Job Safety Analysis (JSA) Process » Sample Worksheet


Job Safety Analysis Worksheet

Job To Be Performed: Tripping Pipe in Hole
Department       Task performed by: (names) Date
  Dave Driller        
JSA written by: Darrel Derrickman    
Dave the Driller Mike Motorman     Supervisor
Fred Floorman     Terry Toolpusher
Frank Floorman    
Personal Protective Equipment, Special Tools and Other Equipment Required: Supervisor Approval (Signature)
Hardhat, Safety toe Boots, Safety Glasses Terry Toolpusher
Step No. Sequence of Basic Job Steps Potential Hazards Recommended Safe Job Procedures
1 Traveling block moving up derrick Swinging blocks hitting sides of derrick. Tong counterweight line getting hooked on blocks or elevators Stabilize blocks and elevators. Do not put tongs on pipe too soon. Look up and live!
2 Put make-up tongs on and wrap spinning chain Pinch points when latching tongs to pipe. Keep hands and fingers on designated handles. Keep good tail on spinning chain. Keep control of chain.
3 Latching pipe into elevators Pinch points of elevators and pipe. Dropping stand across derrick. Swinging pipe. Derrickman should tail out pipe and stabilize stand after pickup. Floormen watch for snag or short stand.
4 Stabbing pipe Slipping while tailing pipe. Pinch points of pipe and tongs. Missing box. Get firm hold. Give driller clear view. Place hands and legs properly.
5 Throwing chain, torquing pipe, unlatching tongs Chain breaking, stuck by chain, pinch points - getting hand or fingers in chain. Tongs slipping. Make sure tongs are latched properly. Hold tongs out of way after unlatching. Stay clear of chain and out of swing of tongs
6 Pulling slips Strains Proper lifting techniques. Lift together. Use moving pipe as leverage.
7 Lowering pipe Hitting bridge, line parting brake, or hydromatic failure Lower pipe at controlled speed. Watch weight indicator.
8 Set slips and unlatch elevators Pinch points at slip handles, elevator links, and elevator latch Slow down pipe and set slips. All hands should work together. Proper lifting and hand placement.