Job Safety Analysis (JSA)
Specific Job (Description): Work Order # (if applicable): Date: JSA#:
Safety Analysis
Finishing Temporary Facilities/ MRF and 2/1-7/21 New Revised
warehouse repair
Instructions: Plant / Location Department (check box): Hazard Controls - Required PPE (check box):
1. List basic steps of job
Bess Facility Project Mechanical Maintenance ☐ Hard Hat ☐ Fall Protection ☐
/Tagoloan Misamis Oriental Electrical Maintenance ☐ Safety Glasses ☐ Respirator ☐
(limit steps to 10)
2. List expected hazards Operations ☐ Hearing ☐ Welding Wear ☐
for each step Protection
3. List Controls for each Coal Handling ☐ Safety Boots ☐ FR Clothing ☐
hazard
4. See team leader for
Material Handling ☐ Face Shield ☐ Tyvek Coveralls ☐
review and signature Lab ☐ Chemical ☐ Cooling Vest ☐
5. After completion of job, Goggles
forward to Safety Office/Admin ☐ Leather Gloves ☐ Racking Suit ☐
Department Gas Turbine Team ☐ Impact Gloves ☐ Chemical Suit ☐
Work Permit Required: Engineering ☐ Rubber Gloves ☐ Special PPE (list ☐
below):
Yes NA
Name of Contractor: ☐ Rubber Goods
Power Dimension Inc.
Place a check in the box next to hazards you expect to encounter on the job. List all hazard controls on next page
Energy Isolation Hot Work Permit No: Work at Height Permit Electrical Work Lifting Activity Permit CSE Permit No: Excavation Permit
Work Permit Type: Permit No: No: Permit No: No: No:
Supervisor MR. ERNESTO BALANON/Jet Louis F. Magallones
Site Contact & No 09157566586 / 09954660700
Approval Signature: Date of Approval:
“Everyone has the STOP WORK AUTHORITY”
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Job Safety Analysis (JSA)
INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC
E 1 to E8
(C1) (C2) (C3) (C4) (C5)
Almost Certain (P5) S2 S7 E3 E6 E8 S1 to S8
Likely (P4) M2 S3 S8 E4 E7 M1 to M4
Possible (P3) L4 M3 S4 E1 E5 L1 to L5
Unlikely (P2) L2 L5 M4 S5 E2
Rare (P1) L1 L3 M1 S1 S6
Level of Risk Tolerable ALARP ALARP Intolerable
ALARP = As Low As Reasonably Practicable
Consequence or Hazard Effect
(Where an event has more than one ‘Loss Type’, choose the ‘Consequence’ with the highest rating)
Loss Type
(Additional ‘Loss Type’ may exist
Insignificant Minor Moderate Major Catastrophic
for an event; identify & rate
accordingly)
First aid Medical treatment Single Fatality Multiple fatalities
Harm to People Lost time
Exposure to minor health Exposure to major health Loss of quality of life Impact on health ultimately
(Safety / Health) Reversible impact on health
risk risk Irreversible impact on health fatal
Insignificant Moderate environmental Catastrophic environmental
Environmental Impact Minor environmental harm* Major environmental harm*
environmental harm* harm* harm*
Business Interruption, Material
Substantial or total los of
Damage & Other Consequential No disruption to operation Brief disruption to operation Partial shutdown Partial loss of operation
operation
Losses
Serious breach of law;
Minor legal issue non- investigation/ report to Major breach of the law; Very considerable penalties
Legal and Regulatory Low level legal issue compliance and breaches of authority, prosecution considerable prosecution and and prosecutions. Multiple
the law and/or moderate penalty penalties law suits and jail terms
possible
Slight impact – public
Impact / Reputation Limited impact – local public Considerable impact – National impact – national International impact –
awareness may exist but
Social / Community concern regional public concern public concern international public attention
no public concern
Probability
Probability (How often?) Examples (Near misses as well as actual events) % chance of occurring
Almost certain The unwanted event has occurred frequently, occurs in order of one or more times per year and is likely to reoccur within one (1) year > 75% - 100%
Likely The unwanted event has occurred infrequently, occurs in order of less than once per year and is likely to reoccur within five (5) years > 50% - < 75%
The unwanted event has happened in the business at some time; or could happen within ten (10) years
Possible > 20% - < 50%
Unlikely The unwanted event has happened in the business at some time; or could happen within 20 years > 5% - < 20%
HAZARD ANALYSIS CHECKLIST (Review conditions on day of carrying out this task & add as required)
Environment Personal Protective Equip Electrical Equipment Permits Required
“Everyone has the STOP WORK AUTHORITY”
Page 2 of 6
Job Safety Analysis (JSA)
Danger/Caution Tags Tested and Tagged Energy Isolation Permit
Lighting
Noise Gas Detector – RCD Boards Used Hot Work Permit
Dust Safety Showers In Good Condition Work at Height Permit
Vibration Double Eye Protection VRD on Welding Equipment High Voltage Permit
Adjacent Rotating Plant Chemical Suit Mechanical Equipment
Other Work Groups Hearing Protection Hydraulic Tooling
Heat Rubber Boots Scaffolding Tagged
Weather e.g. rain Safety Harness and Lanyard Ladder(s)
Possible Hazards Welding Shield Lifting Equipment Tagged
Fall From Height Oxy Goggles Compressed Air Tooling
Falling Objects Gloves -Type: Rubber Crane(s) Competencies Required
Stored Pressure Fire Extinguisher Forklift High Risk Licences
Radiation Exposure Fire Blanket Elevating Work Platform Trade Certificate
Contact with Electricity Dust Mask Barricading in Place Equipment Operation
Contact With Chemicals Half Face Respirator Documents Vehicle Licences
Vehicle Interaction SDS Isolation Officer
Task Requires a Sentry /
Suspended Loads Emergency Plan Spotter
Crush or Pinch Points
Manual Handling Other PPE:
Housekeeping Trip hazards Requirements
Inappropriate Guarding
**If the conditions of the job change, and new hazards are present, a new JSA and Pre-Job Briefing shall be conducted**
“Everyone has the STOP WORK AUTHORITY”
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Job Safety Analysis (JSA)
Hazards (may include a change process) Recommended Controls or Actions
Inherent Residu
Job ACTIVITIES al Risk
Risk Select the highest level possible from the hierarchy
Step Identify hazards, unsafe conditions and unsafe work Rating
Rating of controls
practices associated with each task / operation that have (After)
(Before)
not been identified in the Work Instruction
All employees assigned to this task will attend a
pre-construction safety meeting, which will
Miscommunication/miscoordination that can lead include the pertinent JSAs, Standard Operating
Pre-Construction Safety
1 Meeting.
delay of works and parallel works. Procedures, types of potential hazards, and
actual hazards present and controls for those
hazards.
Head, hand and eye injuries Wear 100% Complete PPe’s
Discoordination from other working group, Parallel
Preparation for Repair of Proper coordination to other contractors
2 Temfacil
of work to other work group
Conduct visual inspection of hand tools before
Defectives hand tools
using
Installation process repair on
3 temfacil Muscles strain
Do not over reach tools that used for fix the
wood supports
Eye injuries Used of safety goggles to prevent eye injuries
Dust exposures Wear appropriate N95 dust mask
Remove the unused materials to prevent any
Tripping Hazards
4 tripping hazards
Conduct proper site inspection before executing
Uneven ground surface /slip trip and fall hazards
the job activity
Provide proper Platform/ladder to prevent from
Falling Hazards when reaching above the working
falling, if it exceeds up to 1.8 height wearing of
platform
Safety Harness must be provided.
Be aware from the old wood support from
5 Nail Puncture Wounds protruding nails to prevent any accidents while
working
Protruding nails from old support must remove
immediately.
6 Miscommunication from working members Proper communication must apply when
working in a group
“Everyone has the STOP WORK AUTHORITY”
Page 4 of 6
Job Safety Analysis (JSA)
Hazards (may include a change process) Recommended Controls or Actions
Inherent Residu
Job ACTIVITIES al Risk
Risk Select the highest level possible from the hierarchy
Step Identify hazards, unsafe conditions and unsafe work Rating
Rating of controls
practices associated with each task / operation that have (After)
(Before)
not been identified in the Work Instruction
.
Material Dust Always wear appropriate N95 dust mask
Ensure work area clean and Hand injuries due to sharp edges of materials Wear proper hand gloves for the right job
free Do not over reach of tools /conduct proper
Muscle strain and sprain
housekeeping
Date Coverage: January 18-24, 2021 Prepared by: Jet Louis F. Magallones
EHS Officer
EMPLOYEE SIGN ON
(The Team Member(s) signature is an indication that they have reviewed this JSA and have participated in a discussion about the basic steps of the job, expected job
hazards, and hazard control methods necessary for performing the job safely. Where single person work is taking place, it will only indicate a review of this JSA)
NAME Signature Name SIGNATURE
11.
12.
13
14.
15.
16.
17.
18.
19.
21.
“Everyone has the STOP WORK AUTHORITY”
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Job Safety Analysis (JSA)
“Everyone has the STOP WORK AUTHORITY”
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