JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT ACTIVITY OR TASK: General Cutting, welding and grinding Location / Project:
Job Number: JSA
Preparation & task work team:
JSA Number: G21 JSA Revision:
Competence = Relevant Training/Qualifications + Experience
Competence/ Qualific’n req’d to complete work safely JSA approved by person responsible i.e. Team Leader / Tradesman
Name: Position / Competence/
License: Date: Codes of Practice & Legislation that are applicable:
2. HAZARD IDENTIFICATION Identify hazards that may be present by ticking items on the list below. 3. PRECAUTIONS: hard hat, safety glasses, safety boots compulsory
WORK LOCATION
HAZARDOUS AREA
HIGH RISK HIGH RISK ADDITIONAL
PRECAUTIONS PERMITS Difficult Entry/Exit Falling Objects Suspended loads Gloves: type ……… …. Hot Work Oxygen Deficiency Hazardous Substances - attach MSDS
to JSA Poor Lighting Poor
Visibility Goggles Excavation Oxygen Excess Working at Heights Slippery Surfaces Inhalable Dusts/Fibres Full Face Shield Confined Space
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
(trench collapse)
Electrical Feeds
Levels Vest Work
Clearance Poisonous
Gas Present
Motor Room Hazards
Trip Hazards Use of Chemicals Harness Access to Area Temperature Extremes Toxic Substances Electrical Hazards - LV Elevated Work Platform Fire Extinguishers High Voltage Access Defined Confined Space Barricades Scaffolding Explosive Gas Present Potential for Difficult Rescue Electrical Hazards - HV Difficulty to Communicat e amongst
workers Ventilation Other?
Manual Handling
Moving Machinery
Lighting HAZARDOUS SUBSTANCES in work
area / to be used -attach MSDS
Sharp Materials Tools & Equipment Erect Scaffolding to access PERMIT NUMBER Ladders used in the task Heat/ Sunlight/ Radiation Respirator or Dust mask Working at Heights Traffic Movement Erect Warning signs Personal Locks or Tag system Working near Crane & Crane Runways Working near Operation Processing Lines Group isolation Rail Movement
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
Pressurised Fluids
Pneumatics Fall Arrest
systems Flamm. Materials Present Welding Face Shield
4. ENVIRONMENTAL HAZARDS – (IMPACTS) tick those identified
Air Pollution (dust, fumes)
Spills to ground
Other:
Noise (plant & equipment) Soil Erosion Spills to drains/waterw ays Hazard to Flora /Fauna
RISK RATING TABLE
This table is used to calculate whether the hazard you have identified
is Extreme: 9-10
High: 7-8, Medium: 5-6 or
Low: 3-4 5. EQUIPMENT REQUIRED:
Static Plant & Equipment Mobile Plant & Equipment Safety / Emergency Equip’t
The objective of rating the risk is to lower the risk by initiating risk control measures. The score is noted in the JSA risk score column on the next page – both before & after risk control measures have been nominated.
NAME OF TASK: General Cutting, welding and grinding JSA Number: G21 Rev:
Consequences: how severe an injury? Likelihood: How likely is it to be that bad? Death Serious Injuries Medical Treatment Req’d 1st Aid req’d Almost Certain - Expected to Occur 10 9 8 7 Likely – could happen sometime 9 8 7 6 Moderate – could
happen but not likely 8 7 6 5
Unlikely – could
happen but very rare 7 6 5 4
Rare - could happen
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT Ste p No. Logi cal sequ ence
Sequence of Basic Job Steps
Break down Job into steps. Each step should accomplish a major task
and be logical.
Environmental Aspects
Potential Safety & Environmental Hazards/Impacts
Identify the hazards (health and safety or
environmental) associated with each step, examine each to
find all possible risk factors Risk Ratin g Use table on the previo us page to score risk
Recommended Corrective Action or Procedure
Determine what actions are necessary to eliminate or minimise all hazards that could
lead to an accident, injury, illness or environmental incident. The risk must be
reduced or controlled to a level that is acceptable before work commences. Indicate who is to perform the action where
applicable against each action
Risk Ratin g Of the risk followi ng correc tive action
1 Determine Location Injury or equipment damage as a result of unfamiliarity with worksite
Toolbox talks before job start, correct supervision
2 Receive PTW Injury or equipment
damage as a result of unfamiliarity with job scope and permit system
All personnel working on permit must understand permit to work system and if in doubt ask supervisor
3 Pre-work setup Injury due to fire. Explosion, sparks and flashes, as a result of poor welding habitat setup
Hot work procedure must be adhered to and permit conditions observed.
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
4 Welding, grinding and oxy cutting
Injury due to fire. Explosion, sparks and flashes, as a result of failure to adhere to permit conditions.
Maintain a visual check of conditions in
welding habitat, fire extinguisher, gas testing, cover drains, use fire spotter
Ensure adequate fresh air is around weld area and that fumes are efficiently extracted away from the local work area.
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) / SAFE WORK METHOD STATEMENT
Ensure job is set up as per safe welding procedures.
Only trained personnel to carry out welding. Fit earth clamp securely to job.
Welders must wear flame resistant work clothing
and supplied leather PPE where applicable. Wear gloves to protect hands and arms. Wear welders shield with filter shade No. 7 to 15 inclusive.
Wear AS1337 safety spectacles under welding shields.
Use welding screens or blankets to shield arc from other personnel.
Welders assistants MUST WEAR anti weld flash eye
protection to AS1337.
If assistant required to look at the arc, then the sameprotection as welder is required.
5 Clean up worksite Slips trips and falls due to poor housekeeping
Remove tools equipment and rubbish from worksite and maintain a clean work
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) CONSULTATION & SIGN-OFF RECORD
I confirm by my signature below, that I have attended a briefing on the requirements of the attached Job Safety & Environment Analysis and agree to perform the work in the manner detailed on it.
I confirm that copies of the relevant Permits, MSDS's, Isolation Plans etc. have been reviewed. JSA NAME JSA No: Rev:
JOB SAFETY & ENVIRONMENT ANALYSIS (JSA) THIS SAFE WORK BRIEFING / TRAINING WAS CARRIED OUT BY (responsible
person at that location) :
Name: Signature: Date:
Client sign off (where applicable) Site / Project Manager sign off (document reviewed)
