JHA No :

JOB HAZARD ANALYSIS (JHA) Risk Assessment Tier (RAT 1) PREPARED BY : ANDRY SASTRAWAN
PTW REFERENCE : DATE/TIME PREPARED :
UNIT/EQUIPMENT : Hammer Test, Rubbing Stone APPROVED BY : ANDRI SASTRAWAN
LOCATION : PLANT OFFSITE DATE/TIME APPROVED :-
WORK : Hammer Test For Concrete Slab And Barrier Pole Fire Hydrant Equipment PAGE 1 OF 2

Safety Representative Signature:

MACHINE/EQUIPMENT INITIAL RESIDUAL

NO JOB S TEP TOOL INVOLVED POTENTIAL HAZARD/LOSS RISK RISK CONTROL MEASURES RISK REMARKS
IN EACH STEP (H,M,L) (H,M,L)
1  Persiapan dokumen kerja, dan  Penanganan secara  Kesalahpahaman/ M  Semua dokumen pekerjaan telah disetujui (CMS, L
peralatan kerja/Preparation of work manual/Handling Misunderstanding Drawing & Plot, JHA, PTW ) dan harus berada di
documents and work equipment. manually  Dokumen kurang lengkap/ lokasi kerja / All work documents have been approved
Document incomplete (CMS, Drawing & Plot, JHA, PTW ) and must be on
the job site
 Semua pekerja harus mengikuti TBM / All workers
must attend Toolbox Meeting
 Laporkan dan deskripsikan pekerjaan yang akan
dilakukan / Report and describe the work to be done.
 Komunikasikan segala sesuatunya dengan pengawas
dan pihak-pihak terkait / Communicate everything with
supervisors and related parties
 Persiapkan dokumen pekerjaan dan safety sesuai
dengan aturan yang berlaku / Prepare work documents
and safety in accordance with applicable rules.
 Pelajari dan implementasikan semua aturan yang
berlaku / Learn and implement all applicable rules.
 Pastikan kondisi tubuh fit / Ensure the body condition
is fit.
 Cukup minum dan ketersediaan air minum / Sufficient
drinking and availability of drinking water
 Gunakan APD yang sesuai (Helm safety dengan tali
dagu, kacamata safety, sarung tangan dan sepatu
safety dan coverall) / Use the appropriate PPE (safety
helmet with chin strap, safety glasses, hand gloves
and safety shoes and coverall)
 Memperhatikan posisi tubuh yang baik saat bekerja /
Pay attention to good body position while working.

1
 MACHINE/EQUIPMENT INITIAL RESIDUAL
NO JOB S TEP TOOL INVOLVED POTENTIAL HAZARD/LOSS RISK RISK CONTROL MEASURES RISK REMARKS
IN EACH STEP (H,M,L) (H,M,L)
2 Tes Palu / Hammer Test :  Hammer Test, batu  Cidera tangan/ Hand injuries M  Pekerja yang terlibat dalam pekerjaan ini harus L
 Meratakan media (Permukaan beton) gosok, Kuas, dan Kain  Cidera belakang/ Back bone kompeten/W orkers involved in this work must be
dengan batu gosok/ Flatten the media Lap/Hammer Test, injuries competent
(concrete surface) with rubbing stone. Rubbing Stone, Paint  Cedera Kepala/Head Injury  Pekerja harus fokus dalam pekerjaan ini/W orkers
 Membersihkan media (Permukaan brush, and cloth must focus in this work.
Beton) yang akan di tes dengan kuas  Gunakan sarung tangan pada saat menggunakan batu
cat/kain /Clean the media (Concrete gosok dan hammer test/use hand glove when using
Surface) to be tested with a paint brush rubbing stone ang hammer test
/ cloth.
 Melakukan Tes Palu pada media yang  Waspada terhadap pipa Hidran saat bekerja dan berdiri/
sudah di tentukan / Conduct a hammer Be aware of Hydrant pipes when working and
test on the specified media standing.
 Mencatat hasil tes Palu/ Record  Gunakan APD yang sesuai (Helm safety dengan tali
hammer test results. dagu, kacamata safety, sarung tangan dan sepatu
safety, dan coverall) / Use the appropriate PPE
(safety helmet with chin strap, safety glasses, hand
gloves and safety shoes dan coverall)

6  Pembersihan lokasi Kerja /  Penanganan secara  Terpeleset dan tersandung/ M  Membersihkan dan merapikan peralatan kerja setelah L
Housekeeping manual/ Slipping and tripping aktivitas kerja/ Clean and tidy up work equipment
Manual handling after work activities

7  Keadaan darurat/ Emergency
 N/A  Cidera kepala dan belakang /
Head and back injuries
M  Tidak panik, lakukan pertolongan pertama sementara L Emergency contact number
secepatnya, ikuti rute darurat yang telah di (5555/0461 3120000)
setujui/Don't panic, do first aid as soon as possible, Muster Point 3
follow the emergency route that has been approved.
 Memberikan pertolongan pertama dan Evakuasi atau
Hubungi kontak emergency jika terjadi kecelakaan
kerja/Provide first aid and evacuation or contact
emergency contacts in the event of a work accident.

Note : As a guideline to JHA RAT1 Risk Levels the following definitions apply :
H = High Risk : the likely outcome is one or more Fatalities or Property Damage could exceed 5 to 20 MM USD
M = Medium Risk : the likely outcome is one or more Days Away From Work Cases or Property Damage could exceed 500k to 5 MM USD 2
L = Low Risk : the likely outcome is one or more First Aid Cases or Property Damage would not exceed 500k USD