JSA #3 - DB Installation
JSA #3 - DB Installation
Weather Conditions (Current or expected change in weather conditions that could impact health and safety)
Heat Cold Snow/Ice __ _ Rain Wind Severe
Required Basic Personal Protective Equipment: Hard Hat, Safety Glasses, Safety Toed Shoes and High Visibility Clothing
Permit Required
Tools
Excavation PPE (Above Basic) Guards and Handles
Critical Lift
Goggles Grinders
Hot Work
Face Shield Air Hose Pins/Whip Stays
Energized Electrical
Gloves Tool Inspection
Confined Space
Sleeves Powder-Actuated Tools
Breaking/Entering
Knee Pads Support/Clamp Materials
Lifting People
Respiratory Protection
Utility/Life Line Impairment
Hearing Protection
Chemical Resistance Welding/Burning
Electrical Protection Welding Screens
Physical/Site Hazards
Welding/Burning Protection Fire Blankets
Access/Egress
Fire Watch (Multiple Floors)
Surfaces-Slips/Trips/Falls
Fire Extinguishers
Moving Equip.-Spotters
Combustibles/Flammables
Barricades/Guardrails Fall Protection (FP)
Ventilation
Overhead Work Body Harness
Falling Objects/Debris Non-Shock Lanyard/Tether
Others In Area Self Retracting Lifeline Lock Out/Tag Out (LO/TO)
Floor Hole Covers Shock-Absorbing Lanyard LO/TO
Rigging Plan (Contractor
& Hoisting (R&H)or Site)
Lighting Suspension Trauma Straps Lock/Tag Assignments
Rigger/Operator Qualifications
Confined Space Vert. Lifeline w/ Rope Grab LO/TO
EquipmentPlan Inspection
Review
Housekeeping Elevated Work Checklist Notify Affected
Lifting Equipment Users
Capacity
Flammables FP Equipment Inspection Release Stored Energy
Beam/Monorail Capacity
Stings/Bites/Poisonous Plants Guardrail Inspection EnergyFall/Come
Chain Source L/O Confirmed
Along Capacity
Rescue Plan
Softeners
Positioning Self Tag LinesElectrical
Pinch Points/Body Placement Overhead/Radius
Cable, Wire or Cord Clearance
Routing
Ladders
Heavy/Bulky Objects Electrical
Ground FaultHazards/Dist.
ProtectionLimits
Selection-Type/Height Setup Location Inspection
Cramped Quarters Cord Inspection
Placement/Stability
Weather/Wind Impacts Equipment Inspection
Inspection
Tie-Off and Secure Tools-Double Insulated
R&H Coordination
Electrical Contact Hazard Crane/Lift Checklist
Ergonomics
Repetitive Motion Outrigger Placement/Support
Body Position Barricade/Tag Swing Radius
Health Hazards Scaffolds
Vibration Communication Procedure
Noise Approval-Competent Person Lift Permit
Overhead Reach Inspection
Burns Personnel Platform Permit
Muscle Strain Tag-Verify Service
Dust
Silica Fall Protection
Asbestos Load Handling
Lead Spreader Beam Staging
Hex Chrome Page 1 Material/Equipment Staging
Radiation Body/Hand Position
Air Quality Release Rigging
JOB SAFETY ANALYSIS (JSA)
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JOB SAFETY ANALYSIS (JSA)
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JOB SAFETY ANALYSIS (JSA)
CREW SIGNATURES (ALL CREW MEMBERS INVOLVED IN THIS JOB MUST READ, REVIEW & SIGN)
REMINDERS:
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JOB SAFETY ANALYSIS (JSA)
1) THIS JSA IS GOOD FOR ONE WEEK PROVIDED THE TASK REMAINS THE SAME
2) FOR REPETITIVE WORK ACTIVITIES THE JSA MUST BE REVIEWED DAILY BY THE CREW AND SAFETY REPRESENTATIVE
3) IF A CHANGE IN THE WORK CONDITION IS CONSIDERED SIGNIFICANT, OR A NEW CREW IS ASSIGNED TO THE WORK, A NEW JSA IS
REQUIRED
CONTRACTOR
BAYER:
FACTORS WHICH INCREASE THE RISK OF INJURY: RUSHING FATIGUE MIND NOT ON TASK
LINE OF FIRE COMPLACENCY
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