Job Safety Analysis

TRS-HS-FRM-0001

Instructions for completing Job Safety Analysis (JSA) form

Section I -Enter general information about the site and job task.
Section II - Determine whether any of these operations apply to the job task to be performed. Make note of any special training, permit, certification, and risk assessment
requirements.
Section III - Identify any human/organizational factors that could impact the ability to perform the work safely.

1. Break the job down into steps - Be as specific as possible. Write each job step in a new row of column A (Activity/Step). It’s a good idea to leave an extra row between
steps in case you need them later. Add additional rows to the table as needed, or if completing the JSA on paper, print additional copies of the sheet to
accommodate all job steps.
2. Determine the hazards associated with each job step and write them in column B (Hazards). Use the examples of hazards provided below to trigger your thinking
about different types of hazards and energy sources.
3. List any control measures that will be taken to ensure that step is done safely in column C (Control Measures). Use the control measure examples and hierarchy
provided to trigger your thinking about different types of controls and their effectiveness at reducing risk. Controls toward the top of the table tend to be more
effective at minimizing the severity and/or likelihood of an event than the controls toward the bottom of the table. If this job involves a Life Crucial Operation,
continue to step 4. Otherwise, repeat steps 2-3 for each of the job steps identified, then proceed to step 8.
4. Considering the hazards involved and the control measures that will be in place, determine the worst credible severity of an incident that could result from this job
step. Use the severity table provided. Write the severity number in column D (Severity).
5. Considering the hazards involved and the control measures that will be in place, determine the likelihood that an incident will result from this job step. Use the
likelihood table provided. Write the likelihood number in column E (Likelihood).
6. Multiply the severity number by the likelihood number and enter the product in column F (Risk).
7. Consider the risk rating against the thresholds provided in the Overall Risk Ratings.
i. Very low and low risk ratings of 1-2. This level is generally considered acceptable provided that all control measures are applied.
ii. Medium risk ratings of 3-9. Medium risk requires a planned approach to control the hazard and applies additional controls if required. Action taken must be
documented on the risk assessment form.
iii. High and Very High-Risk ratings of 10-25. For all high and very high risk, Column G (Additional control measures) must be implemented to further reduce the risk
to a medium or low level. Such activities shall not be proceeded until applying additional control measures. The Construction Director/Manager or facility Manager
must personally review the activities with a High or Very High residual risk score and approve additional control measures by signing off the JSA.
8. Repeat steps 2-7 for each of the job steps identified.

Section IV - Provide the name, company, and title of those who prepared and reviewed/approved this form in the signature box provided. The Construction Director/Manager or
facility Manager must review and approve the additional control measures that have a High or Very High-Risk rating before proceeding the task. Additional space is also provided
for crew members to sign the JSA if desired.

Reference Table in completing Section III – Job Safety Analysis (Column B – Hazard)
Biological & Environmental Electrical Chemical Gravity/Height Mechanical & Motion
Altitude Arc Flash Air Emissions Equipment Tipping/Collapsing Being Thrown Off/Under
Animal Bite/Sting Buried Utilities Chemical Products Excavation/Trench Equipment
Blood-Borne Pathogens Damage to Leads/Cables  Carcinogenic Falling Objects Disintegration of Moving
Contaminated Food/Water Damage to Switches  Combustible/Flammable Floor Openings/Edges Components
Insect-Borne Disease Energized Circuits/Conductors  Explosive Grating Removed Driving/Vehicle Traffic
Pests Inadvertent Energization  Toxic Inadequate Support Ejection of Workpiece/Debris
Poisonous Plants Lack of Isolation/Grounding  Corrosive Lack of Access Ladders/Stairs Entanglement
Precipitation Missing/Damaged Insulation  Reactive Suspended Load Friction
Temperature/Humidity Overhead Lines Client/Process Chemicals Unstable/Insecure Materials Movement/Shifting
Unsanitary Conditions Overload of Circuits Lack of Containment Work Above/Below Others Moving Parts
Weather Stored Energy Leakage/Spills Work at Height/Fall Hazards Pinch/Crush Points
Wind/Turbulence (Batteries/Capacitors) Material Incompatibility Walking/Working Surface Projectiles
Pressure Water Near Electrical Conductors Produced/Disturbed by Work  Slippery Rotating Equipment
Abrasive Blasting Work Environment  Asbestos  Uneven Sharp Edges, Corners, or Points
Compressed Gases Cluttered  Lead  Obstructed Shearing
High Pressure Fluid Confined Space  Silica  Steep Stored Energy
Pressure Testing Damaged Tools/Equipment  Welding Fumes  Moving/Swaying/Pitching (Springs/Accumulators)
Pressure Washing/Blasting Entrapment  Dust  Insufficient/Unstable Striking
Radiation Erosion Water Discharges Ergonomic Trapped Between Equipment and
Intense Light Hazardous Atmosphere Wastes Generated Awkward Postures/Movement Fixed Structures
Lasers  Oxygen Rich/Deficient  Hazardous Excessive Force/ Exertion Unexpected/Uncontrolled
Microwaves  Contaminants  Non-Hazardous Heavy/Awkward Load Movement
Naturally Occurring Ignition Sources Sound Repetitive Motion
Radioactivity Radioactive Inadequate Ventilation Continuous Noise Same Position
Material Poor Lighting/Glare Intermittent Noise Vibration
X-Rays Restricted Access/Egress Extreme Noise
Runoff Impact Noise

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Reference Table in completing Section III – Job Safety Analysis (Column C – Control Measure)
Most Effective Controls Examples
Elimination  Make connections at ground level before erecting  Remove a dangerous machine from service
(Remove the hazard altogether) a structure to eliminate work at height  Provide power outlets to avoid trailing cords
Substitution  Use latex rather than oil-based paints
(Replace the material/process  Reduce energy, such as speed, force, amperage, pressure, and temperature
with a less hazardous one)  Use water-based detergents instead of organic solvents
Engineering/Isolation  Ventilation  Isolate hazardous energy sources
 Secondary containment
(Design effective control  Machine guarding  Interlocks
 Barriers
measures to protect people and  Enclosures  Platforms and guardrails
 Improve lighting
the environment)  Circuit breakers  Exclusion zones
Warning  Signs  Horns  Labels
 High visibility paint
(Alert people to the hazards)  Backup alarms  Beepers  Tags
Administrative  Work rotation to minimize exposure
(Provide training, procedures,  Inspect safety equipment  Training and supervision
etc.)  Good housekeeping practices
PPE  Safety glasses  Fall harness and lanyards  Respiratory protection
Least Effective
(Personal protective equipment)  Hearing protection  Gloves  High visibility vests

Reference Table in completing Section III – Job Safety Analysis

Reference Table in completing Section III – Job Safety Analysis (Column D –Severity)
(Column E – Likelihood)
Impact On Chances of
Severity Level Likelihood Level Probability
People Equipment / Property Occurrence
 Extensive losses of high value
Likely to occur within the next
equipment/property
Almost 1 year.
Major 5 Single / Multiple fatalities  Loses exceeding SAR 3,750,000; or 5 1 in 100
Certain More than 80% chance of
Major unplanned impact on budget and
schedule occurring
 Losses of equipment/property that
Likely to occur within the next
Injury or illness resulting in cannot be readily replaced; or
2 years.
Significant 4 permanent total or partial  Losses exceeding SAR 375,000; or Likely 4 1 in 1,000
More than 60% and less than
disability Significant unplanned impact on project
80% chance of occurring
budget
Injury or illness resulting in  Loss of equipment that can be readily Likely to occur and may do so
medical treatment or replaced; or within the next 3 years.
Moderate 3 Possible 3 1 in 10,000
temporary disability/loss of  Losses exceeding SAR 37,500; or More than 40% and less than
function Minor impact on the budget 60% chance of occurring
Unlikely to occur and may do
 Loss of equipment that can be readily
Injury or illness requiring first- so within the next 5 years. 1 in
Minor 2 replaced, or Rare 2
aid treatment only More than 20% and less than 100,000
Losses less than SAR 37,500
40% chance of occurring.
Extremely unlikely to occur
 Near Miss/no impact or damage to within the next 5 years. 1 in
Negligible 1 Near Miss/no harm Unlikely 1
equipment or property Less than 20% chance of 1,000,000
occurring

Reference Table in completing Section III – Job Safety Analysis (Column F – Risk)

Risk Matrix Overall Risk Ratings

Severity Very Low Low Medium High Very High
Likelihood
1-Negligible 2-Minor 3–Moderate 4-Significant 5-Major 1 2 3-9 10-16 20-25

5 – Almost Medium High High Very High Very High

Certain (5) (10) (15) (20) (25)
High and Very High-Risk ratings of 10-25.
Medium Medium High High Very High
4 – Likely Additional control measures must be implemented to further reduce the
(4) (8) (12) (16) (20)
High and very high risk to acceptable level.
Medium Medium High High
3 – Possible Medium (9)
(3) (6) (12) (15) Note: The Construction Director/Manager or Facility Manager must
Low Medium Medium High personally review the activities with a High or Very High residual risk
2- Rare Medium (6)
(2) (4) (8) (10) score and approve suitable additional control measures by signing the
Low Medium Medium JSA.
1 – Unlikely Very Low (1) Medium (3)
(2) (4) (5)

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Section I – General Information

Emergency Procedures
Emergency Contact Name Emergency Contact Phone Number
Primary Contact Primary Contact
Secondary Contact Secondary Contact
Details
Program Number. Company Name ALUMACO
Project Name SURAH ISLAND HE-01 Date 06/06/2024
JSA /Risk Assessment Title Category ☒ New ☐ Revised

Specific Location Building

Plant Tools & Equipment Required Surveying equipment, Measure taps,Hammers,Lifting devices Area
This procedure describes the arrangements for the planning and organization of lifting operations at construction sites. for example, the use of cranes,
Work Scope/Description
hoists, cherry pickers, forklifts, lorry loaders and scissors lifts. Also lifting accessories such as chains, ropes, slings, hooks, shackles and eyebolts.

Section II – Does this job require any of the following operations?

 = Requires f normal/special training  = Requires certification or Competent/Qualified Person designations

= Requires a permit/form/report ∆ = Lif e Crucial Operations = Requires full Risk Assessment

Description Yes Description Yes

Aerial Lifts  ∆ ☐ Cranes - Critical lift   ∆ ☒

Confined Space   ∆ ☐ Hot Work  ☐

Dismantling and Demolition  ☐ Loading/Unloading Material ∆ ☒

Electrical Hazards   ∆ ☐ Noise Exposure  ☐

Excavation/Trenching   ∆ ☐ Powered Industrial Trucks   ∆ ☐

First Line Breaks   ∆ ☐ Radiation Area Work   ☐

Grating/Floor Plate/ Guardrail Removal ∆ ☐ Respiratory Hazards  ☐

Hazardous Energy Control   ∆ ☐ Roof Work   ∆ ☐

Hazardous Materials
  ☐ Scaffolding   ∆ ☒
Asbestos & Lead Work
Hazardous Materials
  ☐ Site/Vehicle Traffic ∆ ☒
Crystalline Silica & Cadmium
Hazardous Waste Operations  ☐ Steel Erection  ∆ ☐

Heavy Equipment   ∆ ☒ Work at Height (> 6 ft)   ∆ ☒

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Rigging, & Cranes   ∆ ☒ Other ☐

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Section III – Job Safety Analysis Risk Assessment (Post Control Measures)
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J)
Activity/Step Hazards Control Measures Severity Likelihood Risk Additional Control measures Severity Likelihood Risk
Drivers shall be well trained,
Driver should be certified, Clear
traffic sings shall be providing at Waring hazard lights and sings will
Site preparation and mobilization of cranes Over speeding, Collision with 3 3 9 be installed, Traffic controllers shall 2 1 2
site
each other, traffic accident Cranes position and ground control vehicle movement during
surface need to clean and operation
compacted

• Road traffic accident – vehicle Site labor shall be trained in the use of 4 3 12 • Some PPE e.g. hard hats and high 2 1 2
visibility vests are color coded to allow
collision / personal injury personal safety equipment and PPE
easy identification of trades. Riggers /
• Damage to materials and through onsite training and tool box Banks men will wear a orange hard hat
and high visibility vest, for example
equipment – financial and talks. Training shall include both the
production loss use and purpose of the protective
equipment
• Labor shall be provided with
Traffic
personal safety equipment and PPE at
no cost to themselves and shall be
provided with replacement protective
equipment on an old for new basis.
Labor shall not be required to utilize
old or damaged protective equipment
in order to reduce costs.

• Hoarding / fencing shall be erected 4 2 8 • Security signage shall be erected 1 1 1

once the Contractor has taken • Site set up shall be in accordance with
possession of the site the requirements set out in by the TRSDC
• Hoarding shall be at least 6 ‘ tall and in – Standard Health and Safety
Unauthorized entry to site by 3rd Party Injury to 3rd Party shall be sufficient to prevent Requirements.
unauthorized access
• Site access points shall include a
boom gate (or similar) and security
station that is manned by security
personnel 24/7 for the duration of the
project

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Heat stroke 1. Self-determination of heat stress 3 3 9 Workers should add extra salt to 3 1 3
Restlessness exposure their food
Irritability 2. Maintain a healthy life style Distribute approved water bottle to
Heat exhaustion 3. Drink water or other fluids worker for drinking water
Heat stress De hydration frequently
Heat cramps 4. Avoid excessive exposure
Heat rash 5. Flex leg muscles several times
before moving
6.Keep skin clan and periodically
allow skin to dry.
Constantly working without 1 Daily safety task instructions briefing 4 5 20 Adequate PPE and proper clothing during 5 1 5
drinking water, exposed to sun to be when working under high temperature e.
conducted to all workers prior to g. lightweight, cotton and light colored).
commencement of works. 18 Train supervisors to detect and
2 Comply with Summer working Plan manage symptoms of heat stress among
and the workforce. 19 Provide temperature-
heat stress procedures as per HSE controlled rest areas with adequate
plan. provision of tables and chairs to be in
3 Provide adequate quantity and place. 20 Provide Heat Stress General
quality of Awareness Training with regular refresher
drinking water by arranging water sessions for all operatives. 21 Encourage
coolers. workers to keep covered up during the
4 Limit work in extreme temperatures summer months (using a long-sleeved
during shirt and a hat with a brim or flap that
summer times. protects the ears and neck), especially
5 Providing shaded work areas as during mid-day when the sun is at its
much as hottest. 22 If practical, allow workers to
possible. set their own pace of work. 23
Working in hot weather / working in heat– direct to sun 6 Regular intake of food and drink Monitoring & supervision.
adequate
quantity of water.
7 Reduce oily related food and soft
drinks.
8 Sharing heavy work.
9 Ensure that the operative is fit to
work
under direct sunlight
10 Use of buddy system to monitor
colleague’s health
11 Scheduled rest breaks to be
provided
(Frequent breaks, minimum 10 mins
every 2
hours.
12 Drink water every 30 minutes and
Electrolytes as per manufacturer
recommendation and timescales.
13 Schedule work to minimize
exposure.
14 Newly mobilized workers shall be
acclimatized and never assigned
heavy task or
direct exposure to hot environment.
15 Re-schedule hard work activities in
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coolest
part of day where possible. Ensure no
worker
work alone in heat stress area.
16 Site supervisors shall perform job
rotation to the workers .
Proper PPE to be use
Survey /Setout Slip, trip and fall Barricade to provide at edge of 2 4 8 Avoid work at adverse weather 2 1 2
deep excavation condition

Riggers should be 3rd party

certified
Rigger shall train Operator shall follow only rigger
Poorly secured instruction
Lifting gear shall be 3rd party
incorrect lifting and erection TUV certified the Providing information, training,
practices Rigger supervisor close instruction or supervision necessary
including unsafe rigging and to protect all persons from risks to
Monitoring the task and has
Rigging, Lifting and Installation of Precast inadequate 4 6 24 their health and safety from work 2 2 4
valid TUV certification
members incorrect loading and Monitoring worker health and
Making sure that adequate
unloading method training communication workplace condition to prevent
inappropriate or unstable practices in place injury
work area for cranes Sharing information about the Providing adequate and accessible
faulty lifting anchor or site facilities for welfare of the worker
connection, Ensuring that health and safety while at work
procedures or process are in
place,

Provide proper barricade and

Cranes losing balance signages to stop unauthorized
Punch point Make sure Rigger and Operator are
entry
Poor equipment maintenance competent and train person
Make sure that the area is level
Loading and unloading Personal struck by falling load 4 6 24 Make sure supervisor conduct 2 1 2
and compacted
Un authorized entry toolbox meeting before activity
Make sure outriggers are fully
Work without work permit Never allow anybody to cross
extended
Crossing under the under the suspend load
Practice ergonomics /manual
suspended load lifting

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Scaffold collapse, use of poor

Using proper safety equipment, Avoid over loading, stay claim on
Scaffolding quality of damaged materials, 3 3 9 2 1 2
inspect scaffolding materials, scaffolding, A scaffold should
insufficient maintenance of
stay organized, Be fully licensed always have a guardrail
scaffold
Use fall protection cover (to
Misuse of ladders, Faulty prevent falling through
protective measure, Lack of opening), shall be provided
Work at height familiar and experience, stable access to high workplace, 4 6 24 Use proper PPE at work height 2 1 2
incomplete scaffold and regularly review your risk
roofing, prevention measures, Conduct a
job site inspection every six
months or more
Trained signalman with flags
Hot work permit should be
Operating a machine without available
Guards in place 2 numbers of fire extinguishers Shall be wear PPE
Use of plant and heavy equipment 4 3 12 2 1 2
Fire, Crushing or rollover, Approved air supply hose with Must be train the workers
Falling hydro test certificate
Employee shall wear ear muff
while using compactor

Eyes injuries due to the flying

Inspection should be done
particles
before use any tools
Hammer may cause of
Always keep tools in box
injuries
Using of Hand tools Always keep clean 4 2 8 Use proper tools for job doing 2 1 2
Damage handless of hand
Awareness among the workers
tools
for the safe using
Falling from Hight
While climbing ladder caring
tools in hand
All equipment shall be All operators required valid third-
equipped with reverse alarm party certificate.
Equipment, unexpected and revolving warning light. All Equipment require for valid
Movement of heavy equipment and vehicle break down. Equipment, Trained flagman wearing 4 3 12 2 2 4
inspection third party
unexpected break down. reflective jacket shall be
certificate.
assigned to all heavy
equipment. Operators need to trained
and inducted.
Unnecessary personnel shall be
excluded from the excavation
area.
Increase the frequency of
routine disinfection of surfaces,
floor and office items (keyboards,
Provided Awareness Briefing to
mouse, desks etc.) at the
all employees & Crews.
plants/camp areas as part of
Unhygienic Awareness & Information
normal housekeeping activities
condition. Ill health signage need to be posted.
Covid – 19 pandemic disease outbreaks 4 3 12 2 2 4
Spread of disease Fatality All employees need to inform to
Sanitize rooms including all his Supervisor / Site nurse for any

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such symptom.
office items and tools between
each shift. Prevent the use of
desks, office items etc. by other
personnel

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Awareness shall be made to

workers on hygiene and
proper
PPE use and disposal
In case of emergency, supervision
shall report the event to HSE and
immediate superior and follow
Emergency at
EPC & TRSDC Emergency
workplace,
Protocol.
Personnel injury,
Emergency Preparedness Fatality, Damage to 4 3 12 2 2 4
Property Medical team shall be reported
Impact to those require medical
marine treatment.
Environment
Emergency preparedness
materials shall be readily
available at site

Note: Insert additional rows or print additional sheets as necessary to accommodate all job steps.

Section IV – Approval and Signatures

Prepared by Company Position
Sohail Alumaco QC engineer

Reviewed and approved by Company Position

Victor Alumaco QA/QC Manager

High and Very High residual risk rating (10-25)

Note: All High and Very High residual risk ratings (10-25) require review and approval by Construction Director/Manager or Facility Manager before starting work to ensure that the additional controls are adequate to execute the task safely.
Reviewed and approved by Company Position

TAHA Alumaco Project Manager

Reviewed by Crew Company Position

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