Job Safety Analysis - Risk Identification

Location: JSA Number:

Prepared By: Crews Reviewed By: Supervisor's

Date: Date:
No Form : L2-CI-CF-HSE-8-3

Complete page 1 & 2 prior to performing all work

1. DESCRIPTION OF WORK:

Complete page
1 for ship

2. HAZARD IDENTIFICATION Note: Yellow = Golden Rules

Exposure to ✓ Exposure to ✓ Exposure to or ✓ General Notes:

Energy: Substance: requirement for
Situations:
Electrical Acids/Alkalis Permit To Work 1) Inform Team Leader of work being conducted.
Mechanical Gases Energy Isolation 2) All work being done will follow and reference the relevant
Hydraulic Vapours Ground Disturbance Procedures.
Pneumatic Fumes Confined Space Entry 3) All Lifting operations must be managed in coordination with the
Steam Dangerous Goods Working At Heights Supervisor
4) All personnel involved in the operation must be part of the JSA
Pressure systems Hazardous Substances Lifting Operations

Heat Fibres Driving Safety Crew/ Personnel;

Noise Microbiological Management of Change Name Signature
Vibration Open Pits/floor plates
High Temperature Suspended Loads
Low Temperature Slippery Surfaces
Flames Workplace Lighting
Commissioning Of Plant
Emissions

3. PRECAUTIONS NOTE: Safety Helmet,

Engineering Controls Personal Protection

Permits Required Administrative Controls Emergency Management
✓ Required And In ✓ ✓ (PPE) Required and ✓ ✓
and in place: Required and In Place: Required and In Place:
Place: Available:

LOTO Fire Extinguishers Notify SLC Safety Helmet Personal Exposure Detectors
Cold Work Barricades Notify Team Leader Eye Protection Warning Devices
Confined Space Guarding Complete Site Induction Safety Footwear Man Down Alarm
Hot Work Housekeeping Observer/Buddy required Protective Gloves Process Control
Work at Heights System Purging Limited Duration Hearing protection Maintenance
Work over Water Mechanical Ventilation Work Instructions Respirator Inspection
Lifting Lighting Quality Control Coveralls Liquid Containment
Bunkering Scaffolding Assembly Points Impervious suit Air Emissions Control
Energy Isolations Alarms Harness Waste Minimisation
Safety Showers High Visibility Vest Emergency Access adequate
Breathing Apparatus Life Jacket Emergency escape route
Communications Chin Strap
Radiation Detector
Stiffy Sticks
Fall Arrestors

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 JSA - Risk Identification Eliminate  Substitute  Control  Mitigate

Item No: STEPS HAZARDS POTENTIAL CONSEQUENCES CONTROLS

(Energy Sources) (Injury, illness, damage) (Consequence/ likelihood)

1 Persiapan alat Alat las tidak aman, short - Terbakar - Pre-Used Check welding machine
- Pre-Used Check grinding machine
- Ledakan - Welder terlatih
- Helper terlatih
- People Injury - PTW

2 Pengelasan Api terbuka - Terbakar - Sertifikasi welder

- Menggunakan Kap Las yang layak
Electrical - Tersengat listrik - Flash back arrester terpasang untuk tabung acetylene
dan oksigen
Sinar UV - Burnt Eye - Pastikan tidak ada bahan mudah terbakar di area
penngelasan
Incompetent Welder - Struktur Las buruk, kekuatan tidak maksimal - Batasi/Barikade area pengeleasan
- Siapkan alat pemadam api ringan, fire blanket
- People Injury

3 Penggerindaan Grinder Movement (Mechanical Energy) - People Injury - Personnel terlatih

- Gerinda dilengkapi safety guard
Percikan api - Terbakar - Pakai Faceshield
- Pastikan tidak ada bahan mudah terbakar di area
Api terbuka penngelasan
- Batasi/Barikade area pengeleasan
- Siapkan alat pemadam api ringan, fire blanket

4 Finishing dan Houskeeping Sumber panas - Bekas pengelasan dan gerinda terbakar - Fire Watch, keep monitor no open flame for 1 hour after
welding/grinding
Slip & Trip - Tersandung bahan dan alat kerja - Kembalikan alat pada tempatnya

- Bersihkan kembali area kerja

AAR; Action & Responsible Person of Every Step

RECOMMENDATION ACTION BY DUE DATE
Item Job Step
What Who When
1 Persiapan alat - Persiapan PTW

- Pre-Used Check welding machine

- Pre-Used Check grinding machine

2 Pengelasan - Menggunakan Kap Las yang layak

- Flash back arrester terpasang untuk tabung acetylene dan oksigen
- Pastikan tidak ada bahan mudah terbakar di area penngelasan
- Batasi/Barikade area pengeleasan
- Siapkan alat pemadam api ringan, fire blanket

3 Penggerindaan - Pakai Faceshield

- Pastikan tidak ada bahan mudah terbakar di area penngelasan
- Batasi/Barikade area pengeleasan
- Siapkan alat pemadam api ringan, fire blanket
4 Finishing & Housekeeping - Fire Watch, keep monitor no open flame for 1 hour after welding/grinding

- Kembalikan alat pada tempatnya

- Bersihkan kembali area kerja

Page 2 Version 2.0 - July 2022