JOB SAFETY ANALYSIS (JSA) FORM

Job Location/Site: Task/Activity: ERECTION AND DISMANTLING OF SCAFFOLDING Work Area:

Emergency situation /Evacuation
SL. NO

JSA NO:11 PCR NO : PCR NO: Date:

Permit N0:

Gas Leak / Fire /Any Emergency: In case of emergency, all works must be stopped, equipment must be switched off
and left in safe condition. All personnel shall reach the nearest muster point considering the wind direction (upward or cross-ward) WHO IS AT RISK

ACTIVITY STEPS

HAZARDS INVOLVED

CONTROL MEASURES

Morning tool box Meeting And JHA Discussion

Work Permit

People Not Understanding What The Plan Or Hazards Are; People Afraid To Ask Questions Presence Of H2S gas and Toxic gas In Work Areas Presence of chemical or flammable items Unauthorized commencement of works May result in exposing people and/or potential to harm or danger.

People Equipment Facility Environment

Make Sure Everyone Is Involved With The JSA/JHA Discussion And Understands; Encourage Everyone To Ask Questions And Participate. Don't Make Anyone Feel For Speaking Up Or Questioning Try To Identify These Types Of things In Your Work Areas Before Starting the work; Clear Carefully Work Areas By gas testing and daily site inspection Authorized work permit holders shall ensure obtaining and maintaining valid work permits. The supervisor responsible for this activity has to check the PPE of his staff to ensure that all required items are available and properly used. Inform all people regarding permit conditions before work starts. Supervisors must conduct daily toolbox talk about nature of work and associated potential hazards and their essential precautionary measures. Carryout gas test by QP Authorized gas tester time to time. All groups working in different area inside station shall have H2S personal gas monitor(certified)

People Equipment Facility Environment

Gas test

May found toxic gas or H2S gas leak People or extreme oxygen limit in air Environment

PJ247/JSA-11-REV-0

ERECTION AND DISMANTLING OF SCAFFOLDING Page 1 of 3

JOB SAFETY ANALYSIS (JSA) FORM

SL.NO ACTIVITY STEPS HAZARDS INVOLVED WHO IS AT RISK CONTROL MEASURES

4
Scaffolding Preparation of work/Hauling of materials

Mobility restriction, access obstruction, congestion in the work area if hauling/storing of material in not properly planned and coordinated. Nearby existing facilities if any subject to physical damage during material hauling

People Equipment Facility

Survey the area and confirm safe location of temporary of material prior to hauling. Provide temporary holding area at location that will not congest/obstruct plant access or restrict mobility of other activities. Obtain necessary permit Provide temporary holding area at location that will not congest/obstruct site access or restrict mobility of other activities. Scaffold rack is a must for holding scaffolding material. No pipes, couplers will be stored on the ground or anytime scattered on the ground. Observe extra caution in mobilizing material at site Take extreme care during erection and override it if needed.

Erection & of Scaffolding

Use Damage to onsite detectors People /switches / transmitters etc Facility Equipment Fall of objects / Tools. People Facility Equipment

Provide guardrail & toe board to prevent falling of tools /objects Dont keep the unnecessary materials on the scaffold platform Hand tools to be tied with permanent structure or person If required barricade the area during erection work.

7 8 9 10 11

Accidental Fall of Person Unstable Scaffold Weak Scaffold

People People Facility Equipment People Facility Equipment People Facility Equipment People Facility Equipment

The Scaffolder must use Safety Harness/full body harness to prevent accidental fall The scaffold must be inspected, certified & tagged bythe competent person confirming its suitability The scaffold tag must indicate the maximum load that itcan bear

Damaged Scaffold Modified Scaffold

The scaffolding is to be inspected at least weekly for any damage due to weather condition (rain, high windetc) or other unsafe conditions. In case of any modification, addition in the scaffold, ithas to be reinspected & certified Page 2 of 3

PJ247/JSA-11-REV-0

ERECTION AND DISMANTLING OF SCAFFOLDING

JOB SAFETY ANALYSIS (JSA) FORM

SL.NO ACTIVITY STEPS HAZARDS INVOLVED WHO IS AT RISK CONTROL MEASURES

12

Improperly Supported Scaffold

People Facility People Facility

Ensure Scaffold is securely supported on a rigid groundand not on process piping / vessel or equipment Do not use if green Tag is missing Do not use if red tag is available.

13

Incomplete Scaffold

14 15

Old Scaffolding Housekeeping Clean up worksite

Doubtful Integrity

Do not use if it does not have valid inspection tag attached Remove tools equipment and rubbish from worksite and maintain a clean work environment. Arrange housekeeping on daily and every shift bases Supervisor shall conduct tool box meeting in this regards

Slips trips and falls due to poor housekeeping

People Environment Facility Equipment

Project Engineer PREPARED BY:

HSE/QA/QC Manager REVIEWED BY:

Project Manager APPROVED BY:

Page 3 of 3 PJ247/JSA-11-REV-0 ERECTION AND DISMANTLING OF SCAFFOLDING