Information
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Department
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Vessel or Location information
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Customer if other than BBI/NRBL:
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Location
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Conducted on
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Evaluation Conducted By:
JSEA REVIEW
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Is the JSEA header filled out completely and reflect the correct date?
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ALL STOP. JSEA header must be completed before work can continue.
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Does the JSEA identify the person having UWA (Ultimate Work Authority)?
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ALL STOP. JSEA must display the name of the person identified as having UWA.
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Does the JSEA identify a PIC or PLW?
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ALL STOP. JSEA must contain the name of the PLW or PIC.
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Do the JSEA tasks identified match the work being performed?
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ALL STOP. JSEA must be updated to properly reflect the work being performed before work can commence.
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Have all hazards associated with each step been properly identified?
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Have corrective actions been identified for each step?
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ALL STOP. JSEA Must be updated to ensure that all hazards have been properly addressed.
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ALL STOP. JSEA must be updated to ensure that all hazards have been properly identified.
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Have all personnel assigned to the tasks signed the JSEA?
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Does each corrective action have an individual or group of individuals assigned to it?
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ALL STOP. JSEA Must be updated to ensure that all hazards have been assigned to at least one person.
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ALL STOP. JSEA must be updated to ensure that all corrective actions have been assigned to at least one person.
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Does the JSEA contain a SWA (Stop Work Authority) statement?
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ALL STOP. All JSEA's must contain a SWA statement clearly stating that each person has authority to use SWA.
CLOSING
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Was the JSEA deemed acceptable according to the information provided to the auditor along with observations conducted on the jobsite?
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ALL STOP until the JSEA is updated to properly reflect the work being performed. Instruction must be provided to the PLW/PIC and crew to ensure understanding of the JSEA process before work is allowed to commence.
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Final comments:
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Evaluator signature:
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PIC/PLW Signature:
