JOB SAFETY ANALYSIS

Ref: – JSA–
Facility / Site:……………………………………………… Location within Site:………………………. Permit No:……………………. Permit Type: ……………… Date:…………………….

Task Description: Initial energization and running of Battery room HVAC supply Fans

REQUIRED REFERENCES JSA REVIEW

Have the relevant Procedures, Standards, Guidelines,
or Safe Work Practices been reviewed? Yes N/A
Pending confirmation by the Task Leader of site conditions, I agree that the attached JSA identifies the
significant Task Steps, Hazards, and Controls.

JSA REVIEWER (Supervisor or Designate):

RISK ASSESSMENT
Must existing Procedures or Work Practices be
Yes No Name / Signature: Company:
modified to perform this work?
After mitigation, are there any hazards that continue to WORK SITE VERIFICATION
present a potentially significant risk? (Scenario-Based Yes No
Risk Assessment required)
The Work Team has assessed the worksite conditions and confirms:
 The JSA addresses the applicable hazards and necessary controls.
PPE REQUIRED DURING THIS TASK
 The Team has the appropriate resources (people and equipment) to do the job safely.
HARD HAT SAFETY GLASSES
 Others that could be affected by the work have been informed.
FACE SHIELD TASK LEADER:
SAFETY SHOES / BOOTS
GOGGLES

Name / Signature: Company:

FALL PROTECTION
FALL RESTRAINT
COMPLETE THE SECTION BELOW IF THIS JSA IS NOT PART OF A PERMIT PACK
GLOVES:
COTTON Work Team Declaration:
LEATHER I acknowledge that I have reviewed the attached JSA, I understand my roles
and responsibilities, and I will comply with the instructions for this task.
IMPACT PROTECTION
Name (print): Name (print):
Dust mask OTHER (specify):
Work clothes

OTHER PPE (specify):

 TASKS/STEPS POTENTIAL HAZARDS HAZARDS CONTROLS HAZARD PORT MITIGATION
(Number) (What could go wrong?) (How can harm be prevented?) STATES
1. Permitting work  Work condition not safe  COMM PTW signed by authorized person  ERP System in
 Procedures and tasks not clear  HSE team to assess continuously the conditions of place.
 Lack of supervisory work in the assigned area
 Miscommunication  One person to issue work permits
 Not correct PPE worn  Toolbox talks
 Equipment not inspected and  Competency of personnel and supervisory for the
certified activity
 Define hierarchy and reporting flowcharts
 Define proper NOMEX PPE to be used for the work
 Check inspection certificates of equipment for the
job

2. Checking equipment  Pinch point / hand & fingers injuries  Wearing adequate NOMEX PPE  First aid box
 Tripping Electrical cables  Chemical gloves  Trained first aiders in place.
 Arrange cables to avoid tripping
 Use proper tools
3. Initial  Uncontrolled energisation
 Confirm equipment identification label MSBI ERP
energization resulting in electrocution or
corresponds with PTW and associated work Fire extinguishers (CO2)
running of serious injury.
pack engineering drawings, and is within
battery room Insulated hock
commissioning subsystem boundary.
HVAC supply  Fire resulting in or serious
fans injury, burns or Equipment  Confirm a LUN has been issued for the
damage. equipment/sub-system
 Display signs and barriers around work
 Moving machinery with the area.
potential cause serious injury,
equipment damage  Verify rescue hook, fire extinguishers, etc.
are in the area as needed.
 Ensure all mechanical guards are in place
prior to starting the fans.
 Mechanical commissioning to be in
attendance to confirm all associated
dampers are in the correct position before
starting the fans and confirm correct
rotation and airflow
 Mc certificate
4. Functional tests  Electrocution or serious 1. Ensure open communications are MSBI ERP
of associated injury. established between start/stop stations and
safety circuits. Fire extinguishers (CO2)
battery room
Test start/stop  Fire resulting in serious injury, Insulated hock
stations with burns Equipment damage Ensure fire extinguishers (CO2) is in place
associated .
HVAC fans.
5. Completion of  Equipment to be left in 1. All commissioning signs and barriers to be left MSBI ERP
Testing operation as required indicating equipment is in service
‘LIVE’.
Work permit and ICC is signed off and returned to
the PTW office
6. Housekeeping  Equipment and tools remain on site.  Proper communication during TBTs.  Plastic bags
 Slip trip and fall.  Put back equipment to proper place  Trash bins
 Trash left in the work place.  Clear all work place from trash
 Fire hazards.  Segregate trash

Name Position Date Signed

Prepared By
Checked By
Approved By