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Job Safety Analysis Worksheet

JOB/TASK Torch Cutting structural steel DATE

Work Area Permits(s) Required and attached YES NO

Recognized/Unanticipated Tools Required to do the job

Major Steps of Task: Safe Plan:
Hazards: safely:
Preparation of area & materials for Combustibles (i.e. wood, paper, Burn permit must be secured prior to -Safety briefing prior to activities.
torch cutting. debris, flammable liquids, brush, torch cutting operations. Area must -Burn/Torch cutting permit in place
residual flammable liquids in pipes or be cleared of combustibles (i.e. -Fire Watch assigned
vessels, UST/AST verified gas free) brush, paper, wood, flammable -Crew briefed on hazards of lead
liquids, etc.). Fire extinguisher -Fire extinguisher
inspected for compliance and in -Fire Blanket
place for torch cutting operations.
Fire Blanket must be available for
combustibles that remain.
Cutting structural steel with -Burn hazard, hot, molten steel -Barricade work areas -Hard hat, safety glasses, fire proof
oxy/propane torches -Fumes from burning -Use buddy system coveralls, leather gloves minimum,
-Heavy steel beams capable of -Wash hands before eating or leather over-the-ankle boots.
pinching, crushing & falling smoking
-Heat stress -Review symptoms for heat stress
-Eye hazards -Inspect torch hose, tip, gauges,
-Muscle Strain tanks.
-Secure tanks
-Fire watch in place
-Fire extinguisher in place
-Area inspected for combustibles

Storage of Oxy/Propane tanks Broken valves, high pressure Secure all bottles from falling Rope or chain for securing bottles.
release, fire or explosion -Store Oxygen and propane upright Do not use wire. Wrenches for
a minimum distance of 20 feet from attaching or removing regulators.
each other
-Remove all regulators from bottles
and replace with storage caps when
bottles are not in use
-Label empty bottles.
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Adjacent Work/Processes and/or co-occupancy Yes No Other workers adjacent, above, below
Notified them of our presence Coordinated with adjacent work supervisor/customer operator Can work safely

TEAM MEMBERS SIGNATURES

The signature of the Supervisor certifies the completion of the Hazard Assessment and Safe Plan of Action by the crew.

Supervisor’s Signature: Date

Instructions: 1. Write the name of the job or task in the space provided. 2. Conduct a walk-through survey of work area. 3. Write the steps of the task in a safe sequence. 4. List all possible
hazards involved in each step as well as reaction to failure. 5. In the Safe Plan column, provide the corrective actions that will be taken to keep the hazard from becoming an accident or injury. 6.
In Tools column list tools needed to do the job, additional safety equipment, etc. 7. Have each team member that helped develop and will use this STA sign in the spaces provided at the bottom.
8. Review the STA at the end of the task for improvements. (NOTE: THE WORK SHALL STOP IF CONDITIONS CHANGE, JOB CHANGES, OR DEFICIENCY IN PLAN IS NOTED.)
Review checklist on page 3
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Safe Plan of Action Checklist (Check the items that apply)

Permits/Clearances
Utility Clearance Obtained Hazards Safe Plan
Confined Space Power de-energization required Insulation blankets required Wire watcher required
Overhead Utilities
Critical Lift Required clearance distance = 10 ft. Safe work zone marked
Hoisting & Rigging Safety Review Crane or other Signalman assigned Tag lines in use Area around crane barricaded
Boom Assembly and Breakdown Lifting Equipment Lifting equipment inspected Personnel protected from overhead load
Boom Proximity Reviewed as-builts Subsurface surveys Received dig permit
Underground Utilities
Concrete Structure Penetration Required clearance distance = ft. Safe work zone marked
Soil Excavation Lock Out/Tag Out/Try Out? Permit required Confirm that equipment is de-energized
Electrical
Pneumatic Test Reviewed electrical safety procedures Additional info below
Hot Work Permits Inspected prior to entering Proper sloping/shoring
Excavations
Scaffolding Erection Plan Barricades provided Access/egress provided Protection from accumulated water
Steel Erection/Decking/Flooring/ Grating Checklist Permit Fire Extinguishers Fire watch Adjacent area protected
Fire Hazard
Request for Shutdown Unnecessary flammable material removed Additional info below
Electrically Hazardous Work Vehicular Traffic or Traffic Barricades Cones Signs Flagmen Lane closure
Radiation Work Permit for Visitors Heavy Equipment Communication with equipment operator Additional information below
Required PPE Noise > 85 dB Hearing protection is required: Ear plugs Ear muffs Both Additional info below
Hard Hat Inspect general condition GFCI in use Identified PEP required for each tool
Hand & Power Tools:
Ear Plugs/Ear Muffs Reviewed safety requirements in operators manual(s) Guarding OK Additional info below
Eye Protection List sharp tools, material, equipment
Safety Glasses Hand Hazards
Face Shield PPE gloves, etc. Protected sharp edges as necessary Additional info below
Chemical Goggles Reviewed proper lifting tech. Identified material requiring lifting equipment
Manual Lifting
Welding Hood Hand protection required Back support belts Additional information below
Hand Protection Inspect general condition before use Ladder inspected within last quarter
Ladders
Cut Resistant Gloves Ladder tied off Proper angle and placement Reviewed ladder safety
Welders Gloves Inspect general condition before use Tags in place Properly secured
Scaffolds
Nitrile Gloves Toe boards used Footings adequate Materials properly stored on scaffold
Surgical Gloves Inspect for trip hazards Hazards marked Tools & material properly stored
Slips, Trips, Falls
Rubber Gloves Extension cords properly secured Work zone free of debris Additional information below
Electrical Insulated Gloves List potential pinch points:
Arm Sleeves Pinch Points Boomlifts/Scissorifts
Foot Protection Working near operating equipment Hand/Body positioning Additional information below
Safety Toe Boots The task creates potential for direct contact with hazardous chemicals.
Rubber Boots Working w/Chemicals Reviewed MSDS hazards and precautions Have proper containers and labels
Rubber Boot Covers Have identified proper PPE (respirators, clothing, gloves, etc.
Dielectric Footwear Heat stress monitoring (>85º F; 29.4º C) Liquids available Cool down periods
Heat Stress Potential
Respiratory Protection Sun Screen Reviewed Heat Stress symptoms Additional info below
Dust Mask (NIOSH) Proper clothing (i.e., gloves, coat, coveralls) Wind chill (<32º F; 0º C)
Cold Stress Potential
PAPR w/ Hepa Filter Reviewed Cold Stress symptoms Warm up periods Additional information below
Supplied Air Respirator Air emissions Water discharge Hazardous wastes Other wastes
Environmental
SCBA Pollution prevention Waste minimization
Emergency Escape Respirator Weather Terrain Adjacent operations or processes Biological hazards
Natural or Site Hazards
Special Clothing Animals/reptiles/insects hazards
Tyvek® See notation Non-Flammable Caution barricade tape required Danger barricade tape required
Overhead Work
Poly Coated Tyvek® Rigid railing required Covers over opening Warning signs required
NOMEX® Additional Information
Rain Suit
Fall Protection
-Fall protection required when working 6 feet above ground.
Harness -Fire Blankets required equipment
Double Lanyard Required -Fire Watch for 30 minutes after torch work stops
-Torch carts cannot be picked up by strap or chain unless cart is ANSI rated for picking and a picking eye is on
Anchorage Point Available cart.