[CLIENT] JOB SAFETY ANALYSIS FORM (JSA FORM)

Job Title: Department: Analysis By: Additional PPE Required: Tools Required: Identified Safety, Environmental and Procedure/ Hazards JSA No.: Revision No.: Reviewed By: Date of Issue: SCRIBE LEADER: Approved By: Project Supervisor in-charge: Recommended Safe Job Steps and Procedures Resp Person / Action by

Sequence of Basic Steps

1.

Mobilization of tools, equipment & fall arrest system materials

1.1

Accidental knocks onto process equipment

1.1.1 1.1.2.

Follow agreed access routes. Ensure that proper care and attention is paid to surrounding equipment when materials are being moved. Client will inform Contractor of any process related hazards in the area and identify any areas where access is restricted. Contractor to inform EM Control House directly or via EMR before start of every work day (to mitigate and keep the control house operator aware, and account for the people working in that area).

Contractor Supervisor Contractor Supervisor & Workers Client Supervisor, Contractor Supervisor Contractor Supervisor

1.2

Process related hazards

1.2.1.

1.2.2.

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

1.3 1.4.

Traffic Hazards Unauthorised access to work area.

1.3.1. 1.4.1.

1.5.

Bad housekeeping / Trip hazards Manual Handling related hazards.

1.5.1.

1.6.

1.6.1.

2.

Access to Flare Stack

2.1

Fall from height

2.1.1

All personnel to follow Jurong Refinery traffic rules and pedestrian rules. The work area will be barriered off using red and white barrier tape at agreed limits with signs stating that access is restricted to authorized personnel only. Good housekeeping will be maintained at all times. All tools and equipment to be placed properly to prevent trip hazards. All personnel will follow safe manual handling procedures. Personnel will assess each load before lifting and use team lifts where necessary. Where necessary the supervisor will arrange for alternative safe means of lifting. All personnel accessing the stack must wear either a full body safety harness or roped access harness complete with twin lanyards. Personnel must clip on to the ladders using the twin lanyards to maintain 100% tie off. After the initial access a temporary fall arrest system will be installed to the full height of the stack to allow ease of movement between levels. Once the fall arrest system has been installed and inspected by the supervisor personnel can clip to it using the rope grip devices.

Contractor Supervisor & Workers Contractor Supervisor

Contractor Supervisor & Workers Contractor Supervisor & Workers

Contractor Supervisor

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

2.2.

Exhaustion, fatigue, heat stress and dehydration.

2.2.1. 2.2.2.

2.2.3.

2.2.4. 2.4. Inclement weather, lightning strike. 2.4.1.

2.4.2.

Workers to take breaks at intermediate platforms as necessary. Workers should not carry out any work at height if they are feeling unwell. If they begin to feel unwell whilst working at height they should inform their supervisor immediately and descend to next platform to rest. All workers should follow the ExxonMobil site heat stress management plan. Supervisors to ensure that all workers take adequate rest stops and drink enough water. All personnel carrying out works on the stack are to be physically fit and acclimatised. EM supervisor to provide Contractor with EM radio. Supervisor to check the CAT1 announcement from the control house via channel 1A and evacuate the workers immediately if there is CAT1 announcement. Contractor Supervisor to monitor weather conditions, instruct descent from stack and prevent ascent during periods of inclement weather or CAT1 situations.

Contractor Worker Contractor Worker

Contractor Worker

Contractor Worker Contractor Supervisor

Contractor Supervisor

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

2.4

Falling objects

2.4.1

2.5

Inadequate training

2.5.1

All hand tools are to be used correctly and without overreaching. When not in use the tool should be stored in a secure container, or attached to the operatives tool belt. Fixings and other materials which pose a fall risk should be stored in secure solid containers when not in use, and returned to stores at the end of each shift. At no time should personnel pass beneath those working at height. The area beneath personnel working at height should be considered an exclusion zone. All personnel involved in the works will have had the required training. All equipment will be checked by the senior operative in order to ensure that the technician has set it up correctly and is aware of its proper use. Third Party personnel who wish to climb using the temporary fall arrest system will be trained in its use by the supervisor and will sign onto a special toolbox talk to say that they understand its use and will follow the instructions of the supervisor.

Contractor Supervisor/ Contractor Worker

Contractor Supervisor/ Client Supervisor/ Client workers

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

2.7.

Manual handling

2.7.1

2.8.

Worker becomes incapacitated

2.8.1.

Personnel will follow correct manual handling techniques at all times. Where personnel are operating from roped access heavy or unwieldy items will be lifted or lowered to them via hand line. Do not attempt to move/lift loads which may cause loss of balance or interfere with the access equipment. If necessary alternative mechanical means of lifting will be provided. Activate rescue plan Call EMR or SS to activate Fire & Security emergency personnel. Access ladders will be installed by trained and competent personnel. The ladder will be inspected by a senior steeplejack or supervisor and passed as safe before being released for general use. Access scaffolds will be installed by trained and qualified personnel using standard scaffold components. The scaffold will be inspected by a senior steeplejack or supervisor and passed as safe for use before being released for general use.

Contractor Supervisor/ Contractor Worker

3.

Installation and use of temporary access to Flare Tip

3.1.

Incorrect installation

3.1.1.

Contractor Supervisor Contractor Worker Contractor Supervisor Contractor Steeplejack Contractor Supervisor Contractor Steeplejack

3.1.2.

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

3.2.

Unauthorised modification

3.2.1.

3.3.

Falling objects

3.3.1.

3.3.2.

3.3.3.

No personnel will carry out modifications to temporary access systems without authorisation and instruction from the supervisor. Any modifications must be inspected by the supervisor or senior steeplejack before the system is certified as safe for use. The area beneath the working party shall be barriered off. Access to the area will be forbidden whilst the works are ongoing. The area will be monitored by an operative stationed at ground level. Components will be lifted in a controlled manner using a hand line. Components will be secured at the installation level before being released from the hand line. Components will be securely stored away from edges at all times until secured in place. All personnel will be trained and competent in manual handling procedures at height. The supervisor will monitor the works to ensure that procedures are being followed. Where necessary an alternative means of lifting will be provided.

Contractor Supervisor

Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor

3.4.

Manual handling

3.4.1.

3.4.2.

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

3.5.

Fall from height

3.5.1.

3.6.

Pinch points

3.6.1.

All personnel working at height will wear full body safety harnesses or full body roped access harnesses complete with twin lanyards. Personnel will maintain 100% tie off to a suitable hard point or fall arrest line at all times. Personnel will wear appropriate gloves when assembling access. Personnel to be familiar with the use of the hand tools. Hand tools will be used for the task for which they were intended, will not be modified and will be checked before use for defects. All personnel working at height will wear full body safety harnesses or full body roped access harnesses complete with twin lanyards. Personnel will maintain 100% tie off to a suitable hard point or fall arrest line at all times. The area beneath the working party shall be barriered off. Access to the area will be forbidden whilst the works are ongoing. The area will be monitored by an operative stationed at ground level.

Contractor Supervisor Contractor Workers

3.7.

Use of hand tools

3.7.1.

3.7.2.

4.

Replacement of corroded / missing items/ flare tip components etc.

4.1.

Fall from height

4.1.1.

Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers

4.2.

Falling objects

4.2.1.

Contractor Supervisor Contractor Workers

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

4.2.2.

4.2.3.

Components will be lifted in a controlled manner using a hand line. Components will be secured at the installation level before being released from the hand line. Components will be securely stored away from edges at all times until secured in place. All personnel will be trained and competent in manual handling procedures at height. The supervisor will monitor the works to ensure that procedures are being followed. Where necessary an alternative means of lifting will be provided. Personnel to be familiar with the use of the hand tools. Hand tools will be used for the task for which they were intended, will not be modified and will be checked before use for defects. Installation will be carried out by competent personnel. All installed items will be inspected by the supervisor to ensure that they have been installed correctly on completion.

Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers

4.3.

Manual handling

4.3.1.

4.3.2. 4.4. Use of hand tools 4.4.1.

4.4.2.

4.5.

Incorrect installation

4.5.1.

4.5.2.

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

5.

Painting Works

5.1.

Chemical hazards

5.1.1.

5.2.

Falls from height

5.2.1.

5.3.

Falling objects

5.3.1.

The materials used will be subject to a COSHH assessment. Safe use procedures for the material will be specified in the assessment. The Supervisor will ensure that all personnel handling the material or likely to come into contact with it will be issued with the appropriate PPE and will follow the correct handling procedures as specified in the COSHH assessment. A toolbox talk will be carried out before the works start covering all safe work procedures to be followed. All personnel working at height will wear full body safety harnesses or full body roped access harnesses complete with twin lanyards. Personnel will maintain 100% tie off to a suitable hard point or fall arrest line at all times. The area beneath the working party shall be barriered off. Access to the area will be forbidden whilst the works are ongoing. The area will be monitored by an operative stationed at ground level.

Contractor Supervisor Contractor Worker

Contractor Supervisor Contractor Workers

Contractor Supervisor Contractor Worker

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

5.3.2.

5.4.

Use of hand tools

5.4.1.

All tools will be secured to the operatives belt or in a suitable pouch secured to the bosuns chair or located on an adjacent platform when not in use. The paint containers will also be secured to the bosuns chair or stored on an adjacent platform. Personnel to be familiar with the use of the hand tools. Hand tools will be used for the task for which they were intended, will not be modified and will be checked before use for defects. Personnel to be familiar with the use of the hand tools. Power tools will be used for the task for which they were intended, will not be modified and will be checked before use for defects. All electrical tools and equipment will be inspected by an LEW before being used on site. Operatives will inspect their tools before use and report any defects to the supervisor.

Contractor Supervisor Contractor Worker

5.4.2.

5.5.

Use of power tools

5.5.1.

5.5.2.

5.6.

Electrocution

5.6.1.

5.6.2.

Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

5.6.3.

Power supplies will be fitted with a circuit breaker. All personnel working at height will wear full body safety harnesses or full body roped access harnesses complete with twin lanyards. Personnel will maintain 100% tie off to a suitable hard point or fall arrest line at all times. The area beneath the working party shall be barriered off. Access to the area will be forbidden whilst the works are ongoing. The area will be monitored by an operative stationed at ground level. All tools will be secured to the operatives belt or in a suitable pouch secured to the bosuns chair or located on an adjacent platform when not in use. The paint containers will also be secured to the bosuns chair or stored on an adjacent platform. Personnel to be familiar with the use of the hand tools. Hand tools will be used for the task for which they were intended, will not be modified and will be checked before use for defects.

6.

Cleaning of oxidised material at flare tip

6.1.

Falls from height

6.1.1.

Contractor Supervisor Contractor Workers Contractor Supervisor Contractor Workers

6.2.

Falling objects

6.2.1.

Contractor Supervisor Contractor Worker Contractor Supervisor Contractor Worker

6.2.2.

6.3.

Use of hand tools

6.3.1.

6.3.2.

Contractor Supervisor Contractor Worker Contractor Supervisor Contractor Worker

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Sequence of Basic Steps

Identified Safety, Environmental and Procedure/ Hazards

Recommended Safe Job Steps and Procedures

Resp Person / Action by

6.4.

Airborne dust

6.4.1. 6.4.2.

7.

Demobilisation and Housekeeping

7.1.

Accidental knocks onto process equipment

7.1.1 7.1.2.

All personnel carrying out the works or working in the area will wear N95 type respiratory protection. Personnel may also be issued with goggles for eye protection from dust. Follow agreed access routes. Ensure that proper care and attention is paid to surrounding equipment when materials are being moved. Client will inform Contractor of any process related hazards in the area and identify any areas where access is restricted Contractor to inform EM Control House directly or via EMR before start of every work day (to mitigate and keep the control house operator aware, and account for the people working in that area). All personnel to follow Jurong Refinery traffic rules and pedestrian rules. The work area will be cleared and housekeeping carried out to return it to its original condition and remove any waste material. Barriers will only be removed once housekeeping is completed.

Contractor Supervisor Contractor Supervisor Contractor Supervisor Contractor Supervisor & Workers Client Supervisor, Contractor Supervisor Contractor Supervisor

7.2.

Process related hazards

7.2.1.

7.2.2.

7.3. 7.4.

Traffic Hazards Bad housekeeping / Trip hazards

7.3.1. 7.4.1.

Contractor Supervisor & Workers Contractor Supervisor & Workers Contractor Supervisor & Workers

7.4.2.

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This JSA was reviewed the following team members:

Name Signature Dept /Company Tel / VHF

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