JOB SAFETY ANALYSIS FRONT SHEET

INSTALLATION / SITE :

JSA REFERENCE No.: DATE :

DEPARTMENT : Construction - Mechanical JOB SAFETY ANALYSIS TEAM (FIRST NAMED-JSA TEAM LEADER)

NAME & SIGNATURE POSITION

PERMIT TO WORK No.:

TASK DESCRIPTION: Pipeline Coating Dilip Sharma / B.K. Gouda Contractor Site Lead

Abhay Kumar Contractor Site HSE Engineer

Pipeline Gridind,Blasting,Coating
Srinivasan / Murugan S. Cairn Construction Engineer

Pranay Kashyap/ANISH ANAND HSE- CAIRN

REFERENCES AND ANY OTHER RELEVANT INFORMATION

CONFIRMED ALARP
(e.g. P&ID’s, Drawings, Procedures, Work Instructions, Certificates, Special Tools or Equipment)
JSA APPROVED BY (Installation / Facility / Site Manager):

NAME (PRINT) :

SIGNATURE :

POSITION :

DATE :
 JOB SAFETY ANALYSIS RISK METRIX

JSA Renewal Sheet

Reviewed by Cairn HSE (Name & Approved by PS/PM/IM/CM

Week # Date Finding as per site situation Recommended control measures Responsibility
Signature) (Name & Signature)

01
02
03
04
 JOB SAFETY ANALYSIS WORKSHEET
Task Description Summary
JSA Ref No
4. Initial 7. Residual
1. Activity 5. Existing Controls & Controls Required 6.
STEP 2. Potential Hazard 3.Hazard Effect Risk Risk
Description E P R Responsible E P R
1.Working without work 1.Illegal operation 1. Strict compliance to the PTW procedure and requirements.
Site
permit. 2. Work to be commenced after obtaining valid work permit.
Obtain Permit To Engineer
1 2.Performing authority must 2.Clash of activities 2 2 4 3. PTW must be kept visible at work location. 2 1 2
Work /Performing
be available at work location. 4. Permit issuer and receiver must conduct work site inspection prior to work. Authority
1.Ensure the personnel's are communicated of the hazards associate with access, location congestion,
1.Remote work site / location. 1.Stings, bites. remote location and Job related hazards.
2.Presence of Animal, Insects 2.Back Strain / Injury. 2.Effective TBT shall be conducted & activity shall be carried out in presence of site supervisor only.
& Reptile 3.Applicable PTW shall be ensured & Valid.
3.Entry into live plant area. 3.uncontrolled release of 4. Site survey to be carried out to identify any obstruction for site access.
pressure 5. Ensure good housekeeping at work place.
6.Remove all unwanted materials from work place. Site
Access at Site & 4.Over head power line & 4.Electrocution or fire due to 7. Work area shall be barricaded & work material should be stored within barricaded area. Engineer
2 3 3 9 3 1 3
Area Preparation other obstruction contact with OHL line. 8. Competent work crew & supervision should be ensured. /Performing
9. Drinking water facilities is adequate and certified. Authority
5.Slip, Trips & Fall due to poor
5.personsl injury
floor condition. 10 Drinking water containers are to be properly identified and cleaned regularly.
6.Soil contamination , effect 11. Rest area are to be provided / to be adequate.
6.In case leakage of exiting on human health injury,
12. work will be stopped immediately and inform to OPS production head
pipeline collapse of trench, water-
logging. 13. Dust suppression program to be adequate.
14. Site survey to be done for potential overhead power line within work vicinity & appropriate precaution
to be taken i.e. line isolation, safe & clear distance from OHL
1.Rain 1.Slippery Surface due to 1.Work will be stopped in case of adverse weather i.e. rain & high wind condition & PTW shall be
rain. revalidated prior to resume the activity. Don't inter into water logged area
2.High Wind 2.Building collapses
3.High Temperature 3.Heat Related Illness 2.Plenty of drinking water shall be made available at site. Site
Adverse Climate
4.Plant Emergency 4.Plant Emergency Related Engineer
3 & Plant 3 3 9 3.Cairn Oil & Gas Heat Stress Guidance shall be followed. 3 1 3
Hazardous effect /Performing
Emergency 4.In case of plant emergency activity will be resume after PTW revalidation followed by competent
Authority
persons inspection.
5.Emergency vehicle to be kept at site.
6.Personnel competency to be ensured for emergency response.
1.Pinch Point 1.Pinch Injury 1.All tools are to be used in safe manner.
2.Repetitive movements 2.Caught in / between man 2.All tools are to be used by trained personnel
machine inter face. 3. All tools have to be required guard.
3.Ergonomics 3.Back Strain Fatigue , 4. Right Tools are to be being used for each job.
5.Ensure all are using adequate PPEs while working with hand tools.
Machine / 6. Cairn Oil & Gas inspection colour code shall be ensured on all service tool Site
equipment Engineer
4 3 2 6 7.Pinch point hazards related awareness to be ensured with all via tool box talk 3 1 3
operation & use /Performing
8.Ensure pre-use inspection for tools before each use.
of hand tools Authority
9.Ensure all are using adequate PPEs while working with hand tools.
10.Ensure crew are using tools with protective handle.
11. Ensure all hand tools are storing in tool boxes
12.Ensure all defective/damaged tools are to be replaced.
13.Ensure crew rotation to avoid long awkward positions and fatigue
 1.Injury due to Vehicle 1. Ensure the only Cairn Oil & Gas certified with inspection sticker on vehicle/equipment to be used.
1.Vehicle Incident
incident
2.Impaired emergency 2. Gas testing shall be carried out prior to any vehicle access at plant area.
2.Underground utility damage response due to obstructed
access 3. Ensure the only Cairn Oil & Gas certified vehicle / equipment Operator.
3.Worker take rest underneath 4. Ensure that vehicle follow only approval vehicle / equipment access path.
3.loss of life.
vehicle / equipment 5 .Banks man shall be deployed while vehicle reversing.
6. Rest shelter shall be used during rest hours no workers will be permitted to rest underneath the
4.Obstruction on access & 4.Electrocution due to
vehicles.
overhead power line overhead power line
7. Underground utilities to be barricaded. ACE Site
Vehicle Entry /
5 3 3 9 8.Speed limit sign board & barricading shall be provided at work place Engineer 3 2 6
Movements
9. Daily / pre-use inspection shall be ensured by driver / operator. /Supervisor
10. Back-up alarm / visual signals to be being used / Banks man to be provided.
11.All man lift operators are to be properly certified.
12. Material / loads to be secured.
13. Seat belts are to be used.
14. Vehicles are to be parked at designated parking place.
15. Persons are not to be transported on material carrier
16. Vehicle and mobile equipment are to be free from any visible defects. vehicle shall not park under line
OH line. safe distance shall be maintained from the edge of the excavation.
1.Fall in line with flame of 1.Burns injury 1.Ensure ISI Regulator with flash back arrester with booth end & Non return Volve.
Heating Torch 2.Coating materials should kept at designated place.
2.Hazardous and toxic fumes 2.Air Contamination and 3. LPG cylinder was inspected by competent person & Ensure cylinder inspection tag.
exposure to atmospheres and headache 4.Don't allow any hot work activity near LPG Cylinder.
surrounding
3.Slip,Trip,fallutilities. 3.Physical Injury 5. Ensure fire blanket on LPG cylinder & Cylinder don't keep direct sun light.
4.Inadequate utilization of 4.Personal Injury 6. Ensure proper inspected hose pipe and proper joint with Jubilee clamp.
PPE 7. Ensure soap solution lotion and liquid for leakage test.
8.Cylinder always keep on vertical position, Safe handing & transportation .Follow cairn hot work ACE Site
Field joint
6 3 3 9 procedure at site Engineer 3 1 3
Coating 9 .Activity must be performed by trained technician /insulators. /Supervisor
10. Ensure "Procedure for Coating" is addressing the stated hazard.
11. Every personnel must be made aware of the surrounding utilities.
12. Ensure proper utilization of PPE's by insulators/technicians involved in the activity.
13.Goal post to be provide properly each working location near & under OHL power line
14.Proper personal protective equipment viz, coveralls, masks, goggles etc. shall be provided to control
the abrasion.
15.While material handling proper posture shall be ensured.
 1.Unavailbility of drinking 1.Heat related illness 1.Esnure plenty of cool drinking water in available at site , .
water
2.Lack. of or inadequate rest 2.Collapse of workmen 2. Ensure adequate rest shelter is available for workmen to take rest as per procedure and heat Site
shed Engineer
7 Heat stress 2 2 4 index flag system. 2 1 2
/Performing
3.Failure to follow heat index 3 Heat stress guideline and flagging system to be follow.
Authority
flag system.
4.Ensure 5-7 litter water drink in every person in a day
1.Electric Shock 1.Personal Injury. 1.Constant supervision of work in the vicinity of Overhead HT lines
2.Burn Injury/Flash Over 2.Damage to plant Utility or 2.Area to be physically verified before starting the activity near by OHL line.
machinery. 3.Don’t allow any activity under OHL Power line & arrange proper goal post under OHL.
3.Fire 3.Damage to equipment. 4. Maintain proper distance from OHL & take extra precaution & safe distance from any power line
Site
Working Near to Traffic controller/ helper to be appointed to ensure safe clearance Engineer
8 OHL-(11kv to 4 4 16 5.Overhead lines to be identified in the swing radius of the crane and goal posts shall be installed prior to 3 2 6
/Performing
33kv) start work. Authority
6. No vehicle to be parked below OHL LINE
7. To ensure all preventive measures & safety precaution for the existing OHL-from the working area.
Also ensure the safe working distance awareness among the moving vehicle drivers.
1.Poor communication 1.Working without extension 1.Cain guideline According approval then proceed night work activity
2.Inadequate illumination of permit 1.Ensure engaged crew is trained in working night shift
2.TBT include Emergency Response Plan. Site
Engineer
9 Night work 3.Eating at site 2.Human fatigue 3 2 6 3.Ensure effective night shift supervision 3 1 3
/Performing
3.Poor Visibility 4.Stop work in the event of adverse climate Authority
4.Attracting Live Reptiles 4.Snake bite 5.Ensure night shift personnel get enough sleep or rest during day
6.Ensure personnel are trained to meet any emergency that may occur at night.
1.Accumulated construction 1.Slip / Trip injury 1. Area shall be cleared post job completion.
waste and / other
2.Tripping materials
Falling Hazard 2.Personal injury. 2. All Work Areas are to be free of debris
3.Fire hazards 3.Property Damage 3. Passageway / walkway are clear of debris
4. Avoid / openings are to be covered. Site
Engineer
10 House Keeping 2 2 4 5. Adequate lighting to be being provided. 2 1 2
/Performing
6. All material are to be properly stored and neatly stacked. Authority
7. Toilet, washing facility is inadequate & to be maintained properly.
8. All construction material to be secured with barricading and appropriate signs.
9. PTW shall be closed post job completion