JSA (Job Safety Analysis) Sheet

Ref-
Activity Name:- Maintainance & greeceing activity of excavator
Location:- Date :

Sr.No. Sub-Activity Name Type Of Hazard Risk(s) Involved Risk Control measures
Only inducted worker shall be deputed at the work place.
1 Manpower Mobilization Untrained worker Personal injury
Given Tool Box Talk to all workers.
2 Maintainance activity Slip/Trip Personal injury/Skin irritation Ensure engine swithced off before opening.

1.Cleaning
a. Forget to shut off
a.Driver keeps bucket at ground level.
engine resulting into
B.Shuts off the engine
accidental start of a. SOP to be displayed in the local language for cleaning activity
c.Close the cabin.
engine. a. Major Injury on the pockland.
D.Lock the cabin
3 b. Fall from height due b. Major Injury b. SOP to be formed as part of training of pockland driver and
e.Collects the cotton waste
to improper method to c. Skin diesease banks man before certifying them competent to work on same.
-- Ground level cleaning
access the height. c. Only trained driver to work on the pockland w
-- Height cleaning climb on the
c. Splash of grease or
conveyor to access the height.
contact with grease
-- Clean and grease using gre

a. Issue of fire in barrel

during storage of
2.Diesel filling activity. barrel of diesel.
A.Diesel brought at the site in 200ltrs b. Injury to the person
barrels in truck. while movement of the 1.Fire hazard a. To designate the area for temporary parking of the truck
B.Truck parked in designated parking truck. 2.personnel injury containing the diesel barrel.
area. c. Fall injury while 3.personnel injury b. To barricade the area with cautionary board of " Diesel highly
4
C.Truck moves to the area where filling climbing to access the 4.Diesel spillage issue. flammable material stored"" No smoking and open flames
activity is to be carried out. diesel charging port 5.Eye injury due to the allowed".
D.Cleaner opens the knob of the barrel d. Overflow of the splashed diesel. c. Use of proper access method to
of diesel. diesel from the storage
E. Cle tank.
e. Splash while
removing

Name & Signature of Site Engineer / Supervisor :___________

Name & Signature of Site In-charge :___________

Name & Signature of Project In-charge :__________

Name & Signature of HSE Officer : ______