Page 12 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Description of Activity to be carried out:

Work Location:

STEEL STRUCTURE ERECTION JOB AT OFF PLOT

AREA

Dolphin Onshore Facilities Project

Risk Assessment Log Section:

Step

JGC approve the use of this MSJSA :

Critical Steps in this Activity:

GENERAL

Potential Hazards:

Signature:

Date:

HSE Controls to be Implemented:

Work Without MS and Work permit

-

FILE NAME:1430-601-3-424<03>

Position: JGC HSE Manager

Activity Guidelines used:

1.0

Name:

Page 12 of 25

Supervisor to ensure that a valid PTW is available before

start of the job where applicable.
Supervisor to ensure that toolbox talk is conducted before
start of job conveying job related hazards and preventive
measures.
Safe activity pre-checklist sheet to be filled in daily before
start of job by supervisor.

RL0-306013-M32-424<03>

Page 13 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Step

Critical Steps in this Activity:

Potential Hazards:

HSE Controls to be Implemented:

2.0

Working at height

FILE NAME:1430-601-3-424<03>

Poor planning
Fragile / soft roof
Unguarded opening
Open sides
Unsafe access / egress
High wind speed
Falling hazard
Falling object Hazard

Page 13 of 25

Area Engineer to plan before start of activity

JGC Working at Height Procedure (S-000-1654-114 Section
4.22) to be used as guideline for working at height.
Only relevantly trained & skilled manpower to do the job
Provide safe access / egress including ladder / scaffold with
valid inspection & tag
Wear and anchor full body harness with lanyard while
working above 2.0 meter.
The area shall be enclosed with barriers with sign board.
No entry work at height

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Page 14 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Step

3.0

Critical Steps in this Activity:

Steel Structure Erection

Potential Hazards:

Poor planning
Unsafe / Improper scaffold
High wind speed
Falling hazard
Falling object Hazard
Heat stress

HSE Controls to be Implemented:

4.0

Use of scaffold for working at

height

FILE NAME:1430-601-3-424<03>

Improper Scaffolding
Falling object hazard
Personnel Injury due to slip / trip, struck
against, struck by and fall from height
Improperly stored / scattered scaffold
material
Page 14 of 25

Follow safety precautions regarding working at height as

described in Step # 1.0
JGC Working at Height Procedure (S-000-1654-114 Section
4.22) to be used as guideline for working at height.
Supervisor to ensure that tool box talk is conducted before
start of job
Safe activity pre-checklist sheet to be filled in daily before
start of job by supervisor.
No horizontal walking on steel members or sliding down the
steel columns
Ensure that the scaffolds are weekly inspected and tagged
and are safe as per the JGC Scaffolding Procedure S-0001654-125
Also follow applicable safety precautions in Safe Work
Method Statement for Scaffolding Job.
No walk along unguarded steel structural members for
access to working platform
Area under steel structure erection to be properly barricade
and post safety signs
Proper illumination for jobs at night
Ensure availability of cold water at job site all the time.
Drink water frequently to avoid dehydration all the time.
Ensure availability of heat stress shelter at job site all the
time.
Portable toilet facility to provide whenever work is on going.
Act as per instructions against each flag color to prevent
yourself from heat stress in summer
Ensure availability of 1st aider, 1st aid kit and list of 1st aiders
and emergency numbers at job site.
Only trained & experienced & certified scaffolders will
erect / alter / dismantle scaffolds.
Ensure that the scaffolds are weekly inspected and tagged
and are safe as per the JGC Scaffolding Procedure S-0001654-125
Also follow applicable safety precautions in Safe Work
Method Statement for Scaffolding Job.
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Page 15 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Step

Critical Steps in this Activity:

5.0

Use of ladder / Lightweight

Staging for working at height

Potential Hazards:

Improper selection of ladder / stepladder /

lightweight staging
Improper / unsecured use of ladder /
stepladder / lightweight staging
Excessive use of ladder / stepladder /
lightweight staging
Position of ladder / stepladder / lightweight
staging on Soft or unleveled surface
Falling Hazard
Overloading
Improper angle
Falling object hazard
Personnel Injury due to slip / trip, struck
against, struck by and fall from height

HSE Controls to be Implemented:

FILE NAME:1430-601-3-424<03>

Page 15 of 25

JGC Ladder & Lightweight Staging Procedure (S-000-1654114 Section 4.13) to be used as guideline for working at
height.
All ladder / stepladder / lightweight staging should be of
approved type
Select & use appropriate ladder as per job nature and
height
Use only non-conductive material ladder for electrical job
Physical inspection before each use
Secure properly before each use
Minimize use of ladder / stepladder / lightweight staging
Position ladder / stepladder / lightweight staging on a stable
and level surface
No over stretching / over reaching
No overloading
Dont use boxes, stool to level up ladders
Ladder inclined at an angle of 75
Three point contact to be made all the time while climbing
or coming down on ladder / stepladder
No tools / material carrying in hands while climbing or
coming down on ladder / stepladder
Wear and Anchor fall protection equipment when working at
height more than 2.0 meter
All joints, steps, and fittings of lightweight staging should be
properly secured
Movable parts of lightweight staging should operate freely
Rungs to be kept oil / grease free
Platforms free of cracks / warped
Additional securing for long ladders

RL0-306013-M32-424<03>

Page 16 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Step

6.0

Critical Steps in this Activity:

Use of MEWP i.e. Mobile

Elevated
Work
platforms
(Telescopic or Scissor Lift)

Potential Hazards:
-

Improper Planning
Use of equipment without valid certified &
current inspection
Uncertified operators
Overloading (Exceeding SWL)
Improper guards / barriers
Equipment on Soft or unleveled surface
Slippery surfaces under MEWP
Improper barricade & Signs
Poor supervision
Exceeding maximum gradient during MEWP
operation
Poor condition of control panel of MEWP
MEWP on slippery floor
Unguarded / open sides on MEWP
By-passing dead man handle of MEWP
MEWP without Emergency Stop Device
Struck against / Struck by
Unstable hoist ways
Unguarded moving parts
Falling from Height
Falling objects
Overreach
High wind speed
Fire Hazard
Environmental hazard- leakage f oil

HSE Controls to be Implemented:

-

FILE NAME:1430-601-3-424<03>

Page 16 of 25

Prior approval from JGC before using man-lift on roof

A banks-man will guide the man-lift operator for movement of
man-lift on roof.
Rigging Supervisor shall physically check condition of lifting
tackles of man-lift before lifting man-lift for shifting up on roof &
man-lift can be lifted if lifting tackles found in satisfactory
condition.
JGC Working at Height Procedure (S-000-1654-114 Section 4.22)
to be used as guideline for working at height.
Plan the job properly covering all aspects before start of activity
Supervisor to ensure that toolbox talk is conducted before start of
job conveying job related hazards and preventive measures.
Safe activity pre-checklist sheet to be filled in daily before start of
job by supervisor.
Only MEWPwith Valid certified & current JGC inspection to be
used
3rd party certified operators to operate the MEWP
SWL & maximum number of passengers to be clearly marked on
MEWP and never overload or exceed these limits
All sides of MEWP to be covered by a top rail & mid rail
Inside moving and self closing door for MEWP
Use of toe board where applicable
Always position MEWP on a solid, level and stable surface
capable withstanding intended load, out riggers to use if required.
Make sure to lock on wheels for mobile towers / platforms during
working.
Use stop blocks on slippery floors while positioning MEWP
Barricade area properly. Hard barricade if working on roofs and
use safety signs
Full time supervision by a competent person for critical jobs
MEWP used on gradients to have warning alarm system
Control levers and buttons of dead man type
MEWP control panel with Emergency Stop Device
Reverse alarm for MEWP
Proper guarding on moving parts
Fall arrest equipment (Full body harness and lanyard) to be worn
all times and anchored by passengers on MEWP
Never try to overreach by leaning from MEWP platform
Secure material / tools on platform
No use of ladder or boxes etc. on MEWP platform to gain extra
height
No MEWP operation in high wind speed condition
MEWP to be equipped with a portable fire extinguisher
Use of drip tray

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Page 17 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Step

7.0

Critical Steps in this Activity:

Refueling of Equipments e.g.

Generators, Man Lifts, Cranes,
etc

Potential Hazards:

Environmental hazard due to Spillage of oil

during refueling.
Fire Hazards during refueling.
Personal injury due to slip / trip
Inadequate hose connection
Struck against / Struck by
Over fueling

HSE Controls to be Implemented:

FILE NAME:1430-601-3-424<03>

Page 17 of 25

Management of spills will comply with the measures stated

in the Spill Contingency, Procedure S-000-1654-128.
Trained personnel for refueling
Stay near your equipments fueling point when refueling.
Ensure a safe access to the equipment to be refueled
Wearing of appropriate PPES at all time during refueling
Switch off equipment before starting refueling
Never overstretch refueling hose
Never overfill or top the fuel tank
Refueling to be done at slow rate to reduce the potential for
spillage and static ignition buildup
Let the fuel dispenser shut off automatically and leave the
nozzle in the tank for six to eight seconds so the fuel can
settle down and any fuel in the nozzle can drip down into
fuel tank
Ensure drip tray under the equipment to be refueled.
Hose and refueling assembly should be in good condition
Refueling to be done only by refueling vehicle and trained
person.
If fuel is needed to be taken on site in cane, use the
recommended jerry cane
Ensure the availability of fire extinguisher near refueling
point
No ignition source /smoking near refueling point
Switch off mobile phone before starting refueling

RL0-306013-M32-424<03>

Page 18 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

HSE Information / Requirements
Resources and Competency
Does the Work Team have the necessary capacity, capability, experience & authority to avoid, minimize, monitor and control the risks (Training / Awareness / Equipment, etc.)?
Detail minimum expected requirements:

Workforce Will be trained relevant to the job they have to perform. Working at Height and Heat stress training will be given to
workforce. Supervisor to conduct tool box talk daily before start of work. Equipment to be inspected and certified by JGC
Communications / Workforce Consultation
Have all members of the Work Party attended the Toolbox Talk, and have they been made fully aware of the risks that they are taking (Residual risks)?

TBT Record No.

Yes
Supervisor to conduct tool box talk daily before start of work explaining the hazards involved in the job and Preventive
Measures to be taken.
External Risk
Has an assessment been conducted to identify all external (to the activity) hazards and potential risks (3rd parties such as other workforce teams or other adjacent parties)? What is the
result?
Risk Assess. No.

Job Safety Analysis has been carried out keeping in view all external Risks / Hazards. No simultaneous activities will be carried out
in the barricaded area by any other party.
H&S Training
Employees should be trained in the proper interaction with equipment, and the proper response to incidents involving this equipment. List the training your employee(s) has received.

Workforce Will be trained relevant to the job they have to perform. Scaffolding & Refueling Training will be given to workforce as
per their job natures.
Specialist Training
Will the workforce require any specialist training?

YES / NO (IF YES, list the specialist training required for the job):

YES
Workforce Will be trained relevant to the job they have to perform. Specialist training for Scaffolding, Man-lift Operators and
Riggers training will be given to workforce as per their job natures.
FILE NAME:1430-601-3-424<03>

Page 18 of 25

RL0-306013-M32-424<03>

Page 19 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

High Potential Risks

Does the task require special access / egress / heavy lifting / entry into confined spaces or work at height / in excavations?
(IF YES, a separate Risk Assessment needs to be completed).

YES / NO

Risk Assess. No.

YES
Working at Height
Other Impacts
Are there any other ways in which the work will be affecting and/or protecting the Health and Safety of the team members?

YES / NO (If so, please describe below):

YES
Heat Stress
PTW / Isolations: Other Certificates / Permits
What other precautions (e.g. electrical isolation, permits to work) are required and who will authorize them?

PTW / Cert. Nos.

YES
Permit to work will be obtained wherever applicable.

Contingency / Emergency Response

Should special emergency procedures be instituted, e.g. Emergency Drill, providing Fire Wardens, extra First Aid cover, etc.?

YES / NO (If so, please describe below):

YES
AVAILABILITY OF 1ST AIDER, 1ST AID KIT, LIST OF 1ST AIDERS AND EMERGENCY NUMBERS AT JOB SITE.

Air Emissions
Will the work you perform produce or cause the release of any air emissions?

YES / NO

(If YES, list air emissions and method for preventing impact to the environment):

No

FILE NAME:1430-601-3-424<03>

Page 19 of 25

RL0-306013-M32-424<03>

Page 20 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Water Discharges
Will the work you perform produce or cause the release of any wastewater?

YES / NO (IF YES, how will the wastewater be handled?):

No
Materials
What materials (chemicals, oils, etc.) and/or equipment will you be handling or bringing on-site to perform the contracted work?

Diesel as a fuel for equipments.

Environmental Training
Have employees been trained in the proper handling of materials and equipment, and the proper response to incidents involving these materials? List the training your task employees
have received.

Safe Refuelling, Use of Drip tray and Spill Control training will be given to workforce as per their job nature.
Waste Generation
Will the work you perform result in any wastes? YES / NO (IF YES, list the disposal location, as well as amounts and types of wastes expected and the proposed disposal method):

YES
Waste will be disposed off as per JGC Waste Management Procedure S-000-1654-126.
Energy
Will the work you perform consume energy (electricity, compressed air, natural gas, steam, etc.)? YES / NO (IF YES, explain what type of energy will be consumed, and how you will
minimize consumption):

Yes, Diesel fuel will be used in MEWP, cranes, generators etc. Equipment will be stopped if it is not needed to reduce fuel consumption

FILE NAME:1430-601-3-424<03>

Page 20 of 25

RL0-306013-M32-424<03>

Page 21 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Other Impacts
Are there any other ways in which the work will be affecting and/or protecting the environment?

YES / NO (If YES, please describe below):

No
Environmental Monitoring
Describe any environmental monitoring to be performed, including sampling methods, frequency, analytical requirements and laboratory to be used:

Environmental legal requirements given in JGC Environmental Monitoring Procedure S-000-1654-129 will be followed.
Legal requirements
Identify environmental legal requirements applicable to the work that has not already been addressed by the Project.

Not Applicable

FILE NAME:1430-601-3-424<03>

Page 21 of 25

RL0-306013-M32-424<03>

Page 22 of 13Page

SAFE WORK METHOD STATEMENT (SWMS) Incorporating Job Safety Analysis

Training modules required to complete Activity:

List Codes of Practice, Legislation, Standards which apply to this Activity:

JSA will be used as a training module

Standard
Codes

ASTM-1599
ASME B31.3
ASME B16.5

List Plant / Equipment / PPE required for this Activity:

Crane, power generator, welding machines,

compressor.

List Equipment / Maintenance

Checks required for this Activity:

Pre job equipment check

will be done before starting
the job

PPEs:

Engineering Certificates / Permits / Approvals required for this Activity

(e.g. RLC Permit Road closure, Utility isolation, Special Waste license, etc.)

No
Type

Safety Helmet

Reference/Documents

Safety Shoes

Safety Glasses

Coverall

As per job requirement:

Safety Gloves
Dust Masks

Ear Plugs
Fall protection equipment

Person(s) Responsible for Supervising / Inspecting Work:

Person(s) responsible for supervising the work, inspecting and approving work areas, work methods, protective measures, plant equipment and power / other tools:

NB: List of qualifications/experience is held in local JGC files see JGC HSE Group for details.
Name: .

ANTHONEY

Name: .

M. BOOTA

Position:

Position:

AREA IN CHARGE

Signature: .................................................................

AREA IN CHARGE

Signature: .................................................................

For a list of names and signatures of staff instructed in this Safe Work Method Statement and JSA, see JGC training records.

Copy 1 - To be posted at the Worksite / Supervisor at the Worksite

Copy 2 - To be retained by JGC HSE Group (24 months)
Copy 3 - To be held by the subcontractor (24 months)

FILE NAME:1430-601-3-424<03>

Page 22 of 25

RL0-306013-M32-424<03>

SAFE ACTIVITY PRE-CHECK (SAP) SHEET

Company:

Date:
DESCON ENGINEERING QATAR L.L.C

Foreman (print
name):

ANTHONEY

Location:

Task Description:

Steel Structure Erection in (Off Plot Area)

OFF PLOT AREA

MUSTER / ASSEMBLY POINT LOCATION:

IS YOUR DESIGNATED PLACE OF WORK TIDY? - YES or NO (If "NO" housekeeping must be performed prior to work commencing).
PERMIT TO WORK REQUIREMENTS

Key Task Related Hazards

(tick box)
YES
NO N/A

Excavations

Working at Height

Access Only

Heat Stress

Plant & Equipment

Electrical

Confined Spaces

Isolations

Lock Out / Tag Out

Hot work

Instrumentation

Fall protection equipment

Safety Shoes
Ear Plugs
Coverall

Pre / Commissioning / START-UP

EXCAVATION

YES

NO

Key Preventative Control Measures

N/A

HOTWORK (Non PTW controlled)

YES

NO

SHORED / SLOPED / BENCHED

FIRE EXTINGUISHER

LADDERS PROVIDED

FIRE BLANKET

BURIED SERVICES IDENTIFIED

CYLINDERS UPRIGHT & SECURED

VEHICLE STOP BARRIERS / BOARDS

COMBUSTIBLES REMOVED

EXCAVATION INSPECTED

FIRE WATCH (Safety Passport check)

SPECIAL PPE (VISORS, GLOVES, etc)

EMERGENCY COMMUNICATIONS

CONFINED SPACES
STANDBY MAN

YES

NO

N/A

VENTILATION

WORK BELOW RESTRICTED

PERMIT to WORK

BARRIERS / SIGNS POSTED

GAS TEST COMPLETED

FLAME ARRESTORS FITTED

TALLY BOARD or similar

WELDING CABLES IN GOOD CONDITION

EMERGENCY ACCESS

CHEMICALS

COMMUNICATIONS

MSDS REVIEWED / AVAILABLE

SAFETY HARNESSES

SKIN / EYE / THROAT IRRITANT

SUITABLE (Ex.) LIGHTING

SHOWER or EYEWASH AVAILABLE

SPECIAL PPE AVAILABLE AS PER MSDS

CONTAINERS LABELLED PROPERLY

SCAFFOLDING
SCAFFOLD INSPECTED

YES

NO

N/A

YES

NO

INSPECTION SCAFTAG POSITIONED & IN DATE

SIGNS POSTED

SAFE ACCESS / EGRESS PROVIDED

RISK ASSESSMENT CONDUCTED

TOEBOARDS, KICKPLATES IN ORDER

HAZARDS COMMUNICATED

HANDRAILS SECURED

GROUNDING

HARNESS & LANYARDS INSPECTED

CONTAINMENT REQUIRED / PROVIDED

STATIC LINES - TIE OFF POINTS

ABSORBENT AVAILABLE IN SITU.

PLANT & EQUIPMENT

PLANT & EQUIPMENT INSPECTED

YES

NO

N/A

PORTABLE TOOLS
TOOLS, APPLIANCES INSPECTED

DEFECTS REPORTED

PORTABLE APPLIANCES INSPECTED

EXTENSION CABLE CHECKED & TAGGED

OPERATOR CERTIFIED

OPERATORS CERTIFIED

CABLES, HOSES INSPECTED

PPE REQUIREMENTS IDENTIFIED

FLAGMEN TRAINED / POSITIONED

GUARDS POSITIONED

FILE NAME:1430-601-3-424<03>

YES

NO

N/A

PPE

N/A

YES

LIFTING GEAR, RIGGING INSPECTED & CERTS.

BANKSMAN / COMPETENT PERSON
IDENTIFIED
LIFTING PLAN / CALCS & M/S CHECKED

OCCUPATIONAL HEALTH

N/A

NO

N/A

NO

N/A

YES

Page 54 of 25
RL0-306013-M32-424<03>

SAFE ACTIVITY PRE-CHECK (SAP) SHEET

FIRST AIDER / FIRST AID KIT

HARD HAT

HEAT STRESS

BOOTS

GLASSES

COVERALLS / HIGH-VISIBILITY VESTS

DUST
HYGIENE (FOOD / WATER) CONTAINERS

NOISE

FACE MASKS

VIBRATION

GENERAL WORK GLOVES

YES

ELECTRICITY

NO

N/A

YES

SPECIALIST PPE

PTW REVIEWED (COMPETENT PERSON)

WELDERS, FIRE RETARDANT GLOVES

SYSTEM LOCK OUT

ELECTRICAL RUBBER GLOVES

EAR DEFENDERS / PLUGS

HARNESSES / LANYARDS

WELDERS SCREEN

FACE MASK (DUST - FUMES)

SYSTEM TAGGED OUT

JSA / METHOD STATEMENT IN PLACE

SYSTEM DISCONNECTED

SYSTEM TESTED

MANUAL HANDLING

YES

NO

N/A

RESPIRATORS

WORKER(S) TRAINED (Safety Passport check)

SELF CONTAINED BREATHING APPARATUS

LIFTING, PULLING

FIRE RETARDENT CLOTHING

ENVIRONMENTAL CONSTRAINTS

SHARP OBJECTS, PINCH POINTS

ENV. STUDY REPORT COMPLETED

YES

ENV. HAZARDS IDENTIFIED IN MS

SOUND GROUND / UNDERFOOT CONDITIONS

WORK AREA CHECKED (R&E SPECIES)

WASTE CONTAINERS / AREA IDENTIFIED

YES

NO

N/A

NO

N/A

(TROLLEYS, FORKLIFTS, etc) available

FLYING PARTICLES

N/A

STRETCHING

GENERAL

NO

SPILL CONTAINMENT

CABLES SECURED ABOVE HEAD HEIGHT

ENV. MONITOR INFORMED / AVAILABLE

VOIDS / HOLES COVERED & SECURED

SITE PLANT & VEHICLES

BARRIERS & TAPE PROVIDED

SAFE DISTANCE - VEHICLES & PEDESTRIANS

ALL HAZARDS COMMUNICATED

SIGNS ERECTED AND VISIBLE

OTHER WORKERS SAFETY CONSIDERED

NOISE / EXHAUST HAZARDS IDENTIFIED

YES

NO

N/A

Foreman

/ Supervisor: I have discussed the above potential hazards involved in the task, reviewed the SAFE
ACTIVITY PRECHECKLIST SHEET Card with the employees under my control, and implemented suitable and sufficient
controls to minimize the risks involved.
Name (print)

Signature

ANTHONEY

Employees: I / WE ACCEPT THE RESPONSIBILITY FOR THE SAFE BEHAVIOUR OF MYSELF AND MY CO-WORKERS
DURING THE TASKS IDENTIFIED ABOVE:
EMPLOYEE NAME

SIGNATURE

EMPLOYEE NAME

1. SANAULLAH

10. JAVED IQBAL

2. AB. KAREM BUTT

11. M. IMRAN

3. A.C.K SILVA

12. M. HANIF

4. SYED ASIF HUSSAIN

13. RAB NAWAZ NIAZI

5. AZMAT HUSSAIN

14. ALAM MIRAJ

6. EMMANVEL B TUBID

15. DEHHES

7. RAJESH KUMAR SINGH

16. ADNAN YOUSAF

8. KUMAR PEREY SINGH

17. DANTE P CAPEIA

9. ARAUN NARAIN

18. ROHLAUF

FILE NAME:1430-601-3-424<03>

SIGNATURE

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