SAFETY MANAGEMENT SYSTEM (SMS) Element 6 Safe Operations

Attachement ID
Job Safety Analysis (JSA) Worksheet Dept/Div/Unit

Division name: AS&QFSD Unit Name: Supply & Install CCTV Systems at Facility: Qatif GOSP-2
Qatif Facilities
Job description: Form Works JSA No.
Date: 07/ 28 /2022 Time: from 0600 to 1800 JSA Observer: Site Supervisor

JSA team (initials): MD Eng: Reviewed by: JSA TEAM Approved by:
OPER Suprv:
Oper Eng:
Contractor Suprv:

STEP HAZARDS RISK CONTROL MEASURES WHO IS RESPONSIBLE STATUS

List the steps required to be For each step list the hazards that could List the control measures required to eliminate or Write the name of the Confirm the risk
perform the activity in the cause an injury, equipment damage or minimize the risk of injury arising from the identified person responsible to control measures
sequence they are carried out. Use environmental impact when the task is hazards (Engineering Controls, Procedures, Training, implement the control have been
as many lines as needed to performed PPE, Stop Work Trigger). For each identified hazard measure identified implemented
describe the job. There may be assign control measure(s) numerically linked to that
more than one hazard per job. List hazard.
each hazard

1.1 Unauthorized entry and work 1.1.1 Only project safety-oriented personnel
shall be allowed in the area

1.2 Workers unaware of work- 1.2.1 Crew members to assign on the activity
1.0 Workforce entry in the related hazard and shall have proper knowledge on the job Supervisor
emergency procedure and must be aware of ERP and HSE Officer
area
locations of assemble areas Permit Receiver

1.3 Chance of struck by 1.3.1 Only trained and competent flagmen/

passing vehicles on the riggers shall be assigned for road traffic
road signals. Area must be hard barricaded

2.0 Apply all necessary work 2.1 Lack of information on job 2.1.1 Secure necessary permit. Supervisor
permits description, Location, 2.1.2 Only qualified/trained work permit HSE Officer
equipment and tools to be receiver to obtain work permit from the Permit Receiver
used issuer prior to start the job complies
with all instructions specified in the

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 permit
2.1.3 Safe work permits and other pertinent
documents shall be secured before any
works commence. Comply the work
permit and shall follow the safety
procedures.
2.1.4 A joint inspection must be conducted
both by Permit Issuer and Permit
Receiver prior to signing of permit.

3.1 Lack of knowledge/ 3.1.1 Topic to be discussed must be based on

understanding the activities and safety requirements
on the approved work permit
Supervisor
3.2 Miss communication 3.2.1 Each job steps must be clearly explained
3.0 Pre-task briefing HSE Officer
to all crew members and the potential
Permit Receiver
hazards during the activities

3.3 Language barrier 3.3.1 Pre-task briefing shall be translated in

crew members’ local languages

4.0 (Mobilize to carry-out the 4.1.1 Communicate hazards to the workforce Supervisor
job according to the plan. to make them aware HSE Officer
4.1.2 Give training on emergency procedure Permit Receiver
to the work force.
4.1.3 Emergency contact details must be
4.1 Natural Habitants (need to
posted at site.
consider)
4.1.4 Buddy system must be implemented for
easy reporting.
4.1.5 Standby vehicle must be at site in case
of emergency.
4.1.6 Full site supervision at all time.

4.2 Vehicle to Pedestrian 4.2.1 All drivers shall have a Saudi Arabian
Access and other vehicles, Government driver’s license.
human & vehicle interface 4.2.2 Safe access shall be maintained at site
for vehicles and equipment.
4.2.3 Pedestrian safety precautions shall be

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 discussed in daily TBT
4.2.4 All traffic rules and signs should be
followed (on site approved speed limit-
20KPH)
4.2.5 All employees shall be wearing full
personal protective equipment. (helmet,
safety glass, high visibility vest, safety
shoes)

4.3.1 Vehicle and Pedestrian Traffic route

4.3 Unidentified Vehicle and
must be clearly identified with signs.
Pedestrian Traffic Route
4.3.2 Trained Flagmen shall be assigned

4.4.1 Safe access shall be maintained at site

For vehicles and equipment as well as
for the workforce.
4.4 Poor Access/egress
4.4.2 A separate access with barricade and
signage information shall be provided
for pedestrian only

5.1 Improper Manual Handling 5.1.1 Manual handling shall be covered in Supervisor
5.0 Manual Handling daily TBT and be HSE Officer
implemented on site, safe manual Permit Receiver
handling procedure to be adopted
5.1.2 Ergonomic Awareness Training correct
body positioning during lifting.
5.1.3 Buddy system may apply
5.1.4 Use of mechanical lifting if possible
5.1.5 Provide adequate information,
instruction and training to workmen
5.1.6 Proper supervision and constant
monitoring must be done
5.1.7 Ask for help on heavy and awkward
load, use mechanical lift if necessary.
5.1.8 Check label for weight information for
manual lifting or have an information
from site engineer or supervisor for the
material/object estimated weight

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 5.2.1 All materials, tools and equipment shall
be stored in a correct
manner and the site shall be cleared as
the work progresses
5.2.2 Keep work areas as clean and dry as
possible.
5.2 Poor housekeeping
5.2.3 Wear suitable foot wear with anti-slip
sole.
5.2.4 Proper waste disposal
5.2.5 Remove all obstruction in access way
5.2.6 Materials shall be segregated with
proper markings at per standard.

5.3.1 Always use correct hand gloves when

handling Material
5.3 Sharp Edges 5.3.2 Ensure all protruding nails were
removed or bended.
5.3.3 Discuss the hazard in TBM.

6.0 Cutting and fixing of form 6.1.1 Always use correct hand gloves when Supervisor
materials, supports using handling materials HSE Officer
Hand and Power tools 6.1.2 Ensure all protruding nails were Permit Receiver
6.1 Sharp objects, use of
removed or bended.
damaged tools
6.1.3 Use only color-coded tools
6.1.4 Install protection or rebar caps to all
protruding objects/rebar

6.2.1 All electrical cables must be checked for

any cut/opening or
protruding wires.
6.2.2 All electrical cables used for power tools
6.2 Damage electrical cables
connection must be raised over head by
providing wooden poles.
6.2.3 Provide GFCI/ELCB when using electrical
power connections.

6.3 Pinch points/ line of fire 6.3.1 Ask for help on heavy load.
6.3.2 Use mechanical lift if necessary.

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 6.3.3 Proper supervision
6.3.4 Do not put yourself in the line of fire

6.4.2 Ask for help on heavy load.

6.4.1 Use mechanical lift if necessary.
6.4 Improper manual handling 6.4.2 Observe proper lifting technique
6.4.3 Knows estimated material weight
6.4.4 Buddy system may apply

6.5.1 All materials, tools and equipment shall

6.5.2 Be stored in a tiny manner and the site
shall be cleared as the work progresses
6.5.3 Keep work areas as clean and dry as
6.5 Poor housekeeping possible.
6.5.4 Wear suitable foot wear with anti-slip
sole.
6.5.5 Proper waste disposal and maintain
good housekeeping

6.6.1 Ensure inspection is done prior to pour

concrete
6.6.2 Ensure all supports can carry the
concrete loads
6.6.3 Assign pouring watchman in case of
6.6 Collapse of form work concrete leakage
6.6.4 Ensure tie rods supports and braces are
continuously inspected during concrete
pouring
6.6.5 Slab form works shall have approved
load calculation as per drawing

7.0 Removal of forms/ 7.1 Improper manual handling 7.1.1 Manual handling shall be covered in
De-shuttering pinch points, line of fire daily TBT and be implemented on site
7.1.2 Ergonomic Awareness Training (TBT)
correct body positioning during lifting.
7.1.3 Buddy system may apply
7.1.4 Use of mechanical lifting if possible
7.1.5 Provide adequate information,
instruction and training to workmen

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 7.1.6 Proper supervision and constant
monitoring must be done
7.1.7 Ask for help on heavy and awkward
load, use mechanical lift if necessary.
7.1.8 Avoid to stand in the line of fire / do not
stay or position in form work laying
direction
7.1.9 Use appropriate tools for de-shuttering
activity
7.1.10 Use hands gloves with rubber surface

7.2.1 Always use correct gloves

7.2.2 Remove or bend protruding nails/ de-
nailing shall be done on the same area
where dismantling is being done prior to
7.2 Sharp edges and protruding
transfer dismantled form materials
nails
7.2.3 Barricade de-nailing area, put removed
nails in a bucket or box
7.2.4 Dismantling shall be one at a time to
give way for de-nailing activity

7.3.1 Keep work areas as clean and dry as

possible.
7.3.2 Wear suitable foot wear with ant- slip
sole.
7.3.2 All materials, tools and equipment shall
be
stored in a tiny manner and the site shall
7.3 Poor housekeeping
be cleared as the work progresses
7.3.3 Form works materials for re-use shall be
stocked properly and shall not
obstructing
on the access
7.3.4 Damaged form materials shall be
immediately disposed

7.4 Collapse during removal of 7.4.1 Use alter support during removal of tie-
Support/ dismantling rod and other braces for wide size

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 shuttering materials to avoid sudden
collapse of the shuttering materials

7.4.2 Use crane if possible, to support by lifting

belts for wide size and heavy shuttering
supports to avoid collapse during
dismantling
7.4.3 Dismantling process shall be followed
base on method statement

8.1.1 Ensure that the scaffolds are inspected Supervisor

and tagged and are safe HSE Officer
8.0 Working at heights 8.1.2 Install RED tags during scaffold erection, Permit Receiver
activities YELLOW tag in incomplete scaffold and Scaffold Supervisor
must use fall protection (full body
8.1 Improper Scaffolding harness with double lanyard) and
GREEN tag for complete scaffold.
8.1.3 Do not removed/change tag if not
authorized nor dismantle any portion if
you are not a certified erector/scaffolder
8.1.4 Scaffold inspector/supervisor to use
scaffold checklist form during inspection

8.2.1 Ensure good housekeeping, clear all

access from obstruction and tripping
8.2 Tripping hazards hazards
8.2.2 Scrap rebar shall be immediately
removed from scaffold platform
8.2.3 Keep tools inside toolbox

8.3 Falling object hazard 8.3.1 Barricade areas beneath working at

heights and assign watch man to control
persons to cross under falling hazards
area
8.3.2 Install signage regarding the work at
heights activities
8.3.3 Avoid simultaneous activities on ground
and above ground on the same area
8.3.4 Use canvass tool bag when hoisting low

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 weights materials
8.3.5 Rebar shall not be stocked in the
scaffold platform

8.4.1 Use 100% tie off using full body harness

with double lanyard on yellow tagged
8.4 Personnel Injury due to scaffold
slip / trip, struck against, 8.4.2 Only personnel with working at heights
struck by and fall from training can work at heights
height, back injury, heat 8.4.3 Remove/protect all protruding objects
tress 8.4.4 Provide proper work break, proper
manual lifting, avoid lifting using back
force, heavy objects shall not be lifted
alone

8.5.1 No scaffold erection, dismantling,

modification and working at heights on
wind speed above 65KPH (40MPH)
8.5.2 No scaffold erection, dismantling,
modification and working at heights
8.5 Bad weather condition
activities during heavy sandstorm
8.5.3 No scaffold erection, dismantling,
modification and working at heights
activities during rain fall
8.5.4 Re-inspect all scaffolding platforms after
rains, sandstorms and strong winds

9.1.1 No external activities shall be performed Supervisor

9.0 Working in Adverse 9.1 High winds / Sand Storms when sand storms / visibility is poor HSE Officer
Weather Conditions 9.1.2 Use dust mask during sandstorms Permit Receiver

9.2 Heat Stress / Heat related 9.2.1 Workers shall be provided with rest
illness shelters and breaks on regular intervals
9.2.2 Workers shall be provided with cold and
sufficient drinking water at job location
9.2.3 All workforce shall be trained on “Heat
Stress” management system
9.2.4 Job rotation system shall be applied

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 within the group.

9.3 Environmental condition/ 9.3.1 Weather condition shall always be

high temperature checked every 30minutes

10.1.1 Adequate water coolers with disposable

10.1 Lack of drinking water cups will be provided.
“NO DRINKING WATER NO WORK’

10.2.1 Rest shelter near work area to be

installed
10.2 Rest shelters lack of
10.2.2 Rest shelters shall be provided with fans
Ventilation
and proper bench for resting and must Supervisor
10.0 Welfare Facilities be covered with green net HSE Officer
Permit Receiver
10.3.1 Portable toilet will be provided for
personnel working in the area.
10.3.2 Sufficient number of toilets shall be
10.3 Insufficient toilet facilities provided as per required ratio or
depends on the distance from the
working area

11.1.1 Approved extended work permit to be

obtained prior to start of work.
11.1 Unauthorized extended 11.1.2 Adequate Supervision shall be ensured.
work 11.1.3 All workers shall wear clear safety
glasses.
11.1.4 HSE coverage to be available Supervisor
11.0 Extended work if HSE Officer
required Permit Receiver
11.2.1 Adequate illumination shall be provided
in all work areas and Access
11.2.2 No equipment shall be used in poorly
11.2 Insufficient illumination
illuminated area.
11.2.3 Dedicated electrician, maintenance
personnel to be available at extended
hours

12.1 Overfilled 12.1.1 Refuelling to be done at slow rate to Supervisor

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 reduce the potential for
spillage and static ignition build up
12.0 Re-fuelling 12.1.2 Never overfill or top the fuel tank
12.1.3 Ensure drip tray under the equipment to
be refuelled
12.1.4 Let the fuel dispenser shut off
automatically and leave the nozzle in
the tank for six to eight seconds so the
fuel can settle down and any fuel in the
nozzle can drip down into fuel tank

12.2.1 Refuelling to be done only by refuelling

vehicle and trained person
12.2.1 Switch off equipment before starting
refuelling
12.2.2 Ensure the availability of fire HSE Officer
extinguisher near refuelling point Permit Receiver
12.2.3 No ignition source /smoking near
12.2 .2 Fire
refuelling point
12.2.4 Switch off mobile phone before starting
refuelling
12.2.5 Ensure earthing is properly installed
prior to refuelling
12.2.6 If fuel is needed to be taken on site in
can, use the recommended jerry can

12.3.1 Never overstretch refuelling hose

12.3.2 Hose and refuelling assembly should be
in good condition
12.3 Damaged hose
12.3.3 Stay near equipment’s fuelling point
connection/ leak
when refuelling
12.3.4 Ensure availability of MSDS and
emergency spill kit on the diesel truck

13.0 Housekeeping 13.1 Health Hazard 13.1.1 Drinking containers must be in good Supervisor
sanitary, tightly capped, HSE Officer
and clearly marked Permit Receiver
13.1.2 Condition for use and cup dispenser Environmental

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 must be provided.
13.1.3 Dust control shall be performed to
control the dust in the area

13.2.1 Regular disposal of waste, debris and

scrap materials shall be
carried out
13.2.2 Trash bin for waste, used paper cups,
coordinator
scrap and debris must be provided
13.2.3 Housekeeping must be done prior to
13.2 Environmental Pollution
closing of work permit
13.2.4 All unused materials shall be removed
from site on a daily basis and disposed
only in an approved dumping area
13.2.5 Dust control shall be performed to
control the dust in the area

14.1.1 All shall be familiar with SA and RAPCO

emergency contact numbers. (see below
contact numbers)
14.1.2 All work permits shall be cancelled in
case of any emergency
14.1.3 All equipment shall be shut off, power
Supervisor
14.1 Unawareness of isolated and are secured during
HSE Officer
14.0 Emergency emergency.
emergency response Permit Receiver
14.1.4 All personnel shall proceed to the
nearest assembly point in upwind / cross
wind direction during emergency.
14.1.5 Head count shall be conducted at the
Assembly point.
14.1.6 All crew shall remain calm at the muster
point till all clear alarm is sounded

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 JSA Communication meeting attendance with all personal conducting job at the field
JSA description: Form Works
JSA No. .

No SA Badge Name Dept / Div / Contractor Name Position Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

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 11.

12.

13.

14.

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