JSA (Job Safety Analysis) Sheet

Activity Name:- Sand receiving, sampling & unloading. Ref-

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.

Vehicle entry at main Checking of documents & instructing driver not to exceed speed
2 Unauthorised entry Major injury
gate limit of 15 km/Hr.

For sampling use proper inspected tools.

Ensure no vehicle moment while sampling.
3 Sampling of material Fall Personal injury
Can explore the possibility of use of sampling point with two
poles,wire rope and FBSH while at height.

Provision of banks man for guiding the process and stopper for
vehicle.
4 Loading & unloading Fall/Slip/Trip Personal injury
Ensuring the level ground for unloading dumper at dumping area.

Name & Signature of Site Engineer / Supervisor :___________

Name & Signature of Site In-charge :___________

Name & Signature of Project In-charge :__________

Name & Signature of HSE Officer : ______