Doc. No.

FORM_DF-SCTDOF-HSE-012-E
FORM
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 1 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E

Department Work Area Prepared by (Supervisor) Approved by (Dept. Leader) JSA No. Rev. No.
Name: Name:
CAR-001
Signature: Signature:

Operation/Job description: Confined Space Entry Rig Name: Scarabeo 9

Date:
Risk Assessment
Responsible for the
Seq. No. Activity Step Hazards Precautions/Measures to be taken (L: Low / M: Medium / H: High)
measure
Cons. Prob. Risk
1. Coordinate with other
discipline supervisors, other
work permit applicants in
surrounding areas.
2. Ensure all personnel
involved in the operation
understand the exact work
scope (verify to avoid Supervisor
1. Conflicting activities. miscommunication)
2. Misinterpretation of the scope of 3. Supervisor shall ensure
work and associated hazards and facilities are available and in
precautions required for execution. place for Rescue &
1 Prepare Work Permit \ JSA H L M
3. Language barrier- Evacuation purposes, and
miscommunication are communicated prior to
4. Incorrect or insufficient Personnel commencement of activities.
Protective Equipment (PPE) 4. Supply and wear the correct
PPE for the activities
undertaken (hard hat, safety
shoes, safety glasses, FRC
uniform, gloves, as a
minimum) Any additional or
Specialist PPE required shall
be provided before
commencement of activities.
 Doc. No. FORM_DF-SCTDOF-HSE-012-E
FORM
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 2 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E
1. Ensure personnel are fully
briefed on their working
environment and that the
correct Personal Protective
Equipment is supplied &
utilized in the correct fashion
as the activity dictates.
1. Slips 2. CS Attendant & CS Team
2 2. Trips shall ensure adequate Supervisor
Working Environment M L L
3. Falls lighting and access/egress All CS Team
4. Dropped objects for activities to commence.
3. CS Attendant shall ensure
area is barriered to prevent
unauthorized access to CS
4. CS Attendant shall ensure
the availability of the “Log
Sheet” for entry/exit of
personnel in the CS
1. Lack of oxygen 1. Review PTW System prior to HSE Officer H M M

2. Narrow spaces commencing the CS activity. CS Attendant

3. Breathing difficulties 2. All activities shall be Supervisor
4. Awkward postures performed only by trained,
certified & competent All CS Team
personnel.
3. Maximum occupants: n°4
people.
Confined Space Activities 4. Maximum continuous work
3 time: 2 hours.
5. Fixed limit for oxygen
concentration is: Upper
21,5%, Lower 20%.
6. Interruption of activities and
evacuation of internal area if
oxygen concentration is
 Doc. No. FORM_DF-SCTDOF-HSE-012-E
FORM
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 3 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E
outside external fixed limit,
and subsequently ventilation.
7. Visive contact from the
outside
8. Musculoskeletal disorders
1. Ventilation 24h before entry
& continuous if required.
2. Radio communications for
CS team and stand-by man.
(if necessary/required)
3. Gas Test performed from
outside by a competent &
1. Low level of oxygen certified AGT. HSE Off
4 4. Gas test is required to enter CS Attendant
Access/Egress to Confined 2. Breathing difficulties
the confined space prior to Supervisor H M M
Space 3. Contaminated atmosphere every entry.
4. Slips, Trips, Falls 5. Entry log of access/egress of All CS Team
personnel.
6. Access, Egress & internal
environment shall be
assessed at every level of
ongoing activities. If in doubt
exit the Confined Space and
seek assistance.
Emergency Management 1. Low level of Oxygen 1. Tripod and winch available if CS Attendant H M M
2. Acute illness development in CS vertical rescue. Alternative Supervisor
3. Injury Rescue Plan must be
4. Entrapment discussed/provided if the
access is deemed difficult or
hazardous to personnel.
2. Safety harness for all CS
5 entrants.
3. Interruption of activities and
pre-determined evacuation
 Doc. No. FORM_DF-SCTDOF-HSE-012-E
FORM
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 4 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E
of Confined Space.
4. In the event of emergency,
Confined Space Attendant
has FULL authority to order
immediately evacuation of
the personnel.
5. Recheck the ventilation &
perform Gas Test prior to
recommencement of
activities.
1. Restrict manual
handling of weight more
than 15kg.
6 1. Over exertion. 2. Minimize handling Supervisor
Manual Handling oversized/awkward
2. Restricted movement due to area M L L
shaped loads. All CS Team
of Confined Space dimensions.
3. Use mechanical means
for loads whenever
possible.

Housekeeping 1. Improper waste disposal. 1. Check after completion Supervisor M L L

2. Trip and slip hazard. of activities that all
3. Unsafe working conditions. equipment/garbage & All CS Team
4. Leave objects/debris behind in the consumables are
CS removed from CS and
immediate surrounding
area.
7 2. Correctly dispose of
generated waste in
proper container.
3. All electrical
leads/cables, air hoses
and materials shall be
removed and stored
appropriately.
 Doc. No. FORM_DF-SCTDOF-HSE-012-E
FORM
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 5 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E

REMINDER:
This is a Generic Job Safety Analysis Template.
It is your duty to modify this JSA to adhere to specific requirements and any hazards that may be present in your workplace.
Always ensure that your Hot Work is performed Safely and in compliance with local Safety Regulations and Procedures
 Doc. No. FORM_DF-SCTDOF-HSE-012-E
FORM
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 6 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E

Probability for the analysis

PROBABILITY Before mitigation After mitigation
of the quantified risk
The event is highly unexpected by the HSE risk assessment team because the preventive/protective measures applied have always shown to be
A Very unlikely Never occurred in the Energy sector. Less frequent than 10-5 events/year
effective and/or it could only happen under a freak combination of adverse conditions.
Already occurred in the Energy sector. Similar occurrences have already been recorded in the The event is unexpected by the HSE risk assessment team the preventive/protective measures applied have always shown to be effective
B Unlikely Between 10-5 and 10-4 events/year
Energy sector. and/or it can only happen under a freak combination of adverse conditions.
Already occurred in the Company. Some similar occurrences have already been The HSE risk assessment team is aware that the event could happen even if the preventive/protective measures applied have shown themselves to
C Possible Between 10-4 and 10-2 events/year
recorded in the Saipem group (less than once a year). be effective and/or presence freak combination of adverse conditions is not necessary for it to occur.

It has occurred many times in the Company. Many occurrences have already been recorded The event would not surprise the HSE risk assessment team because the preventive/protective measures applied have often shown to be ineffective
D Probable Between 10-2 and 10-1 events/year
in the Saipem group (more than once a year). and/or it probably will occur if the conditions remain unchanged.

It has occurred on the site many times a year. Many occurrences have already been recorded The event would not surprise the HSE risk assessment team because the preventive/protective measures applied have almost always been shown to More frequent than 10-1
E Very probable
at one particular branch in the Saipem group (more than once a year). be ineffective and/or it is certain that it will occur if the conditions remain unchanged. events/year

EFFECTS ON ENVIRONMENT and Communities

SEVERITY ANNUAL FREQUENCY / PROBABILITY OF OCCURRENCE
INJURY TO DAMAGE TO
OF
PERSONS ASSET IMPACT ON HIGH CLEAN UP
INCIDENT LOCAL
REQUIREMENTS/ REPUTATIONAL A B C D E
SPATIAL EXTENSION VULNERABLE INTERVENTION/ COMMUNITIES
AREAS* REMEDIATION AUTHORITIES IMPACT
IMPACT
Very Very
Slight injury or Managed with Unlikely Possible Probable
Slight damage unlikely p robable
L1 limited health internal Reporting not Not reported
No disruption Very Minor Not impacted Not impacted
Negligible effects emergency necessary in the news
to operation

SEVERITY OF THE CONSEQUENCES

(First Aid) team 1 Minor
Minor pollution
Minor injury Minor damage
contained at site Managed with Reported to
Effects on health Brief disruption
L2 level and that internal Local authority Not reported 2 Low
(Medical Treatment (cost10K€- Not impacted Not impacted
Low doesn’t spread on emergency without any in the news
or Work Restricted 100K€ or 1day
the environmental team fines
Case) downtime)
media
3 Medium
Pollution of the
Serious injury or environmental media,
Local damage
health effects or up to a medium area Managed with Reported to Local
Partial disruption Might be 4 High
L3 temporary or (within the operational internal authority (Port Reported in
(cost100k€-500k€ or Not impacted impacted with no
Medium permanent total site, or at most within emergency Authority, etc) with Local News
1-7 days lasting effect
invalidity a team negligible fines
downtime)
(Lost Time Injury) few km) with short
term effect. 5 Major
Reported to
Red Area - inacceptable risk: the activities Pollution of the
Majorcannot
damagebe carried out until additional control measures able to reduce the risk to anwith
Impacted acceptable levelauthority
National (yellow or green area) have been implemented.
environmental media
L4 - the risk is tolerable Major
as it disruption
is assessed as ALARP
up to (As LowImpacted
a vast area as Reasonably Required the short term (inspections, fines, Reported in
with short Practicable). The activities can be commenced, but it is necessary to:
Single fatality (cost 500k€-3M€ or intervention of effect (up to stop of operations) National
High (beyond the site of the term effect o Identify adequate risk reduction control measures
1-2 weeks external facilities few months with not negligible News
incident) with medium o Ensure that the risk is subjected to periodic monitoring and assessment so that it remains
downtime) effect) fines
term effect. constantly within the ALARP range.
Pollution of the Reported to o Guarantee, in this way, that a risk threshold considered inacceptable is not exceeded.
Extensive damage Impacted with The ALARP level can be defined by using a qualitative assessment or with a cost/benefit analysis to assess
environmental media Required the National authority
Very mayor medium or long
L5
up to a vast area Impacted with intervention of
term effect
(inspections, fines, Reported in whether the implementation of measures to mitigate the identified consequences or reduce the frequency
Multiple fatalities disruption (cost (beyond the site of medium or long external facilities or stop of operations) International
Very High 3M€-10M€ or more (significative can be pursued with a cost that is unreasonably greater than the benefits actually obtained.
the incident) with term effect remediation not with not negligible News
than 2 weeks time spawn fines Green Area - acceptable risk: the activities can start without the need of any additional control
long term possible
downtime) effect. effect)
measures.
 Doc. No. FORM_DF-SCTDOF-HSE-012-E
FORM
LIFE
Rev. 01 Date: 14/10/2021
JOB SAFETY ANALYSIS
Page. 7 of 3
Ref.Doc. STD_DF-SCTDOF-HSE-001-E

POTENTIAL HAZARDS (tick those that apply) SAVING RULES

ICON HAZARD  ICON HAZARD  ICON HAZARD  (TICK IF APPLICABLE TO THE TASK)
Fall from height Suspended loads Confined space

Pinch points / sharp Dangerous

Fall into water
edges atmosphere
Bypassing Energy
Dropped objects
Crush points / caught Difficult access / ☐ safety control ☐ Confined space ☐ Driving ☐ Isolation ☐ Hot Work
in between egress
Moving / rotating /
Electrical hazard remotely controlled Manual handling
machinery

Weather conditions /
Fire / explosion Slip / trip hazard
Sea state
Safe Mechanical Work Working at
New / ☐ Line of Fire ☐ Lifting ☐ Authorisation ☐ Height
Oil / Chemical
inexperienced Poor visibility
Spills
personnel
Hazardous /
Hot/cold surfaces /
chemicals Biological hazard
substances
exposure
Potential release
Communication Ionizing radiations
of energy

High noise / vibration Vessel

Pressure
levels emergencies

Other
Other Other

All personnel involved in this job must sign the JSA to confirm that they have taken part of the meeting to discuss the JSA measures and have clearly understood their duties and responsibilities.
If the JSA is associated to an ADC, the signatures can be recorded only in the ADC Form.

NAME SURNAME POSITION SIGNATURE