Job Safety Analysis Worksheet

Short Descriptive Title of Task: ■ New Analysis Review Subject Matter Expert Review:
JSA No.: CMIT-F.W.-JSA-037
Tie – in for Power Cable 33 KV Revised (New/Change): NEW
Reviewed
Existing procedures, guidelines or other procedures that apply: PTW required and Special Training Certificates PPE (example: respirator, gloves, special footwear, harness, etc.) and
No.: required: special ER facilities, equipment and supplies needed.
Gloves、helmets,safety goggles, safety shoes
Work Location: BUN, BUS3, FQS Area Authority: Oilfield manager Approval: Simultaneous work underway:

1. Sequence of Basic
2. Potential Hazards 3. Recommended Action or Procedure 4. person in charge
Task Steps

1. Unauthorized work 1. Prepare PTW for this activity before start the work.
2. Isolation Certificate missing 2. Obtain signature on the Isolation Electrical Certificate prior to start your job.
3. LOTO applied on wrong line Eng. Husham
3. Prepare JSA and get signature from all involved parties. Hold JSA Meeting.
4. Use improper
devices/method for LOTO. 4. Apply LOTO devices by the Client and isolate the working (live) line.
Altai
5. Invalid PTW 5. Supervisor must ensure that all activities are carried out by competent person
6. Untrained personnel 6. Conduct TBT and explain the JSA to all employers involved in these activities.
1. Work startup 7. Lack or poor communication 7. Perform training for Electrical Safety, First Aid (CPR, Electrical Burns) and Fire TEL:
8. Miss communication Prevention.
9. Training missing 07833044617
8. Barricade around the working area and provide the site with safety signs.
10. Assign workers for this job
11. Present symptoms of 9. Provide electrical PPE for the workers perform this job and check his integrity.
COVID-19 10. All preparation should be supervised by electrical engineer and HSE supervisor.
12. Tools used are damaged, 11. First Aid kid present on site and drinking water.
missing or not designed for 12. Test your worker for COVID-19 symptoms before enter work area
electrical job. 13. Emergency Services should be contacted to be present on site, during job.
13. Inclement weather at the 14. Before start your job, Client should start make preparation for controlled shut
working site (wind, rain,
cold) down of the power lines.

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 1. Obtain the signature for your PTW, before work start. Eng. Husham
1. Electric shock. 2. Before work start, inform the client about your intentions. Altai
2. Falling from height. 3. Perform necessary TBT and explanation of the JSA content to your workers.
3. Dropping objects – hand 4. Tools used during connection should be undamaged, isolated and required for this
tools and/or materials - TEL:
4. Hand, arm and face
job. Use only electrical isolated tools.
injuries. 5. Workers should have electrical PPE (gloves, shoes and work suit) and Safety 07833044617
5. Electric arc. Harness. Full body harness with lanyard and hook to be used all time.
6. Lack or poor job 6. Work area to be checked in advance, leveled and clean from debris, if required.
experience. 7. Man basket and/or ladder to be inspected. Third party valid inspection is
2. Connection power 7. Usage of damage or
cable to H-Pole Tie-in necessary. No mechanical and/or hydraulic malfunctions are accepted.
improper hand tools.
8. Operators should have valid certifications and work experience for this task.
using a ladder or a man 8. Unstable work surface for
ladder and/or man basket. 9. Supervision of the HSE and Electrical Engineer, during job.
basket – mechanical 10. Workers selected for this job, must have previous work experience in this task.
9. Structure damage of the
connection - man basket. 11. Barricade working area and post warning signs. Keep pedestrians outside work
10. Arm hydraulic failures. area.
11. Inexperienced/non- 12. First Aid Kit, fire extinguishers and emergency response unit(ambulance) present
qualified operator using
on site.
this equipment
12. Bad weather: rain, fog, etc 13. Personal present at work site, should maintain a safety distance, to prevent any
electrocution in case accidents occurs.
14. If weather is deteriorating - fog, rain, high wind speed - work will be cancel and
postponed for a future date.

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 Eng. Husham Altai
1. Move all materials, tools, equipment and waste out of working area, when work is
1.Back pain. completed.
2.Slip and Trip. 2. Make sure that no materials, tools and/or equipment was left behind. TEL:
3.Falling from same level. 3. Maintain fix barricade in area, if situation is required. Post warning signs.
3. Housekeeping 4.Hand injury. 4. Garbage bags resulting from housekeeping to be loaded in trucks and removed 07833044617
5. Bitten by venomous from worksite area
animal/insects. .

All the staffs working on the site ensure to be familiar with the details above, and follow the instruction.
SIGNATURE: