RISK ASSESMENT REPORT

ABK PROJECT
Job No./Name:
Doc. Ref.No:

Assessor (s):
Sunarto (Service Supv). 13 MAY 2003
Assessment purpose:
Supplementary to method statement

Activity: "MEMBUKA TUTUP RADIATOR PANAS".

Job / Task

Buka tutup Radiator

Prepared by:
Position
:

Likelihood
1.
Unlikely/improbable
2.
Remote
3.
Quite possible/occasional
4.
Likely/Probable
5.
Very/probable

People at risk
Pekerja

Cause to Adverse Effect

Uap Panas

Adverse
Effect

Likelihood

Severity

Luka
bakar

RFN
9

Existing Control
Follow Procedure

Residual Risk
LxS=
2x3=6

Assessment
JSA

Signature: ____________________

Approved by: ____________________________

Signature: ____________________

Date:

Position:

Date:

____________________

Severity
1.
Negligible
2.
Slight
3.
Moderate
4.
Critical/High
5.
Catastrophic/very high

Risk Factor Number (RFN)

1-2: Trivial/Acceptable
3-5: Tolerable
6-9: Moderate / Acceptable with review
10-15: Substantial
16-25: Intolerable/Unacceptable

____________________________

____________________

Prepare Job Safety Analysis when residual risk is equal to or greater than 6