JOB SAFETY ANALYSIS

Tangguh Expansion Project

WORK ACTIVITY (JOB) TITLE: Transport & Delivery / Installation of Anchor Bolt and DATE : 21-Mar-19
Template
LOCATION : JSA NO. : JS/MEI/017
WORK TEAM REVIEWED BY: JSA PREPARED BY:
1. Signature:_____________
1 7 CSTS Construction 2. Signature:_____________
2 8 Name :__________________ 3. Signature:_____________
3 9 Signature:__________________ 4. Signature:_____________
4 10 5. Signature:_____________
5 11 CSTS HSSE 6. Signature:_____________
6 12 Name :__________________ 7. Signature:_____________
Signature:__________________ 8. Signature:_____________
CRITICAL QUESTIONS: Everyone Ready/Capable To Work? Potential Spill/Gas Release Addressed? Worst Case Discussed?

REQUIRED SAFETY EQUIPMENT

Hard Hats Goggles Safety Harness Hearing Protection Barricades Other (List): __________________________________
Safety Shoes Face Shield Cotton Gloves Flame Resistant Clothing LEL Monitor Check Gloves Matrix, Dust mask (if
Safety Glasses Work Vests Leather Gloves Fire Extinguisher H2S Monitor applicable)_____________________________________

APPLICABLE SAFE WORK PRACTICES/SPECIAL PRECAUTIONS

Hot Work Permit Special Pre-Job Safety Discussions Confined Space Entry Permit Pollution Prevention Measures
Energy Isolation Review Emergency Action Plans Use of Specialized PPE Redundant Protection Measures
Written Procedure Site/Job Orientation Overhead/Underground Utility Lines Simultaneous Operations

POTENTIAL HAZARDS
Lifting Hazards Short Service Employees Elec. Shock/Flash (includes utility lines) Dropped/Falling Objects Low Lighting Ionizing Radiation
Fall Potential Water/Drowning Hazard Haz.Chemical Exposure (includes H2S) Tripping/Slipping Breathing Hazard Other:_________
Skin Irritants Mech. Equip. Hazards Sharp Edges or Hot/Cold surfaces Excavation Hazard Environmental Potential Hazard of
Confined Spaces Fire/Explosion Potential Pinch/Crush/Striking Hazards Confined spaces Extremes Restricted
Elev.Load/Work High Noise Levels Potential Release of Energy Elevated load or work Vehicle Operations Access____________
 BASIC JOB STEPS POTENTIAL INCIDENTS OR HAZARDS WAYS TO ELIMINATE OR CONTROL HAZARDS PIC

1. Delivery of Anchor Bolt 1.1. Lifting Operations- Dropped Object – 1.1.1. Lifting Plan to be in place and relevant approved, trained All Worker
and Template to site Anchor Bolt and Template other competent persons, lifting team, barriers to be in place. Supervisor and
(Unloading at site from material dropped from crane and Appropriate loading and lashing of all loads on delivery Permit Holder
flatbed to storage area) from back of flat bed- Crush injuries vehicles
Lifting plan berada ditempat dan telah disetujui, personil
telah di training, tim lifting dan dibarikade.Muatan dan
lashing yang sesuai dengan beban kendaraan.

1.2. Falling from Height - People (Back of 1.1.2. All workers to access flatbed via ladders. Edge of flatbed All Worker
flatbed) Fatality to be avoided. Do not work in wet conditions (Rain) Supervisor and
Pillar/Posts Hard Barrier to be fitted to sides of vehicles Permit Holder
where they are provided by subcontractor. Footwear to
be in good condition.
Pekerja yang akan akses ke flatbed
menggunakantangga. Tidak bekerja pada kondisi hujan.
Barrier dipasang pada bagian samping kendaraan.
Sepatu dalam kondisi yang baik.

1.3. Man machine interface (Delivery 1.1.3. Pedestrian walkways, signs and barriers, crossing points All Worker
vehicles, flatbeds, refueling vehicles in place. Flagmen for all vehicles. Respect 3m & 5 M Supervisor and
etc: crush Injuries rule. Be aware line of fire should something go wrong and Permit Holder
be able to escape as required.
Disediakan pedestrian dan jalan akses, rambu dan barier,
penyebrangan. Flagman pada masing-masing
kendaraan. Mengikuti ketentuan 3M & 5M. Menjauh pada
line of fire.

1.4. Inadequate Storage of Material 1.1.4. All stored materials shall be in a relatively flat accessible All Worker
Access to materialsOverstocking/ area, there shall be no climbing on materials to access Supervisor and
OvercrowdingCollapse of stacked them, all stacking should be done to prevent the risk of Permit Holder
materials collapse.
Semua material harus disimpan pada area yang datar
dan mudah diakses, tidak diperkenankan memanjat.
Semua material yang disimpan/disusun agar tidak roboh.
2. Handling, Installation 2.1 Falling from height – People on
and Removal ofAnchor Scaffold structure
Bolts and Templatesto
final location and fixing
(Including Survey
Team).
2.2 Delay in Access / providing treatment 2.2.1 Working at height rescue plan should be in place and All Worker
-Emergency Response for those
working at height. Conditions
complicated
2.3 Lifting Operations- Dropped Object – 2.3.1
Anchor Bolt and Template from
crane, tools and equipment. –
Property Damage
2.4 Dropped Object – Anchor Bolt and
Template collapse (Inadequately
secured – Temporary works
calculation design)Fatality
2.1.1 Scaffold to be built for access and certified, Harness shall All Worker
be worn by all persons accessing scaffold. Persons Supervisor and
should work within the confines of the certified Permit Holder
scaffolding. Working from Height Procedure to be
adhered to.
Scaffolding dibuatkan akses dan disertifikasi, body
harness harus dipakai pada saat mengakses scaffolding.
Personil scaffolding yang bekerja harus lulus sertifikasi
scaffolding.Wajib mengikuti prosedur bekerja
diketinggian.
regular drills should be scheduled. Adequate numbers of Supervisor and
first aiders should be on site Permit Holder
Menyediakan rencana darurat pada saat bekerja
diketinggian dan drill regular dilaksanakan secara
terjadwal. Jumlah first aider yang cukup dilapangan
Lifting Plan to be in place and relevant approved, trained All Worker
competent persons, lifting team, barriers and signage Supervisor and
erected. No persons to stand under suspended load. Permit Holder
Only authorized persons to be within barriers.
Lifting plan harus ada ditempat dan disetujui, kompeten
person telah detraining, lifting plan, barrier dan rambu.
Tak satupun orang berdiri diatas beban. Hanya orang
yang memiliki otorisasi yang diperkenankan.
2.4.1 Temporary works calculation shall be provided and CSTS
approved before construction begins to be confirmed by Engineer
CSTS Engineer. Verification of built Anchor Bolt and Supervisor
Template.
Perhitungan pekerjaan sementara disediakan dan
disetujui sebelum pekerjaan konstruksi dimulai. Dilakukan
verifikasi sebelum Anchor Bolt and Template dikerjakan.
2.5 Pinch points - During lifting and fitting
Anchor Bolt and Template-
Lacerations/Crush Injuries
2.6 Manual Handling of Anchor Bolt and
Template/hoses, fittings, scaffolding
(<25kgs) Sprain/Strain
2.7 Adverse Weather – High winds –
Lifting, Rain, Flooding of excavations
2.8 Sharp edges – Laceration from
Anchor Bolt and Template, rebar in
area, wire, protruding sharp hazards.
Impalement injuries
2.5.1 Identification of potential pinch points before activities Electrical
start. Ensure potential pinch points are regularly revisited Team
throughout movement of Anchor Bolt and Template.
Encourage Use of tag lines. PPE as identified -Gloves as
per approved CSTS Matrix
Mengidentifikasi potensial titik jepit sebelum bekerja.
Pastikan titik jepit potensial dicek sebelum memindahkan
Anchor Bolt and Template.
2.6.1 Mechanical lifting devices should be used wherever All Worker
practicable. Ensure all manual handling activities are Supervisor and
restricted to loads of <25kgs otherwise a detailed manual Permit Holder
handling assessment shall be produced. Ensure
approved manual handling techniques are observed
during lifting
Pengangkatan mekanik seharusnya secara praktis bias
dilakukan. Pastikan semua manual handling dengan
beban maksimal 25 kg. Diatas beban tersebut akan
dilakukan assesmen sesuai prosedur. Pastikan teknik
manual handling disetujui dan diobeservasi selama
pengangkatan.
2.7.1 Weather to be assessed on an individual basis for All Worker
parameters of crane and type of load (Please check Supervisor and
Method statement and Guidance with Lifting guys)Also Permit Holder
condition of excavation/Soil – Use Daily Excavation
checklist. Approved by Civil Engineer
Kondisi cuaca di nilai berdasarkan lokasi kerja masing-
masing untuk parameter crane dan tipe beban yang akan
diangkat. (Agar diperiksa sesuai dengan metode
pelaksanaan dan acuan lifting plan)
Kondisi galian dilakukan pemeriksanaan harian yang
disetujui oleh engineer sipil
2.8.1 Survey area for obvious areas that pose a threat, All Worker
cover/protect, wear suitable PPE. Supervisor and
Amati semua area untuk memastikan tertutup/terproteksi Permit Holder
dan memakai APD yang sesuai.
2.9 Working in Excavation – Drowning,
Collapse of excavation, confined
space entry
2.10 Use of Hand tools – Spanner,
Screwdriver, hammer, handsaw,
Cuts, sprains strains.
2.11 Use of electric tools- Drill, Grinder,
Welding Machine - Entanglement
Laceration, Foreign body in eye
2.12 Electrocution Use of electric Drill,
Grinder/ Use of generator- Fatality
2.9.1 Adhere to the procedure for excavations control ensuring All Worker
civil engineer checklist is completed.Adhere to excavation Supervisor and
procedure Permit Holder
Mengikuti dan melaksanakan prosedur untuk mengontrol
galian yang dipastikan oleh engineer sipil
2.10.1 Suitable tools to be used, inspected prior to use, in good All Worker
condition and used by competent persons.Appropriate Supervisor
PPE should be used.
Gunakan alat kerja yang sesuai, diinspeksi sebelum
dipakai dan kondisi bail serta digunakan oleh orang yang
berkompeten. Gunakan APD yang sesuai.
2.11.1 Electric Tools to be inspected before use, tagged and All Worker
used by competent persons. (Eye Safety training should Supervisor
be carried out) Appropriate PPE should be used. Fire
Extinguisher in place. Ensure eyewash station to be
identified.
Peralatan listrik telah diinspeksi sebelum dipakai,
ditagging dan dipakai oleh orang
yangberkompeten.(Pelatihan Eye Safety akan
dilaksanakan), gunakan APD yang sesuai. APAR
tersedia di tempat kerja. Pastikan posisi pencuci mata
diketahui.
2.12.1 Electrical RCD to be fitted to all tools double shroud All Worker
insulation type, in good condition, tagged, inspected prior Supervisor
to use. All cable extensions inspected and routed
correctly. Use correctly rated equipment/Tools.
RCD listrik harus sesuai dengan pada semua alat kerja
dengan jenis insulasi dan dalam kondisi baik, ditagging,
diinspeksi sebelum dipakai. Semua extension kabel
diinspeksi dan digulung dengan benar. Gunakan alat
yang benar.
2.13 Environmental Spills,
generator, Grease, Oil)
(Fuel for 2.13.1 Drip tray to be in place, daily check list for generator to be HSSE &
used. Spill kit, eye wash station and suitable storage. Construction
Drip tray berada ditempat, ceklis harian untuk generator Manager
yang akan digunakan. Spill kit, eye wash dan gudang
penyimpanan tersedia.

2.14 Ignition source, Fire
(Generator/Drill/Fuel- Burns)
Grinder, Welding Machine
2.14.1 Daily check list for generator to be used. Fuel to be All Worker
stored separately and away from generator. Refueling Supervisor and
activities should be undertaken with standby man in Permit Holder
attendance. Fire Extinguisher to be available at location.
Ceklis harian untuk generator yang akan dipakai. Bahan
bakar ditempatkan secara terpisah dan jauh dari
generator. Pengisian bahan bakar dikerjakan oleh orang
fuel. Fire extinguisher tersedia di tempat.

2.15 Chemicals (Diesel. Fuel for 2.15.1 MSDS /COSHH Assessment Supervisor and
generator, Grease, Oil,)Welding 2.15.2 PPE as appropriate HSSE
fume, Carcinogen, Skin Irritant. Tersedia MSDS /COSHH Assessment dan gunakan APD
yang sesuai

2.16 Noise (Use of Drill, Grinder) –Noise 2.16.1 Establish if Hearing protection is required. And provide All Worker
induced hearing loss protection and signage to warn person as required. Supervisor and
Jika proteksi pendengaran diperlukan, maka gunakan Permit Holder
pelindung dan rambu

2.17 HAV’s from Drill, Grinder – Vibration 2.17.1 Assessment should be made by CSTS industrial CSTS
White finger Hygienist and rotation of personnel as required. if Industrial
required, records kept. Hygienist
Penilaian dilakukan oleh HI CSTS dan dilakukan
pergantian pada personil jika dibutuhkan, dibuatkan
catatannya.
 2.18 Fatigue Heat Stress/WelfareHeat 2.18.1 All persons should declare any know health concerns All Worker
Syncope issues during the STARRT period to their supervisor, Supervisor and
regular breaks to be taken – Morning, lunch, afternoon. Permit Holder
Shade, rest area provided. Plentiful clean drinking water
should be available. Adhere to Heat stress Procedure.
Semua pekerja harus mendeklarasikan dalam kondisi
sehat selama STARRT CARD kepada supervisor,
istirahat rutin dilakukan, pada pagi, siang dan sore.
Tempat berteduh tersedia dilapangan. Air minum yang
cukup. Rasio jumlah toilet sesuai, bersih dan berfungsi,
fasilitas cuci tangan tersedia dilapangan.
2.18.2 Ratio of toilets to be adhered to, cleaned and functioning,
hand washing facilities to be available. CSTS
Rasio toilet harus sesuai, dibersihkan, dan berfungsi, fasilitas
cuci tangan harus tersedia.
2.19 SIMOP’s(Persons working below/ 2.19.1 Site SIMOP’s Matrix to be reviewed for all activities. As All Worker
alongside) Fracture well as local impact from individual work scopes. Supervisor and
SIMOP matriks lapangan dilakukan kajian untuk semua aktivitas Permit Holder
dilapangan. Pastikan masing-masing area ikut terlibat.
2.20 Slips and Trips (Whilst standing on 2.20.1 Walking and Working boards on rebar. Handrails around All Worker
or moving across rebar, scaffolding access points to prevent falls. Identification of approved Supervisor and
and formwork Uneven ground access and egress to the worksite. Use of staircase for Permit Holder
surfaces – Fracture access not ladders. High level of housekeeping.
Akses dan platform kerja diatas besi. Handrail dipasang pada
akses agar tidak terjatuh. Identifikasi akses yang telah
disetujui. Gunakan staircase bukan tangga. Kebersihan
yang baik.
2.21 Competencies - Persons Carrying 2.21.1 All relevant competencies for each task, trade should be All Worker
out tasks they are Not Competent met prior to work starting this includes GACP and internal Supervisor and
for (Injury – Business Loss) and external training as well as 3rd Party assessment Permit Holder
Semua kompetensi yang terkait dengan masing-masing
pekerjaan harus sesuai sebelum memulai pekerjaan
termasuk GACP dan pelatihan baik pelatihan yang
dilaksanakan oleh internal dan eksternal oleh pihak
ketiga
3. Make good/Site 4.1 Stored Material left on site 4.1.1 Ensure stored material equipment barriered and signed All Worker
Tidy/Housekeeping Pastikan material , perlatan ditempatkan dengan Supervisor and
dipasang barier dan rambu Permit Holder
4.2 Emergency Response and Welfare 4.2.1 Ensure minimum numbers of First Aiders and welfare All Worker
reduced facilities are maintained at all times right up the end of Supervisor and
works Permit Holder
Pastikan jumlah minimum first aider dan fasilitas
kesejahteraan pekerja dipeliharan.