JOB HAZARD ANALYSIS WORK SHEET

Serial No: Revision No: PTW No: Date:

Section A - JHA Cover Sheet

Job Title: INSTALL VENT PIPE

Area: Tag No/Equipment No: Service /Medium:

ZETO RULES
Permit to Work? Overriding or Disabling SCE Working at Height Lifting Operations Ignition Source Control
Hazardous Chemical
Energy Isolation Confined Space Entry Excavation Driving
Handling

Risk Category of the Job:

Name Designation / Company / ID Date / Time Signature REMARKS :
PREPARED BY:
Muhammad Riduan Safety Supervisor 29-12-18 10am
JHA Prepare Team
1. Leader
Mohd Faize Asst. Project Manager 29-12-18 10am
2. Front Line Supervisors
3. Expert / Specialist

Note: 1, 2,3 may be same person

Allan Lee Safety Manager 04-01-19 / 11am

REVIEWED BY:
JHA Review Team
1. Owner and/or Contractor Reps.

APPROVED BY:

RISK ASSESSMENT MATRIX DESCRIPTION

 JOB HAZARD ANALYSIS WORK SHEET
Serial No: Revision No: PTW No: Date

Section B - JHA Work Sheet Task Analysis

Job Title: INSTALL VENT PIPE

Step Description of Potential Hazards & Who or What RISK Control and /or Recovery Action/
No Basic Task /Step Consequence might be Harmed RATING Measures Responsible
(P E A R)) Inherent / Person(s)
Initial
1. Delivering tools / equipment 1.1 Hit by moving P, R C3 1.1.1 Signalman to PJC / Work
to working area. machinery / vehicle. assist moving Crew
machinery /
vehicle.
C3 1.1.2 Wearing high- PJC / Work
visible vest at all Crew
time.
1.2 Sharp edge / cuts. P C3 1.2.1 To wear cut PJC / Work
resistant hand Crew
gloves at all
1.3 Equipment / Tool P C3 time. PJC / Work
drop onto feet. 1.3.1 To wear safety Crew
C3 shoes at all time. PJC / Work
1.3.2 Extra precaution Crew
when lifting and
carry equipment
1.4 Ergonomic. P C2 / tool. PJC / Work
1.4.1 Minimum 2 Crew
workers to carry
heavy or long
C2 equipment. PJC / Work
1.4.2 Practice proper Crew
body positioning
while lift and
carry tools /
equipment.
Step Description of Potential Hazards & Who or What RISK Control and /or Recovery Action/
No Basic Task /Step Consequence might be Harmed RATING Measures Responsible
(P E A R)) Inherent / Person(s)
Initial
1.5 Slip, trip and fall P C2 PJC / Work
due to poor 1.5.1 Keep work area Crew
housekeeping inside tidy at all time.
work area.
1.6 Usage of faulty P, R C2 PJC / Site
tools or equipment. 1.6.1 All tools and Supervisor
equipment need to
be inspected prior
C2 to use. PJC / Site
1.6.2 Faulty tools and Supervisor
equipment need to
be tag red and
remove from
worksite.

2. Erecting scaffold. 2.1 Unstable scaffold P, A, R C3 2.1.1 Erection of PJC / Work

For working at height to leads to falling of the scaffold to be supervised Crew
access to the top of vent aluminum scaffold and by competent person.
pipe. workers fall from C3 2.1.2 Erection of PJC / Work
height. scaffold need to start Crew
from bottom to top.
C3 2.1.3 Base plate and PJC / Work
mudsills needed to be Crew
use on soft ground.
C3 2.1.4 Do not place PJC / Work
scaffold on uneven Crew
ground.
C3 2.1.5 Check the scaffold PJC / Work
level by using water level Crew
/ measurement tool.
C2 2.1.6 To install outrigger PJC / Work
for the aluminum Crew
scaffold.
C2 2.1.7 Ensure the wheel PJC / Work
locked before using it. Crew
2.2 Ergonomics. P C2
Step Description of Potential Hazards & Who or What RISK Control and /or Recovery Action/
No Basic Task /Step Consequence might be Harmed RATING Measures Responsible
(P E A R)) Inherent / Person(s)
Initial
2.2.1 Ensure correct PJC / Work
C2 numbers of persons are Crew
appointed for erection. PJC / Work
2.2.2 Avoid twisting of Crew
C2 body during lifting of
parts. PJC / Work
C2 2.2.3 Practicing correct Crew
body positioning.
2.2.4 Practice buddy PJC / Work
2.3 Sharp edge / cuts. P C2 system when lifting the Crew
scaffold component. PJC / Work
2.3.1 To wear cut Crew
2.4 Slip, trip and fall. P C2 resistant hand gloves at
all time. PJC / Work
2.4.1 Ensure working
Crew
and walking area free
from obstructions.

3. Install new vent stack frame. 3.1 Slip, Trip and Fall P C3 3.1.1 To practice PJC/ Work
proper housekeeping. Crew
3.2 Contact with P C3 3.2.1 To wear hand PJC/ Work
concrete gloves while carry out Crew
the task.
C3 3.2.2 To wear dust PJC/ Work
mask while carry out the Crew
task.
C3 3.2.3 To wear safety PJC/ Work
glasses while mixing the Crew
cement.
C3 3.2.4 SDS to be PJC/
available and updated. Supervisor
3.3 Vent stack frame P, A C3 3.3.1 To place support PJC/ Work
fall for the vent stack frame. Crew
3.4 Ergonomics P C2 3.4.1 Minimum 2 PJC/ Work
workers to carry heavy Crew
3.4 Muscle strain P or long equipment.
C2
Step Description of Potential Hazards & Who or What RISK Control and /or Recovery Action/
No Basic Task /Step Consequence might be Harmed RATING Measures Responsible
(P E A R)) Inherent / Person(s)
Initial
3.4.1 Practice proper PJC/ Work
body positioning while Crew
lift and carry tools /
C2 equipment.
3.4.2 Buddies system PJC/ Work
when lifting heavy or Crew
long object.
4. Install vent pipe. 4.1 Vent pipe fall P, A , R C3 4.1.1 To wear hard hat PJC/ Work
to the ground. at all time. crew
C2 4.1.2 Buddy system PJC/ Work
while working. crew
C2 4.1.3 Appoint worker PJC/
to hold the vent pipe Supervisor
when it being fasten.
4.2 Sharp edge / P C2 4.2.1 To wear cut PJC/ Work
pinch point. resistance hand gloves at crew
all time.
4.3 Falling object. P, A C2 4.3.1 Toe board to be PJC/ Work
installed properly. crew
C2 4.3.2 Secure all tools. PJC/ Work
crew
C2 4.3.3 All workers must PJC/
wear hard hat with chin Supervisor
strap at all time.
C2 4.3.4 To wear safety PJC/ Work
4.4 Expose to P shoes at all time. crew
vapor. C2 4.4.1 To wear 3m dust PJC/ Work
mask. crew
4.5 Ergonomic. P C3 4.5.1 Work rotation. PJC/ Work
crew
C2 4.5.2 Practice proper PJC/ Work
body positioning. crew
C2 4.5.3 Apply buddy PJC/ Work
system. crew
Step Description of Potential Hazards & Who or What RISK Control and /or Recovery Action/
No Basic Task /Step Consequence might be Harmed RATING Measures Responsible
(P E A R)) Inherent / Person(s)
Initial
5. Install guard rail 5.1 Spark might lead P, E, A, R C3 5.1.1 Continuously spill PJC/ AGT/
to fire. water when performing Supervisor
hot work activity eg:
hacking work
C3 5.1.2 To cover the PJC/ Work
goose neck with crew
C3 geotextile.
5.1.2 Gas test to be PJC/ AGT/
performing before hot Supervisor
work and monitor
continuously every 2
C3 hours. PJC/ AGT/
5.1.3 An AGT have to Supervisor
ensure 0% LEL achieved
and then proceed hot
C2 work activity. PJC/ Work
5.1.4 Fire extinguisher crew
5.2 Exposed to dust P need to be available and
C2 easy to reach. PJC/ Work
5.2.1 To wear 3m dust crew
5.3 Exposed to noise P C2 mask. PJC/ Work
5.3.1 To wear ear plug crew
and ear muff.

6. Dismantling Aluminum 6.1 Falling from P, R C3 6.1.1 Scaffold to be PJC / Work

scaffold. Aluminum scaffold. dismantles by competent crew
person.
C3 6.1.2 Person in charge PJC / Work
to monitor the process at crew
all time.
C2 6.1.3 Only use internal PJC/ Work
ladder / ladder with hand crew
rail when climb up and
down the scaffold.
C2 6.1.4 Do not climb up PJC/ Work
scaffold from its frame. crew
C2
Step Description of Potential Hazards & Who or What RISK Control and /or Recovery Action/
No Basic Task /Step Consequence might be Harmed RATING Measures Responsible
(P E A R)) Inherent / Person(s)
Initial
6.1.5 Apply first in last PJC/ Work
C2 out concept. crew
6.1.6 Keep scouting PJC/ Work
after top and middle rail crew
C2 being dismantle.
6.1.7 All component PJC/ Work
need to be immediate lift crew
down and place at
designated area once
C2 being dismantle.
6.2.1 Ensure correct PJC/ Work
number of persons for crew
C2 dismantling scaffold.
6.2.2 Avoid twisting of PJC/ Work
body during lifting of crew
C2 parts.
6.2.3 Practicing PJC/ Work
6.2 Ergonomic. P C3 correct body positioning. crew
6.2.4 Practice buddy PJC/ Work
system when lifting the crew
6.3 Sharp edge / P C3 scaffold component.
pinch point. 6.3.1 To wear hand PJC / Work
C2 gloves at all time. crew
6.3.2 Take extra PJC / Work
precaution while carry crew
6.4 Miss P C3 out the task.
communication. 6.4.1 Green tag need PJC/ Work
to be replaced with red crew
C2 tag.
6.4.2 Do not leave PJC/ Work
uncompleted scaffold crew
unattended.
 JOB HAZARD ANALYSIS WORK SHEET
Serial No: Revision No: PTW No: Date

Section C - JHA Tool Box Briefing Form

Description Yes No Remark
1.All the task activities
2.Hazards related with task activities and consequences
3.Who might be harmed (PEAR)
4.Control and / or recovery measures
5.Who is responsible for what
6.Actions in case of any emergency
Declaration: Team Leader / Site Supervisor

I certified that I briefed the above subject matter of JHA to all the members of job execution team.
No Name Designation / Company / ID Date / Time Signature. Remarks
11111
.
Declaration: Job Execution / Work team.
I acknowledge receiving these instructions and understood the scope of work, hazard & risk control measures risk associated with it
and to comply with the JHA.
No Name Designation / Company / ID Date / Time Signature. Remarks

1.

2.

3.
4.
5.
6.
7.
8.
9.
10.