JOB HAZARD ANALYSIS (JHA) WORKSHEET

JHA NO. PTW NO WORK PERMIT TYPE cold

FACILITY LOCATION SPECIFIC WORKSTATION
EQUIPMENT NO. WORK DESCRIPTION Lifting & installation of FRP underground storage tank
NOTE
1. JHA Shall be applicable for all work activities which required PTW.
2. Personnel carrying out the work shall be fully familiar with the written Work/Operating Procedures develop for the job. The Work/operating procedures shall describe, in step-by-step instructions, the correct
method of executing the specified work.
3. Prior to commencement of work, the task-specific JHA shall be discussed amongst all personnel involved in the execution; and requirements contained shall be fully understood and agreed by all involved
personnel.

POTENTIAL CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY

JOB STEP DESCRIPTION OF JOB STEP POTENTIAL HAZARD
Consequences
1 Worksite Preparation  Miscommunication  Property  Supervisor explain  Supervisor  Stop work and
Damage the method to all  Foreman de-brief.  Supervisor
 Personnel crew before start  Workleader  First Aid Kit  Foreman
injury work during pre-  Riggers  First Aider
job safety meeting

 Proper task
delegation

 Make sure crew

fully agreed on the
task & understood
by signing JHA
Sheet.

 Unauthorized work  Conflicting  Obtained approved  Supervisor  Stop work

with other PTW  Foreman  Supervisor
work/party  Workleader  Foreman
 Riggers

 Wrong  Personnel  Use suitable  Supervisor  Only inspected

tools/equipment for injury tools/equipmen  Foreman tools/equipment  Supervisor
the job t  Workleader with approved  Foreman
 Pre-inspection  Riggers sticker are
on each tools allowed to be
and equipment used
 JOB HAZARD ANALYSIS (JHA) WORKSHEET

 Congested  Personnel  Routine  Lifting  Workplace

Working Area injury Housekeeping Supervisor inspection  Supervisor
 Property before & after  Workleader  First aid kit  Foreman
damage work  Rigger  STOP Work  First Aider
 Remove &  Helper Authority
clear
obstruction
material
 Display caution
signage

2 Crane preparation  Malfunction crane  Property  Crane  Lifting  STOP work  SHO
damage inspection & Supervisor authority  Lifting
certification  Spilt kit standby supervisor
 Crane Manual  Crane at crane  Lifting
checklist operator Foreman
 Daily routine
inspection
before start
work

 Incompetent crane  Property  Compliance to  SHO  Qualified crane  SHO

operator damage Active  Lifting operator  Lifting
 Personnel Assessment supervisor supervisor
injury Evaluation  Lifting Lifting
Foreman Foreman
 Incompetent lifting  Property  Compliance to  Crane  Qualified &  SHO
team damage Active operator trained lifting  Lifting
 Personnel Assessment  Supervisor team supervisor
injury Evaluation  Workleader  In House lifting  Lifting
 Banksman/ awareness Foreman
 signalman training

3  Pre-sling of rigging  Damage lifting  Personnel  To Inspect the  Supervisor  Unsure lifting
equipment gear injury lifting gear prior to  Foreman gear are  Supervisor
 Property use  Riggers inspected  Foreman
damage  Workleader  Use Impact
 Competent lifting Gloves
team are engage

 Discard Damage
Lifting Gear
 JOB HAZARD ANALYSIS (JHA) WORKSHEET

 Improper Manual  Body Injury  Posture, lifting &  Supervisor  First Aid Kit  Supervisor
Handling stability technique  Foreman  TBM  Foreman
 Use mechanical  Workleader  PJSM
device whenever  Riggers
necessary.
 Sufficient
manpower
 Avoid twisting
motion.
 Identify Load
Weight
 Buddy System
 Slip, trip and fall  Personnel  Housekeeping area  Supervisor  Workplace  Supervisor
injury  Ensure safety boot  Foreman inspection  SHO
sole in good  Riggers
condition  Workleader
 Avoid short-cut
step.

 Sharp Edges  Hands and  Identified & cover  Supervisor  Close supervision  SHO
finger injury any of sharp edge  Foreman by supervisor  Supervisor
 Body Injury  Remove  Signalman  Proactive  Foreman
protruding  Crane intervention  Rigger
material/ sharp Operator  First aid kit at First Aider
edges  Riggers jobsite
 Workleader  Use impact Glove

4 lift of Storage Tank  Uncontrolled  Property  Taglines to be  Supervisor  Weather forecast

movement of load damage attached  Foreman monitoring  Supervisor
(COG not in  Barricade &  Riggers  Workleader
correct align) warning signage at  Workleader  Installation of  Signalman
Jobsite.  Signalman Guide bumper
 Additional webbing
sling for control  Only Authorized
COG person allow to
 JOB HAZARD ANALYSIS (JHA) WORKSHEET

enter jobsite

 Communication  Message not  Use VHF radio as  Supervisor  Standard Hand

Failure clearly primary method  Foreman signal to be  Supervisor
delivered for communication  Signalman utilized  Foreman
 Property  Crane  Signalman to  Signalman
Damage  Dedicated Operator wear the high
 Personnel Signalman in place  Workleader florescent yellow
Injury vest
 Under rated lifting  Lifting gear  Follow SWL  Supervisor  SHO
gear failure  Follow Approved  Foreman  Discard all  Supervisor
 Property lifting plan  Workleader damaged lifting  Foreman
Damage  Barricade & gear
 Personnel warning signage at  STOP work
Injury Jobsite. authority.
 Only Authorized
person allow to
enter jobsite
 Slip, trip and fall  Personnel  Housekeeping area  Supervisor  Workplace  Supervisor
injury  Ensure safety boot  Foreman inspection  SHO
sole in good  Riggers
condition  Workleader
 Avoid short-cut
step.

 Sharp Edges  Hands and  Identified & cover  Supervisor  Close supervision  SHO
finger injury any of sharp edge  Foreman by supervisor  Supervisor
 Body Injury  Remove  Signalman  Proactive  Foreman
protruding  Crane intervention  Rigger
material/ sharp Operator  First aid kit at First Aider
edges  Riggers jobsite
 Workleader  Use impact Glove
 JOB HAZARD ANALYSIS (JHA) WORKSHEET

 Drop Object  Personnel  Stay clear from  Supervisor  Only essential

Injury the lifting area  Foreman lifting team are  Supervisor
 Barricade &  Signalman involved  Foreman
warning signage  Crane
surrounding lifting Operator
area  Workleader
 Wesel to be use
upon lifting
activities
5 Anchoring & lashing  Slip, trip and fall  Personnel  Housekeeping area  Supervisor  Workplace  Supervisor
tank injury  Ensure safety boot  Foreman inspection  SHO
sole in good  Riggers
condition  Workleader
 Avoid short-cut 
step.

 Sharp Edges  Hands and  Identified & cover  Supervisor  Close supervision  SHO
 Pinch Point finger injury any of sharp edge  Foreman by supervisor  Supervisor
 Body Injury  Remove  Proactive  Foreman
protruding  Riggers intervention  Rigger
material/ sharp  Workleader  First aid kit at First Aider
edges jobsite
 Use impact Glove

 Improper Manual  Body Injury  Posture, lifting &  Supervisor  First Aid Kit  Supervisor
Handling stability technique  Foreman  TBM  Foreman
 Use mechanical  Workleader  PJSM
device whenever  Riggers
necessary. 
 Sufficient
manpower
 Avoid twisting
motion.
 Identify Load
Weight
 Buddy System
 JOB HAZARD ANALYSIS (JHA) WORKSHEET

6 Work Completion  Untidy workplace  Block of  Housekeeping  Supervisor  Workplace  Supervisor

emergency  Foreman inspection  SHO
escape route  Workleader
 Riggers
 SHO

 Slip, trip and fall  Personnel  Housekeeping area  Supervisor  Workplace  Supervisor
injury  Ensure safety boot  Foreman inspection  SHO
sole in good  Riggers
condition  Workleader
 Avoid short-cut
step.

 Sharp Edges  Hands and  Identified & cover  Supervisor  Close supervision  SHO
finger injury any of sharp edge  Foreman by supervisor  Supervisor
 Body Injury  Remove  Signalman  Proactive  Foreman
protruding  Crane intervention  Rigger
material/ sharp Operator  First aid kit at First Aider
edges  Riggers jobsite
 Workleader  Use impact Glove
 JOB HAZARD ANALYSIS (JHA) WORKSHEET

JHA APPROVAL DURING PTW APPLICATION

REVIEWED BY APPROVED BY
NAME NAME

DESIGNATION WORK LEADER DESIGNATION PRODUCTION SUPERVISOR /MAITENANCE SUPERVISOR /BASE

SUPERVISOR/FUNCTIONAL SUPERVISOR
SIGNATURE SIGNATURE

DATE DATE

AFTER PTW HAS BEEN APPROVED

WORK TEAM (CONFIRMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PRE_JOB/TOOLBOX MEETING _ AFTER PTW HAS BEEN APPROVED)

Name (S) Designation Signature Signature Signature Signature Signature Signature Signature Name (S) Designation Signature Signature Signature Signature Signature Signature Signature