Professional Documents
Culture Documents
Work Location:
Step
1.0
Signature:
Date:
Potential Hazards:
Step
2.0
Potential Hazards:
-
3.0
4.0
Material Offloading
Potential Hazards:
-
Defective Tools
Damage of underground services
Exposure to dust during excavation
Fall of personnel into excavated holes
6.0
Fence Installation
Potential Hazards:
- Hand injury due to sharp edges of fence.
Personnel injury due to
wrong hand tools and cutter.
sharp edges of fence.
- Injury during wire tensioning.
- Fall / Trip during installation
8.0
Damage of material.
Personal injury
Peoples have been briefed / trained in hazard & precautions of the job
Communications / Workforce Consultation
Have all members of the Work Party attended the Toolbox Talk, and have they been made fully aware of the risks that they are taking (Residual risks)?
Yes
External Risk
Has an assessment been conducted to identify all external (to the activity) hazards and potential risks (3rd parties such as other workforce teams or other adjacent parties)? What is the
result?
Risk Assess. No.
Job Safety Analysis has been carried out keeping in view all external Risks / Hazards. No simultaneous activities are carried out by
other Parties
H&S Training
Employees should be trained in the proper interaction with equipment, and the proper response to incidents involving this equipment. List the training your employee(s) has received.
All employees attended JGC induction training and DESCON HSE training, Emergency training as is conducted also
Specialist Training
Will the workforce require any specialist training?
No
YES / NO (IF YES, list the specialist training required for the job):
Does the task require special access / egress / heavy lifting / entry into confined spaces or work at height / in excavations?
(IF YES, a separate Risk Assessment needs to be completed).
YES / NO
No
Other Impacts
Are there any other ways in which the work will be affecting and/or protecting the Health and Safety of the team members?
No
No
Air Emissions
Will the work you perform produce or cause the release of any air emissions?
No
YES / NO
(If YES, list air emissions and method for preventing impact to the environment):
No
Materials
What materials (chemicals, oils, etc.) and/or equipment will you be handling or bringing on-site to perform the contracted work?
No
Environmental Training
Have employees been trained in the proper handling of materials and equipment, and the proper response to incidents involving these materials? List the training your task employees
have received.
No need
Waste Generation
Will the work you perform result in any wastes? YES / NO (IF YES, list the disposal location, as well as amounts and types of wastes expected and the proposed disposal method):
No
Energy
Will the work you perform consume energy (compressed air )? YES / NO (IF YES, explain what type of energy will be consumed, and how you will minimize consumption):
Yes, Diesel fuel will be used in grader, shovels, cranes, excavators, jackhammers, diesel generator and fork lifter. Equipment will be stopped if it is not
needed to reduce fuel consumption
Other Impacts
Are there any other ways in which the work will be affecting and/or protecting the environment?
No
Environmental Monitoring
Describe any environmental monitoring to be performed, including sampling methods, frequency, analytical requirements and laboratory to be used:
Not Applicable
Legal requirements
Identify environmental legal requirements applicable to the work that has not already been addressed by the Project.
Not Applicable
Standard
Codes
Hard hat
Safety glasses
No
Type
Reference/Documents
Safety shoes
Coveralls
Hearing protection
Hand gloves
Full body harness and life line
Respiratory protective equipment
NB: List of qualifications/experience is held in local JGC files see JGC HSE Group for details.
Name: .
Mustafa
Position:
Supervisor
Name: .
Naeem Ashraf
Position:
Engineer
Signature: .................................................................
Signature: .................................................................
For a list of names and signatures of staff instructed in this Safe Work Method Statement and JSA, see JGC training records.
Copy 1 - To be posted at the Worksite / Supervisor at the Worksite
Copy 2 - To be retained by JGC HSE Group (24 months)
Copy 3 - To be held by the subcontractor (24 months)
Date:
Foreman (print
name):
Location:
Task Description:
MUSTER / ASSEMBLY POINT LOCATION:
IS YOUR DESIGNATED PLACE OF WORK TIDY? - YES or NO (If "NO" housekeeping must be performed prior to work commencing).
PERMIT TO WORK REQUIREMENTS
YES
(tick box)
NO
N/A
Excavations
Access Only
Plant & Equipment
Electrical
Confined Spaces
Isolations
Lock Out / Tag Out
Hot work
Instrumentation
Pre / Commissioning / START-UP
EXCAVATION
YES
NO
N/A
FIRE EXTINGUISHER
LADDERS PROVIDED
FIRE BLANKET
COMBUSTIBLES REMOVED
EXCAVATION INSPECTED
CONFINED SPACES
NO
N/A
EMERGENCY COMMUNICATIONS
WORK BELOW RESTRICTED
PERMIT to WORK
EMERGENCY ACCESS
CHEMICALS
COMMUNICATIONS
SAFETY HARNESSES
YES
NO
N/A
YES
NO
N/A
YES
NO
N/A
YES
NO
N/A
SCAFFOLD INSPECTED
SIGNS POSTED
HAZARDS COMMUNICATED
HANDRAILS SECURED
GROUNDING
YES
NO
N/A
PORTABLE TOOLS
DEFECTS REPORTED
OPERATOR CERTIFIED
OPERATORS CERTIFIED
OCCUPATIONAL HEALTH
N/A
VENTILATION
NO
YES
STANDBY MAN
SCAFFOLDING
YES
GUARDS POSITIONED
YES
NO
N/A
PPE
HARD HAT
HEAT STRESS
BOOTS
DUST
GLASSES
NOISE
FACE MASKS
VIBRATION
YES
ELECTRICITY
NO
N/A
SPECIALIST PPE
HARNESSES / LANYARDS
SYSTEM DISCONNECTED
WELDERS SCREEN
SYSTEM TESTED
YES
NO
N/A
YES
NO
N/A
YES
NO
N/A
MANUAL HANDLING
YES
NO
N/A
RESPIRATORS
LIFTING, PULLING
STRETCHING
ENVIRONMENTAL CONSTRAINTS
GENERAL
YES
NO
N/A
FLYING PARTICLES
SPILL CONTAINMENT
Foreman / Supervisor: I have discussed the above potential hazards involved in the task, reviewed the SAP Card with
the employees under my control, and implemented suitable and sufficient controls to minimize the risks involved.
Name (print)
Signature
Employees: I / WE ACCEPT THE RESPONSIBILITY FOR THE SAFE BEHAVIOUR OF MYSELF AND MY CO-WORKERS
DURING THE TASKS IDENTIFIED ABOVE:
EMPLOYEE NAME
SIGNATURE
EMPLOYEE NAME
1.
10.
2.
11.
3.
12.
4.
13.
5.
14.
6.
15.
7.
16.
8.
17.
9.
18.
SIGNATURE