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Rev.

: 0
Date: 22.06.13
Page: 1 of 2
DATE:
Project Ref. /Job Title /Work Order:
A B C D E Brief Description of Job
Never heard of
in Industry
HSE Occurred
in Industry
HSE Occurred
in QP
Occurrs several
times a year in
QP
Occurs several
times a year at
this site.
Job Location: Lay Down Area
Hazard Area Classification:
Hot work
Participants (Parties involved in JSA)
Severity
Before
Mitigation
Severity After
Mitigation
2xC=MEDIUM 2xB=LOW
3xB=MEDIUM 3xA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
3xB=MEDIUM 3xA=LOW
Working at night - Grinding, Cutting,Welding &
Radiography
LOW
Slight damage, no
disruption to
operations
Slight effect Slight Impact LOW LOW LOW LOW
No damage No effect No Impact NO RISK LOW
LOW
0
1
RISK ASSESSMENT MATRIX
Potential
Severity
People Asset / Production
No Injury
Slight Injury or
Health Effects
Environment
JOB RISK ASSESSMENT FORM
INCREASING PROBABILITY
23 JSA No.:
HIGH HIGH
MEDIUM MEDIUM MEDIUM HIGH
Major damage
(=QR.25,000,000)
Major effect
Regional
Impact
LOW
PROJECT/JOB DETAILS
All the mitigation measures identified in JSA are in
place before starting the activities
Reputation
EPIC of New LGO Tank (2114FI) and Utilization of LC
Tank (2145FA) at QP Refinery, Mesaieed
LOW LOW
National
Impact
LOW
Minor damage (=
QR.250,000)
2
3
4
5
LOW
Extensive damage
(=QR.25,000,000)
Massive effect
International
Impact
MEDIUM MEDIUM HIGH HIGH HIGH
Minor Injury or
Health Effects
Major Injury or
Health Effects
Single fatality or
permanent total
disability
Permit Requirements:
HOT
MEDIUM MEDIUM
Multiple Fatalities
Local damage
(=QR.1,300,000)
Localized effect
Minor effect Limited Impact LOW LOW MEDIUM MEDIUM MEDIUM
Required Control/Mitigation Measures & Checks Action Party
REVISION: 00
Unauthorized work Obtain valid permit to work and PTW shall be validated for the specific day Site Supervisor & Site Safety
officer
Workers starting the job
without discussing JSA & TBT
JSA must be in place during working. Ensure all the persons take part in the tool box
meeting discussion & have understood the JSA.
Site Supervisor & Site Safety
officer
Mechanical & Safety
JSA -
Approved By
Probability Factor
Work site supervisor
Sl. No. Activity ( Job Steps) Potential Hazards
Haste or shortcut Responsible person shall conduct inspection monitor the work activities and have to ensure
safety standards work procedure are strickly adhere.
Site Supervisor & Site Safety
officer
Starting Job Without Permit Ensure that Permit to work is in place prior to commencement of the Job.
Site Supervisor must be available at site during working.
Site Supervisor & Site Safety
officer
By Passing Permit requirements Ensure that all other precautionary measures mentioned in the permit shall also be
fulfilled.
Site Supervisor & Site Safety
officer
1 Work start-Up
2 Grinding
Rotating equipment parts Make sure guards are fitted to all moving parts of the grinder and ensure the proper used
of the guards.
Site Supervisor & Site Safety
officer
Exposure of workers to various
hazard like hand injury, dust,
eye injury & flying objects
Ensure workers are complying with min. PPE requirements. safety shoes, safety helmet,
safety goggle & coverall.
Site Supervisor & Site Safety
officer
Damage grinding disk Inspect the grinding disc prior to use (ring test). Make sure that disc is compatible with the
grinding machine.
Site Supervisor & Site Safety
officer
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
3xB=MEDIUM 3xA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
4XB=MEDIUM 4XA=LOW
Job Steps: List the main sequential steps. Each Step should be analyzed with the associated risks involved and its severity
Alternatives Considered: What are the possible means of achieving the job outcome with less risks
Now undertake the JSA and record in the table above. Using JSA Hazard Checklist, Critical Questions & Risk Assessment tables.
Ensure workers are complying with min. PPE requirements. safety shoes, safety helmet,
safety goggle & coverall.
Site Supervisor & Site Safety
officer
Fire hazard Remove all combustible and proper isolation of the cutting area. Used of fire blanket and
availability of fire extinguiser.
While carrying out tests, there must be contingency plans, emergency kits, appropriate
warning signs and barricades.
There must be QP-Refinery safety approved calibrated Radiation survey meter for the
measurement of stray radiation levels associated with work.
Safety devices such as Flashing red/Amber warning lights, cordons notices, interlocks, QP-
Refinery safety approved Dose meter and emergency kits must be available at working
site.
Radiation supervisor / patrol the area around the controlled area to keep away non
classified persons in addition to setting up the controlled area cordons/visible warning
signs/audible alarms.
The controlled area must be surrounded by substantial barriers/ clearly visible
ropes/ribbons and placards marked with Danger Radiation----keep out.
Colored flashing amber / red lights must be placed along the outer barrier in addition to
safety signs and posters.
Site Supervisor & Site Safety
officer
JOB SAFETY ANALYSIS
Accidental Leak radiation Radiography contractor must have the valid certificate of registration from the agency
issuing the radioactive source and custom clearance papers.
Site Supervisor & Site Safety
officer
Radiographer dose exceeding
the annual radiation dose
Industrial radiographers / Radiography technicians/specialists accepted by the QP and
must be medically certified and must have a certificate showing their annuall record of
absorbed radiation
Site Supervisor & Site Safety
officer
Site Supervisor & Site Safety
officer
6
Body fatigue/heat stress Frequent breaktime shall be allocated. Adequate cold drinking water supply. Site Supervisor & Site Safety
officer
Qualified, trained & experienced employee Radiation protection supervisor must be at
site to regulate the activities of radiographers.
Site Supervisor & Site Safety
officer
Radiography
Ionizing radiation ( Leaky
Equipment
QP approved method statement for radiography activity must be at work location before
carrying out the radiography
Site Supervisor & Site Safety
officer
Inadequate shielding/Locking
of equipment
Must take approval from QP-Refinery Safety before bringing radioactive material to site,
the equipment must be locked when not operating and it must not be leaky
Site Supervisor & Site Safety
officer
Exposure of persons to
radiations
Electrocution/Damage cable Welding cables shall be in good condition. Proper earthing of the welding machine. Pre-
used inspection of the welding machine. Double insulated cables and avoid working in wet
areas.
Site Supervisor & Site Safety
officer
Working at Night
Poor illumination/Slip & trip Adequate ligthing shal be installed. Clear means of acces & egress.Good Housekeeping Site Supervisor & Site Safety
officer
Hot tabs end pieces of welding
rod/sparking & UV rays.
Ensure workers are complying with min. PPE requirements. safety shoes, safety helmet,
safety goggle & coverall, welding goggles/shield and welding gloves.
Site Supervisor & Site Safety
officer
5
Mechanical damage to source
or equipment by fire or
explosion
To transport shielded equipment containing radioactive source, Transporting vehicle must
be conspicuously marked with radiation warning symbol and notice.
When not in use shielded equipment with radioactive sources must be kept in specially
designated storage places which must be locked.
Untrained/Unauthorized
personnels starting the job
Fire hazard Remove all combustible and proper isolation of the cutting area. Used of fire blanket and
availability of fire extinguiser.
Site Supervisor & Site Safety
officer
4 welding
Burns Ensure workers are complying with min. PPE requirements. safety shoes, safety helmet,
safety goggle & coverall.
Site Supervisor & Site Safety
officer
Explosion Flash back arrestor between the cylinder torch.Hose in good condition.Gas monitor clearly
cited.Experience personnel for thye job.Inspect cylinder and hoses before the job start.
Site Supervisor & Site Safety
officer
Site Supervisor & Site Safety
officer
Electrocution Pre-use inspection of the grinding tools. Double insulated wire and proper cable
management. Avoid working in or near wet areas.
Site Supervisor & Site Safety
officer
3 Gas Cutting
Burns