Appendix A: Format for JHA Worksheet

JHA No: GWDC-

JOB HAZARD ANALYSIS Date:
Next Review Date /
PetroChina (Halfaya) Non-Routine Job/Task √ Routine Job/Task
Valid till:
Location: Halfaya Oil Field Missan Province Reference:
Halfaya Performing Agency: GWDC
Iraq (WO /Project #)
Job/Task Description:

Flow back Equipment Mobilization

Section / Section /
No. Name Position Signature No Name Position Signature
Contractor Contractor
1 Wissam Jasim Team Leader GWDC 6 Salah mehdi Operator GWDC

2 Ali Jasim Operator GWDC 7 Hamid

3 Hussain Hashim Operator GWDC 8 Haithem

4 Amjad Ramdan Operator GWDC 9

5 Sohail sayed Operator GWDC

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 1
 Inherent risk Residual
Description of Potential consequences level risk level
Step Hazards and threats / Hazard/risk controls already in Additional hazard / risk
job/task step on Health, Safety, (Acceptable / Action by (Acceptable
No. causes place controls recommended
(what and where) Environment and Asset not / not
Acceptable) Acceptable)

 Improper
 PCH PTW system is
communication  Collapse of the
Issuance of the PTW followed
 Area authority not operation activity  Wellsite inspection before Shakeel /
1 from Production
informed for the job leading to human
 Proper Communication is Acceptable
equipment mobilization Ghazwan
Acceptable
department made before
 Other contractors injuries Faisal
commencement of the job
operating for the job

 PCH PTW system is  Coordination with

 Improper communication
followed rig/rigless supervisor
 Contract holder not  Collapse of the
Approval of the PTW  Proper Communication is before mobilizing the
informed about operation activity Shakeel /
2 from PCH contract
movement leading to human
made before Acceptable equipment
Ghazwan
Acceptable
holder department/PMC commencement of the job  Sending daily report
 Other contractors injuries Faisal
 Mobilization notice is portraying all daily
operating for the job
emailed activities done

 The crane checklist is

available for use which is
 Conduct meeting
checked by the job
with crane operator
supervisor for crane to be
 Leaks in the hydraulic  Collision with the for spotting of
OK for Job
system equipment equipment.
 SOP in place for Crane Shakeel /
Inspection of the crane  Crane not certified  Fall of the equipment, Not  Surface conditions
3 and slings  Damaged Slings  Human injury
Operation
Acceptable need to be checked
Ghazwan Acceptable
 Proper PPE is available。 Faisal
 Improper rating of  Damage to  Supervisor should
 Tag lines should be used for
crane equipment be available for the
guiding the load in lifted
job
conditions.
 Outriggers pad should be
made available

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 2
 Inherent risk Residual
Description of Potential consequences level risk level
Step Hazards and threats / Hazard/risk controls already in Additional hazard / risk
job/task step on Health, Safety, (Acceptable / Action by (Acceptable
No. causes place controls recommended
(what and where) Environment and Asset not / not
Acceptable) Acceptable)

 Coordinate with the driver

 Road traffic  GWDC and PCH Driving
 Driver of the vehicle is about the traffic rules and
Accident, Fatality policy in place and
not competent regulations Shakeel /
Mobilize equipment to  Equipment Damage followed Not
4  Secure the load properly Ghazwan Acceptable
working area  Driving speed limit not  Damage to vicinity  Certified HTV drivers are Acceptable
while mobilizing Faisal
followed or to location can utilized for the equipment
 Weather conditions to be
occur transportation
kept in mind
 Proper Manual handling
techniques followed
 Awkward body posture
 Back injuries, (Before lift during lift and
(twisting, bending,
 Muscle injuries, securing the object),
kneeling, while lifting
Manual Handling for tendon and  Buddy system in place for  Use manual handling aids
the tools and Not Shakeel /
5 unloading the ligaments injury, heavy lifting, such pallet truck, sack truck. Acceptable
equipment. Acceptable Ghazwan
equipment cuts, & abrasions  Proper Supervision done  Area clear from obstructions
 Fall of object, Faisal
 Crushing by Job supervisor
 Type of load (shape,
 Pinch Points  Manual handling and
size and grip points)
weight lifting trainings are
provided to the employees
 Over turning risk of
the crane
 GWDC and PCH policy in
 Swinging of the load
 Adverse weather place for stop working if  Use wind speed
Loading, offloading and  Reduced Visibility Shakeel /
conditions (Fog, Sand wind speed is more than Not monitoring device
6 spotting of the  Control difficulties Ghazwan Acceptable
Storm, High wind 35km/hr Acceptable  Ensure adequate
equipment for crane operator Faisal
speed)  Suspend operation in case visibility
 Collision with the
of poor visibility
other equipment

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 3
 Inherent risk Residual
Description of Potential consequences level risk level
Step Hazards and threats / Hazard/risk controls already in Additional hazard / risk
job/task step on Health, Safety, (Acceptable / Action by (Acceptable
No. causes place controls recommended
(what and where) Environment and Asset not / not
Acceptable) Acceptable)

 Movement under  Line of fire to be

 Human Injury  PCH Lifting and Hoisting
suspended loads observed
Loading and offloading  Damage to policy in place and Shakeel /
 Not using Tag line Not  Emphasising these
7 the equipment from
 Not using banksman
Equipment followed
Acceptable points in Pre job meeting
Ghazwan Acceptable
vehicles  Fall of the  Lifting points colour coded Faisal
 Not using proper lifting  Supervision is necessary
equipment
eye for the operation

Review – Performing Agency

Approval – PetroChina Authorities

Area Authority Section Head / Deputy Manager

Discipline Engineer Contract Focal Department / PMC (If any) ☐ Approved - all non-routine jobs/tasks ☐ Approved – all routine jobs/tasks
☐ Confirmed - all routine jobs / tasks
Name: Wang Junwei
Name: Shakeel Ahmad Name: Name:

Sign:
Sign: Sign: Sign:

Hazard Prompt – “Check  ”

Identify the job/task hazards and assess the risks of personnel may be exposed to before safeguards are implemented

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 4
√ Electrical ☐ Chemical √ Tools √ Gases
√ Vehicles √ Height ☐ Depth √ Weight
√ Pressure √ Access ☐ Vibration ☐ Noise
√ Weather /Working environment ☐ Bacteria √ Dust √ Slip / Trip
☐ Radiation ☐ Rotating Equipment √ Moving Equipment √ Lifting Equipment
√ Heat √ Dehydration/ Hot Work / Sun √ Hot / Cold Objects √ Overhead Hazards
☐ Biological ☐ Entrapment √ Lighting √ Manual Handling
☐ Conflicting Activities Others: _____________________
Personal Protective Equipment for Job/Task
Minimum PPE Requirements: 1)________________, 2________________, 3)_________________, 4)________________
√ Safety Harness ☐ Face Shield ☐ Airline ☐ Gloves – Hyflex (Nitrile)
√ Face Mask ☐ Sun Screen √ Dusk Mask ☐ Gloves – Leather Riggers
☐ Clear Safety Glasses ☐ Hearing Protection ☐ Confined Space Harness Others: H2S Detector
√ Monogoggles √ Breathing Apparatus √ Gloves - PVC
Plant, Equipment & Tools for Job/Task
√ Ladder ☐ Drill ☐ Excavator ☐ MEWP (Mobile Elevating Work Platform)
√ Hand Tools ☐ Grinder √ Winch ☐ Fans
☐ Shovel √ Scaffold ☐ Extension Leads ☐ Vacuum Cleaner
☐ Welding Machine √ Fire Extinguisher √ Power Source ☐ Spill kits / Housekeeping
☐ Compactor ☐ Fire Blanket √ Crane Others: __________________
Tagging & Signs
☐ Men Working Above ☐ Flagging ☐ Personal Danger Tags √ Information Tags
√ Barrier Mesh ☐ Personal Locks ☐ Out of Service Tags Others: __________________
Instructions, Permits, Certificates
☐ Method Statement ☐ P & IDs ☐ Cold Work Permit ☐ Isolation Certificate (Electrical) ☐ Radiography Certificate
√ Procedures ☐ MSDSs √ Hot Work Permit ☐ Confined Space Certificate ☐ Demolition of Security Defense
√ Work Instructions ☐ SIMOPS ☐ Gas test Certificate ☐ Road Closure Certificate
☐ Emergency procedure ☐ Toolbox talk ☐ Isolation Certificate (Physical) ☐ Excavation Certificate

Hierarchy of Controls / Additional Notes

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 5
 Hierarchy of Controls
Examples
Controls
Manual Handling Electrical
Elimination / Substitution of Hazard or hazardous Use of mechanical device instead of manual Use of other source of energy in place of electrical / use
process handling / Reduction in size or weight of the item of low voltage equipment
Reduce the distance & time of exposure to Use of specific rated enclosures, identify specific
Isolation / separation of hazards from receptors
manual handling location
Engineering controls / safeguards for prevention Work place design, guarding / securing, local
Use of correct fuses, grounding, proper spacing
and mitigation exhaust ventilation, lighting etc.,
Shift / rotation job, fitness, Method statement, Access control, Barriers, Signage, SOPs, Training,
Administrative & Procedural Controls
Training, Permit to Work Competency, Permit to Work
Personal Protective Equipment Helmet, Electrical Shoe, Face shield, Apron, electrical
Helmet, Shoes, goggles, protective clothing etc.,
gloves etc.,

Notes:

Location / Agency / Discipline /Serial Number All non-routine jobs / contractors – Valid for specific task
JHA No# (CPF1 / PCH / Mech / 20210127) Validity of JHA All routine jobs – Maximum validity should be 1 year or review on any
(CPF1 / CPECC / Mech / 20210127) near miss / Incident occurrence.
Jobs/tasks those were identified as repeated nature to execute in
Non-routine jobs/ Jobs that requires a work permit as defined in the
Routine jobs/tasks operational areas on specific equipment by specific discipline without
tasks Procedure on Permit to Work System
change in the nature of working environment.
WO – Work Order number
Reference:
Location Eg., CPF1, Export pump area PM – Preventive Maintenance number (from SAP)
(WO /Project #)
Project – Project ID number
Team Leader should provide the brief description of the job / task being
Details of performing agency
Performing Job/Task planned to carryout
Eg., PCH- Mechanical or CPECC-Mechanical
Agency Description: No different jobs / tasks should be clubbed even the execution team
might be same

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 6
 Team leader will select the team members based on disciplines involving
Job supervisor responsible for the defined job/task in the task execution, area concerned, competency, skills with the
Team Leader Team Members
execution consultation of Area Authority. Team should be limited to maximum of 6
members.
Job / task should be breakdown into basic steps based on
Description of Hazard and
task execution methodology & associated priorities & risks. Refer to Hazard prompt table (pg.3 of this JHA template)
job/task step Threat/Cause
(Maximum of 10 steps)
Potential Define the maximum potential loss /affect to the Health &
consequences on safety of the personnel involved, surroundings people, Hazard / risk
List out the existing controls that can limit the occurrence of loss /
Health, Safety, environmental emissions, damage to the assets etc., from controls already in
damage.
Environment and the identified hazard. It should consider no controls are in place
Asset place.
Acceptability of risk level will be subjected to the JHA team’
discretion based on the assessment of competency & skill
levels of the task execution personnel.
Inherent risk
JHA team may also consider the guidance from Risk Additional hazard / JHA team should identify the independent control measures as many as
levels
Assessment Matrix (consult with PCH HSE Manager) on risk controls possible even by incremental cost / investment for organizing necessary
(Acceptable / Not
identification of acceptable risk levels. recommended resources like people, equipment, time etc., to achieve the risk levels till
acceptable
For simplicity, all ‘Low’ category risks can be considered as acceptable levels.
'acceptable' and other categories can be considered as 'not
acceptable'.
Team should determine that all residual risk levels are in acceptable
Team should identify the responsible action party for Residual Risk levels when the identified controls were in place at the time of task
establishing the identified controls and ensure the level execution.
Action by
adequacy and efficiency of the functioning of controls on (Acceptable / Not However, Area Authority decision will be the final for confirming that the
right time. acceptable residual risk levels are acceptable and will ensure to perform the task
with all identified controls measures in place.
Upon completion of the JHA, concerned discipline engineer
should review and confirm that the identified controls Area Authority shall be responsible to approve all non-routine jobs /tasks
measures will be adequate for safe execution of the task. and contractors’ JHAs by confirming the adequacy of control measures.
Review Discipline engineer can also suggest additional controls if Approvals
(performing any required. (PetroChina Area Authority shall be responsible to verity & confirm the adequacy of
agency) PetroChina Contract Holder Department / PMC should be authority) control measures for all routine jobs / tasks, and Section Head / Deputy
responsible to review the contractors’ JHAs and confirm Manager in charge of that operational area shall be responsible to
that the identified controls will be adequate to perform the approve all the routine jobs/tasks.
task by contract workers in a safe manner.

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 7