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JSA (Job Safety Analysis) Sheet

Activity Name:- Deshuttering of Column Ref-

Location:- Date

Sr.No. Sub-Activity Name Type Of Hazard Risk(s) Involved Risk Control measures
Manpower Untrained worker,lack Only inducted worker shall be deputed at the work place.
1 Personal injury
Mobilization of skill awareness Given Tool Box Talk to all workers.

Area barricade to restrict entry.

Ensure full body safety harness anchor by each workmen.

Engaged trained & experienced psreson on the job.


2 Deshuttering Fall of material Personal Injury
Maintain good house keeping at work site.
Ensure all hand tools are inspected.
Conduct tool box talk before starting the work.

Ensure recommended PPE should be worn the worker such as safety


Unispected FBSH Fall of person
shoes,helmet, hand gloves goggles & dust mask.
Without edge Inspected FBSH having double lanyard, shockabsorber should be
Fall of person
protection provided.
3 Working at height Life line, hard barication and safety net should be provided on edge.
Unapproved scaffold Fall of person

Scaffold shall be erected on even surface by providing base plate, side


support, and ledger at every at 500mm with side supports wherever
height increases beyond 2 mtrs .

Night work permit to be taken from concern engg.and safety dept.


Darkness, fall of
Personal injury, Ensure proper illumination during dark hours.
4 Work during dark hours person, fall of
damage to property Electrical cable should lead min 2 m height. No exposed electrical
machinery
wire.Earthing.
Route shall be illuminated.

Name & Signature of Site Engineer / Supervisor :___________


Name & Signature of Site In-charge :___________

Name & Signature of Project In-charge :__________


Name & Signature of HSE Officer : ______

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