Professional Documents
Culture Documents
Likelihood
Decision justification
Check Point
1-
2-
What Other Work Activities Are Taking Place at the Same Time?
3-
4-
In What Situation That The Group Need To Stop The Job (Tick if Applicable) :
A key member of the team has to leave, takes a break or absent from the workstation.
Other:
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5-
Comments/Feedback / Work Improvements (related to the topic discussed) from Work Group:
6-
Ensure Everyone has Clear Understanding of What They Are Required To Do?
Name
Assesment Leader
(Name) :
Revision Number:
Assesment Members
(Name) :
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Assesment Leader
(Name) :
Revision Number:
Assesment Members
(Name) :
Area:
(Signature) :
Date:
Review By (HSE)
(Name) :
3-Nov-13
Job Sequence
Hazard
Pinch point.
Bahagian yang menyebabkan tersepit.
Risk Control
Risk
People
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Assesment Leader
(Name) :
Revision Number:
Assesment Members
(Name) :
Area:
(Signature) :
Date:
Review By (HSE)
(Name) :
3-Nov-13
Unstable terrain.
Permukaan yang tidak rata
Traffic hazard.
Hazad lalu lintas.
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Assesment Leader
(Name) :
Revision Number:
Assesment Members
(Name) :
Area:
(Signature) :
Date:
3-Nov-13
Review By (HSE)
(Name) :
Applicable legal & other requirements relating to the task (if any) :
*Note: General OSH Act and Factories and Machinery Act shall be applied at all times.
*Note: In the absent of HOD/Manager or during weekend/public holiday/night or normal shift supervisor or higher authorized person is authorize/responsible to sign (approved) the JSA.
Rev No : 4 (07.10.2013)
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Date
Shift
1st
2nd
3rd
D/N
Work Area
Comment
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Duty
Signature
Name
Duty
Signature
ETY ANALYSIS
Signature:
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ETY ANALYSIS
Signature:
Signature:
Approved By (HOD/Manager)
Signature:
(Name) :
Risk Assessment
(with current control)
Probability
Severity
Risk Control
Risk
Rating
Risk Assessment
(with additional control)
Probability
Severity
2
2
Risk Control
Risk
Rating
Responsible person
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ETY ANALYSIS
Signature:
Signature:
Approved By (HOD/Manager)
Signature:
(Name) :
Page 10 of 27
ETY ANALYSIS
Signature:
Signature:
Approved By (HOD/Manager)
Signature:
(Name) :
Page 11 of 27
Hazard Checklist
List of hazards
Senarai Hazad
Falling/Dropped objects.
Objek jatuh.
Flying objects.
Objek terbang
Noise.
Bunyi bising.
Pinch point.
Bahagian yang menyebabkan tersepit.
Potential energy from the equipment / material.
Pelepasan tenaga tersimpan oleh alatan / material
Job Sequence
Aturan Kerja
Hazard Checklist
List of hazards
Senarai Hazad
Slippery surface
Permukaan licin.
Unstable terrain.
Permukaan yang tidak rata
Vehicle collision.
Pelanggaran kenderaan.
Job Sequence
Aturan Kerja
Hazard Checklist
List of hazards
Senarai Hazad
Static electricity.
Elektrostatik
Lightning.
Kilat/ petir .
Haze.
Kabus .
Job Sequence
Aturan Kerja
Hazard Checklist
List of hazards
Senarai Hazad
Breathing problem.
Masalah pernafasan
Exposure to radiation.
Pendedahan kepada radiasi.
Dog Bites.
Gigitan daripada anjing.
Job Sequence
Aturan Kerja
Hazard Checklist
Job Sequence
Aturan Kerja
List of hazards
Senarai Hazad
Category: Other
Lain-lain
Narrow space.
Ruang kerja yang sempit.
Traffic hazard.
Hazad lalu lintas.
Tire Cut.
Kerosakan pada tayar.
Hazad
Hazard Checklist
Job Sequence
Aturan Kerja
Hazard Checklist
Job Sequence
Aturan Kerja
Hazard Checklist
Job Sequence
Aturan Kerja
Hazard Checklist
Job Sequence
Aturan Kerja
Hazard Checklist
Job Sequence
Aturan Kerja
RISK MATRIX
Severity Level
(Value)
Probability (Value)
Very Unlikely (1)
Unlikely (2)
Possible (4)
Likely (8)
Negligible (1)
16
Moderate (2)
16
32
Significant (4)
16
32
64
Low Risk
Medium Risk
High Risk
Rating Keys:
S = Severity (consequences)
P = Probability (Likelihood of an event
occurring)
Severe (8)
Catastrophic (16)
16
32
64
128
16
32
64
128
256
HARM TO PEOPLE
PROPERTY /
EQUIPMENT
DAMAGE
SEVERITY DESCRIPTION
1- NEGLIGIBLE (1)
2-MODERATE (2)
3-SIGNIFICANT (4)
4- SEVERE (8)
5-CATASTROPHIC
(16)
Medical Treatment/
Restricted Work case.
PROBABILITY
CRITERIA
VERY UNLIKELY
(1)
Illness requiring
Within site boundary.
medical treatment
Short term
and/or recurrent illness
environmental impact. (Any illness that cause
Single license breach
temporally work
recoverable by
restriction and/or
worksite
resulting in change of
work)
UNLIKELY (2)
POSSIBLE (4)
Multiple
fatalities/multiple
serious injury
Extended breach of
license conditions
and/or uncontrolled
release.
Significant
Life threatening illness
environmental impact (A very serious illness
beyond the site
contracted at work
boundary unlikely to
that can cause the
last beyond 12
employee death)
months.
Recovery/rehabilitation
may requireexternal
assistance.
Massive &
Uncontrolled release
Multiple life
with significant
Over RM100k.
threatening illness
environmental impact
Extensive damage
(A very serious illness
extending well beyond
(multiple
contracted at work
site boundary.
fires/explosion) or loss
that can cause the
Chronic pollution
of installation/facilities.
deaths of several
resulting in damage
employees)
lasting more than 12
month.
LIKELY (8)
VERY LIKELY
(16)
Gas cylinders are to be secured in upright position in well-ventilated area and protected from direct heat. Bottle keys to be s
Gas cylinders are to be transported using racking cylinder.
Gas testing is to be carried out immediately before start of Hot Work.
Install flashback arrestor before opening gas supply and lighting the flame.
Install welding screen.
Perform leak test.
Provide a portable fire extinguisher.
Remove all materials which may catch fire from the work area.
Use correct grinding / cutting disc.
Use extraction/ventilation system.
Use extractor/ventilation system to remove fumes from work area.
Use fire blanket.
Welding cables / hose in good condition & free from any damages