10/2021

Process -2021
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)

Job area is considered: unit area:- Ammonia storage tank Establishment/Project: JSA No.:
Project No: 1.

Contractor: Hill India tkIS India: Client:

Person participating in 1. 1. 1.
Job Safety Analysis. 2. 2. 2.
3. 3. 3.
4. 4. 4.

JOB DESCRIPTION: PCC, RCC, Concrete work

Requirement of adding Personal Protection Requirement of adding special equipment or tool

Requirement of Working Permit Equipment.
(Check the relevant box) (Additional list)
Restricted space 1. Helmet 6.Goggles 1.
Heating job 2. Shoe 7. Cotton hand gloves 2.
Digging 3.Full body harness 3.
Isolation / Energization 4. Lifeline
Other job  5. Ladder/Scaffold

JSA considering procedure Yes No Comment

Is JSA establishment participated by job implementing group? 

Is JSA considered by Job implementing group before carrying out the job? 

Is JSA sheet used/ consulted in work implementation? 

tkIS India Form: Job Safety Analysis

 10/2021
Process -2021
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)

Is the job carried out step by step? 

Do you propose to improve JSA sheet (give in detail) 


Is detail of any trouble showing

ACTIVITIES HAZARD/ DANGER CONTROL MEASURE ACTION

Separate the job into the Describe all hazards identified for each Describe fully all equipment, facility, and/or procedure
main tasks and record task based on observations and controls applicable for each hazard.
them in sequence. experience.

 The risk of accident due to un

trained person  Conduct TBM before start the work

Pre-work safety training

 Ensure all team worker are attain the tool box
 Slip hazard. training before deploy of work.
 Trip hazard  Use all mandatory PPE and job specific PPE.
Area cleaning
 Snake bite  Ensure work under supervision.

 Ensure first aid facility is there at site.

PPC work  Chemical burns to body  Use coverall concreting works
 Dermatitis disease  Use safety goggles while working with PCC work

tkIS India Form: Job Safety Analysis

 10/2021
Process -2021
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)

 Wash the effected body part with water

immediately after concrete burns.
 Use anti itching cream

 Tool box talk must be conduct supervisor and

safety to make sure everyone understand the
 Personal injury or harmful hazard and how to control.
 Body or eye injury  .Ensure all equipment in good condition and
Concrete pouring  Loss of eye vision body got inspected by Competent person .
electric shocked on damaged  J Use Rubber gloves, gum boot, safety goggles,
electric cable mask, face shield , disposable coverall during
pouring concrete.

Form installation and  Hand injury  Conuct tool box talk before start the work.
fixing  Personal injury  Ensure PPE’S must be worn and use it properly
 Cut from the sharp and pointed before commencing activity to protect our ear and
surface or edge. eye like ear plug, safety glass, face shield.
 Slip, trip  Make sure all protruded nail remove before wooden
 Property damage material lying at the ground.
 Always keep finger away between in wooden and
concrete.
 Maintain good housekeeping before and after the
job.
 Remove all unwanted material and secure properly

tkIS India Form: Job Safety Analysis

 10/2021
Process -2021
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)

to keep access and egress free of obstruction.

 Place barricade and signage on working area.
 Ensure personnel train and competent to performing
activity.
 Remove all nail from the planks, wood and plywood
after dismantling.
 Make sure all dismantling material secure properly.
 Tool box talk must be conducted prior to start
activity.
 Hand injury  Wear appropriate PPE’S before starting activity
Reinforcement
 Body hit by rebar  Maintain good housekeeping before and after finish
steel installation
 Slip work on the area.
and fixing
 Trip  Tools must be inspected and use by train competent
person.

 Pinch point  Pre start tool box talk discuss and understand the
 Cut hazard on area
Using vibrator machine
 Bone problem  Ensure all worker train and competent to perform the
 Body injury task.
 Fall/slip/trip  Handling of equipment safety and maintain properly

 

tkIS India Form: Job Safety Analysis

 10/2021
Process -2021
Construction HSE Management
QM code
thyssenkrupp PIN LP-CHM-022 F01
JOB SAFETY ANALYSIS
Industrial Solutions (India)

Prepared by Reviewed by Approved by

(Contractor ) ( ) ( Client )
Name: Name: Name:

Designation: Designation: Designation:

Signature: Signature: Signature:
Date: Date: Date:

tkIS India Form: Job Safety Analysis