JOB SAFETY ANALYSIS

Location /System
Task Description
JSA Team

Date

JSA:

Site Visited

Is an MOC required Yes

No X
Are there any Y2K Issues Yes
No X
Has consideration been given to weather conditions Yes
Hazard Effect (HE)x Probability(P) =Risk(R) *R Signifies residual risk after control measures in place

SEQUENCE OF BASIC JOB STEPS

HAZARDS IDENTIFIED

HE

No X

CORRECTIVE MEASURES / RECOMMENDATIONS

Are written procedures available

HE(R*)

P*

R*

Yes

ACCEPT RISK ?

SAFETY EQUIPMENT REQUIRED

Safety hard hat

Safety boots
Safety glasses
Goggles
Fire resistant clothing

Work vests
Safety Harness
Fire extinguishers
Fire watch
Fire blanket

Face shield
Barricades
Rope off area.
Cotton Gloves
Leather Gloves

Hearing protection
Vessel entry permit
Hot work permit
Scaffolding
Chemical resistant gloves

Lock out
Tag out
Lifting precaution
Dust/Chemical Mask
Gas Detectors

CHECKLIST PROMPTS
NOTE: Checklist is not comprehensive.
PROCESS FLUID RISK - Flammable, Toxic, Corrosive, Pressure, Temperature, Foaming, LSA/Pyrophoric Scale, Hydrates, Sand / Debris, Wax, Inventory Volume, System Status
ISOLATION HAZARD RISK - Isolation standard, Past Performance, Integrity Problems, Proof of valve integrity, Impact of work on isolation, Possible to monitor Pressure Build Up
Migration from other systems, Scope for reverse flow, Scope for blockage, Trapped pressure, Local ESD facilities, Time to initiate ESD, Time to shutdown/blowdown
ACTIVITY TYPE RISK - Breaking Containment, Hot Work, Heavy Lift, Confined Space Entry, Drilling/Well Operations, Explosive Handling, Diving, Radiography, Electrical/High Voltage, Overboard Work
Scaffolding, Manual Handling, Water jetting/Sand Blasting, Impact on Safety Systems, Handovers, Use of Hand tools, Non-routine task, SIMOPS
HAZARD TYPE RISK - Falling from height, Falling objects, Collision, Access/Egress, Moving Machinery, Noise, Chemical exposure, Weather Conditions, Fumes/Dust, Illumination, Competence of personnel,
Hazard to Environment, Flaring / hydrocarbon gas release, Spillage / Oil to sea, Spillage / chemical, Waste management / hazardous waste, Trapped between, Emissions to atmosphere

JSA Team Leader:

Date :

Site Supervisor Endorsement :

Date :

No X