JOB TITLE OR OPERATION LOCATION DATE NO DOC.

JOB SAFETY ANALYSIS

WORKSHEET
Lifting Gear Inspection HSE-JSA/XII/17

COMPLETE BY EMPLOYEE/ OPERATOR REVIEWED AND APPROVED BY

Signature :
Name : 1 Sign Name :

Position : 2 Sign Position :

Signature :
3 Sign Name :

Sign :

4 Sign Position :

Signature :
COMPANY/ ORGANIZATION WORK SECTION / DEPARTMENT Name :

ABC Position :

REQUIRE RECOMMENDED PERSONAL PROTECTIVE EQUIPMENT/ SAFE WORK PERMITS

Yes, PPE & Safe Work Permits are recommended,

PPE : Helmet cover all Flame Retardant Safety Body Harness

safety glass/ google Hand Glove

masker safety shoes

BASIC JOB STEP, IN SEQUENCE POTENTIAL HAZARDS RECOMMENDED PREVENTIVE MEASURES

No. A. Job Planing / Preparation

Loud & clear during submit all job

1 Conducted Pre job safety meeting Unclear voice, Miscommunication,
plan & risk assesment

Personal injury Prepare all

Equipment failure, pared cable,
2 Prepare all tool & equipment needed neceseary tools / equipment as per
required on the job

Review minimum PPE requirement,

consider:
Defective of PPE, Improper PPE for
3 Asses PPE requirements Safety halmet, glasses,
the job,
handgloves,shoes, coverall,
additonal PPE i.e body harness,
B. Job Carry Out

Removing Paint using brushing and Wire brusing and dust rust, Use hand glove, face shield,
4
chemical removing paint Iritations/ Chemical Exposure. googles, mask, from injured.

Wearing proper & correct PPE (body

Visual dan Dimensional Checks Unit Fall from a high position, Pinch harness) during perform a job,
5
and Sling point. Hand & body placement in right
position,

Hand & body placement in right

electricity, Chemical Exposure,
6 MPI / PTI Test
Pinch point
position, Ensure there are MSDS/
certificate of chemical list and the
crew understand about content of
MSDS (risk, potential hazard, etc).

C. Job Completion

Bad house keeping, Ensure all tools and equipments are

7 Housekeeping
Loosing tools and equipments return the proper place

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