JSA-工作安全分析模板

1、工作区域：公司：日期：Work Locati on:Compa ny:Date:工作/任务：Job/Task to Be Completed:工作的主要步骤Sequenee ofBasic Steps1、工作计划和安全会议Job pla nning& Tool box meeti ng.造成风险的能量源Ide ntify En ergySource(s)潜在事故或风险Pote ntial Accide nts or Hazards运动Motion不清楚现场程序（如：JSA,方法说明）会导致团队处于危险状 态之中。Un aware of CDB site procedures JSA,） may

2、 put the group in dan ger.工作安全分析con ductivityJob Safety Analysis (JSA)工作安全分析填写人:JSA Completed By:工作安全分析审核人:JSA Reviewed By:消除/减小风险的方法Recomme ndati on to Elim in ate/Reduce Hazards1、CDB所有员工必须参加安全介绍，操作此项工作 的人员必须参加相应的培训；2、随时随地随身细带安全手册；3、对指定的工作进行具体详细的工作安全分析；4、开关前必须获得该项工作的工作许可；5、开始任何新工作前，讨论并填写工作安全分 析。6、开

3、工前对环境因素再次进行识别，并与团队进 行分享。-CDB safety in troducti on for all employees. Specific training must be atte nded by pers onnel who will perform the job.-Always bring training passport at all times or at work place.-Use the specific JSA for give n task.-Appropriate work permit must be obta ined prior to ope

4、rati on.-Discuss and write the JSA prior to operati on.-Before start worki ng aga in foren vir onmen tal factors, which can ide ntify and share with the team.工器具准备Prepare tools运动Motion滑倒、绊倒Slips/ Trips注意观察路面，相互提醒。Watch out the roads, and remind each other to be careful.潜在危险或者相关危险Potential or Associa

5、ted Hazards显滑的工作或走道表面Slippery Working or Walking Surfaces 因滑倒/绊倒/跌倒Slips/Trips/Falls没有覆盖的坑洞Open Hole人工搬运Manual Handling12 /手指受伤Hand/Finger injuries匚夹伤Pinch Points用动/手动工具Power/Hand Tools碎片/微粒Chips / Particles有害物质Hazardous Substances化学品接触Chemical Exposure硫化氢Hydrogen Sulfide (H2S) 砷Arsenic 口苯 Benzene水银

6、Mercury (Hg)有辐射性的工作Radiation Work环境影响Environmental Impact围堰损坏(溢漏/排放)Loss of Containment(spill/release)点火源Ignition Source火灾/爆炸Fire/Explosion电弧光/闪光Arc/Flash机械/转动物件 Machinery/Moving Objects高空危险Overhead Hazards起重方案Lifting Plan Required压力Pressure図旁通关键的保护Critical protection bypass図噪音区域Noisy Area挖掘Excavati

7、ons有害气体Hazardous Atmosphere受限空间Confined Space中暑Heat Stress热表面Hot Surfaces冷表面Cold Surfaces昆虫/动物攻击Insect / Animal Attack光线不足Inadequate Lighting交叉作业Simultaneous Operations (SIMOPS)高空作业Working at Height单独作业Working Alone恶劣天气Adverse Weather额外的工人Additional Workers临边作业Over-the-Side Work潜水作业Diving Operations

8、其它(特定)Others (specify)危险控制和应急方案Hazard Controls & Emergency Plans区工作许可Work Permit人工搬运评估Manual Handling Assessment却手架Scaffolding因个人保护设备PPEA障Physical Barriers凶化学安全数据表MSDS洗眼器Eyewash紧急喷淋Emergency Shower溢漏控制计划Spill Control Plan白通风Ventilation上锁/挂牌Lockout/Tagout火源控制Ignition Source Controls无火花工具Non Sparking

9、Tool索具审查Rigging Assessment口消防/应急小组待命Fire Fighting/ERT Standby 连续性气体测试Continuous Gas Testing紧急撤离计划Emergency Evacuation Plan 临时照明Temporary Lighting工作程序Work Procedure螺栓松开程序Hot Bolting Procedure因伙伴机制Buddy System其它（特定）Others其它（特定）Others所需安全设备PPE & Safety Equipment Required亦全帽因个人气体检测器防尘口罩口灭火器/消防软管上锁/挂牌装置H

10、ard HatsPersonal Gas MonitorDust MaskFire Extinguisher / FireLock Out / Tag Out Devices酚全鞋棉手套口呼吸器（过滤芯）Hose防漏盘Safety ShoesCotton GlovesRespirator (cartridge)消防毯/阻燃布Containment Pans呼全眼镜皮手套供给式呼吸器Fire Blankets / Retardant吸附垫Safety GlassesLeather GlovesAirline BATarpsAdsorbent Pads防护面罩橡胶/化学品手套自给式呼吸器全身式安全

11、带溢漏装置Face ShieldRubber/Chemical GlovesSCBAFull Body HarnessSpill Kit护目镜警示带化学围裙缓冲式双系索管塞GogglesCaution TapeChemical ApronDouble Lanyard with ShockPipe Plug即力保护安全路障聚乙烯外套Absorber个人浮动装置Hearing ProtectionSafety BarricadeTyvek Suit救生索PFDo适的工具因无线电通信化学防护服Life Line其它 otherProper ToolsRadio CommunicationChemic

12、al Suit安全电缆Safety Cable潜在溢漏来源PotentialSpill Sources消除排放的措施/后备防漏措施Recommendations to Prevent Discharge/Back-up Containment需检查的工具和设备Tools and Equipment to be Inspected零排放分析 Zero Discharge An alysis工具和设备 /Tool And Equipment评估小组成员(为实施这项工作，本人参与了工作安全分析，同意并确认对所开展工作采取的危险控制方案是足够的)Assessme nt Team Members(I participated in the JSA carried out for this work and agree/c onfirm the hazard con trols are sufficie nt for the proposed work)名字 / 职位 Name / Position签字 /Signature日期/Date1)2)