Nghi Son Refinery and Petrochemical Limited Liability Company

Company : AMECC/MEGARIG Date :

ACTIVITY: Alignment check JSA No. :
Work Location / Area PTW Number
Equipment’s / Material Hand tools
& Tools Used :

NO. Activity Hazard Impact Control Measures Action By

P E A R
1. Pre-Task Preparation  Noncompliance of NSRP-HSSE Procedures.  Obtain a Valid PTW with relevant certificates.
 Conduct START Meeting to inform the workers of the task Supervisor
 Unauthorized work
descriptions. Workers
 Lack of Communication M M  Discuss START in dual language for clear
 Non-compliance understanding as required.
 All team members must have the necessary NSRP
Trainings
 Use all Mandatory PPE.
 Maintain good communication with all team members.

2. Selecting Closer & Safe  Fire, Explosion, Toxic gas leak, Slips, trips,  Identify the nearest Muster Point.
Muster Point / Emergency Falls, Unsafe selection of muster point.  Ensure all personnel are aware of Safe & nearest Muster Supervisor
Response / Evacuation  Evacuation access route blocked. Point. Workers
Route. M
 Change in wind direction.  Emergency Contact No. 02378738541
 Poor communication with ERT  Plant Telephone: 6700 / 6701
 Obstruction in access for ERT  Wind direction to be monitored from the nearest visible
wind sock.

4. Use of Hand Tools

 Physical Injuries M  Ensure all tools are good condition. Supervisors/
 Don’t place fingers in pinch points. Workers
 Use the right tools for the right job.
 Pinch points  Do not use damaged or handmade tools.
 Tools should not be left lying around.
 Slips/trips/falls hazard  Ensure all wires and cables are properly insulated
 Only Authorized and trained personnel are allowed to
 Improper handling of hand tools operate special tools and equipment.

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 Nghi Son Refinery and Petrochemical Limited Liability Company
 Electric Shock

5. Manual Handling
 Ergonomic Problems. Supervisor /
 Follow NSRP manual handling procedure. Workers
 Pinch point and obstructions.
L L L  Use Buddy system for manual lifting.
 Physical Injuries.  Follow safe manual handling Technique.
 Keep the load close to the body as much as possible.
 Slips/trips/falls hazard.
 Keep the body in a comfortable/correct position
 Improper handling of Load.
 Don’t place fingers in a pinch point.
 Use Specific PPE’s.
 Ensure access & egress are clear from obstructions.

6. Work at Height Supervisor

 Fall from Height Workers
 Falling object H L H
 Wear safety harness and 100% tie-off Technician
 Ensure 3-point contact when accessing ladders.
 Ensure access & egress are clear from obstructions
 Secure all loose materials.
 All hand tools shall be equipped with restraint ropes.
 Proper housekeeping in work area
 Ensure drop zone is barricaded and with Watchman.

Remarks:
P: Person, E: Environment, A: Assets, R: Reputation, L: Likelihood, S: Severity, RC: Record.
JSA Prepared by JSA Reviewed by JSA Verified by Mr.
Name: Name: Name:
Signature: Signature: Signature:

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 Nghi Son Refinery and Petrochemical Limited Liability Company
JSA Checklist
JSA Work Details and checklists
Date: Job Title: Alignment Check JSA Ref #
Description of Work: Alignment Permit # (If applicable):
Originator:
(A) Identify Potential Hazards for The JOB
Hazard Prompt List (Review the job steps and identify if any of the following hazards are applicable) Potential Hazard Exposure Mechanisms
□ Electricity □ Weather □ Excavations/ Earthworks □ Struck – by, against
□ Hot/ Cold Objects □ Insect/ Animal Bites □ Fire □ Contact with
□ Rotating Equipment □ Lighting □ Introduction of Non Native Species □ Contacted by
□ Vehicles □ Driving Hazards □ Harm to Flora/ fauna □ Caught – in, on, Under, between, against
□ Muscular Stress X Falling Objects □ Historical Sites □ Exposure – temperature, chemicals, noise, dust
□ Mental Stress □ Noise □ Vegetation Clearing X Slip, Trip or Fall – from heights, same level
□ Repetitive Work □ Radiation X Spills/ Leaks X Complete Manual Handling Risk Assessment attached
X Heights X Hydrocarbon/ Gas Release □ Other Mobile/ Stationary Equipment □ Overexertion/ excessive force – lifting, pushing, pulling,
□ Lone Worker □ Surfaces X Pressure (Stored Energy) □ Escape of Material – oil spill, gas release, light spill
□ Vibration X Tools/ Equipment □ Fumes/ Vapour/Dust □ Human Factors
□ Moving Objects □ Human Factors □ Light Spill
□ Confined Spaces □ Off Road □ Depths
□ Asbestos □ Chemicals □ Other (List additional Hazards below)
Personal Protective Equipment
X Eye/Face protection □ Hearing protection □ Respiratory protection X Weather conditions
X Head protection □ Safety/Rescue line X Safety harness
•hot/dry
X Foot protection X Hand protection □ Gas detector •wet
X Body protection □ Spill prevention and clean up □ Light shields •windy
• cold
□ Other

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 Nghi Son Refinery and Petrochemical Limited Liability Company

SWMS & JSA Meeting Form

SWMS/JSA MEETING FORM
Work Title: : Alignment check.
PTW No: Date:
PTW Requester : Name/Signature:

A. Subject Discussed

1 Adjacent works
2 Work at Height
3 Manual Handling.
4 Housekeeping
B. Attendance List
Name Div./ Section Position Signature
1
2
3
4
5
6
7
8
C. Feedback
1. Adjacent activities to be considered.

2. Conflicting activities to be discussed & Prioritized.

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 Nghi Son Refinery and Petrochemical Limited Liability Company

Safe Work Method Statement No. TITLE: Alignment check DATE:

Apply Permit to Work with Relevant attachments & certificates.

1.0 Scope 1.1
To complete the activity of Bolt cleaning Works
2.0 References 2.1 etc Contractor Document (VV3160-001-A-131 Rev 1) for Flange Face Repair by CR Asia

3.0 Responsibilities 3.1 etc JGCS JVTT / NSRP

4.0 Equipment 4.1 etc Hand tools

5.0 Materials 5.1 etc N/A

6.0 Resources 6.1 etc N/A

7.0 Procedure 7.1 etc As per attached procedure VV3160-001-A-131 Rev 1.

8.0 Safety 8.1 etc As per attached JSA

9.0 Attachments 9.1 etc JSA, Contractor SWMS (VV3160-001-A-131 Rev 1.)
Maintenance Section Approval
Prepared by: (Contractor) Checked by: (Maintenance)
Permit Requester Section Manager
Name

Signature

Date