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JHA NO.
PTW NO
FACILITY
SOGT
EQUIPMENT NO.
LOCATION
SOGT
WORK
DESCRIPTION
COLD
SPECIFIC WORKSTATION
NOTE
1. JHA shall be applicable for all work activities which requires PTW.
2. Personnel carrying out the work shall be fully familiar with the written Work/Operating Procedures developed for the job. The Work/Operating Procedures shall describe, in step-by-step instructions, the correct method of executing the specified work.
3. Prior to commencement of work, the task-specific JHA shall be discussed amongst all personnel involved in the execution; and requirements contained therein shall be fully understood and agreed by all involved personnel.
JOB
STEP
1
Excavation work
POTENTIAL
HAZARD
POTENTIAL IMPACT
INHERENT RISK
RATING
LEVEL
CONTROL BARRIERS
RECOVERY BARRIERS
RESIDUAL RISK
RATING
LEVEL
RESULT
Incorrect
manual
handling
Pinch point
D2
Medical treatment
D1
Acceptable
D2
D1
Acceptable
Spark
produced due
to fraction
between iron
and rock
Flying object or
debris
B3
B1
Acceptable
Personnel injury
B2
B1
Acceptable
Correct technique.
Assign enough manpower
Suitable hand tools for the excavation
work
Do not use worn shoes
Ensure work area are clean from other
debris or slippery surface
Correct technique.
Assign enough manpower
Suitable hand tools for the excavation
work
AGT shall perform gas testing at site
and its surrounding to ensure no
flammable gas present.
D1
Acceptable
D1
Acceptable
Incorrect body
posture
D2
Physical injury
D2
Incorrect body
posture
D2
Spark
produced due
to fraction
between iron
and rock
Flying object or
debris
B3
Personnel injury
B2
Physical injury
D2
M
M
First aid
Medical treatment
D1
Acceptable
B1
Acceptable
B1
Acceptable
D1
Acceptable
First aid
PTW NO
FACILITY
SOGT
EQUIPMENT NO.
LOCATION
SOGT
WORK
DESCRIPTION
COLD
SPECIFIC WORKSTATION
NOTE
1. JHA shall be applicable for all work activities which requires PTW.
2. Personnel carrying out the work shall be fully familiar with the written Work/Operating Procedures developed for the job. The Work/Operating Procedures shall describe, in step-by-step instructions, the correct method of executing the specified work.
3. Prior to commencement of work, the task-specific JHA shall be discussed amongst all personnel involved in the execution; and requirements contained therein shall be fully understood and agreed by all involved personnel.
JOB
STEP
3
Housekeeping
POTENTIAL
HAZARD
POTENTIAL IMPACT
INHERENT RISK
RATING
LEVEL
CONTROL BARRIERS
RECOVERY BARRIERS
RESIDUAL RISK
RATING
LEVEL
RESULT
Incorrect
manual
handling
D2
Medical treatment
D1
Acceptable
Pinch point
D2
D1
Acceptable
Physical injury
D2
D1
Acceptable
First aid
JHA NO.
PTW NO.
DATE
COLD
NAME(S)
DESIGNATION
FACILITY
SITE SUPERVISOR
LOCATION
SPECIFIC WORKSITE
EQUIPMENT NO.
WORK DESCRIPTION
APPROVED BY
NAME
NAME
DESIGNATION
SITE SUPERVISOR
DESIGNATION
SIGNATURE
SIGNATURE
DATE
DATE
WORK TEAM (COMFORMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PRE-JOB/TOOLSBOX MEETINE
NAME(S)
DESIGNATION
SIGNATURE
NAME(S)
DESIGNATION
SIGNATURE