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Job Safety Analysis Sheet

Job Description: Bedding Work JSA Ref. No.: JSA-GS-Civil-03

Project Title: Work Area: Permit No.:

WPMP / EF 1772 Date:


Personal Protective Equipment & Tools Needed For Work Activities: Hard Hat, Safety Shoes, Safety
Glasses, Coverall, Hand Gloves, Dust Mask, Barriers, Warning Signs
SEQUENCE OF Yes /
POTENTIAL HAZARDS PRECAUTIONS
BASIC JOB STEPS No

Yes • Obtain the required Permit To Work.


Non-compliance to KOC-
Pre-Work Yes • Conduct Tool Box Talk.
HSEMS Procedures
Yes • Hold pre-job Safety Meeting.

Yes • Flagman should be employed / assigned to


Fall into the trench control and monitor equipment and manpower
movement during the work.
• Flagman should be assigned to control and
Yes
Personnel hit by equipment monitor equipment and manpower movement
during the work.

Yes • Keep equipment or excavated material at safe


Bedding distance from the edge of the trench to avoid
Intrusion of Bedding materials
Work erosion and other related incident.
into the trench, Soil Erosion
Yes • Bedding materials to be kept at safe distance
from the edge of trench.
Yes
• Signalman/flagman will be assigned to control
Collision of Equipment traffic flow, when applicable.
Yes
• Install barricade and warning signs.

Blocked access to emergency Yes • Ensure the approach to emergency equipment


equipment is not blocked due to open trenches.
Additional Hazards
(Other than
indicated above)

Prior approval/endorsement shall be obtained from Permit Applicant and Permit Issuer before carrying out any changes to existing
safety measures and safe work conditions for the duration of the permit.

Name Controlling Team : MP - IX


JSA Done by Permit
applicant/ Controlling
KOC No. Signature :
Team / Asset Owner

JSA Reviewed by Name Controlling Team : MP - IX


Permit Issuer
KOC No. Signature :

(JSA-GS-Civil-03)