PT.

REKAYASA INDUSTRI
REKAYASA

ENGINEERING & CONSTRUCTION

HSE

JOB SAFETY ANALYSIS AND RISK ASSESSMENT FORM

Doc. No. Date: 25/01/2013 HSE-FF-A.1 Rev. No. 02 Page 1 of 1 Prepared By ENG Petrus Review By Chief / MGR HSE Yogi Prasodjo
Approved By CM Clients Reps.

Company Project Person In Charge Name Position / Tittle of Job Job Activity Date

: : : : : :

PT Widia Sarana Sejahtera 2x35 MW Tonasa Coal Fired Power Plant Petrus Lanang Cathodic Protection Engineer Energizing Transformer Rectifier Onshore 25 January 2013

Name
SIGNATURE DATE

25 Jan 2013

25 Jan 2013
Risk Assessment PR SV RR Recommended Action
Tindakan Pengendalian

NO

Sequence of Basic Job Steps Tahapan Pekerjaan

Hazard
Bahaya

Risk
Risiko

Consequence
Akibat

Result of Risk PR SV RR

1.

Menghidupkan dan mengatur output TR

Pekerjaan dilakukan tanpa dilengkapi dengan permit, short circuit

Tersentuh dengan circuit

Kejut listrik

Shutdown TR

2.

Cek Potensial Pipa

Probability (PR) Frequent =5 Probable = 4 Occasional = 3 Unlikely = 2 Improbable = 1 Note : * : Tanpa control *) : Dengan control

Severity / consequence Keparahan Catastrophic = 5 Major = 4 Moderate / serious = 3 Minor = 2 Negligible = 1

Risk Rangking (RR) Tingkat Risiko Score Level 19-25 Extreme high 13-18 High 6-12 Medium 1-5 low

Recommendation Action Tindakan Pengendalian Tingkat pengendalian Hierarchy of Control E= 1+2+3+4+5 1= Eleminasi H= 3+4+5 2= Substitusi M= 4+5 3= REKIND technik L=5 4= Administrasi 5= APD

PT. REKAYASA INDUSTRI

REKAYASA

ENGINEERING & CONSTRUCTION

HSE

JOB SAFETY ANALYSIS AND RISK ASSESSMENT FORM

Doc. No. Date: 25/01/2013 HSE-FF-A.1 Rev. No. 02 Page 2 of 1 C

Probability (PR) Frequent =5 Probable = 4 Occasional = 3 Unlikely = 2 Improbable = 1 Note : * : Tanpa control *) : Dengan control

Severity / consequence Keparahan Catastrophic = 5 Major = 4 Moderate / serious = 3 Minor = 2 Negligible = 1

Risk Rangking (RR) Tingkat Risiko Score Level 19-25 Extreme high 13-18 High 6-12 Medium 1-5 low

Recommendation Action Tindakan Pengendalian Tingkat pengendalian Hierarchy of Control E= 1+2+3+4+5 1= Eleminasi H= 3+4+5 2= Substitusi M= 4+5 3= REKIND technik L=5 4= Administrasi 5= APD

PT. REKAYASA INDUSTRI

REKAYASA

ENGINEERING & CONSTRUCTION

HSE

JOB SAFETY ANALYSIS AND RISK ASSESSMENT FORM

Doc. No. Date: 25/01/2013 HSE-FF-A.1 Rev. No. 02 Page 3 of 1 C

Probability (PR) Frequent =5 Probable = 4 Occasional = 3 Unlikely = 2 Improbable = 1 Note : * : Tanpa control *) : Dengan control

Severity / consequence Keparahan Catastrophic = 5 Major = 4 Moderate / serious = 3 Minor = 2 Negligible = 1

Risk Rangking (RR) Tingkat Risiko Score Level 19-25 Extreme high 13-18 High 6-12 Medium 1-5 low

Recommendation Action Tindakan Pengendalian Tingkat pengendalian Hierarchy of Control E= 1+2+3+4+5 1= Eleminasi H= 3+4+5 2= Substitusi M= 4+5 3= REKIND technik L=5 4= Administrasi 5= APD

PT. REKAYASA INDUSTRI

REKAYASA

ENGINEERING & CONSTRUCTION

HSE

JOB SAFETY ANALYSIS AND RISK ASSESSMENT FORM

Doc. No. Date: 25/01/2013 HSE-FF-A.1 Rev. No. 02 Page 4 of 1 C

Emergency rescue Plan (Untuk pekerja yang terjatuh dari ketinggian dan tertimpa material dan lain-lain)

Tindakan Awal : Hentikan pekerjaan dan amankan lokasi kerja Hubungi Tim emergency Response Project (Yogi Prasodjo 0812-7117059 atau HT Channel 149.500) - Dengan menyebutkan nama - Lokasi kejadian - Jumlah korban dan kondisi korban - Jenis pertolongan yang dibutuhkan - Tindakan lebih lanjut. - Evakuasi oleh tim medis dibantu first aider untuk dibawa ke klinik Untuk kasus pekerja yg tertimpa material dan jatuh dari ketinggian ; 1. Lakukan evakuasi oleh paramedis / medis dibantu oleh first aider dan dibawa ke klinik / rumah sakit terdekat 1. 2.

Probability (PR) Frequent =5 Probable = 4 Occasional = 3 Unlikely = 2 Improbable = 1 Note : * : Tanpa control *) : Dengan control

Severity / consequence Keparahan Catastrophic = 5 Major = 4 Moderate / serious = 3 Minor = 2 Negligible = 1

Risk Rangking (RR) Tingkat Risiko Score Level 19-25 Extreme high 13-18 High 6-12 Medium 1-5 low

Recommendation Action Tindakan Pengendalian Tingkat pengendalian Hierarchy of Control E= 1+2+3+4+5 1= Eleminasi H= 3+4+5 2= Substitusi M= 4+5 3= REKIND technik L=5 4= Administrasi 5= APD