JOB HAZARD ANALYSIS [JHA] WORKSHEET

JHA NO. PTW NO WORK PERMIT TYPE

FACILITY LOCATION SPECIFIC WORKSTATION

EQUIPMENT NO. WORK DESCRIPTION Manual manhole Excavation

JOB DESCRIPTION OF JOB POTENTIAL POTENTIAL ACTION PARTY RECOVERY ACTION

CONTROL BARRIERS
STEP STEP HAZARD CONSEQUENCES BARRIERS
PARTY
1 Inexperienced Damage to the plant Attend Induction Safety briefing. Supervisor/Safety Inform Control Room. Supervisor
Entry of workers and workers Dept.
excavated machine & disturbing the Work leader to lead and Retraining if required.
mobilize equipment to site equipment supervise
2 Slippery or Slip and trip Clean/dry up wet surface where All Workers First Aider on site. Supervisor / 1st
uneven possible Aider
surface Monitor & make work
Ensure the safety boot is in good site safe to work on
Detecting underground
condition
facilities
Proper housekeeping & remove
all obstruction

3 Strike the Injury To get the latest drawing on the Supervisor / Site First aid Supervisor / 1st
underground location of the underground Engineer Aider
utilities Damage the property utilities Inform CSR on duty
Dust
Pilot digging and shoveling
Trapping during
and Manual Excavation by
Trapping emergency Proper supervision on site
and hand tools
use proper tools
use mask if required

To use two ladders on opposite

sides of excavation when reach 1
meter depth

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4 Improper Personal injury -Follow the erect procedure All workers - First Aider Supervisor/Medic
tools and
Drainage accumulated water equipment Hand injury -Competent personnel - Medic
in site Sharp edges
Property damaged -Wear correct PPE e.g. safety
helmet gloves

5 Cave in Trapped Proper shoring must be put in Supervisor Inform CCR Supervisor / ERT
(Collapse of place and the material must be
soil/sand) rigid. Search & rescue team
to be notified
Access and egress shall be immediately
adequate

Shoring work for the Stand by person to monitor the

excavated pit (when the work & to report & seek
excavation more than 1.5 M) immediate assistant

Slippery or Slip and trip Clean/dry up wet surface where All Workers First Aider on site. Supervisor / 1st
uneven possible Aider
surface Monitor & make work
Ensure the safety boot is in good site safe to work on
condition

Proper housekeeping & remove

all obstruction

7 Back filling the trench Improper Personal injury -Follow the erect procedure ALL worker - First Aider Supervisor/Medic
tools and
equipment Hand injury -Competent personnel - Medic
Sharp edges
Property damaged -Wear correct PPE e.g. safety
helmet gloves

6 Housekeeping Moving weight Back strain from repetitive Identify high risk activities All Workers First aid Supervisor / 1st
when loading manual lifting Aider
Use trolley or manual handling Training on manual
aids lifting techniques

Two person or team lifting

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 Reduce/split the loads into
manageable weight

Slippery work Slip Clean up slippery surface All Workers First aid Supervisor / 1st
area Aider
Dry off the wet area immediately

Use hand rail provided

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 JHA APPROVAL DURING PTW APPLICATION

REVIEWED BY APPROVED BY
NAME NAME

DESIGNATION WORK LEADER DESIGNATION

SIGNATURE SIGNATURE

DATE DATE

AFTER PTW HAS BEEN APPROVED

WORK TEAM (CONFIRMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PRE_JOB/TOOLBOX MEETING _ AFTER PTW HAS BEEN APPROVED)

Name (S) Designation Signature Signature Signature Signature Signature Signature Signature Name (S) Designation Signature Signature Signature Signature Signature Signature Signature

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