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 Rigup

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

2 Abduallh Mohammed Operator GWDC 7

3 Hussain Hashim Operator GWDC 8

4 Hussain Jabbar Operator GWDC 9

5 Gazwan Faisal Operator GWDC

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

 Improper
communication  PCH PTW system is
 Collapse of the
Issuance of the PTW  Area authority not followed
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
commencement of the job
Faisal
operating for the job

 Improper  PCH PTW system is  Coordination with

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

 Approved layouts and

spotting of the equipment
in place
Rig Up surface  Proper tools with proper
 Broken Hammer  Impaled objects  Proper Manual handling
equipment and Use of connections and faces
heads result in bleeding techniques followed
Hand tools (Hammer, should be used. Shakeel /
 loose hammer (Before lift during lift and Not
3 Spanners) for connect
handles,
 Pinch Points
securing the object), Acceptable
 Buddy system in place Ghazwan Acceptable
and disconnect of  Crushing for heavy lifting, Faisal
 Metal piece drifted  Manual handling and
pipefittings and pipe
from the equipment
 Back Injury,
weight lifting trainings are
 Proper Supervision done
lengths. by Job supervisor
provided to the employees
 Proper PPE is available
with the employees

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

 Equipment failure,
 Line leakage,  Spillage resulting in  SOP in place for  Double check of
 Wrong position of environmental equipment setting up equipment placing and
Set up equipment data valves or direction of damage (Soil  Drips trays in place with planning.
header, choke manifold, line and circuits. Contamination,  Use of spill protective  Make sure choke Shakeel /
Not
4 air compressor, Improper Manual Ground water sheet beneath the
Acceptable
manifold bypass valve Ghazwan Acceptable
Separator, surge tank Handling, Improper pollution), equipments should be closed. Faisal
and transfer pump. tools,  Skin dermatitis,  Use of ear Muffs, ear
 Noise Hazard, temporary hearing defenders,  Separator inlet valve
Chemical hazard loss  Trained Operators closed, and bypass
exposure to diesel opened
 Eye Injury,
 Certified Equipment are in  Barricade the area
 finger and body
 High pressure leakage place  Proper Coupling should
injury
while disconnecting  Trained Engineers be done before function Shakeel /
 Ground Not
5 Rigup of ESD and SSV the hydraulic hoses
contamination
available for the job
Acceptable
test Ghazwan Acceptable
and crossover  Proper OP in place for the  Remove unauthorized Faisal
occurs if SSV fails to
job procedure from the location
operate

 Loss of well control

equipment can lead
 Failure to operate to major disaster  ESD/SSV are function
Function test of ESD, ESD, SSV, Flow head  Post maintenance of tested in pre job  No aspect of well control
Shakeel /
SSV, Flow head Actuator, Compressor, Transfer pump can preparation Not equipment operation
6 Actuator, Compressor, Transfer Pump during cause Spillage  Transfer pump is function Acceptable should be ignored
Ghazwan Acceptable
Faisal
Transfer Pump the job resulting in tested in pre job
environmental preparation
damage

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

 Double check the visual

condition of threads,
 Human Injury  Every thread is checked weco seals and gaskit
 Damage to before making up  Always use wire brush
 Damaged threads Shakeel /
Equipment  Weco seals & gaskit are Not for threads cleaning
7 Connections rigup  Damaged weco seals
 Spillage resulting in checked for its working Acceptable  If the wing requires more
Ghazwan Acceptable
 Use of damaged gaskit Faisal
environmental condition otherwise torque than usual to
damage replaced tighten, reopen it and
double-check the
connection.
 PCH and GWDC SOP is in
 Human Injury place to use explosion  Insert cables inside long
Electric cable protection
 Vehicles movement  Damage to proof electric equipment tubing pipes and put soil Shakeel /
and use of explosion Not
8 proof Electric
above the cables Equipment  Cables are protected in
Acceptable
on both sides to make Ghazwan Acceptable
 Non explosive panels  Fire vehicles movement area path way for vehicles Faisal
equipment
by using pipes or burying movement
underground
 Approved layouts and
spotting of the equipment
in place  Proper tools with proper
 Proper Manual handling connections and faces
 Broken Hammer techniques followed should be used.
heads and loose (Before lift during lift and  Follow proper lifting
 Impaled objects
hammer handles, securing the object) techniques
result in bleeding
Rig down, demobilize Flying object  Buddy system in place for  Buddy system should be Shakeel /
 Pinch Points Not
9 the equipment/  Improper Crane
 Crushing
heavy lifting,
Acceptable
used for the heavy lifting Ghazwan Acceptable
Connection Break Operation  Proper Supervision done  Proper signal man Faisal
 Back Injury,
 Driver for vehicle not by Job supervisor should be selected
 Equipment damage
competent  Manual handling and  Coordination with the
weight lifting trainings are crane operator and
provided to the employees driver should be carried
 Certified Crane and out
vehicles along with the
operators of the vehicle

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 4
 Potential consequences
on Health, Safety, Inherent risk Residual
Description of Environment and Asset level risk level
Step Hazards and threats / Hazard/risk controls already in Additional hazard / risk
job/task step (Acceptable / Action by (Acceptable
No. causes place controls recommended
(what and where) not / not
Acceptable) Acceptable)

Equipment & Flow lines  Residue of the well  Spillage resulting in  Can also use CT Shakeel /
 SOP of Flow back includes Not
9 Flushing with clean effluent remains in the environmental
flushing and followed Acceptable
pumping equipment if Ghazwan Acceptable
water pipes and equipment damage available on site Faisal

 Employees and job

 Use of Thrash bags for supervisor restore the
Make housekeeping keeping unwanted well pad and make sure
 Oil Leakages on the every waste remains
and make sure all the  Environment materials Shakeel /
ground
10 waste and oil spillage
 Waste materials
Pollution and oil spill  Use of Drip trays to Acceptable have been removed Ghazwan Acceptable
will be cleaned and  Soil contamination prevent oil leakages  Transport the collected Faisal
including oil rags waste to waste station
removed  PCH waste Disposal
procedures followed  Use forklift and level the
ground work area

 Pressure gauges,  Loss of equipment  Work area and equipment  Equipment opened form
Re-connect every Blind, Choke,  Human injury is checked by production X-tree is saved safely Shakeel /
Not
11 dismantled part of the sampling points,  Spillage team before taking hand
Acceptable
and team leader ensures Ghazwan Acceptable
X-tree back  Environmental over from contractor to be reconnected at the Faisal
 Cellar safety grill
pollution company end of job

 Failure of the  PCH PTW closure

 The employees after
Hand Over the Well equipment, procedure in place
 Improper handover finishing the job must Shakeel /
Pad to production uncontrolled activity  Trained Supervisors
12 department and close
 Improper
can lead to facility available with PCH PTW
Acceptable hand over and close the Ghazwan Acceptable
communication PTW from the respective Faisal
the PTW. and equipment Trainings and are
department
damage authorized

Review – Performing Agency

Approval – PetroChina Authorities

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 5
 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
√ 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: __________________

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 6
 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

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:

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 7
 Location / Agency / Discipline /Serial Number
(CPF1 / PCH / Mech / 20210127) All non-routine jobs / contractors – Valid for specific task
JHA No# (CPF1 / CPECC / Mech / 20210127) Validity of JHA All routine jobs – Maximum validity should be 1 year or review on any
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
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'.

HSE Document No. 3.8.5, Revision 2.0 (Trial Version) Form - 01 Page 8
 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 9