Form No.
JI 2027-FORM-HSE-002
Job Safety Analysis Petrofac
JSA No:
Activity: Grouting Works
JI 2027-JSA-50
Project No:
Project: NEW GATHERING CENTRE, GC-29 IN NORTH KUWAIT
EF-1901
Site/Facility: Work Area: KOC Permit No & Date:
In Case of Emergency, contact KOC @ 160
Hard Hat, Safety Shoes, Safety Goggles/ Glasses, Hand Gloves, Overall, Dust Mask, Total Station &
PPE & Tools:
,Hand Tools & power tools .
RESIDUAL CHECKED
SEQUENCE OF RISK RISK
JOB STEPS POTENTIAL HAZARDS RATING MITIGATION MEASURES
RATING Yes No
Non-compliance of KOC HSEMS Obtain required Permit to Work in 2 (B)
4 (D)
procedures compliance with KOC SA.004 (Permit to LOW
HIGH
Work Procedure).
All personnel must comply with KOC
waste management procedure
KOC.EV.008 and
Pre - work Ensure all personnel have undergone
Project HSE Induction and EOD training.
3 (C) Conduct Tool Box talk. 2 (B)
Poor task planning MEDIUM LOW
Ensure to deploy competent person to do
the task
Ground must be leveled and compacted.
Poor Ground level or compaction. Proper communication must be in place.
Mixer machine Poor visibility. 2 (B)
Keep the area free of unwanted LOW
Presents of unwanted materials. 3 (C)
materials and debris.
MEDIUM
Equipment must be inspected prior to
use.
Protruding steel bars. 3 (C) Sharp parts must be protected 2 (B)
MEDIUM properly. LOW
Grouting Failure of form works
supports. Pre-task meeting to be conducted.
Tripping hazards. Form works to be inspected properly.
Vibration of equipment. All the employees in the job must be
trained.
Poor Visibility.
Use rubber gloves, face shield, rubber
Health hazard
foot with steel toe
Avoid concrete spill if so provide plastic
Grouting Spillage. 3 (C) underneath. 2 (B)
Environment Spill MEDIUM LOW
Drink plenty of water.
3 (C) Take adequate rest. 2 (B)
MEDIUM LOW
Never work alone in one area.
Heat stress Health hazard Ensure cold drinking water supply in place
continuously.
JI 2027-JSA-050 Page 1 of 2
Form No. JI 2027-FORM-HSE-002
Ensure that workplace is maintained clear
Post Work House keeping 3 (C) of debris, waste concrete and other 2 (B)
MEDIUM rubbish which will be disposed in LOW
segregated area.
Make the area clean and tidy
Worksite Supervisor
Reviewed by: Permit Applicant Approved by: Permit Issuer
Subcontractor / Contractor
Name: Name: Name:
Company: Company: Petrofac International Ltd Company: TECHNIP
Designation: Designation: Designation:
Signature:
Signature: Signature:
Date: Date: Date:
JI 2027-JSA-050 Page 2 of 2