Power & Water Utility Company Document ID No :

For Jubail and Yanbu (MARAFIQ)

Page: 1

Rev. No.:
RISK ASSESSMENT FORM
Valid Until :

Marafiq Department /Contractor: - HANWHA – GUSAN ARABIA LTD DATE: 01-08-2012

Facility / Job Location : Specify Activity to be assessed :- Assessment team member Signature
Department:
STG # 5,6 STG # 5&6 (EXCAVATION WORK). 1
MARAFIQ YANBU
2
3
Reviewed By (Hanwha construction Department ): Reviewed By ( Hanwha Safety Section): Approved By (STG 5&6 Project Site Manager):

Name: Signature: Name: Signature: Name: Signature

Date: Time: Date: Time: Date: Time:

SR JOB STEPS POTENTIAL SEVERITY / CONTROL MEASURE

HAZARD CONSEQUENCES (What can be done to prevent it from going wrong?)
(What can cause harm?) (What can go wrong?)
1. Permit to work N/A N/A Required the work permit for specific job.

2. Pre-construction Safety N/A N/A All employees assigned to this task will attend a
Toolbox meeting, which will include the
Meeting pertinent JSAs, Standard Operating Procedure,
types of potential hazards, emergency response,
and actual hazards present and controls for those
hazards.
3. site preparation . Heat stress .L/ physical injury Ensure adequate supply of fresh cool drinking
and illness water or all personal.
PROPRIETARY NOTICE IMPORTANT
THIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANY DISCLOSURE OR USE IS EXPRESSLY PROHIBITED
EXCEPT UPON WRITTEN PERMISSION BY MARAFIQ. Only document with stamps are considered official.
 Power & Water Utility Company Document ID No :
For Jubail and Yanbu (MARAFIQ)
Page: 2

Rev. No.:
RISK ASSESSMENT FORM
Valid Until :

Disposable drinking cups shall be likewise

provided; igloos shall be tapped off and
properly labeled.
Orange juice shall be provided.
Resting shelter must be provided for worker to
taking the rest.

4. Excavation Damage of
under Ground
H / physical injury
fatality
Obtain and review all required as-Built U/G
plant Drawings and prior to activity.
Utility, M / property damage Obtain Excavation permit on top of usual safe
Cave in / wall work permit.
collapse Civil engineer will review the type of soil and
Equipment fall will decide what type of control measures to be
down to done to avoid wall collapse. He will supervise
excavation the excavation work at all times.
Workers Using the safety devise (cable and metal
falling inside detector) before starting the excavation.
excavation In case of excavating near underground services
Hazard to machine will not be used.
public and Only use hand excavation.
traffic Warning lights will be provided in case of road
Equipment crossings. Or around the excavation.
malfunction Observe safe slope ( 45 Degrees-Minimum or
Congested as per soil classification) or
area Heavy equipment and material will not be
Simultaneous allowed near the edge of deep excavation.
activity with Only certified operators will operate heavy
other equipment.
contractors Workers will not be allowed to work close to
Existing the equipment.
PROPRIETARY NOTICE IMPORTANT
THIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANY DISCLOSURE OR USE IS EXPRESSLY PROHIBITED
EXCEPT UPON WRITTEN PERMISSION BY MARAFIQ. Only document with stamps are considered official.
 Power & Water Utility Company Document ID No :
For Jubail and Yanbu (MARAFIQ)
Page: 3

Rev. No.:
RISK ASSESSMENT FORM
Valid Until :

adjacent Equipment will be maintained in good working

structure condition.
Provide Proper Safety Barrier with signage
Maintain Excavation Edge clear of spoils
equipment and materials ( 2.00 Feet away from
the edge)
Daily Inspection of excavation and following
rain storm.
Provide adequate access ladders or Ramps.
Spotter assigned for monitoring equipment
operation.
Provide proper PPE to all workers.

5. Housekeeping N/A N/A Excess materials, rubbish, and any unwanted

material shall be disposed of properly not to
pose hazards to workers.
List of Materials
(Tools, work equipment, safety and emergency items)
Job should be started only after making provision of suitable and safe tools, work equipment, safety and emergency items on site as stated in risk assessment.
Sr. Tools and other work equipment Qty Sr. Safety and Emergency items Qty

1 1 Beacon flashing lamps

2 2 Sign bard
3 3 Warning flashing traffic light
4 4 Traffic cone
5 5 First aid box
PROPRIETARY NOTICE IMPORTANT
THIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANY DISCLOSURE OR USE IS EXPRESSLY PROHIBITED
EXCEPT UPON WRITTEN PERMISSION BY MARAFIQ. Only document with stamps are considered official.
 Power & Water Utility Company Document ID No :
For Jubail and Yanbu (MARAFIQ)
Page: 4

Rev. No.:
RISK ASSESSMENT FORM
Valid Until :

6 6 Safety harness
7 7 Safety glass
8 8 Shoes
9 9 helmet
10 10 Gloves
11 11 HARD HAD
12 12 Beacon flashing lamps
13 13

Information to Employees
(Details of job, hazards, risks and safety precautions)
Prior to commencement of job, Authorized Permit Receiver / Supervisor must give information on details of job, hazards, risks and
safety precautions to all personnel involved in the job and obtain their signatures on the form to acknowledge the same.
Sr. Name of the employee Profession ID No. Signature of the employee
I am informed of job details, hazards, risks and safety
precautions in order to perform above job safely.
1
2
3
4
5

PROPRIETARY NOTICE IMPORTANT

THIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANY DISCLOSURE OR USE IS EXPRESSLY PROHIBITED
EXCEPT UPON WRITTEN PERMISSION BY MARAFIQ. Only document with stamps are considered official.
 Power & Water Utility Company Document ID No :
For Jubail and Yanbu (MARAFIQ)
Page: 5

Rev. No.:
RISK ASSESSMENT FORM
Valid Until :

PREPARID BY MOHAMMED IMRAN KHAN

HSE MANAGER GUSAN, CO, LTD.

PROPRIETARY NOTICE IMPORTANT

THIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANY DISCLOSURE OR USE IS EXPRESSLY PROHIBITED
EXCEPT UPON WRITTEN PERMISSION BY MARAFIQ. Only document with stamps are considered official.