervisors shall conduct
Uncertified Heavy Equipment by Prior to use of Heavy Equipment at work 2 2 4 Ensure Heavy Equipment not in used 2 1 2
RSG THIRD PARTY site, ALL HEAVY EQUIPMENT shall have shall park at designated staging area
CERTIFICATION. VALID AND UPDATED THIRD PARTY
3. Earth work preparations with SAFETY HANDBREAK ON and
RSG CERTIFICATION APPROVED.
for blinding concrete. Unsafe Machinery. CHOKED BLOCK ON THE TIRES to
Ensure the equipment to use is equipped
Unreliable Mechanical Components.
with FUNCTIONAL SAFETY DEVICES like prevent any movement.
Mechanical excavation
back up alarm, flasher lights, horn, etc. Never allow anybody to stay nor rest
Unmaintained vehicle.
…. under parked heavy equipment.
Ensure Heavy Equipment to undergo
All rotating gears shall be safe guarded.
MANDATORY SAFETY DAILY
Ensure to isolate/barricaded and put
INSPECTION prior to start of activity.
SIGNAGE UNDER MAINTENANCE all
Any damaged safety device on the
equipment shall be reported and damage equipment at work site.
Safety Officers shall conduct visual
repaired prior to use at work site.
inspection on safety gears and
Mandatory PPE shall be worn at site i.e.
equipment and that also include
Workers Not Wearing PPE / Lack of HARD HATS, APPROPRIATE GLOVES,
operators and drivers.
PPE. SAFETY GLASSES, REFLECTIVE VEST,
Ensure workers assigned on designated
and SAFETY SHOES. Safety Officers
task are issued with the proper PPE.
shall conduct visual inspection for any
Ensure workers and operators to be
damaged PPE. NO PPE – NO WORK
oriented for proper wearing of PPEs
POLICY.
during Safety Induction or Toolbox
Ensure all working personnel to undergo
Excavation Hazard Excavation less than 1.2m (4ft) deep: 3 2 6 Work permit receiver will ensure Daily 2 2 4
May also require protective system if excavation checklist will be conducted
sidewall cave-in hazard exist. and sign by site supervisor prior to start
Excavation at a depth of 1.2m (4ft) or more
activity
in soil other than stable rock.
Cave-in" POTENTIAL Ensure protective system such benching,
Adequate and suitable protective
HAZARD: sloping, shoring is applied depend on the
system (i.e., benching, sloping, or
actual status of the ground foundation.
shoring) shall be planned.
Ensure protection such jersey or pipe
Excavations greater than 2.4 m (8 ft) deep
Cave- in (side wall barricade are installed to prevent falling
– Type B or C soil.
collapse of excavations)
5. Application of Soil Anti- Hazardous Substance: 4 2 8 Ensure that sprayer machine is in a safe 2 1 2
Termite Control Skin irritants Safety training about chemical handling. operating condition.
Carcinogens Refresher training through toolbox
Respiratory sensitizers talks. Ensure that the operator of sprayer
machine is competent.
Health Hazards Store minimal quantities in the workplace
Acute health effects, the adverse Provide proper PPE’s e.g., hand gloves,
effects appear after a single or Replace caps when they are not required coverall, etc.
short-term exposure to the to be removed.
agent, and the response is Only certified and experienced operator
invariably rapid or immediate. Waste materials stored in a lidded shall operate the equipment.
container and not allowed to overspill
Chronic health effects usually onto the floor. Ensure proper procedure during
result from prolonged or manual/mechanical handling of
repeated exposure to the agent Spillages to be addressed in a timely activity to be done prior to work.
manner
Adverse effect on a worker’s Conduct awareness training prior of its
health because of direct contact Ensure appropriate PPE is used- overall use on how to safely operates the
with / or exposure to the and Gloves, respiratory protective sprayer machine.
chemical through inhalation, equipment (RPE), gloves.
skin contact or ingestion, entry Additional use of PPE’s is mandatory
through a cut or wound Good hygiene practices to be observed requirement during the operation of
the sprayer machine like respirator,
1. Dizziness-The vapors, if Atmosphere monitoring etc.
inhaled, enter the bloodstream
and some can cause short-term No lone working HSE Dept. will verify the ID certificates of
effects (dizziness) and operatives prior to deployment at site
2. Brain damage-Long-term Use appropriate PPE
effects
3. Skin burns Good welfare arrangements to allow hand
4. Toxic- If ingested they may also washing, etc.
have toxic effects.
5. Neurotoxins- Organic solvents Monitor the workplace temperature –
(trichloroethylene) are well- increase of vapor potential and maybe
known neurotoxins. flammability.
6. Kidney Failure - Organic
solvents (e.g., glycol ethers) can
restrict the operation of the
kidneys possibly leading to
failure.
7. Dermatitis- The most common
7. Fabricate formworks for Lack of Training and Only properly equipped personnel who 2 2 4 Ensure operatives not to wear 2 1 2
concrete using hand and Supervision. are trained and certified for electrical rings, wrist watches, jewelry or
or power tool shall perform such other similar objects while
11. Pour concrete from the Ensure all working personnel to undergo 3 2 6 Ensure equipment are 2 2 4
concrete pump truck to the Miscommunication. mandatory training to enhance operated by trained and
formworks. Mishandling. knowledge on the activity. certified personnel.
Falls (from the truck); Ensure all the members of the work team Established appropriate traffic
Electrocution. are fit for the activity. control measures Isolate the
Weather Condition. Ensure all operatives are protected from area during concreting.
Traffic Hazards. direct contact with concrete i.e., Clean equipment in the areas
concrete resistant boots, long pants that will not impact on the
Ergonomics Hazards (i.e.
and long sleeves and ANSI Z87 safety environment or wash-off into
awkward position and
goggles. the stormwater or waterways.
repetitive strain)
Ensure all signals and communication Implement job rotation to
Dropped Objects, Flying
methods are discussed prior to minimize risk of
particles
commencement of activity. musculoskeletal disorder.
Hand and Finger Injury
Safety Officer/Foreman/Supervisor is Ensure the road is well
Heavy Equipment
mandatory to be at work site where compacted and graded to
Overturning i.e. Concrete
activity is being carried out. prevent the equipment from
Pump, Transit Mixer Ensure proper platform is available for the skidding and stock in soft spot.
Spillage of concrete on workers. Wear FBH when required. Proper planning to schedule
the ground and to Ensure correct work practices during the concreting work during
humans. concreting are complied. daylight.
Slip, trip or fall Ensure concrete not entering drainage Pour concrete gradually and
Crush, pinch points. system causing environmental constant visual monitoring of
Poor visibility due to pollution. formworks condition while
darkness. concreting.
Collapse of form works
and shoring
12. Adverse Weather Exposure to extreme Hot Heat stress awareness training just
before and during the hot summer
months to all applicable personnel (who
Conduct mandatory Heat Stress
work outdoors) and those who manage
Awareness training to all employees
personnel and have responsibilities for
prior of deployment at site.
establishing heat stress mitigation
Provide rest shelter and water on site
measures.
prior of activity at site.
Ensure required rest period, and
HSE Dept. to monitor on daily basis for
minimum water needed.
the weather condition at site.
Provide own calibrated data logging
HSE Dept. to identify the Heat Index
Temperature and Humidity monitor to
danger category on daily basis.
ensure timely determination of weather
3 2 6 A standby qualified first aider/site 2 1 2
condition.
Nurse and first aid kit must be available
Danger category color coding shall be
at site.
per the heat index.
Ensure supply of water daily, to provide
Take appropriate action upon
abundant supply of water at site.
developing symptoms of heat cramps,
Ensure site with proper monitoring and
heat exhaustion or heat stroke.
using kestrel equipment heat stress
Ensure designated rest shelter have
program.
sufficient drinking water station.
Administrative controls like
acclimatization, temperature, and
humidity monitoring, flagging system
etc. should be in place.
Exposure to extreme Ensure all workers follow the use of Ensure appropriate PPE’S to be use
Cold clothing when temperature working to when temperature working to outside.
outside
Administrative controls like 3 2 6 Ensure site with proper monitoring and 2 1 2
acclimatization, temperature, and using kestrel equipment heat stress
humidity monitoring, flagging system program.
etc. should be in place
Lighting /thunderstorm Work is strictly prohibited during 3 2 6 Ensure all workers working at site with 2 1 2
lightning and project personnel are not proper shelter in place.
allowed to stay outdoor. Stop work immediately if Lighting
If safe building structures are not /thunderstorm and notify the transport
accessible, employers should guide foreman for the standby of BUS as
workers to hard-topped metal vehicles shelter at site.
with rolled up windows. Remain in the In any case of emergency, a standby
vehicle for at least 30 minutes after vehicle at site radio or cell phone to
meant for emergency parking. Use the with other oncoming vehicles.
headlights at night only.
Provide log sheet to in charge security,
Ensure all workers completed their
monitoring all workers their
COVID-19 booster shot.
temperature prior entering at site.
Be aware of using PPE’s and kept clean
Ensure disinfect or replace equipment,
and sanitized, damaged PPEs replace
PPE, and personal items before moving
immediately.
to other location.
For any purposes of meetings, face to
Prohibit doing shake hands. Use other
face greetings other technique or by
forms of non-contact greeting.
gesture only.
Ensure to avoid touching face if you are
Avoid contacting things if you are not
not sure you touch.
sure and refrain from touching your
Contact with person Handle with care of hygiene hand
13. Personnel interaction with face, nose etc.,
infected with COVID-19, washing guidelines.
co-workers’ control covid 19 Follow the safety protocol when you
potential spread to - All site personnel encourage to
during this pandemic at are inside the office, home and take
others at site. handwashing upon arrival at the site, 3 2 6 2 1 2
worksite care of hygiene and washing
- after exiting any
guidelines.
rooms/cubicle/conference room
Always use with hands soap for
alone,
washing at least 20 minutes.
- prior to taking a break,
Keep all handwashing equipment
- prior to eating lunch,
available at site, keep all materials
- after use of the bathroom,
inventory up to date.
Ensure with site handwashing
All areas must install soap and water
equipment available at Toilets.
handwashing dispenser readily
Make sure soap and water handwashing
available onsite.
facilities are readily available onsite. Do
Keep all workers monitored during the
not rely on hand sanitizer alone.
Safety Induction regarding 2 doses with
Personnel must complete the 2-dose
Booster Vaccine Shot.
with Booster Vaccine Shot.
14. Housekeeping. Poor Housekeeping. Remove banding, crate material, nails, 2 2 4 Ensure all unwanted materials to be 2 1 2
Lack of proper planning paint bottle, etc. and dispose of disposed properly on designated
Worker’s cleaning for Lack of housekeeping properly. location skip bins.
unwanted materials, resources Proper planning and look ahead by Prioritize the housekeeping scheduled
environmental Discipline Supervisor/Foreman. on or before the activity on daily basis
considerations after work Prior to commencing work, as part daily on site.
activity. progress, he shall plan for: Construction Team shall be
Housekeeping resources - hauling accountable for all the materials and
equipment (loader / dump truck / pre-arranged staging location area to
forklift) and dedicated crew. prevent any materials scattered on the
Regular collection of rubbish, every surroundings.
end of shift at minimum
Waste skips / covered metal trash
bins / disposable trash bags, etc.
Temporary staging area of scrap
materials
Note: Insert additional rows or print additional sheets as necessary to accommodate all job steps.
H&S Representative