9.

1 – PP/BIROPOB/W/001

Nama Proyek:Peningkatan Jaringan

Dok.No
Irigasi DI. Sempor Kab.
PP/I2/HSE/322001/01.07.22/003
Kebumen
Rev. No : 00
Nama Owner: Balai Besar Wilayah
Sungai Serayu Opak Hari/Tgl Jumat/1 July 2022
SNVT PJPA Serayu Date
Opak

Nama MK: PT. Indra Karya (Persero)

– PT. Hilmy Anugerah –
PT. Multimera Harapan

Kontraktor: PT. PP (Persero) Tbk

Contractor

Rencana Tanggap Darurat

Emergency Response Plan Proyek

Referensi
Nomor Dokumen Deskripsi
International standard – Occupational health and safety management
BS-OHSAS 18001:2007 Systems
International standard – Occupational health and safety management
OHSAS 18002
Systems – Guidelines for the implementation of OHSAS 18001
ISO 14001:2004 Environmental Management System – Requirements with Guidance for
use
Environmental Management System – General Guidelines on Principles,
ISO/FDIS 14004:2004
System and support Techniques
PP/I2/HSE/322001/01.07.22/001 SHE Plan Proyek Peningkatan Jaringan Irigasi D.I. Sempor Kab.
Kebumen

Revisi / Revision 000

Tanggal / Date Jumat / 1 July 2022

Rizky Ramadhan A SUHERLAN Nur Eko Afilani

SHE PO Proyek HSE Team Leader PM
Dibuat oleh Diperiksa oleh Disetujui oleh
Prepared by Checked by Approved by
Total Nomor Halaman / Total no of pages [inclAtt
©……..PT. PP (Persero) Tbk Page 1 of 10
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Emergency Response Plan

Daftar Isi / Table of Content

Daftar Isi / Table of Content............................................................................................................. 2

1 Pendahuluan & Tujuan / Introduction &Objectives............................................................3

1.1 Pendahuluan / Introduction............................................................................................3
1.2 Penerapan / Applications...............................................................................................3
1.3 Tujuan / Objectives........................................................................................................ 3

2 Identifikasi Potensi Keadaan Darurat / Potential Emergency Identification.....................3

3 Kesiapan Kondisi Darurat / Emergency Preparedness......................................................4

4 Tanggap Darurat / Emergency Response...........................................................................4

4.1 Tanggung jawab Kondisi Darurat / Emergency Responsibilities....................................4
4.1.1 Manajer Proyek / Project Manager........................................................................4
4.1.2 SOM..................................................................................................................... 5
4.1.3 SHE Manager.......................................................................................................5
4.1.4 SAM / Financial / Administration Manager............................................................5
4.1.5 GSP dan SP / General Superintendent and Superintendent.................................5
4.1.6 Petugas P3L / First Aider......................................................................................6
4.1.7 Personil / Personnel..............................................................................................6
4.2 Daftar Kontak Kondisi Darurat / Emergency Contacts....................................................6
4.3 Pemberitahuan dan Pelaporan / Notification and Reporting...........................................6
4.4 Evakuasi / Evacuation....................................................................................................7
4.5 Fasilitas yang tersedia / Availability of Facilities.............................................................7
4.6 Fasilitas P3K / First Aid Facilities...................................................................................7
4.7 Tanggap Tumpahan / Spillage Response......................................................................7
4.8 Pelatihan dan Simulasi / Training and Drills...................................................................8
Lampiran A – Denah Proyek (1 halaman)........................................................................................9
Appendix A – Site Layout (1 page)...................................................................................................9
Lampiran B – Daftar Nomor Telepon Darurat (1 halaman).............................................................10
Appendix B – Emergency Telephone Numbers (1 page)...............................................................10

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Emergency Response Plan

1 Pendahuluan & Tujuan / Introduction &Objectives

1.1 Pendahuluan / Introduction
Rencana Tanggap Darurat ini dibuat sebagai pedoman manajemen K3 untuk karyawan dan tamu
serta memberikan perlindungan lingkungan dan sekitar area proyek.
This emergency response plan is established as guidance of management of the safety and health to
employees and visitors as well as providing protection of the environment and the sites surroundings.

1.2 Penerapan / Applications

Rencana Tanggap Darurat dapat diterapkan di proyek Peningkatan Jaringan Irigasi D.I. Sempor
Kab. Kebumen,Indonesia.

1.3 Tujuan / Objectives

Bertujuan sebagai pedoman untuk menggambarkan, mengidentifikasi dan mengendalikan potensi
keadaan darurat, rencana kesiapsiagaan dan tanggap darurat untuk menghilangkan potensi
keadaan darurat.
Act as guideline to describe, identify and control potential emergencies, plan emergency preparedness and
response to eliminate potential emergency case.

2 Identifikasi Potensi Keadaan Darurat / Potential Emergency Identification

Dibawah ini adalah kondisi darurat yang diidentifikasi dengan potensi terjadinya tinggi dan langkah-
langkah yang harus diambil untuk meminimalkan kemungkinan terjadi:
Hereunder are the identified emergency situations with highest chance of occurring and the measures to be
taken to minimise the chance of occuring:

Kecelakaan kerja / Occupational injuries

 Menyediakan petugas P3K di proyek (rasio 1:100).
Provide first aider persons on site (ratio 1:100).
 Membentuk Tim Tanggap Darurat.
Establish emergency response.
 Menyediakan fasilitas P3K.
Provide site Fist Aid facilities.
 Perawatan lebih lanjut ke Rumah sakit Purbowangi , Muhammadiah Gombong , Palang Biru
Gombong , Muhammadiah Sruweng

Kebakaran / Fire
 Menyediakan alat pemadam kebakaran dimana cocok juga untuk kebakaran listrik.
Provide fire extinguishers that are also suitable for electric fires.
 Membuat hubungan kerjasama dengan dinas pemadam setempat.
Establish a cooperative relationship with local fire department.
 Menydiakan sistem alarm kebakaran dan membuat rencana evakuasi / penyelamatan.
Provide fire alarm system and establish evacuation / rescue plan.
 Menyediakan Titik Kumpul.
Provide assembly point(s).

Gangguan Umum / Public disturbances

 Membuat sistem pemberitahuan dan evakuasi.
Establish announcement and evacuation system.
 Menyediakan Titik Kumpul.
Provide assembly point(s).
 Koordinasi dengan kepolisian setempat.
Coordinate with local police station.

Tumpahan material berbahaya besar / Major hazardous material spill

 Membuat Tim Darurat Tumpahan / Establish Spilled Emergency team.

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 Menyediakan alat pembatas yang memadai ( bak kering, penahan cairan lantai ).
Provide sufficient containment material (drip tray, liquid tight flooring).
 Menyediakan perlengkapan alat tumpahan.
Provide sufficient spill kit material.

3 Kesiapan Kondisi Darurat / Emergency Preparedness

Program Tanggap Darurat adalah disusun dengan mempertimbangkan keadaan proyek, untuk
melindungi dan mengevakuasi personil dan lingkungan selama situasi darurat. Rencana tersebut
mengindikasikan:
The Emergency Response Program is prepared considering the circumstances of the project, to protect and
evacuate personnel and the environment during emergency situations. Plan indicates:

 Identifikasi potnsi darurat

Identified emergency potential(s)
 Tanggungjawab karyawan
Responsibility of employees
 Nomor Telepon dan Fax instansi setempat
Telephone and fax numbers of local authorities
 Tim Tanggap Darurat
Emergency teams
 Jalur Evakuasi
Emergency routes
 Titik Kumpul
Assembly point
 Ruang P3K
First Aid Station
 Denah jalur (dari proyek menuju rumah sakit)
Map of route (site to hospital)
 Lokasi alat pemadam kebakaran
Location of fire extinguishers
 Tanda Alarm
Alarm signals
 Ambulans
Ambulance
 Pelatihan dan Simulasi
Training and drills
 Alur evakuasi kecelakaan kerja tunggal
Flowchart of single accident cause injuryevacuation
 Alur evakuasi bencana alam, kebakaran, ledakan, huru hara.
Flowchart of natural disaster, fire, explosion, mass riot evacuation

4 Tanggap Darurat / Emergency Response

4.1 Tanggung jawab Kondisi Darurat / Emergency Responsibilities
4.1.1 Manajer Proyek / Project Manager
 Bertanggung jawab memastikan tanggap darurat telah direncanakan dan disusun bertujuan untuk
memastikan efektifitas koordinasi dan implementasi selama kondisi darurat berlangsung di
proyek.
Responsible for ensuring that an emergency response is planned and set up for the purpose of ensuring
effective coordination and implementation during an emergency situation at project site.
 Menetapkan personil unuk Tim Tanggap Darurat.
To assign competent personnel for Emergency Response Team.
 Memaintain daftar personil yang telah ditunjuk untuk bertindak sebagaia Tim Tanggap Darurat
termasuk nomor kontak mereka.

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To maintain a list of personnel who have been designated to act as Emergency Response Team including
their contact details.
 Manajer Proyek bertanggung jawab untuk menyediakan sumber daya, alat dan perlegkapan yang
memadai untuk kondisi darurat.
The Project Manager is responsible for providing adequate resources, tools and equipment for emergency
situations.
 Memastikan simulasi evakuasi dan kebakaran diadakan di proyek.
Ensuring evacuation and fire drills are conducted on the Project.

4.1.2 SOM
 Memastikan fasilitas tanggap darurat di proyek memadai dan terpelihara.
Ensuringadequacy and maintain emergency response facilities at site.
 Memastikan bahwa semua fasilitas tanggap darurat ditempatkan dengan benar
Ensuring that all emergency response facilities are properly placed.
 Kerjasama antara Tim SHE dan MK/owner untuk merencanakan dan melaksanakan simulasi
kebakaran dan evakuasi minimal per enam bulan sekali.
Cooperate with SHE Department and Client to plan and carry out fire drills and evacuation drills at least
once in six months.
 Berkoordinasi dengan mk/owner yang berkaitan dengan pencegahan dan penanggulangan
kondisi darurat.
Coordinate with the Client relating to the prevention and mitigation of emergency situation.

4.1.3 SHE Manager

 Memebuat rencana dan melaksanakan simulasi kebakaran dan evakuasi minimal enam bulan
sekali.
Make a plan and carry out of fire drills and evacuation drills at least once in six months.
 Memperbarui informasi tentang fasilitas darurat dan menyampaikannya ke semua orang melalui
induksi, tool box meeting dan papan pengumuman.
Updating information about emergency facilities and present it to all the people through induction, tool box
meetings and notice boards.
 Berkoordinasi dengan mk/owner yang berkaitan dengan pencegahan dan penanggulangan
kondisi darurat.
Coordinate with the client relating to the prevention and mitigation of emergency situation.

4.1.4 SAM / Financial / Administration Manager

 Membangun komunikasi yang dibutuhkan kepada setiap lini instansi yang berwenang
To establish any further required lines of communication to any authorities.
 Bertanggung jawab mengecek dan menghitung jumlah personil
Responsible checking and counting personnel.
 Memantau dan mengambil tindakan yang penting berkaitan dengan perawtan medis korban
Monitor and take necessary action related to victim's medical treatment.

4.1.5 GSP dan SP / General Superintendent and Superintendent

 Sebagai pemimpin di area kerja, bertanggung jawab untuk memastikan semua fasilitas kondisi
darurat tersedia dan dimaintain seperti Alat Pemadam Kebakaran, jalur evakuasi
As a leader in the workplace, is responsible for ensuring all emergency facilities, i.e Fire Extinguisher, clear
emergency access routes –atworkplace are provided properly and maintained.
 Jika akses yang ada diperkirakan akan diblokir oleh material atau untuk tempat bekerja, akses
yang benar harus disediakan sebelum pekerjaan dimulai
If the existing access is expected to be blocked by the material or for the workplace, proper new access
must be provided before the work starting.
 Memastikan bahwa anak buah mengerti apa yang harus dilakukan ketika kondisi darurat.
Ensuring that people in sub-ordinate understand what actions to take when an emergency.

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4.1.6 Petugas P3L / First Aider

 Petugas P3K bertanggung jawab untuk mengkoordinasikan upaya semua personil medis.
Termasuk pergerakan dari dan ke lokasi darurat, mengambil tindakan perawatan medis kepada
korban yang parah, pertolongan darurat di lokasi dan menentukan korban yang mana yang harus
dibawa ke rumah sakit atau yang dibawa ke runag P3K.
The First Aider is responsible for coordinating the efforts of all medical personnel. These includes
movements to and from the location of the emergency, take action to the victim according to severity of
injuries, emergency treatment in the field and determining which patients are to be transported to a hospital
or the First Aid room/station.
 Menemani korban sampai mendapatkan pertolongan dokter.
Accompany the victim/s until get doctor treatment.
 Jumlah petugas P3K harus sesuai rasio 1:100 jumlah staff dan pekerja. Petugas P3K harus
bersertifikat dan harus diperpanjang tiap tahun.
The number of First Aider personnel should be of ratio 1:100 Staff and Workers. The First Aider shall be
certified and the certification shall be renewed every year.

4.1.7 Personil / Personnel

Setiap karyawan harus bekerja sama dengan Tim SHE dalam memastikan semua akses tidak
terhalang untuk melakukan upaya evakuasi dan penanganan kondisi darurat.
Every employee shall cooperate with SHE team in ensuring all accesses are not obstructed for all efforts to
evacuation or emergencies handling.

4.2 Daftar Kontak Kondisi Darurat / Emergency Contacts.

Essential telephone contact list shall be posted and issued to all staff.

Nama / Name Jabatan / Position Nomor Telp / Mobile Telephone Number

Nur Eko Afilani PM / Project Manager 081215068226
Rahmat Kurniawan SOM / Site Operations 081275300088
Manager
Irwan Aziz GSP / General 08127231322
Superintendent
Rizky Ramadhan A HSE PO Proyek 082129024845
SUHERLAN HSE Team Leader 081901417222
RE AULIA Perwat Proyek

HT dibawa oleh masing – masing SOM, GSP, SHE M/O dan SP di area proyek.
Radios are to be carried by SOM,GSP,SHEM/O and Superintendent on site.

4.3 Pemberitahuan dan Pelaporan / Notification and Reporting

Pemberitahuan / laporan harus diisi, selama dan setelah setiap kejadian.
A notification /report shall be filled-in, during and after every occurrence.

 Jenis Alarm Proyek ditentukan sebelum Proyek dimulai dan disosialisasikan ke semua staff
dan pekerja melalui SHE Induction.
The Project Alarm type is defined before Project starts and socialized to all staff and workers through
the SHE Induction.
 Pada kondisi Darurat di tempat kerja, personil yang paling senior harus bertanggung jawab
untuk memberitahukan (atau mendelegasikan untuk memberitahu) dan menjelaskan
kondisi secara aktual kepada GSP.
In case of an emergency situation in the workplace, the most senior person on the scene should be
responsible to notify (or delegate to notify) and explain the actual situation to the GSP.
 GSP dan SP memastikan semua pekerja mengikuti prosedur darurat.

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General Superintendent and Superintendent have to ensure all their crews follow emergency
procedure.
 Personil tidak kembali ke area kerja mereka sampai SP memberitahukan mereka.
Personnel shall not return to their work area until their Superintendent has notified them.

4.4 Evakuasi / Evacuation

Rencana Evakuasi disusun berdasarkan kondisi proyek dan IBPR Proyek. Denah Evakuasi
menunjukan kepada semua karyawan mengenai jalur yang harus diikuti untuk meninggalkan lokasi
darurat.
Tanggung jawab personil dan tindakan yang harus dilakukan tertera pada grafik evakuasi
(penyebab bencana alam, kebakaran, ledakan, huru hara dan kecelakaan kerja tunggal).
Evacuation Plan is developed based on project situation and Project Risk Assessment.The evacuation maps
indicate to all employees which route(s) shall be followed to leave the emergency area.
Responsible person and action shall be taken is shown on evacuation chart (caused of natural disaster, fire,
explosion, mass riot andsingle accident cause injury).

4.5 Fasilitas yang tersedia / Availability of Facilities

 Kecelakaan Ringan : Pertolongan P3K di proyek
Non serious incident(s): First Aid treatment on site
 Kecelakaan memerlukan penanganan medis : Rumah sakit @@@@@@
Incident(s) medical attention needed:@@@@@@ Hospital
 Kecelakaan Berat ; Rumah sakit @@@@@@
Serious incident(s):@@@@@@@ Hospital
 Tumpahan BBM atau Oli : Tersedianya peralatan tumpahan yang memadai
(Oil) spill:spill kit is available sufficient
 Kebakaran : Tersedia alat pemadam kebakaran yang sesuai untuk semua jenis kebakaran.
Jika kebakaran tidak dapat ditanggulangi, Tim Tanggap Darurat menghubungi Dinas
Pemadam Keakaran.
Fire:Availability of sufficient extinguishers for all types of fire. If any fire could NOT be controlled, the
Emergency Team has to contact thefire department.

4.6 Fasilitas P3K / First Aid Facilities

Fasilitas P3K dan Alat P3K tersedia di proyek dengan jumlah yang sesuai untuk menangani
kecelakaan ringan dan sakit.
First aid facilities and first aid kits are present at site in adequate numbers to facilitate minor injuries and
illnesses.

 Ruang P3K / First Aid Station

Peralatan P3K yang harus disediakan di proyek dengan jumlah personil PP dan Subkon lebih
dari 25 personil dapat mengacu pada QSHE/TQM/AE/P012 Prosedur K3L di Proyek Konstruksi
– Lampiran Pendukung 2 : PERMENAKER P3K No. PER.15 MEN VIII 2008 & ISI OBAT P3K.
P3K equipment should be provided in the project with a number of personnel PP and subcon more than 25
personnel can refer to QSHE / TQM / AE / P012 Safety, Health and Envirnmental in Constructions Project
Procedure – Supporting Attachments 2 : PERMENAKER P3K No. PER.15 MEN VIII 2008 and First Aid Kit.

4.7 Tanggap Tumpahan / Spillage Response

Staf dan pekerja dilatih dan bertanggung jawab untuk mengambil tindakan secepatnya pada
kondisi lingkungan darurat.
Staff and Workers are trained and responsible to take action immediately on environment emergency
situation.

Alat Tumpahan tersedia di proyek untuk mencegah meluasnya tumpahan ke lingkungan sekitar.
Tumpahan bbm, oli, dll harus dibersihkan secepat mungkin dilakukan.
Spill kits are provided on site to prevent the release of spilled material to the environment. Spillages of oil,
grease, etc must be cleaned up as soon as is practicable.

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4.8 Pelatihan dan Simulasi / Training and Drills

Pelatihan dan simulasi akan diselenggarakan pada interval acak untuk menilai efektivitas dari:
Training and drills will be organised at random intervals to assess the effectiveness of:
 Penanganan Kebakaran / Fire fighting
 Evakuasi / Evacuation
 Tumpahan Besar / Big spills

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Lampiran A – Denah Proyek (1 halaman)

Appendix A – Site Layout (1 page)

Selalu mengacu pada denah proyek terbaru yang ditempel di papan pengumuman. Revisi
denah proyek tidak akan direvisi dalam dokumen ini.
Always refer to the latest site layout as posted on the notice boards. Revisions to the site layout will
not be revised in this document

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Lampiran B – Daftar Nomor Telepon Darurat (1 halaman)

Appendix B – Emergency Telephone Numbers (1 page)

Selalu mengacu pada Daftar nomor telpon darurat terbaru yang dipasang pada papan
pengumuman. Revisi Daftar nomor telpon darurat tidak akan di revisi di dokumen ini.
Always refer to the latest Emergency Telephone Numbers as posted on the notice boards.
Revisions to the Emergency Telephone Numbers will not be revised in this document

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