JOB SAFETY ANALYSIS

Ref: – JSA - 016

Facility / Site: ……………………………………………… Location within Site: ……………………….. Permit No: ………………………. Permit Type: ………………. Date: …………………….

Task Description: Pipes Bending

REQUIRED REFERENCES JSA REVIEW

Have the relevant Procedures, Standards, Guidelines,
Yes N/A
or Safe Work Practices been reviewed? Pending confirmation by the Task Leader of site conditions, I agree that the attached JSA identifies the
significant Task Steps, Hazards, and Controls.

JSA REVIEWER (Supervisor or Designate):

RISK ASSESSMENT
Must existing Procedures or Work Practices be
Yes No Name / Signature: Company:
modified to perform this work?
After mitigation, are there any hazards that continue to WORK SITE VERIFICATION
present a potentially significant risk? (Scenario-Based Yes No
Risk Assessment required)
The Work Team has assessed the worksite conditions and confirms:
 The JSA addresses the applicable hazards and necessary controls.
PPE REQUIRED DURING THIS TASK
 The Team has the appropriate resources (people and equipment) to do the job safely.
HARD HAT SAFETY GLASSES  Others that could be affected by the work have been informed.
FACE SHIELD TASK LEADER:
SAFETY SHOES / BOOTS
GOGGLES

Name / Signature: Company:

FALL PROTECTION
FALL RESTRAINT
COMPLETE THE SECTION BELOW IF THIS JSA IS NOT PART OF A PERMIT PACK
GLOVES:
COTTON Work Team Declaration:
LEATHER I acknowledge that I have reviewed the attached JSA, I understand my roles
and responsibilities, and I will comply with the instructions for this task.
IMPACT PROTECTION
Name (print): Name (print):
Dust mask OTHER (specify):
Work clothes

OTHER PPE (specify):

 TASKS/STEPS POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT
(Number) (What could go wrong?) (How can harm be prevented?) MITIGATION STATES
1. Permitting work  Work condition not safe  HSE team to assess the conditions of work in the assigned area  PTW system
 Procedures and tasks not clear  Toolbox talks  Tool Box Talk
 Lack of supervisory  Competency of personnel and supervisory for the activity Certificates
 Miscommunication  Define hierarchy and reporting flowcharts inspection
 Not correct PPE worn  Define proper PPE to be used for the work
 Equipment not inspected and certified  Check inspection certificates of equipment for the job
2. Checking equipment  Punch point / hand injuries  Wear correct PPE  PPE
 Falling from machines  Smart grip / 3 points of contact when climbing onto machines  Ladder
 Diesel / oil spill  Use proper ladders / steps  Plastic cover
 Equipment failure  Use containment cans/ plastic covers to prevent spills
 Regular preventive maintenance
3. Pipe lifting spotting  Punch point / hand injuries when  Wear correct leather gloves  PPE
into bending slinging the pipe with lifting slings  Wear head protection  First aid kit
machine  Person hit by excavator arm  Good communication with excavator operator
 Person hit by suspended pipe  Never go in between machine and pipe when suspended
 Person stuck by / crushed between pipe  Avoid punch points, keep hands away from machine
and bending machine  Restrict the area
 Trapped hands / punch points when
spotting the pipe in bending machine
pipe position
4. Bending the pipe  Pipe coating damaged by debris on the  Clean pipe body before operation  PPE
machine  Follow bending procedure, proceed with steps  First aid kit
 Pipe damaged by over-bending  Wear ear protection or ear muffs
 High noise area  Avoid punch points, keep hands away from machine
 Soft/uneven ground  Ensure the bending machine is stable before use
5. Housekeeping  Equipment and tools remain on site  Put back equipment in proper place  PPE
 Slip trip and fall  Clear all work place from trash  Trash bins
 Trash left in the work place  Segregate trash  Plastic bags
6. Working in desert  Biological hazards such as reptiles  Use of PPE  MSBI Emergency
 Poison from the scorpions & snakes  Close supervision response plan
 Heat and stress  Long sleeve coverall (medical treatment
 Personnel missing or lost in the desert  Safety boots + ambulance)
 Personnel Protests  Sufficient drinking water
 Terrorist Attack  Security accompanying
  Provide GSM, sat phone, security spot and radio for personnel
working at uncovered area by phone.
 Assess the situation as quick as possible and announcing the
state of the emergency (Emergency or Alert).
 At any security threats call first the ERT leader mentioned in
back of access badge and emergency contact list.
 In case of any Terrorism threats call first the ERT leader or the
IMT Leader and the COMPANY Field Security Liaison Officer
mentioned in back of access badge and emergency contact list
 Delegate someone to make sure that the area is evacuated.

Name Position Date Signed

Prepared By
Checked By
Approved By