ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ

JOB SAFETY AND ENVIRONMENT ANALYSIS

ວັນທີ່ເລີ່ມວຽກ: Start date: __13_/__02_/_2025_
ຊື່ໜ້າວຽກ: Task name: 2200KVA Transformer Maintenance and replace Oil

ເຄື່ອງມື ແລະ ອຸປະກອນ: Tool and Equipment: Transformation ratio tester ZW160, Winding tester UNI-T, Insulation tester and Hand tools

ອຸປະກອນປ້ອງກັນສວ່ນບຸກຄົນທີ່ຕ້ອງການ: General PPE requirements: Personal Uniform

ສະຖານທີ່: Location: Savanakhet ເຈົ້າຂອງພື້ນທີ: Plant Owner/s:

ໃບອະນຸຍາດທີ່ຕ້ອງການ (ຫົວໜ້າຄຸມງານເປັນຄົນເຮັດ): Permits required (to be completed by supervisor):

ໃບອະນຸຍາດທີ່ຕ້ອງການ ໃບອະນຸຍາດເລກທີ່: Permit number(s):
ສຳລັບໜ້າວຽກ
Required Permits
for work:

ຂ້າພະເຈົ້າໄດ້ມອບໜາຍໜ້າວຽກນີ້ ແລະ ໄດ້ອະນຸມັດຂັ້ນຕອນການເຮັດວຽກໃຫ້ປອດໄພ ພ້ອມລະບຸວິທີການຄວບຄຸມອັນຕະລາຍຕ່າງໆ:

I have assigned this task and approve the identified safe work method and hazard controls.
ຫົວໜ້າຄຸມ ຊື່: Name: ລາຍເຊັນ: Signature:
ງານ:Supervisor:

ຫົວໜ້າຂະແໜງ/ທີ່ປືກ ຊື່: Name: ລາຍເຊັນ: Signature:

ສາ ຫຼື ຜູ້ຈັດການ (ຖ້າ
ຈໍາເປັນ)
Superintendent/
Technical Advisor or
Next up Manager (If
required)

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 1 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS
ເອກະສານຕ່າງໆ / ໃບອະນຸຍາດທີ່ຕ້ອງການ (ໜາຍເອົາຖ້າຕ້ອງການ): Clearances/ Permits that may be required for the task (tick if required):
 ໃບອະນຸຍາດເຮັດວກປອດໄພ:  ໃບອະນຸຍາດກຳມະຕະພາບລັງສີ  ໃບອະນຸຍາດຕັດຕົ້ນໄມ້:  ໃບອະນຸຍາດຖາງປ່າ
Safe Work Permit Radiation Clearance Tree felling Vegetation Clearance Permit
ໃບອະນຸຍາດເຮັດວຽກທີ່ສູງ: ໃບອະນຸຍາດຂຸດເຈາະ / ໃບອະນຸຍາດແຊກຊືມ ໃບອະສນຸຍາດໃຊ້ກະຕ່າເຄຣນ ໃບອະນຸຍາດບຸກເບີກພື້ນທີ່ໃໜ່ (LADR)
 Working at Height Permit  ພື້ນ:  Man Cage Permit  LADR Clearance
Excavation/ Ground Penetration
Clearance

 ໃບອະນຸຍາດຕັດໄພ:  ໃບອະນຸຍາດເຮັດວຽກກ່ຽວກັບຄວາມຮ້ອນ:  ໃບອະນຸຍາດກະແສຟ້າຜ່າ  ໃບອະນຸຍາດເກັບກູ້ລະເບີດ

Isolation Permit Hot Work Permit Lighting Permit UXO Clearance
ໃບອະນູຍາດໄຟຟ້າແຮງສູງ/ໃບອະນຸຍາດຕັດໄຟໃກ້ຄຽງ
ໃບອະນຸຍາດເຮັດວຽກຢູ່ພື້ນທີ່ ໃບອະນຸຍາດຍ້າຍຕະໜ່າງເຫຼັກ ໃບອະນຸຍາດຈູດ/ເຜົາ High voltage/ vicinity clearance
 ຈຳກັດ:  Grid Mesh and Stairway Removal  Burn Off Permit 
Confined Space Entry Permit
Permit
ອັນຕະລາຍໜ້າວຽກທີ່ອາດເກິດຂື້ນໄດ້ (ອັນຕະລາຍຂ້າງລຸ່ມນີ້ເປັນພຽງບາງສ່ວນ, ບາງອັນຕະລາຍທີ່ກ່ຽວຂ້ອງກັບໜ້າວຽກອາດຈະບໍ່ໄດ້ລະລົງໃນນີ້):
Potential Task Hazards (for guidance only, this list may not identify all hazards associated with the task):

 ພະລັງານຫຼົງເຫຼືອ:  ຄວາມຮ້ອນ:  ອຸປະກອນເທິງຫົວ:  ລະເບີດບໍ່ທັນແຕກ:  ຄວາມອິດເມື່ອຍ:

Stored Energy Heat Suspended Load Uncleared UXO Fatigue
ທາດແຫຼວ/ແກ໊ສທີ່ມີແຮງດັນສູງ ຄວາມເຢັນ: ພື້ນບໍ່ຮາບພຽງ: ຈຸດແຫຼມຄົມ: ຂາດນ້ຳ:
    
High Pressure Liquid/ Gas Cold Uneven Ground Sharp Edge Dehydration
ອາຍນ້ຳ: ຝຸ່ນລະອອງ: ພື້ນມື່ນ: ການສັນຈອນ: ເຊື້ອລາ:
 Steam  Dust  Slippery Ground  Traffic  Biological –
bacteria

 ວັດຖຸໄວໄຟ:  ສຽງດັງ:  ຕົມ:  ປະທະສັດລ້ຽງ:  ລັງສີ

Flammable Materials Noise Boggy Ground Animal Interactions Radiation

 ສານເຄມີ:  ການເບີ່ງບໍ່ເຫັນແຈ້ງ:  ພື້ນບໍ່ແໜ້ນ:  ອຸປະກອນເຄື່ອນທີ່:  ຕົ້ນໄມ້ຫັກທັບ:

Hazardous Chemicals Poor Visibility Unstable Ground Moving equipment Tree fallen

 ອາຍຄັວນ:  ການຍົກວັດຖຸໜັກ:  ວຽກທີ່ສູງ:  ວຽກໃກ້ກັນ:  ການສັ່ນສະເທືອນ:

Hazardous Vapour Heavy Lifting Working at Height Nearby Work Groups Vibration

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 2 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS
ອາກາດເປັນພິດ: ໄຟຟ້າ: ວຽກເກົ່າຊ້ຳໆ:
 Hazardous Atmosphere  Electricity  Repetitive manual 
work
ອັນຕະລາຍໄດ້ຖືກ
ຄວບຄຸມ ຄວາມສ່ຽງຍັງ
ຈະເກີດຂື້ນບໍ່.
ຂັ້ນຕອນໜ້າວຽກ ອັນຕະລາຍຂອງໜ້າວຽກ ວິທີການຄວບຄຸມ ເກີດຂື້ນໄດ້ / ບໍ່ເກີດຊື້ນ
Task Steps Task Hazards Controls With the hazard
controls in place,
can harm still
occur? Y/N
Work safety policy
Submit a proposal for Safe work Submit a proposal for Safe work permit from Area Controller
0
permit from Area Controller

Isolate Power supply to each Electric shock Isolation must be done by Area operator, The Main Isolator
transformer has to lock
By padlock 0
Apply locks and tags on

Team member apply lock and Tags Break of Electrical safety policy Team leader has to check make sure all member apply their
on the lock box or Multi-lock personal tag and tag on lock box or Multi-lock
0

Break og Electrical safety policy Team leader has to check make sure all member sign on JSEA
Team member has to sign on this
JSEA bofore start work
0
Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 3 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS

Test for dead bofore work Break of Electrical safety policy Check and test make sure no power

Start work All Injury Check all tools condition and correctly. 0
Working by correct procedures
Working place is good and safe condition
All operation will be observation by team leader

Job completed Miscommunication Report to Area controler 0

Clean up work place area

Team member Remove all personal Break of electrical safety policy Make sure team remove tag, personal lock and sign off 0
tags and locks,
Area controler remove the master
lock
Team member sign off on This JSEA

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 4 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS
Re-energize power and hand back to
area controler

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 5 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS
ແຕ້ມແບບຜັງໜ້າວຽກ: Sketch of Task Step:

Specialist tools:

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 6 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS
ທີມງານ: ຂ້ອຍ/ພວກເຮົາໄດ້ລະບຸຂັ້ນຕອນການເຮັດວຽກໃຫ້ປອດໄພ ເພື່ອຈະເຮັດວຽກໂດຍປັດສະຈາກການບາດເຈັບ, ພວກເຮົາເຂົ້າໃຈ ແລະ ເຫັນດີທີ່ຈະປະຕິບັດຕາມຂັ້ນ
Work Team Members: ຕອນການຄວບຄຸມອັນຕະລາຍທຸກຢ່າງ:
I/we have identified the appropriate safe work method to complete the task without getting hurt, and understand and agree to apply the
hazard controls.
ຊື່: Name(s): ເລກບັດ#: ID #: ລາຍເຊັນ: ຊື່: Name(s): ເລກບັດ#: ID #: ລາຍເຊັນ: Signatures(s):
Signatures(s):

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 7 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.
ການວິເຄາະຄວາມປອດໄພ ແລະ ສະພາບແວດລ້ອມຂອງໜ້າວຽກ
JOB SAFETY AND ENVIRONMENT ANALYSIS

Form No: 2248131 Release 8 Release 05/02/2019 Form SSHE Manager Page 8 of 8
No: Date: Owner:
This form is a CONTROLLED DOCUMENT. Please check you are using the latest released document.