JSA (Job Safety Analysis) Sheet

Ref-
Activity Name:-Drain line work

Location:- Date :

Risk(s)
Sr.No. Sub-Activity Name Type Of Hazard Risk Control measures
Involved
Only inducted worker shall be deputed at the work place.
Untrained
Manpower Personal Given Tool Box Talk to all workers.
1 worker,lack of skill
Mobilization injury Required work permits should be taken before start of activity
awareness
Work Shall be carried out under continuous Supervision.
Ensure general work permit taken by engineer & verified by Safety dept.
Ensure safe Access whle unloading of pipe
Unloading of pipe Improper Personal
Unloading shall be done in presence of supervisor.
from vehicle by unloading,Fall of Injury,
2 Ensure no person shall stand in front of slop
using slop ramp / person., material property
manually stuck to person, damage. Avoid unauthorised entry.
Workmen should be having all required PPEs
Unloading area should be identified provide caution sign boad.
Safety shoes safety helmet safety goggle florecent jacket cotten hand
gloves to be used.
Personal Ensure unauthourised entry, ensure safe distance between man and
Trap hazard
Injury Hydra or Farana
Ensure only inspected Hydra or Farana should use for material shifting
and pipe fixing
Shifting of pipe at Ensure hydra operator have valid licence
work location by
3 Only inspected and damage free slings/web belt should use
using hydra /
manually Before lifting of material with lifting equipment safety supervisor inspect
Fall hazard ( Personal
all tied slings are in proper way,then only material to be lifted.
material fall, Hydra injury, Fatal
or Farana tilt ) accidents No person stand below the lifted load Precautaions to be taken to
prevent load swing. Tied with guide rope
Predefining all the work location for above work.
While moving the material it will be kept tied at both end with guide rope
Ensure hydra operator have valid licence
Only inspected and damage free slings/web belt should use
Trap hazard,Fall Ensure area of work with even surface without any obstacle
Personal
hazard ( material Ensure after drain pipe shifting to fix position person will go for
4 Fixing of drain pipe injury, Fatal
fall, man fall, Hydra allignment
accidents Ensure persons leg is away from/ not below the load/pipe
or Farana tilt )
Ensure guide rope to control material swing
Insure only inspected hand tool use for work
Work Shall be carried out under contineous Supervision.
Personal Night work permit to be taken from concern engg.and safety dept.
Work during dark Darkness, fall of injury,
8 Ensure proper illumination during dark hours.
hours person, damage to Electrical cable should lead min 2 m height.No exposed electrical
property 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 : ______