JOB SAFETY ANALYSIS (JSA) RECORD SHEET

PROJECT TITLE: ABC PROJECT DATE: May 26, 2016

CONTRACT: 000000 CONTRACTOR:
CONTRACTOR SUPERVISOR: JSA # : 00-YYYY
COMPANY:
DESCRIPTION OF ACTIVITY: Survey works, detection and exposure of existing underground utilities,
installation of barricade, EXPLORATORY EXCAVATION, backfilling, and demobilization of materials and
equipment.

Approved By:
Prepared By: Reviewed By:
Safety Engineer HSE Manager Project Manager
Date: Date: Date:
References:
Construction HSE Manual

1. Survey works

Basic Job Step Potential Hazard Recommended Action

1.1 Preparing and Fall from the same level. • Equipment shall be properly stacked and should not be positioned on the
collecting of equipment ground.
from the surveying
Vehicles. Struck against equipment • PPE shall be worn like safety shoes and gloves.
causing hand and foot • Do not carry equipment which can’t be handled by single person.
injury on collecting • Carry your equipment close to your body to avoid tension to your arms.
equipment.
1.2 Movement of Caught between • Caution shall be taken on loading the equipment emphasizing that body parts
equipment or materials. equipment causing hand could be pinched.
or body injuries. • PPE shall be worn especially gloves.

1.3 Setting the Struck by moving vehicle. • Station flagman where necessary especially on areas to be surveyed.
equipment on work site. • Surveyor and surveyor aid shall wear high visibility vest.
• Barricade the area.
• Work on hours which are not busy for traffic.
1.4 Surveying activities. Exposure to dust and not • Dust mask shall be worn by surveyor and his aid.
shaded area. • If dust is cannot be kept to minimum, wet method shall be done.
• Bottled water shall be brought on work site.
• Frequent breaks or find a shaded area to minimize exposure to direct
sunlight.
Fall from the same level • Awareness on surrounding shall be practiced especially on equipment and
protruding object on the ground.
• Surveying equipment shall be stacked properly.
1.5 Marking of specific Exposure to paint • RPE shall be worn and training shall be done prior to donning of RPE.
locations with spray substance and not shaded • If natural ventilation is insufficient, replace method of painting to mark specific
paint. area. location.
• Bottled water shall be brought on work site.
1.6 Collecting of Fall from the same level. • Awareness on surrounding shall be practiced especially on equipment and
equipment for protruding object on the ground.
demobilization. • Surveying equipment shall be stacked properly.
Struck against equipment • PPE shall be worn like safety shoes and gloves.
causing hand and foot • Do not carry equipment which can’t be handled by single person.
injury on collecting • Carry your equipment close to your body to avoid tension to your arms.
equipment.
 2. Underground utilities detection
Basic Job Step Potential Hazard
2.1 Known and unknown Hit by the hand tools of
underground utilities. underground utilities
Damage of existing utilities
due to usage of mechanical
excavation
Inhalation of gas due to
leakage.
3. Barricade and safety signs installation
Basic Job Step Potential Hazard
3.1 Collecting of Struck against materials
materials (e.g. barricade, causing hand and foot injury
safety signs, lights, on collecting equipment.
drums, etc.)
Fall from the same level.
Overexertion
3.3 Installation of safety Struck by vehicle while
materials on site. installing work precaution
and barricade.
Struck against materials
causing hand and foot injury
on installing safety
materials.
Fall from the same level.
Exposure to direct sunlight
and dust.
4. Excavation of marked areas
Basic Job Step Potential Hazard
5.1Digging • Slip, trip and Fall into
a. Manual digging using excavation
hand tools (e.g. shovel, • Cave-in, side wall
pick, crowbar) Collapse of the excavation
• Inhalation of toxic gas
• hit the underground
utilities due to using pointed
crowbar.
Recommended Action
• Workers involved shall be inducted by competent person and safety
personnel of the present of underground utilities prior to start the activity.
• Crowbar hand tools shall be used only in hard soil.
• Existing utilities shall coordinate the underground utilities department such as
PDD, UD communications and other department where necessary.
• Existing utilities shall be protected prior to start the activity.
• Excavate Trial pits to expose the utilities and mark and coordinate with the
concern department.
• Contractor shall never use the mechanical equipment as the area has
underground utilities.
• Contractor competent person shall inspect in regular basis.
• First aider shall be available in the job site.
• If any suspected leakage workers should be immediately evacuate the area,
the competent the person shall be contacted the concern department.
• Induction shall be provided to the involved workers prior to start the activity.
Recommended Action
• PPE shall be worn like safety shoes and gloves.
• Do not carry equipment which can’t be handled by single person.
• Carry your equipment close to your body to avoid tension to your arms.
• Materials shall be properly stacked and should not be positioned on the
ground.
• Be sure on carrying equipment, your eyesight is not blocked by carried
materials.
• Carry only materials you can handle.
• Bend by the knees technique shall be taught
• Buddy system shall be practice.
• Warm-up exercise prior to collecting of materials.
• Use portable trucks or trolleys on materials that can’t be handle by hand.
• Flagman wearing high visibility vest shall be station and shall caution
approaching vehicle.
• All workers involve shall wear high visibility vest.
• Road work sign shall be installed prior to work.
• PPE shall be worn like safety shoes and gloves.
• Be reminded of the topographic or terrain of the work area.
• Inform workers of the protruding object on area, remove them if necessary.
• Minimize the exposure to sunlight by rotation of workers.
• Shaded rest shelter shall be provided on site.
• PPE like dust mask shall be worn.
Recommended Action
• Barricade shall be provided and signage’s to warn other people.
• PPE shall be worn at all times.
• Contractor to provide excavation safety protection measures as per the soil
type of the excavated areas to prevent side wall collapse.
• Contractor assign first aider shall be present on the site during the activity to
administer the injured workers.
• Health surveillance shall be monitor to the involve worker.
• Stop the activity competent person shall coordinate the concern department
such as UD, PDD other department when necessary.
b. Working on excavation
5.2 Installation of shoring
materials (where
applicable).
Collecting of materials to
be used on shoring.
5.3 Back filling
Manual backfilling
5.4 Mechanical back
filling
5.5 Compaction
Presence of H2S in
excavation
Sidewall collapse
Adverse weather condition
(e.g. rain, high water table,
fog, flood)
Struck by falling object or
fall from the edge of
excavation.
Contact on live utilities
• Hand and body injuries
• Overexertion
• Caught in materials being
installed.
• Struck by hand tools.
• Hand and body injuries
• Overexertion
• Exposure to hot
environment and dust.
Struck by or crushed by
equipment on ground
personnel
Exposure to high noise due
to plate compaction
machine.
• Training shall be done prior to excavation on the hazard of H2S.
• Personnel shall not work if the excavation is not properly ventilated.
• Personal gas detector (calibrated) shall be available at work site.
• Toolbox talk shall be done prior to work stressing the hazard of exposing to
dangerous atmosphere.
• CSES shall monitor the job being done in excavation.
• Access and egress shall be installed.
• Excavation checklist shall be tick by competent personnel.
• Trench box or other suitable protection shall be installed before working on
excavation.
• If there is water on excavation, proper procedure like dewatering shall be
done to avoid cave-in.
• Train the workers on signs of excavation collapse like bulging or cracking of
protective system.
• Vibration from contractor equipment shall be minimized to secure the
sturdiness of excavation wall.
• Spoil materials shall have a clearance of at least 2 ft away from the edge of
excavation.
• Stop activities on site in case of bad weather conditions.
• Monitor the weather forecast.
• Toolbox talk shall be done prior to start of work.
• Access and egress shall be installed to excavation.
• Emergency vehicle shall always be available at site.
• Restriction near and on the edge of excavation shall be implied.
• Barricade the excavation to limit the access to caution also the pedestrian.
• Tools and spoil soil shall be away at least 2 ft from the edge of excavation.
• Stop block shall be installed at least 1m from the edge of excavation.
• Permit shall be obtained prior to work.
• Restrict workers and inform not to stay closed with utilities.
• Lights shall be provided when work at dark hours is necessary.
• Mark the utilities with warning tapes or visibility stickers.
• Minimum PPE shall be worn.
• Direct supervision of supervisor or foreman.
• Carry only materials you can handle.
• Bend by the knees technique shall be taught and practice all the time.
• Buddy system shall be practice.
• Warm-up exercise prior to collecting of materials.
• Use portable trucks or trolleys on materials that can’t be handle by hand.
• Caution shall be taken on installing the materials emphasizing that body parts
could be pinched.
• PPE shall be worn especially gloves.
• Proper body positioning.
• Buddy system shall be practiced especially on large material to be installed.
• See shoring drawing on page 17.
• Minimum PPE shall be worn.
• Direct supervision of supervisor or foreman.
• Buddy system shall be practice.
• Warm-up exercise prior to collecting of materials.
• Minimize the exposure to sunlight by rotation of workers.
• Shaded rest shelter shall be provided on site.
• PPE like dust mask shall be worn.
• Drinking water shall be provided on site.
• Allow only necessary personnel into areas where equipment is operating.
• Maintain line of sight with operators.
• Establish and use appropriate hand signals.
• Daily equipment inspection checklist will be performed each day prior to the
use of the equipment.
• All operator manuals must be with the machine.
• Bucket and attachments must be grounded when not in use.
• Only trained and qualified Operators are allowed to run the equipment.
• Use spotters where high noise levels or poor visibility interfere with an
operator's ability to see objects on all sides of the equipment.
• Utilize safety vests at all times.
• Swing radius is to be barricaded while working around ground personnel.
• Keep all personnel out from under loads.
• Ear plugs or ear muffs shall be worn while compaction is on progress.
• Rotation of workers to operate the compactor.
 5. Housekeeping and demobilization of tools and equipment:
Basic Job Step
7.1 Collecting of materials
and equipment
7.2 Demobilization
Potential Hazard
Fall from the same level.
Struck against equipment
causing hand and foot
injury on collecting
equipment.
Caught between equipment
causing hand or body
injuries.
Collision with other vehicles
Recommended Action
• Equipment shall be properly stacked and should not be positioned on the
ground.
• PPE shall be worn like safety shoes and gloves.
• Do not carry equipment which can’t be handled by single person.
• Carry your equipment close to your body to avoid tension to your arms.
• Caution shall be taken on loading the equipment emphasizing that body parts
could be pinched.
• PPE shall be worn especially gloves.
• Adhere to all road rules.
• Give sufficient warning using vehicle indicators.
• Park legally and out of the path of traffic.
• Attach and activate beacon light to warn traffic users.
• Ensure traffic management plan is approved and implemented where
required.
• Familiarize yourself with site.