JOB SAFETY ANALYSIS FORM

SEQUENCE OF BASIC ACTIVITY

STEPS/ PRESSURE LEAKAGE TEST POTENTIAL HAZARD HAZARDS CONTROL RESPONSIBLE PARTY
1) Check pipe length Trip hazard Watch your steps Site supervisor
2) Check mech. joints & pipe joints Trip hazard Proper handling of tools Site supervisor

Follow safety procedure for small tools

3) Check manual pump
4) Inject water pressure w/ manual pump
5)Water pressure established, repeat #2
procedure
6) Check end caps
7) Release of water pressure
Parts defect/ Malfunction
Bursting of rubber hose
Bursting of main pipes body and
its joints
Detachment where installed
Hit by pressurized water
requirement inspection Site supervisor
Pump gradually/ constant observation Site supervisor
Initial backfill of trench Site supervisor
Secure support/ tightly installed Site supervisor
Complete PPE suits and stand clear Site supervisor
REVISION:
Concrete Batching Plant Requirements
Description unit Qty
1) Design Mix 20N/mm2 or 3000 psi ( 28 days ) ea 1
2) Design Mix 28N/mm2 or 3500 psi ( 28 days ) ea 1
3) Test Certificate
a. Cement ea 1
b. Sand ea 1
c. Gravel stone ea 1
d. Water ea 1
e. Admixture ea 1
4) Batching plant calibration certificate ea 1
5) Testing equipment calibration certificate ea 1
6) Concrete cylinder sample
a. 3000 psi ( 28 days ) ea 3
b. 3500 psi ( 28 days ) ea 3

Note: All of the above, need to be submitted today to CTJV

MANHOLES TABULATED DATA Width x 2 Width x 2
SURVEY ORDINATES Top wall Bottom slab Wall & slab Height ( outside-mtrs ( inside
Description Northing Easting finished elev finished elev. Thickness ( meters ) ) -mtrs )
Manholes # 1
Manholes # 2
Manholes # 3
Manholes # 4
Manholes # 5
Manholes # 6
Manholes # 7
Manholes # 8
Manholes # 9
Manholes # 10
Manholes # 11