JOB HAZARD ANALYSIS

HOW TO USE THIS FORM : Installation / Facility PLATFORM

1) Crew performing task reviews ALL generic JHA considerations. Location
2) Review previous JHA update(s) for useful information which will help this task. Associated Work Permit Type COLD
3) Create new JHA update with generic form and ALL considerations for this task. Associated Work Permit Number
4) Carry out task as per plan. If any conditions change---STOP & RE-ASSESS. Electrical Isolation Certificate Number
5) File JHA update for future reference. Physical Isolation Certificate Number
WORK ACTIVITY WASHDOWN JHA Cross-Reference Number

Job Description of Potential Control / Recovery

L S R L S R Result
Step Job Step Hazards Measures
1 Check / prepare / set up flashing equipment 1.1 manual handling 1 1 1 1.1 PPE,training,equipment 1 1 1 ACCEPTABLE
(I.e pumps,hoses) and pull hoses to worksite1.2 Improper lifting technique 1 1 1 safety passport,barricade
1.3 Obstruction to workers (hoses) 1 1 1 first aid.

2 Prepare hose for washdown and cleaning 2.1- refer 1.1 1 1 1 refer 1.1
2.2 - Personnel working at height 1 1 1
2.3 Overhead objects 1 1 1

3 Carry out washdown / cleaning 3.1 water under pressure 1 1 1 refer 1.1
3.2 Pressurized hoses 1 1 1

L - LIKELIHOOD S - SEVERITY R - RATING RESULT

CATEGORY DEFINITION CATEGORY DEFINITIONS H 3 6 9 6 - 9 UNACCEPTABLE
LOW 1 Remote LOW 1 No Injury No Damage No Pollution M 2 4 6 3 - 4 TOLERABLE
MEDIUM 2 Possible MEDIUM 2 First Aid Injury Minor Damage Minnor Pollution L 1 2 3 1 - 2 ACCEPTABLE
HIGH 3 Probable HIGH 3 Lost Time Injury Major Damage Major Pollution L M H
IS THERE A SAFER WAY TO COMPLETE THE JOB ? ARE THERE ALTERNATIVES WITH LESS RISK ? LIKELIHOOD
 JHA NUMBER Date This JHA Created :
TASK SAFETY MANAGEMENT OUTLINE
Date JHA Last Revised :
WORK ACTIVITY EQUIPMENT
Type of Equipment Manufacturer Tag. No. Precise Work Site

WORK ACTIVITY PARTICIPANTS THIS JHA CREATED BY

Name Discipline Position Performed Name Discipline Position

WORK ACTIVITY RESPONSIBILITY JHA SUBMITTED BY JHA ACCEPTED BY

WORK LEADER RECEIVING AUTHORITY APPROVING AUTHORITY
Name :- Name Name :-
Signature :- Signature :- Signature : -
Date :- Date :- Date :-
Time :- Time :- Time :-
WORK ACTIVITY RESPONSIBILITY JHA SUMITTED BY JHA ACCEPTED BY
WORK LEADER RECEIVING AUTHORITY APPROVING AUTHORITY
Name Name :- Name :-
Signature :- Signature :- Signature : -
Date :- Date :- Date :-
Time :- Time :- Time :-
 JOB HAZARD ANALYSIS

HOW TO USE THIS FORM : Installation / Facility

1) Crew performing task reviews ALL generic JHA considerations. Location
2) Review previous JHA update(s) for useful information which will help this task. Associated Work Permit Type
3) Create new JHA update with generic form and ALL considerations for this task. Associated Work Permit Number
4) Carry out task as per plan. If any conditions change---STOP & RE-ASSESS. Electrical Isolation Certificate Number
5) File JHA update for future reference. Physical Isolation Certificate Number
WORK ACTIVITY FLUSHING & CLEANING JHA Cross-Reference Number

Job Description of Potential Control / Recovery

L S R L S R Result
Step Job Step Hazards Measures
1 Check / prepare / set up flashing equipment 1.1 manual handling 1 1 1 1.1 PPE,training,equipment 1 1 1 ACCEPTABLE
(I.e pumps,hoses) and pull hoses to worksite1.2 Improper lifting technique 1 1 1 safety passport,barricade
1.3 Obstruction to workers (hoses) 1 1 1 first aid.

2 Prepare lines/vessel/drip pans for flusing 2.1- refer 1.1 1 1 1 refer 1.1
cleaning. 2.2 Personnel workign at height 1 1 1
2.3 Overhead objects 1 1 1
2.4 Confined space 1 1 1

3 Carry out flushing / cleaning 3.1 water under pressure 1 1 1 refer 1.1
3.2 Pressurized hoses 1 1 1
3.3 O2 defiency ( vessel) 1 1 1
3.4 Toxic chemical 1 1 1

L - LIKELIHOOD S - SEVERITY R - RATING RESULT

CATEGORY DEFINITION CATEGORY DEFINITIONS H 3 6 9 6 - 9 UNACCEPTABLE
LOW 1 Remote LOW 1 No Injury No Damage No Pollution M 2 4 6 3 - 4 TOLERABLE
MEDIUM 2 Possible MEDIUM 2 First Aid Injury Minor Damage Minnor Pollution L 1 2 3 1 - 2 ACCEPTABLE
HIGH 3 Probable HIGH 3 Lost Time Injury Major Damage Major Pollution L M H
IS THERE A SAFER WAY TO COMPLETE THE JOB ? ARE THERE ALTERNATIVES WITH LESS RISK ? LIKELIHOOD
 JHA NUMBER Date This JHA Created :
TASK SAFETY MANAGEMENT OUTLINE
Date JHA Last Revised :
WORK ACTIVITY EQUIPMENT
Type of Equipment Manufacturer Tag. No. Precise Work Site

WORK ACTIVITY PARTICIPANTS THIS JHA CREATED BY

Name Discipline Position Performed Name Discipline Position

WORK ACTIVITY RESPONSIBILITY JHA SUBMITTED BY JHA ACCEPTED BY

WORK LEADER RECEIVING AUTHORITY APPROVING AUTHORITY
Name :- Name :- Name :-
Signature :- Signature :- Signature : -
Date :- Date :- Date :-
Time :- Time :- Time :-
SEEB BY : DESB F/SUPT. SEEN BY: PCSB C.S.R SEEN BY: PCSB PLATFORM SUPERINTENT

Name :- KASSIM PASAK Name :- JIMSON RANGKING Name :- RUSLAN GHANI

Signature :- Signature :- Signature :-
Date :- .10.2005 Date :- .10.2005 Date :- .10.2005
Time :- Time :- Time :-
 JOB HAZARD ANALYSIS

HOW TO USE THIS FORM : Installation / Facility

1) Crew performing task reviews ALL generic JHA considerations. Location
2) Review previous JHA update(s) for useful information which will help this task. Associated Work Permit Type
3) Create new JHA update with generic form and ALL considerations for this task. Associated Work Permit Number
4) Carry out task as per plan. If any conditions change---STOP & RE-ASSESS. Electrical Isolation Certificate Number
5) File JHA update for future reference. Physical Isolation Certificate Number
WORK ACTIVITY FLUSHING JHA Cross-Reference Number

Job Description of Potential Control / Recovery

L S R L S R Result
Step Job Step Hazards Measures
1 Check / prepare / set up flashing equipment 1.1 manual handling 1.1 PPE,training,equipment
(I.e pumps,hoses) and pull hoses to worksit 1.2 Improper lifting technique safety passport,barricade
1.3 Obstruction to workers (hoses) first aid.

2 Prepare lines/vessel/drip pans for flusing 2.1- refer 1.1 refer 1.1
cleaning. 2.2 Personnel workign at height
2.3 Overhead objects
2.4 Confined space

3 Carry out flushing / cleaning 3.1 water under pressure refer 1.1
3.2 Pressurized hoses
3.3 O2 defiency ( vessel)
3.4 Toxic chemical

L - LIKELIHOOD S - SEVERITY R - RATING RESULT

CATEGORY DEFINITION CATEGORY DEFINITIONS H 3 6 9 6 - 9 UNACCEPTABLE
LOW 1 Remote LOW 1 No Injury No Damage No Pollution M 2 4 6 3 - 4 TOLERABLE
MEDIUM 2 Possible MEDIUM 2 First Aid Injury Minor Damage Minnor Pollution L 1 2 3 1 - 2 ACCEPTABLE
HIGH 3 Probable HIGH 3 Lost Time Injury Major Damage Major Pollution L M H
IS THERE A SAFER WAY TO COMPLETE THE JOB ? ARE THERE ALTERNATIVES WITH LESS RISK ? LIKELIHOOD
 JHA NUMBER Date This JHA Created :
TASK SAFETY MANAGEMENT OUTLINE
Date JHA Last Revised :
WORK ACTIVITY EQUIPMENT
Type of Equipment Manufacturer Tag. No. Precise Work Site

WORK ACTIVITY PARTICIPANTS THIS JHA CREATED BY

Name Discipline Position Performed Name Discipline Position

WORK ACTIVITY RESPONSIBILITY JHA SUBMITTED BY JHA ACCEPTED BY

WORK LEADER RECEIVING AUTHORITY APPROVING AUTHORITY
Name :- Name :- Name :-
Signature :- Signature :- Signature : -
Date :- Date :- Date :-
Time :- Time :- Time :-
 JOB HAZARD ANALYSIS

HOW TO USE THIS FORM : Installation / Facility

1) Crew performing task reviews ALL generic JHA considerations. Location
2) Review previous JHA update(s) for useful information which will help this task. Associated Work Permit Type
3) Create new JHA update with generic form and ALL considerations for this task. Associated Work Permit Number
4) Carry out task as per plan. If any conditions change---STOP & RE-ASSESS. Electrical Isolation Certificate Number
5) File JHA update for future reference. Physical Isolation Certificate Number
WORK ACTIVITY FLUSHING JHA Cross-Reference Number

Job Description of Potential Control / Recovery

L S R L S R Result
Step Job Step Hazards Measures
1 Check / prepare / set up flashing equipment 1.1 manual handling 1.1 PPE,training,equipment
(I.e pumps,hoses) and pull hoses to worksite1.2 Improper lifting technique safety passport,barricade
1.3 Obstruction to workers (hoses) first aid.

2 Prepare lines/vessel/drip pans for flusing 2.1- refer 1.1 refer 1.1
cleaning. 2.2 Personnel workign at height
2.3 Overhead objects
2.4 Confined space

3 Carry out flushing / cleaning 3.1 water under pressure refer 1.1
3.2 Pressurized hoses
3.3 O2 defiency ( vessel)
3.4 Toxic chemical

L - LIKELIHOOD S - SEVERITY R - RATING RESULT

CATEGORY DEFINITION CATEGORY DEFINITIONS H 3 6 9 6 - 9 UNACCEPTABLE
LOW 1 Remote LOW 1 No Injury No Damage No Pollution M 2 4 6 3 - 4 TOLERABLE
MEDIUM 2 Possible MEDIUM 2 First Aid Injury Minor Damage Minnor Pollution L 1 2 3 1 - 2 ACCEPTABLE
HIGH 3 Probable HIGH 3 Lost Time Injury Major Damage Major Pollution L M H
IS THERE A SAFER WAY TO COMPLETE THE JOB ? ARE THERE ALTERNATIVES WITH LESS RISK ? LIKELIHOOD
 JHA NUMBER Date This JHA Created :
TASK SAFETY MANAGEMENT OUTLINE
Date JHA Last Revised :
WORK ACTIVITY EQUIPMENT
Type of Equipment Manufacturer Tag. No. Precise Work Site

WORK ACTIVITY PARTICIPANTS THIS JHA CREATED BY

Name Discipline Position Performed Name Discipline Position

WORK ACTIVITY RESPONSIBILITY JHA SUBMITTED BY JHA ACCEPTED BY

WORK LEADER RECEIVING AUTHORITY APPROVING AUTHORITY
Name :- Name :- Name :-
Signature :- Signature :- Signature : -
Date :- Date :- Date :-
Time :- Time :- Time :-