Classification: Internal Use

Saudi Arabian Fertilizers Co. (SAFCO)

Document No. SOMS- SHEM –08.10

Job Safety Analysis Revision Date: 12.11.2019
Next Revision Date: 12.11.2024

SAUDI ARABIAN FERTILIZER COMPANY

JOB DESCRIPTION: Date: JSA number:

JOB SAFETY ANALYSIS  NEW  REVISED

Department:

JOB LOCATION (Plant): AREA:

No BASIC STEP POTENTIAL HAZARDS MITIGATION PLAN RESPONSIBILITY STATUS

REQUIRED AND/OR RECOMMENDED P.P.E.: ______________________________________________________________________

Prepared by: JSA Team Leader Acknowledged by: Operation Manager

Name: _____________________ Signature: ________ ID #: _______
Name: _____________________ Signature: __________ ID#: __________
JSA Team Members:
Name ID # Department Signature Date Reviewed and acknowledged by Operation Sr. Manager In case of Major /
Significant Risk (Critical Activity).

Name: _____________________ Signature: __________ ID#: __________

Comment: ……………………….………………………………………………………………………………
Approved by Maintenance Manager:
………………………………………….……………………………………………………………………………..
Name: ________________________ Signature: __________ ID #: ________
………………………………………….……………………………………………………………………………..
Classification: Internal Use

Saudi Arabian Fertilizers Co. (SAFCO)

Document No. SOMS- SHEM –08.10

Job Safety Analysis Revision Date: 12.11.2019
Next Revision Date: 12.11.2024

Approved by Maintenance Sr. Manager in case of Major / Significant ………………………………………….……………………………………………………………………………..

Risk (Critical Activity).
……………………….………………………………………………………………………………………………..
Name: ________________________ Signature: __________ ID #: ________

SOMS-SHEM-08.10/22 Rev 0 12.11.2019

INSTRUCTIONS FOR COMPLETING THE JOB SAFETY ANALYSIS FORM

Job Safety Analysis (JSA) is an important incident prevention tool that works by Select a job to be analyzed. Before filling out this from, consider the following:
finding hazards and eliminating or minimizing them before the job is preformed, The purpose of the job-What has to be done? Who has to do it? The activities involved: How is it
and before they have a chance to become accidents. Use JSA for job clarification done? When is it done? Where is it done?
and hazard awareness, as a guide in new employees training, for periodic contacts
and for retraining of senior employees, as a refresher on jobs which run In summary, to complete this form you should consider the purpose of the job, the activities it
infrequently, as an incident investigation tool, and for informing an employees of involves, and the hazards its presents. If you are not familiar with a particular job or operation,
specific job hazards and protective measures. interview an employee who is. In addition, observing an employee performing the job, or
“walking through” the operation step may give additional insight into potential hazards. You may
Set priorities for doing JSA’s: jobs that have a history or many accidents, jobs that also videotape the job and analyze it. Here’s how to do each of the three parts of Job Safety
have produced disabling injuries, jobs with high potential for disabling injury of Analysis
death, and new jobs with no accident history.
RESPONSIBLE
SEQUENCE OF BASIC JOB STEPS POTENTIAL HAZARDS RECOMMENDED ACTION OR PROCEDURE
PERSON
Classification: Internal Use

Saudi Arabian Fertilizers Co. (SAFCO)

Document No. SOMS- SHEM –08.10

Job Safety Analysis Revision Date: 12.11.2019
Next Revision Date: 12.11.2024

Examining a specific job by breaking it A hazard is a potential danger. The purpose of Using the first two columns as a guide, decide Who is responsible? Write the
down into a series of steps of tasks, will the Job Safety Analysis is to identify all hazards, what actions or procedures are necessary to person (receiver) responsible
enable you to discover potential hazards both those produced by the environment or eliminate or minimize the hazards that could lead (Supervisor/Work Permit Issuer
employees may encounter. conditions and those connected with the job to an accident, injury, or occupational illness. receiver/contractor) to
procedure. implement the control measures
Each job operation will consists of a set of Begin by trying: identified.
steps or tasks. To identify hazards, ask yourself these questions 1. Engineer the hazard out: 2. provide guards,
about each step: safety devices, etc.; 3. provide personal
For example: protective equipment; 4. provide job instruction
1. Is the danger of the employee striking training; 5. maintain good housekeeping; 6.
The job might be to move a box from against, being struck by, or otherwise insure good ergonomics (positioning the person in
conveyor in the receiving area to a shelf in making injurious contact with an object? relation to the machine or other elements in such
the storage area. To determine where a
a way as to improve safely).
steps begins or ends, look for a change of 2. Can the employee be caught in, by or
activity, change in direction or movement. between objects? List the recommended safe operating procedures.
Begin with an action word. Say exactly what
Picking up the box from the conveyor and 3. Is there potential for slipping, tripping, or
needs to be done to correct the hazard, such as,
placing it on a hand truck is one step. The falling?
“lift using your leg muscles”. Avoid general
next step might be to push the loaded
4. Could the employee suffers strains from statements such as “be careful”.
hand truck to the storage area (a change
in activity). Moving the boxes from the pushing, pulling, lifting, bending, or twisting?
List the required or recommended personal
truck and placing them on the shelf is protective equipment necessary to perform each
5. Is the environment hazardous to safety
another step. The final step might be step of the job.
and/or health (toxic gas, vapor, mist, fumes,
returning the hand truck to the receiving
dust, heat, or radiation)?.
area. Give a recommended action or procedure for each
Close observations and knowledge of the job is hazard.
Be sure to list all the steps needed to
important. Examine each step carefully to find
perform the job. Some steps may not be Serious hazards should be corrected immediately.
and identify hazards; the actions, conditions and
performed each time; an example could be The JSA should then be changed to reflect the
possibilities that could lead to an accident.
checking the casters on the hand truck. new conditions.
Compiling an accurate and complete list of
However, if the step is generally part of the
potential hazards will allow you to develop the Finally, review your input on all three columns for
job it should be listed.
recommended safe job procedures needed to accuracy and completeness. Determine if the
prevent accidents. recommended actions or procedures have been
put in place. Re-evaluate the job safety analysis
as necessary.

SOMS- SHEM –08.10/22 Rev.0: 10.10.2019