HOW TO USE THIS FORM :

JOB HAZARD ANALYSIS

HOW TO USE THIS FORM :Installation/FacilityEDG

1) Crew performing task reviews ALL generic JHA considerations.LocationLocal Control Panel

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 ACTIVITYPneumatic Test For FM200 Pipe (using N2)JHA Cross-Reference Number

JobStepDescription ofJob StepPotentialHazardsPotentialImpactLSRControl/Recovery MeasuresLSRResult

1Work and site preparation (housekeeping)1.1Protrusion to hand and finger

Minor injury 326 All personal to wear proper and suitable hand protection glove. Eliminate or to make safe any protruding hazard. First aid treatment.212Acceptable

2Install of nitrogen gas for leak test of FM200 pipe 2.1Manual lifting for nitrogen gas cylinder by manpower can cause ergonomic hazards.2.2Cylinder can fall while manual lifting.2.3Workers hit by the cylinder.2.4Unsafe cylinder gas position.

Back ache Body injury Pinch point

326 All worker must wear proper PPE when do manual lifting. Provide glove to avoid pinch point. Do not lift the cylinder alone. Make sure do it with buddy system. If possible use trolley or keep on standing position and tightly bound to strong structure. Do not locate cylinder gas in access & egress pathway. Safe handling of cylinder gas, do not move cylinder by rolling it.122Acceptable

3Blow the pipe to clean iron dust inside pipe happen during cutting, drilling and welding using notrogen gas.(5 bar pressure)3.1Cylinder fall from standing.3.2The pressure hose disconnected.3.3N2 gas accumulate at Local control panel room.3.4Dust/debris from inside FM200 pipeline.

Material damage Major injury/Fatality Asphyxia Respiratory acute339 Make sure the cylinder is tighten to the wall or something that not easily move. Make sure all fittings is tighten properly before blow the pressure for clean up the pipe. Make sure all area that involve for this activity is already barricade and provided with signage to avoid not authorize person coming in or near at the area. OPEN ALL DOORS (ENTRY & EXIT) in Local control panel for ventilation. Cover area (panel) below blowout end pipe. Use Dust mask (PPE).122Acceptable

4Installation of testing device (pressure gauge, flexible hose, nitrogen gas, and pipe fitting)4.1Worker fall from ladder or scaffolding while installing the testing device.4.2Testing device fall from height.4.3Tools falling from height.4.4Unstandard connection hose.

Major injury/Fatality Material damage339 Provide training for working at height for worker that involve to the work activity. Make sure the worker is a competent to do the job. Install toe board at scaffolding to avoid falling material or tools from scaffolding. Provide proper PPE for worker to avoid them from falling at height. Provided first aid kit box in place. Provide first aider and rescue plan (refer to attached) in place. Use standard hose that appropriate with maximum pressure for pneumatic test (27,5 bar).122Acceptable

5Pressure test pipe FM200 (27-31 bar pressure)5.1Cylinder fall from standing.5.2The pressure hose disconnected.5.3Uncontrol filling pressure from cylinder gas.5.4Communcation problem between valve operator and tester due to separate room.5.5Leaking or cracking on welding area or pipe

Material damage Major injury/Fatality339 Make sure all fittings is tighten properly before blow the pressure for clean up the pipe. Provide standby person at any entrance for the test location. Make sure all area that involve for this activity is already barricade and provided with signage to avoid not authorize person coming in or near at the area (access control implementation). Make sure the activity is conducted with competent person. Use regulator, pressure gauge and ball valve to control pressure. Point blow out direction to safe atmosfer and outlet area protected/barricade/warning sign (Danger of nitrogen gas). Use proper communication tools (HT). Cover existing equipment with bluesheet and playwood.

122Acceptable

6Housekeeping6.1Protrusion to hand and finger Minor injury (first aid treatment)326 All personnel to wear proper and suitable hand protection glove. Eliminate or to make safe any protruding hazard. First aid treatment.212Acceptable

L - LIKELIHOODS - SEVERITYR- RATINGRESULTS

CATEGORYDEFINITIONCATEGORYDEFINITIONH3696 9UNACCEPTABLE

LOW 1REMOTELOW 1No InjuryNo DamageNo PollutionM2463 4TOLERABLE

MEDIUM2POSSIBLEMEDIUM2First Aid InjuryMinor DamageMinor PollutionL1231 - 2ACCEPTABLE

HIGH3PROBABLEHIGH3Lost Time InjuryMajor DamageMajor PollutionLMH

IS THERE A SAFER WAY TO COMPLETE THE JOB ? ARE THERE ALTERNATIVES WITH LESS RISK ?L- LIKELIHOOD

JHA Number:TASK SAFETY MANAGEMENT OUTLINEDate This JHA Created: 5-1-2015

Date JHA Last Revised : 7-1-2015

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