Title of the Form Form No. Rev. No. Reference Document No.

Job Safety Analysis (JSA) Work Sheet PR/IS/SFD/F-001 04 PR/IS/SFD/P-003

Job to be Performed: Insulation work JSA No. Date: New / Revised (Rev.0)
Activity
Job Safety Analysis
Worksheet Executing Organization Representative Proponent Section: Proponent Supervisor (name & title):
(Name & Title):
Mohamed Badrudeen, Sulthan A.
(DBN Project Engineer)
Executing Work Location: Proponent Department: Reviewed and approved by
Organization Monomer-I (Proponent Section Head):
(Section/Dept.):
PMD/MEGA
Name of the Contractor (company) Performing the Job L&T (Larsen and Toubro). Work Order No. (If applicable): 4600004482
In addition to mandatory PPE additional PPE/Controls anticipated; check all that apply:
SCBA X Chemical PPE X Face Shield X MHB/SDS X

Respiratory Mask X Electrical PPE X Eye Protection PPE Others;

Fall Protection Ear Plugs/Muffs Eye Wash

Heat Resistance PPE X Floating Device X Coveralls

Residual
Risk Rating Risk Rating
Sequence of Job Steps to be Risk/Hazard (Refer (Low, Mitigation Hazard Control Measures (existing and additional) to (Low,
Action By
Performed Hazard Checklist) Moderate, reduce the risk to moderate or low. Moderate,
High, Critical) High,
Critical)
a. invalidity / Expired 1. Work permit Receiver/issuer shall be certified by PRC Job Supervisor,
Preparations Receiver and Moderate and have valid certificates. Low Permit Issuer &
a) Request for PTW Site Issuer’s 2. Consult the proponent and make sure all the identified Permit receiver,
survey and Certification work spots are correct and marked on the drawing. Site Safety
preparation work. b. Failure of work 3. Ensure that the approval is obtained from all the Officer
b) Daily safety Talk planning concerned and communication has been done with all
c. Lack of the affected parties.
Communications 4. Follow scope of work, methodology statement and the
and Control
contents of this JSA.
PR/IS/SFD/F-001
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 c) Work execution 5. A joint site inspection shall be conducted by the Issuer
d. Incorrect tool for or his designated representative and the Receiver
the job before the permit is approved / signed and after job
d) Tools & equipment completion prior closing the permit.
e. Lack of proper 6. During the toolbox talk the WP Receiver shall highlight
planning the key hazards and associated controls identified in the
JSA.
f. Lack of 7. Be aware of conflicting work scopes in areas prior to
competency commencing work task.
8. Provide good and appropriate PPE.
g. Defective tools & 9. The maximum voltage for portable electrical tools shall
equipment not exceed 220 volts.
10. Keep the worksite clean and tidy and free of electric trip
h. Electrocution hazards (housekeeping).
11. Take a rest at adequate intervals and drink water as
necessary.
12. Contractor safety officer and job supervisor to be always
available.
13. Temporary equipment must be inspected and tagged
with a valid PRC approved 3rd party Inspection Sticker
prior to use.
14. Temporary power supplies must be routed to prevent
tripping hazards.
15. Ensure a complete inspection of tools and equipment is
performed prior to start of work.
16. Use insulated tools for electrical work, all tools and
equipment are to be operated according to
manufacturer’s instructions and to be examined before
use and defective equipment/tools replaced or repaired
immediately.
17. Use validly trained and certified employees to engage in
a specific activity.
18. Ensure Barricade and relevant warning signs are
provided at work activity Zone to avoid unauthorized
entry.
a. Physical injury due Moderate 1. When transporting material, the safe working load
1. Storage, Handling to slip and trip capacity of the trailer or carrier must be verified prior to
and Transportation of bumps. loading and/transporting.
material b. Traffic 2. Load projecting beyond edge/end of the trailer or carrier
Hazard/Congestion shall be highlighted by placing a warning sign
c. Object drop off or (confirming to local regulations) to the end or to the
loose part during edge of load projection.
material 3. All loads should be fully restrained from possible
transportation to movement during/after transport by use of chains,
work area slings, ropes etc.
4. All lifting tackles and accessories shall be properly
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 inspected and color coded and also PRC approved 3 rd
Party Valid Stickers or Tags
5. Make sure that Equipment and all lifting gears are
inspected by PRC approved 3rd party and having valid
stickers or tags.
6. Equipment should be operated by a competent operator
and should be PRC approved 3rd party certified.
7. Rigging should be done by a competent rigger and
should be PRC approved 3rd party certified.
d. The glass wool 8. Follow the Plant speed limit of 40km/h at the main road
dust may cause and 30km/h on the plant road, follow traffic safety
suffocation and signs, wear seat belt.
lead to 9. Trained flag man should perform the task.
contamination. 10. Vehicle entry and Loading/unloading permit required.
e. The glass wool 11. The trailer or carrier shall be an audible reverse alarm.
may lead to skin 12. Drivers should not leave vehicles unattended while the
irritation. engine is running.
13.
f. Eye Irritation by 14. The glass wool must be contained in enclosed
the glass wool containers to prevent dust formation.
dust. 15. All personnels handling glass wool must wear full sleeve
g. Glass Wool is a clothing and hand gloves to prevent direct contact of
flammable the glass wool with the skin to prevent skin irritation.
substance 16. Personnel must use safety goggles to prevent the glass
wool dust from entering the eye and causing eye
h. Injury by
irritation.
scaffolding pipes.
17. The glass wool must be stored away from any source of
i. Aluminum paint is fire to prevent fire hazard.
a highly flammable 18. The scaffolding pipes must be stacked properly with a
liquid. stopper to prevent rolling over and any injury caused by
j. Aluminum paint is it.
acute toxic. 19. The aluminum paint must be stored separately away
from any source of fire.
20. Aluminum paint must not be left open in a confined
room.
21. The MSDS of the aluminum paint must be available and
displayed at site.
22. Training in MSDS must be imparted to all the personnel.
23. Provide good and appropriate PPE.
24. Work under the proper competent supervision only.

a. Reference and Moderate 1. Entry restricted under the insulation installation and
2. Insulation work and standards work piece will be secure by strip wire prior to final fit Low Job Supervisor,
Metal Jacking b. Work piece falling up. Permit Issuer,
on personal (prior 2. All loose materials, i.e. tools, and equipment must be in Permit Receiver,
to final fit up) due several positions to prevent falling from height, Contractor Site
to instability. 3. Safety glasses to be worn all the time on site. Safety Officer

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 4. A full-face shield with safety glasses or goggles is to be
worn when cutting steel with a Cutting wheel.
5. Hot source to be done where possible away from the
potential source
c. Foreign bodies 6. Wear gloves to protect your hand from excess heat
entering the eye during hot weather. This precaution will consider the
during self-tapping exact nature of the work and assess heat generated vs.
process required dexterity during the operation
d. Fire because of an 7. Ear protection shall be worn in all areas where noise
ignition source exposure is likely to be more than 85dB for a period of
from the greater than 8 hrs.
performance of hot 8. Ensure all the equipment or power equipment should be
work inspected by PRC approved third-party and have a valid
e. Hearing loss due to inspection sticker.
excessive noise 9. Qualified and experienced manpower to be deployed for
from sheet bolting Insulation work activities.
f. Electric shock from 10. Provide good and appropriate PPE.
use of electrical 11. SIMOP work locations are communicated to PRC process
equipment. team before commencement.
12. Identify the combined operations/activities.
g. Injury to person
13. SIMOP Hazard communication to be done with work
due to slippage of
load during transit. crew on daily toolbox talk.
h. Material handling 14. Continue supervision to be maintained on SIMOP
equipment injury activities.
to personnel 15. Follow PRC guidelines and requirements for SIMOPS as
i. SIMOPS Activity specified procedure in PR/IS/SFD/P-008.
16. SIMOPS or other combinations of work permits need to
be considered during every planning step of the permit-
to-work process

a. Irritation of eyes Moderate 1. Proper planning and look ahead by Discipline

3. Application of Joint and skin, over Supervisor. Prior to commencing work, he should plan Low Job Supervisor,
sealant exposure to vapor for: Permit Issuer,
cause eyes, throat - Specific Method of Statement / JSA for the job. Permit Receiver,
and noise. - Arrangement of appropriate safety PPE’s and Contractor Site
other arrangements at site. Safety Officer
b. Workers not aware 2. Adhere to Company/Petro Rabigh standards.
of the chemical - PR/IS/SFD/GI-07 Work Permit System
that they are using - PR CSM & Safety Handbook (Fall Protection).
3. Copies of MSDS must be present in their location 1. Site
office 2. safety office 3. Chemical storage area
4. Attached with permit copy also for reference while
process.
4. Supervisor/Forman should discuss the MSDS and must
be fully understood by the workers.

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 5. Qualified and experienced manpower to be deployed for
Joint sealant work activities
6. Obtain the valid work permit as per assigned task and
fully comply with the permit requirements as per
PR/IS/SFD/GI-007.
7. Before commencing the job make sure there is no
combustible material near the area and place the
portable fire extinguisher (DCP) near the activity within
15-meter radius.
8. Ensure all the equipment or power equipment should be
inspected by PRC approved third-party and have a valid
inspection sticker.
9. Should obtain a valid HOT WORK Permit prior to task.
10. PRC approved Fire watcher must stay minimum 30
minutes at the end of shift for inspection.
11. Work under the competent Supervision only.

a. Fall of the Moderate 1. Proper planning and look ahead by Discipline Low Job Supervisor,
4. Working at Height personnel Supervisor. Prior to commencing elevated work, he Permit Issuer,
b. Falling objects should plan for: Permit Receiver,
c. Personal injury, - Specific Method of Statement / JSA for the job. Contractor Site
Fatal - Arrangement for proper work access & fall protection Safety Officer
approved PPE (FBH)
- Proper training of personnel involved in working at
heights
2. Adhere to Company/Petro Rabigh standards.
- PR/IS/SFD/GI-07 Work Permit System
- PR CSM & Safety Handbook (Fall Protection).
3. Individual shall be trained and competent to work at
height.
4. Ensure scaffold is inspected & scaffold tag is in place.
Only approved scaffolder needs to alter (if alteration
required for specific job)
5. Crew members shall never allow to carry anything while
climbing the ladder
6. All persons working above 1.8 meters must wear a full
body harness and be tied-on to a permanent structure
with two lanyards with shock Absorbers.
7. Only approved full body harness is permitted i.e. FBH
equipped with twin shock absorbing lanyard / comply
with ANSI Z359.
8. Keep all small items and tools in a bucket/box.
9. A running toe-board of 150 mm should be installed all
round scaffold.
10. Spanners and other hand tool are being used; it should
be tied with nylon ropes to a permanent structure to

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 avoid free fall.
11. Stationed work activities where required, for cable
laying and other spool erection required,
- Lifeline with 8 to 12 mm with respect to involved work
man on activity. (Single or multiple)
- The lifeline shall be installed by certified riggers with
capable of 5000 lbs anchor points. - Should not
anchored with pipe spools, vents, cable tray, guard
rails, elements of under construction structures.
- Sag at mid span not more than 1 foot.
- Not more than 3 personnel anchorage on installed
lifeline unless designed by structural engineers with
minimum factor of safety 2 against failure.
12. Assess the risk and if required, construct an additional
escape route to overcome an emergency.
13. Below ground level must be barricaded to restrict entry.
14. Signages to be provided on ground level, Vertical lifeline
arrangement to be provide with 10mm wire rope.
15. Develop plans with measures to protect workers during
emergencies and nonroutine activities.
1. All hand tools will be kept in good repair and used only
for the intended purpose.
2. provide rope or tool tie for securing from elevated work
3. any damaged of faulty equipment must be removed
from site immediately
4. All power tools and extension cords shall be inspected
and colour coded for the month
a. Damaged tools 5. All guards and protective devices shall be remained
attached and in proper working order.
b. Inspection and 6. All cords shall be protected from damage and elevated
color coding to prevent trip hazards.
c. Missing guards 7. Power to electrical equipment shall be run through
earth leakage detection circuits (GFCI). Job Supervisor,
d. Electric shock Permit Issuer,
5. Hand Tools and when using Moderate 8. And shall be providing for all out lets to protect
employees from electrical shock and 110 V Low Permit Receiver,
Power tools electrical
9. Never use homemade or makeshift tools and never Contractor Site
equipment Safety Officer
modify or alter a tool.
e. Pinch point 10. Tools must always be in good condition, and tools shall
f. Homemade tools be properly stored when not in use.
11. Ensure tool box / tool bag for small hand tools for
g. Tools storage
elevated work to prevent falling object.
12. Trigger lock must be disabled.
13. Supervisor/Forman should discuss the Hazards and
must be fully understood by the workers.
14. Qualified and experienced manpower to be deployed for
Joint sealant work activities
15. Appropriate PPE’s must be adhered.
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 1. Materials and equipment should be stacked and placed
away from foot traffic.
2. Tools and equipment must be put properly in their
respective places.
a. Lack of proper 3. Trash and scraps are fire hazards and must be collected
planning and disposed of immediately.
b. Uncontrolled spoils 4. Store all liquids (including flammable liquids) in Job Supervisor,
c. Slip/trips/fall approved, clearly labeled containers in designated Permit Issuer,
Moderate
6. Housekeeping hazard storage areas only. Low Permit Receiver,
d. Housekeeping 5. Ensure that all waste materials have been removed. Contractor Site
crew not provided 6. Provide an adequate number of fire extinguishers in the Safety Officer
e. Cuts working area.
7. Work crew must clean the area after work.
8. Keep the exits and entrances always clear.
9. Keep sprinklers, fire alarms and fire extinguishers clear
of obstruction.
1. How to Response Emergency
2. Say this is an emergency
3. Describe the incident location
Job Supervisor,
4. Report injuries, if any
a.Unplanned Permit Issuer,
Moderate 5. Give your name and badge number
7. In case of Emergency Emergency Response Low Permit Receiver,
6. Repeat the above information
Contractor Site
7. Stay on the line until further instruction.
Safety Officer
8. Tetra – Channel 911 0r Channel 1
9. PRC Rescue Plan should be followed
Legends: PTW -Permit to work, UL -Underwriters Laboratories, FM- Factory Manual, TBT – Toolbox talk, PPE-Personnel Protective Equipment

New Revised Revalidate

d Activity: Area grading with fencing arrangement and material loading/Unloading.

JSA Team Members:

Name Designation Department Sign

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 IMPORTANT:
 This JSA must be available at the place where the activity is being performed and all personnel involved must be informed of the hazards
associated with the activities and the control measures to eliminate or minimize the hazards.
 This JSA must be revised if the scope of work changes or if any other major contingency occurs. (Refer Section 4.3.12)
 In case the team assess the residual risks cannot be brought down to Moderate or below, the risk evaluation and control shall be done by
referring Corporate HSE Risk Management Manual.
 Proponent Organization and Executing Organization must sign JSA while revalidation. (Refer Section 4.3.13)
 In case the plant emergency alarm is sounded, all work must be stopped, all permits will be automatically cancelled and Emergency
Response Plan to be followed.
 Ensure the availability of Work Permit receiver during the activity, continuously.

Petro Rabigh Risk Matrix Hazard Effect / Consequence

1 2 3 4 5
Loss Type
Insignificant Minor Moderate Major Catastrophic
Short term Reversible injury Reversible injury to one Single fatality to Multiple fatalities to worker
Safety inconvenience i.e. requiring medical or more worker worker and/or and/or impact on third party
First Aid treatment resulting in loss time severe
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 irreversible
injury/restricted duty damage to one or
more person
Severe, reversible
Reversible health health effects of
Reversible of Permanent Total
effects of little concern that would Health impact on third party.
concern that would Disability to one
concern, requiring typically result in a lost Can include effects of
typically result in or more person.
first aid treatment at time incident. carcinogens, mutagens,
medical treatment. Can include
most. Can include Acute / short-term teratogens and reproductive
Health Can include progressive
minor irritations of effects associated with toxicants (known and
temperature chronic conditions
eyes, throat, nose and extreme temperature suspected), and life-
effects; travel and/or acute /
or skin, or minor effects; or muscular- threatening respiratory
effects; stress; and short-term high-
unaccustomed skeletal effects; sensitization)
sunburn. risk effects.
muscular discomfort. vibration effects;
nervous system effects.
Impact that is
Near-source
Near-source confined Near-source confined unconfined and Impact that is unconfined over
confined and
Natural Environment and promptly and medium-term requiring long- large public area and requiring
short-term
reversible impact. recovery impact. term recovery, long-term recovery, leaving
reversible impact.
leaving residual major residual damage.
damage.

Financial Impact
Note: This includes financial loss or increased cost or Ranging from Ranging from
Greater than US$150MM
saving opportunity loss due to production loss, business Less than US$2MM US$2MM to Ranging from US$10MM US$50MM to
interruption, and cost of repair/replacement of assets. US$10MM to US$50MM US$150MM

1 2 3 4 5
Insignificant Minor Moderate Major Catastrophic
Likelihood Qualitative Quantitative Risk Rating

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 A similar outcome
A has occurred more Greater than
(Almost than once per year 1X10-2 (1 in 100 Moderate High Critical Critical Critical
Certain) at specific plant / years)
site within Petro
Rabigh.

A similar outcome
has occurred more Between 1x10-3
B than once per year (1 in 1000 years)
Moderate High Critical Critical
(Likely) but at different and 1x10-2 (1 in Moderate
plants / sites of 100 years)
Petro Rabigh.

A similar outcome Between 1X10-4

C has occurred in (1 in 10,000
Petro Rabigh or Low Moderate Moderate High Critical
(Possible) years) and 1x10-3
more than once per (1 in 1000 years)
year in the industry.

Between 1x10-5
A similar outcome (1 in 100,000
D has occurred in the years) and 1x10-4 Low Low Moderate Moderate High
(Unlikely) industry, but not in (1 in 10,000
Petro Rabigh. years)
A similar outcome Less than 1x10-5
E
has never occurred (1 in 100,000 Low Low Low Moderate High
(Rare)
in the industry years)

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