JSA – Job Safety Analysis
JOB SAFETY ANALYSIS JSA Number: Date:
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JSA DONE BY: PTW/LWC No sdgdf
Work Instruction#/ JOB PLAN # sdfg
JOB (Brief description)
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JOB LOCATION sdfrgdf DEPARTMENT drfgder
PERSON
JOB PLAN CONTROL RESIDUAL RISK RESPONSIBLE FOR
SL HAZARDS
STEPS MEASURES (High/Medium/Low) CONTROL
MEASURE
2
3
PPE Safety Eye/Face Hearing Respiratory Other Other
Helmet Gloves
REQUIRED Shoes Protection Protection Protection PPE PPE
(Yes/No)
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ADDITIONALPRECAUTIONS /
CONTROL MEASURES, IF ANY: erg
FURTHER PRECAUTIONS / CONTROL
MEASURES, IF ANY: sdfrg
TOOLBOX TALK / erg
TRAINING TO BE GIVEN BY: erg
This is to certify that all work under the scope of the above Job Plan shall be undertaken
By qualified competent persons with experience of the type of work described above, and in all cases in full accordance with NTPC
safety rules (E&M) and conditions of the safety document. What-If failure scenarios have been considered like failure of
tools, tackles, work equipment in this JSA.
Area Engineer Name erg HOS* Name erg
Signature erg Signature erg
*HOS = Head of Section