Appendix A:

JHA No:
JOB HAZARD ANALYSIS Date: 1-8-2018
Next Review Date /
PetroChina (Halfaya) Non-Routine Job/Task Routine Job/Task 10-8-2018
Valid till:
Reference:
Location: OGM967-CPF2\OGM726-CPF2 Performing Agency: FW
(WO /Project #)
Job/Task Description
Pipe lowering-in

Section / Section /
No. Name Position Signature No Name Position Signature
Contractor Contractor
1 Mohammed kareem Site manager
2 Mustafa sabri Site engineer
3 Hisham Dawood HSE manager
4

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 Inherent risk Additional
level hazard / risk Residual risk
Step Description of job/task step Hazards and threats / Hazard/risk controls already in
(Acceptable / controls Action by level (Acceptable
No. (what and where) causes place
not recommend / not Acceptable)
Acceptable) ed
1- Toppling of
machineries 1- SiteBoom operators are
which involves in advised to move the
lowering SiteBoom away from the
2- Collapse or cave trench as much as possible.
in due to soil 2- Leaks will be inspected to
condition/rain avoid hydraulic failures.
water or flood 3- Adequate numbers of exits
water. will be planned for the
3- Cave in due to workers to get out from the
site in case of emergency
excavated soil.
Pipe Lowering-in 4- Hard barricade will be Acceptable
4- Slips, trips and planned to avoid
falling in while the machineries, personal
excavated soil and/or third party falling in
blocking the the trench.
access. 5- At least caution tapes will be
5- Machineries or placed on at least 2 meters
personal fall in. away from the edges of the
6- Improper manual trench to avoid trespassers.
handling of hand
tools.

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 Review – Performing Agency Approval – PetroChina Authorities

Area Authority Section Head / Deputy Manager

Discipline Engineer Contract Focal Department / PMC (If any)
☐ Approved - all non-routine jobs/tasks ☐ Approved – all routine jobs/tasks
☐ Confirmed - all routine jobs / tasks
Name Name Name Name

Sign Sign Sign Sign

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 Hazard Prompt – “Check  ”
Identify the job/task hazards and assess the risks of personnel may be exposed to before safeguards are implemented
☐ Electrical ☐ Chemical ☐ Tools ☐ Gases
☐ Vehicles ☐ Height ☐ Depth ☐ Weight
☐ Pressure ☐ Access ☐ Vibration ☐ Noise
☐ Weather /Working environment ☐ Bacteria ☐ Dust ☐ Slip / Trip
☐ Radiation ☐ Rotating Equipment ☐ Moving Equipment ☐ Lifting Equipment
☐ Heat ☐ Dehydration/ Hot Work / Sun ☐ Hot / Cold Objects ☐ Overhead Hazards
☐ Biological ☐ Entrapment ☐ Lighting ☐ Manual Handling
☐ Conflicting Activities Others: _____________________
Personal Protective Equipment for Job/Task
Minimum PPE Requirements: 1)________________, 2________________, 3)_________________, 4)________________
☐ Safety Harness ☐ Face Shield ☐ Airline ☐ Gloves – Hyflex (Nitrile)
☐ Face Mask ☐ Sun Screen ☐ Dusk Mask ☐ Gloves – Leather Riggers
☐ Clear Safety Glasses ☐ Hearing Protection ☐ Confined Space Harness Others: __________________
☐ Monogoggles ☐ Breathing Apparatus ☐ Gloves - PVC
Plant, Equipment & Tools for Job/Task
☐ Ladder ☐ Drill ☐ Excavator ☐ MEWP (Mobile Elevating Work Platform)
☐ Hand Tools ☐ Grinder ☐ Winch ☐ Fans
☐ Shovel ☐ Scaffold ☐ Extension Leads ☐ Vacuum Cleaner
☐ Welding Machine ☐ Fire Extinguisher ☐ Power Source ☐ Spill kits / Housekeeping
☐ Compactor ☐ Fire Blanket ☐ Crane Others: __________________
Tagging & Signs
☐ Men Working Above ☐ Flagging ☐ Personal Danger Tags ☐ Information Tags
☐ Barrier Mesh ☐ Personal Locks ☐ Out of Service Tags Others: __________________
Instructions, Permits, Certificates
☐ Method Statement ☐ P & IDs ☐ Cold Work Permit ☐ Isolation Certificate (Electrical) ☐ Radiography Certificate
☐ Procedures ☐ MSDSs ☐ Hot Work Permit ☐ Confined Space Certificate ☐ Demolition of Security Defense
☐ Work Instructions ☐ SIMOPS ☐ Gas test Certificate ☐ Road Closure Certificate
☐ Emergency procedure ☐ Toolbox talk ☐ Isolation Certificate (Physical) ☐ Excavation Certificate

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 Hierarchy of Controls / Additional Notes

Hierarchy of Controls
Examples
Controls
Manual Handling Electrical
Use of other source of energy in place of electrical / use
Elimination / Substitution of Hazard or hazardous Use of mechanical device instead of manual
of low voltage equipment
process handling / Reduction in size or weight of the item
Use of specific rated enclosures, identify specific
Reduce the distance & time of exposure to
Isolation / separation of hazards from receptors location
manual handling
Engineering controls / safeguards for prevention Work place design, guarding / securing, local
Use of correct fuses, grounding, proper spacing
and mitigation exhaust ventilation, lighting etc.,
Shift / rotation job, fitness, Method statement, Access control, Barriers, Signage, SOPs, Training,
Administrative & Procedural Controls
Training, Permit to Work Competency, Permit to Work
Personal Protective Equipment Helmet, Electrical Shoe, Face shield, Apron, electrical
Helmet, Shoes, goggles, protective clothing etc.,
gloves etc.,

Notes:
Location / Agency / Discipline /Serial Number All non-routine jobs / contractors – Valid for specific task
JHA No# (CPF1 / PCH / Mech / XXX) Validity of JHA All routine jobs – Maximum validity should be 1 year or review on any
(CPF1 / CPECC / Mech / XXX) near miss / Incident occurrence.
Jobs/tasks those were identified as repeated nature to execute in
Non-routine jobs/ Jobs that requires a work permit as defined in the
Routine jobs/tasks operational areas on specific equipment by specific discipline without
tasks Procedure on Permit to Work System
change in the nature of working environment.
WO – Work Order number
Reference:
Location Eg., CPF1, Export pump area PM – Preventive Maintenance number (from SAP)
(WO /Project #)
Project – Project ID number
Team Leader should provide the brief description of the job / task being
Details of performing agency planned to carryout
Performing Job/Task
Eg., PCH- Mechanical or CPECC-Mechanical
Agency Description:
No different jobs / tasks should be clubbed even the execution team
might be same

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 Team leader will select the team members based on disciplines involving
Job supervisor responsible for the defined job/task in the task execution, area concerned, competency, skills with the
Team Leader Team Members
execution consultation of Area Authority. Team should be limited to maximum of 6
members.
Job / task should be breakdown into basic steps based on
Description of Hazard and
task execution methodology & associated priorities & risks. Refer to Hazard prompt table (pg.3 of this JHA template)
job/task step Threat/Cause
(Maximum of 10 steps)
Potential Define the maximum potential loss /affect to the Health &
consequences on safety of the personnel involved, surroundings people, Hazard / risk
List out the existing controls that can limit the occurrence of loss /
Health, Safety, environmental emissions, damage to the assets etc., from controls already in
damage.
Environment and the identified hazard. It should consider no controls are in place
Asset place.
Acceptability of risk level will be subjected to the JHA team’
discretion based on the assessment of competency & skill
levels of the task execution personnel.
Inherent risk
JHA team may also consider the guidance from Risk Additional hazard / JHA team should identify the independent control measures as many as
levels
Assessment Matrix (consult with PCH HSE Manager) on risk controls possible even by incremental cost / investment for organizing necessary
(Acceptable / Not
identification of acceptable risk levels. recommended resources like people, equipment, time etc., to achieve the risk levels till
acceptable
acceptable levels.
For simplicity, all ‘Low’ category risks can be considered as
'acceptable' and other categories can be considered as 'not
acceptable'.
Team should determine that all residual risk levels are in acceptable
Team should identify the responsible action party for Residual Risk levels when the identified controls were in place at the time of task
establishing the identified controls, and ensure the level execution.
Action by
adequacy and efficiency of the functioning of controls on (Acceptable / Not However, Area Authority decision will be the final for confirming that the
right time. acceptable residual risk levels are acceptable, and will ensure to perform the task
with all identified controls measures in place.
Upon completion of the JHA, concerned discipline engineer
should review and confirm that the identified controls
Area Authority shall be responsible to approve all non-routine jobs /tasks
measures will be adequate for safe execution of the task.
and contractors’ JHAs by confirming the adequacy of control measures.
Discipline engineer can also suggest additional controls if
Review Approvals
any required.
(performing (PetroChina Area Authority shall be responsible to verity & confirm the adequacy of
agency) authority) control measures for all routine jobs / tasks, and Section Head / Deputy
PetroChina Contract Holder Department / PMC should be
Manager in charge of that particular operational area shall be responsible
responsible to review the contractors’ JHAs and confirm
to approve all the routine jobs/tasks.
that the identified controls will be adequate to perform the
task by contract workers in a safe manner.

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