JSA-工作安全分析模板

1、conductivityw v *mbi.事 km jahltaldva liaa-rmm工作安全分析job safety analysis (jsa)c工作區(qū)域：公司：日期：work location:company:date:工作/任務：job/task to be completed:工作安全分析填寫人：jsa completed by:工作安全分析審核人：jsa reviewed by:工作的主要步驟sequence of basic steps造成風險的能量源identify energy source(s)潛在事故或風險potential accidents or hazards消

2、除/減小風險的方法recommendation to eliminate/reduce hazards1、工作計劃和安全會議job planning& tool box meeting.動motion不清楚現(xiàn)場程序(如： jsa,方 法說明)會導致團隊處于危險狀 態(tài)之中。unaware of cdb site procedures (i.e jsa,) may put the group in danger.1、cdb所有員工必須參加安全介紹，操作此項工 作的人員必須參加相應的培訓；2、隨時隨地隨身細帶安全手冊；3、對指定的工作進行具體詳細的工作安全分析；4、開關前必須獲得該項工作的工

3、作許可；5、開始任何新工作前，討論并填寫工作安全分 析。6、開工前對環(huán)境因素再次進行識別，并與團隊進 行分享。-cdb safety introduction for all employees. specific training must be attended by personnel who will perform the job.-always bring training passport at all times or at work place.-use the specific jsa for given task.-appropriate work permit must

4、 be obtained prior to operation.-discuss and write the jsa prior to operation.-before start working again for environmental factors, which can identify and share with the team.工器具準備prepare tools運動motion滑倒、絆倒slips/ trips注意觀察路面，相互提醒。watch out the roads, and remind each other to be careful.潛在危險或者相關危險po

5、tential or associated hazards口悝滑的工作或走道表面有害物質點火源挖掘交叉作業(yè)slippery working or walking surfaceshazardous substancesignition sourceexcavationssimultaneous operations (simops)因滑倒/絆倒/跌倒化學品接觸火災/爆炸有害氣體高空作業(yè)slips/trips/fallschemical exposurefire/explosionhazardous atmosphereworking at height口沒有覆蓋的坑洞口硫化氫口電弧光/閃光受限

6、空間口單獨作業(yè)open holehydrogen sulfide (h2s)arc/flashconfined spaceworking alone口人工搬運口碑機械糜動物件中暑惡劣天氣manual handlingarsenicmachinery/moving objectsheat stressadverse weather口手/手指受傷口苯口高空危險口熱表面額外的工人hand/finger injuriesbenzeneoverhead hazardshot surfacesadditional workers孚傷水銀起重方案冷表面臨邊作業(yè)pinch pointsmercury (hg)

7、lifting plan requiredcold surfacesover-the-side work電動/手動工具有輻射性的工作口壓力昆蟲/動物攻擊潛水作業(yè)power/hand toolsradiation workpressureinsect / animal attackdiving operationso片/微?？诃h(huán)境影響區(qū)唐通關鍵的保護光線不足其它（特定）chips / particlesenvironmental impact圍堰損壞(溢漏/排放)loss of containment (spill/release)critical protection bypass區(qū)噪音區(qū)域n

8、oisy areainadequate lightingothers (specify)危險控制和應急方案hazard controls & emergency plans區(qū)工作許可國化學安全數(shù)據(jù)表上鎖/掛牌消防/應急小組待命工作程序work permitmsdslockout/tagoutfire fighting/ert standbywork procedure人工搬運評估口洗眼器口火源控制口連續(xù)性氣體測試螺栓松開程序manual handling assessmenteyewashignition source controlscontinuous gas testinghot

9、 bolting procedure口和手架口緊急噴淋無火花工具緊急撤離計劃區(qū)1伙伴機制scaffoldingemergency showernon sparking toolemergency evacuation planbuddy system區(qū)個人保護設備溢漏控制計劃索具審查臨時照明其它（特定）ppeo障physical barriersspill control plan通風ventilationrigging assessmenttemporary lightingothers口其它（特定）others所需安全設備ppe & safety equipment require

10、d國安全帽hard hats區(qū)安全鞋safety shoes 弟全眼鏡safety glasses 口防護面罩face shieldo目鏡goggles 即力保護hearing protection 口合適的工具proper tools因個人氣體檢測器personal gas monitor口棉手套cotton gloves口皮手套leather gloves橡膠/化學品手套rubber/chemical gloves警示帶caution tape口安全路障safety barricade 囪無線電通信radio communication防塵口罩dust mask口呼吸器(過濾芯)respi

11、rator (cartridge)口供給式呼吸器airline ba自給式呼吸器scba匚|化學圍裙chemical apron聚乙烯外套tyvek suit化學防護服chemical suit滅火器/消防軟管fire extinguisher / fire hose消防毯/阻燃布fire blankets / retardanttarps口全身式安全帶full body harness口緩沖式雙系索double lanyard with shockabsorber口救生索life line口安全電纜safety cable口上鎖/掛牌裝置lock out / tag out devices口

12、防漏盤containment pans吸附墊adsorbent pads口溢漏裝置spill kit管塞pipe plug個人浮動裝置pfd其它other零排放分析 zero discharge analysis工具和設備 /tool and equipment潛在溢漏來源potential spill sources消除排放的措施/后備防漏措施recommendations to prevent discharge/ back-up containment需檢查的工具和設備tools and equipment to be inspected評估小組成員(為實施這項工作，本人參與了工作安全分析，同意并確認對所開展工作采取的危險控制方案是足夠的)assessment team members(i participated in the jsa carried out for this work and agree/confirm the hazard controls are sufficient for the proposed work)名字 /職位 name / position簽字 /signature日期/d