10-2021

Process
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)
Page 1 of 6

Job area is considered: Unit area: Ammonia Storage tank Establishment/Project:- Installation of 1 x 5,000 MT Ammonia Storage Tank JSA No:-03
Project No: 66-0235 with associated facilities at KFL, , UP

Contractor: Hill India tkIS India: Client:

Person participating in 1. Mr. Zafarullah 1. 1.

Job Safety Analysis. 2. Mr. Nahid 2 2.

3. Mr. Nitesh Kumar 3. 3.

4. 4. 4.

JOB DESCRIPTION: Shuttering & De-Shuttering

Requirement of adding Personal Protection Requirement of adding special equipment or

Requirement of Working Permit Equipment. tool
(Check the relevant box) (Additional list)
Restricted space 1. Helmet 6.Goggles 1.Hammer
Heating job 2. Shoe 7. Cotton hand gloves 2.Lifting Rope
Digging 3.Full body harness ` 3. Spanner
Isolation / Energization 4. Lifeline
Other job  5. Ladder/Scaffold

JSA considering procedure Yes No Comment

Is JSA establishment participated by job implementing group? 


tkIS India Form: Job Safety Analysis
 10-2021
Process
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)
Page 2 of 6

Is JSA considered by Job implementing group before carrying out the job?

Is JSA sheet used/ consulted in work implementation? 

Is the job carried out step by step? 

Do you propose to improve JSA sheet (give in detail) 


Is detail of any trouble showing

ACTIVITIES HAZARD/ DANGER CONTROL MEASURE ACTION

Separate the job into the Describe all hazards identified for each Describe fully all equipment, facility, and/or procedure
main tasks and record task based on observations and controls applicable for each hazard.
them in sequence. experience.
1. Hand & Shoulder injury while  Conduct Tool box talk before the job.
Shuttering Material loading & unloading.  Ensure proper PPE (Safety Helmet, Safety Shoes,
Hand gloves, reflective vest etc.)
shifting at site
 Use hand gloves and shoulder pad to workers
while unloading the shuttering material.
 Improper material handling  Proper material handling/ manual handling
procedures shall be followed.
 Always engage trained workmen for shifting of
materials.
 Provide necessary PPEs.
 Provide training on manual/ material handling
techniques

tkIS India Form: Job Safety Analysis

 10-2021
Process
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)
Page 3 of 6

 Overloading of vehicle  Avoid overloading by means of engaging suitable

carrying vehicle.
 Plan proper sequence of material stacking.
 Engage suitable vehicle to avoid over loading of
vehicle.
 Ensure good condition of access road.
 Deploy trained driver
 Ensure signal Man for guiding /controlling
movement of vehicle.

 Improper sequence of material  Ensure proper stacking of material in the vehicle.

stacking  Proper tighten /securing of material
 Restrict speed of vehicle at site
 Ensure proper access road
 Instruct workmen to avoid overloading.
 Provide necessary PPEs.

 Hand Injury  Use gloves to prevent cuts on hands.

 Fall of material  Move all unnecessary persons away
 Manual handling hazards  If load is heavy take help of other person
Manual shifting of
 Cumulative Back Injuries  Use manual handling techniques.
shuttering material  Persons Injury  Use proper PPE
 Slip, trip and fall  Remove unwanted material from site.
 Sharp edges of rebar  Experience person shall be deployed for rebar
fixing job.

tkIS India Form: Job Safety Analysis

 10-2021
Process
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)
Page 4 of 6

 Poor condition of shuttering  Shuttering material condition shall be checked before

material use.
 Always engage trained workmen for shuttering work.
 Inadequate supports  Provide proper supports to formwork.
 Prior to use inspection shall be carried.
 Competent erection gang shall be engaged.

 Fall of person  Conduct Tool box talk before the job

 Proper supervision
Shuttering work at
 Fall of material  Use Full Body Harness with double lanyard
height scaffolding hook.
 Unsafe working platform  Walkway free from Obstruction
 Provide safe working platform.
 Improper access  Provide safe access and egress.
 Remove unwanted material on daily basis.
 Ensure daily housekeeping to avoid accumulation of
scrap material.

Removal of Shuttering  Slips, trips, falls  General housekeeping required to prevent slip,
 Protruding nails trips and falls.
work & de nailing using
 Puncturing/brushing against  Access area to be clear from all obstructions.
hand tools. sharp edges of concrete
 Use basket while lifting the material.
 Finger getting caught between
the forms  Nails to be removed.
 Dust  Ensure dust mask or respirator.
 Improper manual handling  Allot sufficient manpower.
 Correct PPEs (leather gloves, cut resistant gloves

tkIS India Form: Job Safety Analysis

 10-2021
Process
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)
Page 5 of 6

etc) to be worn. Explain proper manual handling

techniques during tool box talk.
 Maintain good housekeeping.
 Improper Sequence of De-  Dismantling should be carried out in sequence  Fingers getting caught
shuttering manner to avoid sudden collapse. between the forms
 Using ropes for lowering the removed materials.
 Ensure sufficient illumination
 Deploy trained workmen.
 During removal of shuttering no material are to be
De-Shuttering placed on the platforms to prevent slip trips.
work  Ensure only experienced and trained carpenters
are involved in dismantling of shuttering work.
 Barricade the dismantle work area for unknown
entry.
 Competent team should deploy for the dismantle
work.

Prepared by Reviewed by Approved by

(Team -Area supervisor/Engineer/Safety (Area Manager) (Area owner/Area authority)
officer)
Name: Nitesh kumar Yadav Name: Name:
tkIS India Form: Job Safety Analysis
 10-2021
Process
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)
Page 6 of 6

Designation’s Designation: Designation:

Signature: Signature: Signature:

Date: Date: Date:

tkIS India Form: Job Safety Analysis