Job Safety Analysis and Job Impact Environmental Analysis: JSA/JICA HS-F-2000-009

1. JSA/JICA Analyst :Mantenance C Drups 6904 and 6918 Department Service Engineer Company :DP Consulting Work Permit No. :

Job Description : Mantenance C Drups 6904~6918____________________________________________________________ Working location : ___________CTU______________________________________________________

2. Job Safety and Environmental Analysis (JSA/JICA) : JSA/JICA Analyst Fill In With the Correct Details Completely

Procedures Potential Hazards Cause of Potential Hazards 6. Field Verication of Control Measure
(Field Verifier by US or FO)

Working Environment
Environment Impact
Chemicals Leakage
Property Damage

Tools/Equipment
Personal Injuried
Injuries/Illnesses
Control Measures
During Working
Before Working

to Reduce or Eliminate Risk of Environmental

Fire/Explosion
No.
After Working

Impact/Hazard/Accident That May Occur During Cause of Impact/Hazard/Accident That May Occur Signature to confirm
Step of work Impacts/Hazard/Accident That May Occur During Work
Work Description During Work Description

Procetures
Completed Missing already take
corrective action

- Record voltage, current and other parameters at

- Check operation status on Drups
1 × × HMI - COP pannel × Uncarefully - Make sure the work area is clean
6904~6918 and record parameter
- Electrical shock
- Make sure the work area is clean
- Check automatic grease at ALG & - Electrical shock. - Always use insulating gloves during work.
2 × × × Uncarefully
AGB cabinet. - Slip and fall - All working tools are insulated
-Use personal protective equipment
- Make sure the work area is clean
- Manual grease and check amount
- Clean the work area, clean the body grease. - Always use insulating gloves during work.
3 × grease at Accumulator and alternator × × Uncarefully
bearing - Electrical shock - All working tools are insulated
-Use personal protective equipment
- Make sure the work area is clean
- Electrical shock. - Always use insulating gloves during work.
4 × - Check battery system × × Uncarefully
- Slip and fall - All working tools are insulated
-Use personal protective equipment
- Make sure the work area is clean
- Vacuuming,temperature and - Electrical shock. - Always use insulating gloves during work.
5 × × × Uncarefully
cleaning machines - Slip and fall - All working tools are insulated
-Use personal protective equipment
- Make sure the work area is clean
- Electrical shock. - Always use insulating gloves during work.
6 × Check Clutch × × Uncarefully
- Slip and fall - All working tools are insulated
-Use personal protective equipment
- Make sure the work area is clean
7 × Check oil , Water Level ,Belt,Fuel.. × - Slip and fall × Uncarefully
-Use personal protective equipment

3. Person Responsible for JSA/JICA Analysis 4. Person Responsible for JSA/JICA Verification (*)4. Person Responsible for JSA/JICA Verification (*)4. Person Responsible for JSA/JICA Verification

Sign________________________________(JSA/JICA Analyst) Sign_____________________________(Unit sup) Sign__________________________________ (Department Manager of Area Owner or Delegated) Sign_____________________________________ (LSP Safety Manager or Delegated)

Date ___ ___ /___ ___ /___ ___ Time ___ : ___ Date ___ ___ /___ ___ /___ ___ Time ___ : ___ Date ___ ___ /___ ___ /___ ___ Time ___ : ___ Date ___ ___ /___ ___ /___ ___ Time ___ : ___

(*) 3. Person Responsible for JSA/JICA Analysis (**)5. Person Responsible for JSA/JICA Verification
Sign________________________________(Department Manager of Job Owner or Delegated ) Sign__________________________________ (Environmental Development and Operational Control Manager or Delegated)

Date ___ ___ /___ ___ /___ ___ Time ___ : ___ Date ___ ___ /___ ___ /___ ___ Time ___ : ___
Note: (*) For critical work, Department Manager and LSP Safety will attend in approval JSA/JICA process
(**): For activities which generate environmental/community impact
7. Task Supervisor communicates JSA/JICA details to workers in order to comply with all safety measures. Worker sign to acknowledge. (In case worker(s) join JSA/JICA communication later, sign to acknowledge and specified time.)

Check mark (/) if the workers resume work according to the list. Cross mark (X) and specify reason(s) why the workers stoped work according to the list.

Worker Listed Attend to JSA/JICA Communication Signature Worker Listed Attend to JSA/JICA Communication Signature

1.) ___Huỳnh Văn Hiếu_____________________________________________________________________________________Time:__8h30__:_____ 21.) _________________________________________________________________________________________Time:____:_____

2.) ___Tưởng Đình Vũ______________________________________________________________________________________Time:____:_____ 22.) _________________________________________________________________________________________Time:____:_____

3.) __Võ Trung Tín_______________________________________________________________________________________Time:____:_____ 23.) _________________________________________________________________________________________Time:____:_____

4.) _Trần Hoài An________________________________________________________________________________________Time:____:_____ 24.) _________________________________________________________________________________________Time:____:_____

5.) ___Hoàng Xuân Vân______________________________________________________________________________________Time:____:_____ 25.) _________________________________________________________________________________________Time:____:_____

6.) ____Nguyễn Ngọc Minh_____________________________________________________________________________________Time:____:_____ 26.) _________________________________________________________________________________________Time:____:_____

7.) ___Hồ Khoa Trường______________________________________________________________________________________Time:____:_____ 27.) _________________________________________________________________________________________Time:____:_____

8.) _Dương Minh Phụng__________________________________________________________________________________Time:____:_____ 28.) _________________________________________________________________________________________Time:____:_____

9.) ___Nguyễn Văn Nhũ______________________________________________________________________________________Time:____:_____ 29.) _________________________________________________________________________________________Time:____:_____

10.) _________________________________________________________________________________________Time:____:_____ 30.) _________________________________________________________________________________________Time:____:_____

11.) _________________________________________________________________________________________Time:____:_____ 31.) _________________________________________________________________________________________Time:____:_____

12.) _________________________________________________________________________________________Time:____:_____ 32.) _________________________________________________________________________________________Time:____:_____

13.) _________________________________________________________________________________________Time:____:_____ 33.) _________________________________________________________________________________________Time:____:_____

14.) _________________________________________________________________________________________Time:____:_____ 34.) _________________________________________________________________________________________Time:____:_____

15.) _________________________________________________________________________________________Time:____:_____ 35.) _________________________________________________________________________________________Time:____:_____

16.) _________________________________________________________________________________________Time:____:_____ 36.) _________________________________________________________________________________________Time:____:_____

17.) _________________________________________________________________________________________Time:____:_____ 37.) _________________________________________________________________________________________Time:____:_____

18.) _________________________________________________________________________________________Time:____:_____ 38.) _________________________________________________________________________________________Time:____:_____

19.) _________________________________________________________________________________________Time:____:_____ 39.) _________________________________________________________________________________________Time:____:_____

20.) _________________________________________________________________________________________Time:____:_____ 40.) _________________________________________________________________________________________Time:____:_____

Remark : Add Name List as an Attached Document