RISK ASSESSMENT WORKSHEET

ACTION PLAN

Risk Compliance Residual

Section Activity Hazards Potential Incident L C Controls L C Actions By Who When
Ranking Checks Risk

Mining Land Clearing

1. Pembersihan dg Cabang pohon Tertimpa cabang B 5 Extrim Gunakan unit Excavator utk Periksa semua C 3 High Lengkapi Excavator dg Falling Abc 25 Des'04
alat berat lapuk pohon lapuk yg jatuh merobohkan Pohon yg kondisi excavator Object Protective Structure
lapuk sebelum digunakan (FOPS) serta bagian depan
untuk land clearing unit dilengkapi protector

Susun JSEA penumbangan Def 31 Des '04

Pohon dengan Excavator

2. Pembersihan dg
Chainsaw

ATTENDEES: Abc, Def, Ghi, Jkl, Mno, Pqr, Stu

PT. Thiess Contractors Indonesia Page 1 of 1 TCI-HSE-SF518/A0