Professional Documents
Culture Documents
PART-A
JSA Date: 25.08.2021
Unit/Plant Area: BOOSTER PUMP SHED & AREA Area: OLD BOOSTER PUMP SHED DISCHARGE PIPING
Location/Equip:OLD BOOSTER PUMP SHED DISCHARGE PIPING
Description of Work: HOT TAPPING FOR HOOK UP OF CONNECTION OF NEW BOOSTER UNITS
Work Permit Type: Hot Work permit
Job Title: Cutting Works by Grinding M/C Valve Replacement Welding & Cutting
JSA Done By: 00506924 Mandeep Singh
00094014 Awadh Kishor
Declaration:
I have understood all the hazards and control measures mentioned in JSA.
Contractor: ........................................................................
Note:
1. To make JSA process effective, the defined job shall be broken down into sequential steps. Actions / activities for
each steps shall be logical & linked with previous & forward action steps. All possible hazards associated with each job
step shall be deliberated among the persons involved in preparing JSA and recorded carefully. JSA recommendations /
control measures for each hazard / job step should be validated by team members & recorded in the Part-A of JSA sheet.
Use additional JSA sheets as per requirements.
2. Review of JSA shall be done by Location In-Charge. After review Location In-Charge put his signature with name
& date.
3. The Job shall be carried out with safety precautions as per JSA recommendations. In order to ensure that job is
being executed as per JSA recommendations, the job shall be audited by the Location In-Charge/DSO while the job is in
progress and recorded in the Part-B of JSA Sheet with compliance status, name, signature, date & time of audit by the
Officer.
Indian Oil Corporation Limited
Paradip - Haldia - Barauni Pip
Job Safety Analysis Worksheet
JSA No. : 9280J2100052
Status: Not Approved
PART-B
Compliance Audit by JSA Team Members while the Job is being executed :