Internal

APPENDIX ….. Doc. No.: ………

HSE REQUIREMENT

APPENDIX ……

HEALTH, SAFETY AND ENVIRONMENT (HSE) REQUIREMENT

Contract NO. : ………………………

Project : ………………………
Location : Pangkalan Kerinci, Kabupaten Pelalawan,
Provinsi Riau

0 dd/mm/yyyy Issued for Construction

Rev. No. Date Description Prepared by Reviewed by Approved by
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HSE REQUIREMENT
TABLE OF CONTENTS

SECTION 1 - HSSE REQUIREMENTS ................................................................................................................ 5

A. GENERAL……………………………………………………………………………………………………….. 5
A.1 Commitment, Policy and HSSE Management System……………………………………………………...5
A.2 HSSE Resources……………………………………………………………………………………………….5
A.2.1. Project HSE Coordinator…………………………………………………………………………5
A.2.2. Project HSE Officer……………………………………………………………………….............6
A.3 Legal Requirements and Regulations………………………………………………………………………...7
A.4 Termination and Suspension………………………………………………………………………………….7
B. HSSE PROGRAM………………………………………………………………………………………………..7
B.1 Responsibility for HSE…………………………………………………………………………………...….7
B.2 HSSE Communication and Meeting………………………………………………………………………...7
B.3 HSSE Awareness Campaign…………………………………………………………………………...……8
B.4 Accident/Incident Reporting……………………………………………………………………………...…8
B.5 HSSE Inspection and Audit by COMPANY……………………………………………………………..8
B.6 Reward and Punishment scheme………………………………………………………………………… 9
B.7 Control of Work ……………………………………………………………………………………………9
C. TRAINING & COMPETENCY………………………………………………………………………………..10
C.1 Basic Training………………………………………………………………………………………………10
D. SECURITY SYSTEM………………………………………………………………………………………...11
D.1 Security Requirement……………………………………………………………………………………...11
D.2 Security Plan………………………………………………………………………………………………..11
D.3 CONTRACTOR Security Operations…………………………………………………………………….12
D.4 Security Operation…………………………………………………………………………………………12
E. ENVIRONMENT……………………………………………………………………………………………… 12
E.1 General……………………………………………………………………………………………………...19
E.2 Housekeeping……………………………………………………………………………………………….12
E.3 Safe Handling of Hazardous Substances………………………………………………………………… 12
E.4 Waste Management Handling & Transportation………………………………………………………..13
SECTION 2 – SAFETY REQ. ON TOOLS & EQUIPMENT AND OPERATING STANDARDS…………..14
2.1 Tools & Equipment……………………………………………………………………………………………14
2.2 Abrasive Wheels (Including Portable Grinders…………………………………………………………….14
2.3 Compressor, welding St, Power Pack, Hydraulic Power Unit, Etc………………………………………..14
2.4 Electrically Powered Portable Tools and Equipment……………………………………………………....15
2.5 Hand Tools…………………………………………………………………………………………………….15
2.6 Cranes & Others Lifting Equipments……………………………………………………………………….15
2.7 Lifting Appliances and Loose Lifting Tackle……………………………………………………………….15
2.8 Scaffolding and Access……………………………………………………………………………………….16
2.9 Personal Protective Equipment (PPE)………………………………………………………………………16
2.10 Safety Equipment and Fire Protection……………………………………………………………...............17
2.11 Maintenance………………………………………………………………………………………………......17

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2.12 Site Facilities (Office, Workshop, Warehouse, Etc)………………………………………………………..17
2.13 Driving Safety…………………………………………………………………………………………….......17
2.14 Smoking Policy………………………………………………………………………………………………..18
2.15 COMPANY’s Standing Order……………………………………………………………………………….18
2.16 Portable Gas Detector & Personal Gas Detector……………………………………………………………18
SECTION 3 – MEDICAL REQUIREMENTS.. ............................................................................................. .…18
3.1 Drugs and Alcohol......................................................................................................................................... 18
3.2 Health and Fitness for Work ........................................................................................................................ 18
3.3 Environmental Health and other Communicable Diseases ....................................................................... 19
3.4 Occupational Health & Industrial Hygiene Program ................................................................................ 19
SECTION 4 – PROJECT HSSE PLAN REQUIREMENTS ............................................................................ 33
4.1 Project HSSE Plan ........................................................................................................................................ 33
4.2 Contractor Safety Management System ..................................................................................................... 34
4.2.1 Pre-Job Activity…………………………………………………………………………………... 34
4.2.2 Work In Progress…………………………………………………………………………………. 35
4.2.3 Final Evaluation………………………………………………………………………………….. 35
4.3 HSE Performance…………………………………………………………………………………………… 35
4.4 Emergency Preparedness .............................................................................................................................. 36
4.4.1 Emergency Response Plan…………………………………………………………………………. 36
4. 4.2 Emergency Rescue Team………………………………………………………………………… 36
5. ATTACHMENT………………………………………………………………………………………………..
5.1 Attachment 1 : Contractor Safety Management System (CSMS) Flow Chart…………………………..
5.2 Attachment 2 : Project HSEMS Manual & Procedures………………………………………………….
5.3 Attachment 3 : Project Commencement Flow Chart……………………………………………………

LIST OF TABLE

Table 1 Awards/Gift Category…………… ................................................................................................ ..9

Table 2 Punishment Category ..................................................................................................................... 13
Table 3 Competancy Training and Certification Minimum Requirement .................................................. 10
Table 4 Mandatory Training Assessment by Company ............................................................................. 11
Table 5 Applicable Standard for PPE ......................................................................................................... 17

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REVISION RECORD SHEET

REV. PAGE DESCRIPTION DATE

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HSE REQUIREMENT

SECTION 1 : HSE REQUIREMENTS

1.1 GENERAL

1.1.1 Commitment, Policy and HSE Management System

CONTRACTOR acknowledges COMPANY’s strong commitment to HSSE and affirms that it has a
written HSSE policy, which is actively supported and endorsed by CONTRACTOR’s management.
CONTRACTOR shall disseminate its HSE policy widely and will ensure that it is understood by and
complied with by all CONTRACTOR Personnel. This policy will be in English and Bahasa or dual
language are mandatory. In case of different interpretation between the texts, the Indonesian text shall
prevail.
CONTRACTOR’s HSE Management System (HSE MS) should be documented and include an outline of
CONTRACTOR’s HSE organisation, responsibilities for the HSE management process, procedures and
methods of communication to and from personnel.
CONTRACTOR’s HSE MS shall comply with COMPANY’s HSE Manual and procedures.
The CONTRACTOR is not allowed to work if violate COMPANY’s HSE Manual and procedures.
1.1.2 HSE Resources and Personnel Qualifications
CONTRACTOR shall supply, as necessary, the personnel to perform the work as described in Contract
Scope of Work (Contractor Personnel Qualification). These personnel shall meet or exceed the
Qualification as described by the following position:
1.1.3 Project HSE Coordinator
CONTRACTOR shall provide a Project HSE Coordinator for 3 HSE Officers. He / She shall be given
sufficient organizational freedom to ensure full HSE compliance is achieved throughout all stage of the
work at site. The Project HSE Coordinator is responsible for the day-to-day activities at site and manages
the records arising from STOP WORK AUTHORITY (SWA), site inspection program, incident
investigation, HSE training, SafePass Card, Emergency Drills, site HSE performance and implements all
HSE Program and/or requirements as described on agreed CONTRACTOR HSE deliverables, program
and performance plan.
If the CONTRACTOR does not provide a Project HSE Coordinator, then the CONTRACTOR will be
fined a penalty amount to Rp. 1,000,000 (one million rupiah) / day start from the date of the first day
CONTRACTOR start work based on contract.
Job descriptions for Project HSE Coordinator shall be approved by the CONTRACTOR’S Project HSE
Manager; the incumbent shall be subjected to COMPANY’s written approval prior his/her acceptance on
the project.
As a minimum, CONTRACTOR’s job description for Project HSE Coordinator shall provide detail of:
 Required education, qualifications, experience and othe training requirements,
 Roles and responsibilities,
 Reporting lines and communications.
Project HSE Coordinator allocated to the Project shall demonstrate (as minimum) the following levels of
qualifications and experience:
 Bachelor Degree in a technical subject or in engineering or construction management degree,
 Experience – minimum of five (5) years in onshore construction experience of which a minimum of
three (3) years will have been acting in the role of a Project HSE Coordinator,
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 Will demonstrate good communications and training skills.
 Have valid AK3 Umum Certificate is a Must
 Have grasp of the English language – spoken and written.
Project HSE Coordinator shall not shared responsibilities with other project. The Project HSE Coordinator
shall have overall responsibility for monitoring day-to-day activities are implemented and resource
throughout all phases of the work. Project HSE Coordinator shall provide active support to the engineering
team during fabrication works at the fabrication and during construction, installation dan commissioning
stage.
As a minimum this support shall include but not limited to:
 Implement of specific HSE Policies, Objectives, Targets, Deliverables, Program and Performance
Indicators embracing fabrication and construction works,
 Implement COMPANY’s five (5) Golden Rules are addresseed during construction and fabrication
works,
 Monitor day-to-day activities at site is comply with COMPANY’s Environmental Performance
Standards and government regulation.
 Day-to-day implementation of the HSE Program based on Contract,
 Conduct accident and incident investigations properly perform and ensuring timely feedback and/or
reporting at site,
 Coordinate and record daily/weekly/monthly HSE meeting between CONTRACTOR and COMPANY
at site,
 As a role model in HSE field leadership and behavioural safety in the project team. And maintain an
up to date knowledge of HSE matters and also acts as advisor to the field management.
1.1.4 Project HSE Officer
CONTRACTOR shall provide The Project HSE Officer onsite within ratio 1 : 50 (1 Project HSE Officer to
supervise maximum 50 project crews onsite), and they are dedicated for the (…..name of project) Project,
Project HSE Officer is responsible for the day-to-day activities at site such as the records arising from
STOP WORK AUTHORITY program, site inspection program, Incident investigation, lead Tool Box
Talk, Emergency Drills, site HSE Performance and Implements all HSE Program as described on agreed
CONTRACTOR HSE Plan.
If the CONTRACTOR does not provide the Project HSE Officer with a ratio of 1:50 above, then the
CONTRACTOR will be fined a penalty amount to Rp. 1,000,000 (one million rupiah) / day start from the
date of the first day CONTRACTOR start work based on contract.
Project HSE officer allocated to the Project shall demonstrate (as minimum) the following levels of
qualifications and experience:
 Diploma in a technical subject or in engineering or construction management degree,
 Have valid AK3 Umum Certificate is a Must
 Experience – Minimum of three (3) years in construction experience,
 Will demonstrate good communications and training skills,
The Project HSE Officer shall have overall responsibility for monitoring day-to-day activities are
implemented and resource throughout all phases of the work. HSE Officer shall provide active support to
the engineering team during fabrication works and during construction, installation, and commissioning
stage.
As a minimum this support shall include but not limited to:
 Assisting Project HSE Coordinator for implementation and compliance of Project criteria specified by
the Project and exceed all regulatory requirements,
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 Responsible to monitor day-today implementation of Project HSE Plan and strategy during execution
on site, and also project HSE activities in fabrication, mobilization, construction and installation as
well as commissioning and start up,
 Responsible for Project HSE Performance and Compliance control and monitors system and tools to
include but not limited to input/output HSE performance monitoring & reporting system (i.e: HSE
inspection, Safety Intervention, Safety Audit etc.),
 Becoming of the vocal point and advocate of COMPANY’s HSE standard performance and policy
expectations through elegant systematic implementation for all project personnel at site,
 Deliver Project HSE training, prepare course materials and ensure the training are conducted for
Project Team, field personnel and CONTRACTOR’s as per Training Plan,
 Participate and coordinate emergency response exercise for field emergency response team members,
project team and subcontractors and evaluate the effectiveness of the drills and provide support for
improvement.
1.1.5 Legal Requirements and Regulations
CONTRACTOR and Subcontractor shall comply with all applicable safety laws (whether international,
national, regional, or local), regulations, decrees (including permit to work systems) and other safe
operating standards.
CONTRACTOR’S shall take all necessary precautions related to or arising out of the performance of the
project activities in order to protect the work, all personnel, the environment and property of COMPANY,
CONTRACTOR and all third parties.
CONTRACTOR with high risk scope of work in accordance with Government Regulation No. 50/2012
must have SMK3 certificate approved by Indonesian Government
1.1.6 Termination and Suspension
Any infringements by CONTRACTOR identified by COMPANY of the above laws, regulations and safe
operating standards shall be discussed jointly by COMPANY and/or CONTRACTOR and remedial action
mutually agreed upon shall be implemented in a specified time. If remedial action is not implemented
within agreed terms, COMPANY may stop all or any part of the work activities forthwith and suspend
payments in accordance with Contract requirement.

1.2 HSE PROGRAM

1.2.1 Responsibility for HSE
COMPANY will require CONTRACTOR to affirm that all managers and line supervisors are responsible
for ensuring that the work activities are performed in accordance with all applicable safety rules,
regulations and good working practices with equal diligence being paid to fulfilment of the contractual
technical specifications.
1.2.2 HSE Communication and Meeting
CONTRACTOR shall demonstrate that its communication system to enables CONTRACTOR’s personnel
or all project personnel to have relevant information about the HSE risk and control measures at any time.
The Communication system where includes:
 Specific meeting required for the Project activities (i.e: kick off meeting, pre-job, regular safety &
security meeting, tool box talk etc.),
 Organizing any Periodically HSE meetings and reporting (i.e: monthly, weekly, daily etc.),
 Proposing improvements in HSE matters including sharing and lesson learned.
All level of personnel of CONTRACTOR shall be required to participate in the meeting above. The
structure of meeting should define and includes the meeting agenda and formats where the actions are
agreed also is it seen for monitoring the closed out action.
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CONTRACTORS are required to participate in the HSE planning meeting before the start of project work
activities, where the CONTRACTOR must prepare discussion papers for the meeting, with careful
(unlimited) attention to the following items:
a. Safety training program (before and during the term of the Contract) and other mandatory HSE
training including first aid, fire fighting, and emergency action,,
b. Protective clothing,
c. Contingency planning,
d. Transport safety,
e. Health, alcohol, drugs and narcotics,
f. Occupational health (respiratory, hearing conservation),
g. Reporting systems and frequency (accidents, incidents, unsafe acts),
h. Environmental issues.
Minutes of this meeting with action items and implementation dates shall be agreed and given to
COMPANY and CONTRACTOR .
1.2.3 HSE Awareness Campaign
COMPANY implement a comprehensive HSE awareness campaign. The HSE awareness campaign shall
be implemented within one month of effective date and shall run for the entire duration of the work.
CONTRACTOR shall include within the HSE awareness campaign provision for:
 Project safety induction,
 Tool Box Meeting, Safety critical work induction and briefing,
 Safety Meetings,
 Calendar promotion HSE awareness,
 Posters promoting HSE awareness,
 Promotional good and incentives,
 Safety flashes for incidents and the likes.
1.2.4 Accident/Incident Reporting
CONTRACTOR shall have an accident and incident reporting system which shall be compatible with
COMPANY’s Standards & Procedures. Any accident, incident or near miss involving COMPANY’s,
CONTRACTOR’s or any third party’s personnel, plant or equipment, shall immediately verbal report to
COMPANY within 2 hours, notifications shall be reported in written within 24 hours.
1.2.5 HSE Inspection and Audit by COMPANY
CONTRACTOR shall allow COMPANY and COMPANY’s representative at any time to the
CONTRACTOR’s administrative office, installations, equipment, personnel and records when
requested, to enable COMPANY to inspect or audit any aspect of CONTRACTOR’s operations relevant
to HSE, such as CSMS (Contractor Safety Management System) audit, PSR (Project Safety Review)
audit, CoW (Control of Work) audit, Occupational Hygiene Inspection/Audit, tool/equipment,
Environmental Inspection/Audit, etc.
CONTRACTOR has the right for an appointed official to be present during such inspection or audit.
Inspection or audit findings, where relevant, shall be discussed with CONTRACTOR prior to the
completion of a report. CONTRACTOR has the right to review and respond in writing to the final
inspection or audit report prepared by COMPANY. COMPANY will inform CONTRACTOR of any
planned HSE audit to be carried out by COMPANY and will allow CONTRACTOR representatives to
participate in such audits.
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1.2.6 Reward and Punishment scheme
COMPANY implement the Reward program and organize this function in a monthly basis and in
specific Milestone achievements. The reward or award including valuable gifts and appreciation
certificates for safety performance achievement for individual, workgroups and Sub-Contractor and the
program shall include the following but not limited to:
 Awareness campaign
 Award scheme
 Safety performance achievements safe man-hours targets without LTI
 Individual recognition based on HSE performance, personal improvements and HSE
suggestion/observation that raised by HSE meeting etc.
 Various hands out awards/gifts category as below table but not limited to:
Table 1 : Awards/Gift Category

Reward Category Frequency Person to be given Gift Category

Kategori Penghargaan Frekuensi Orang yang mendapatkan Kategori Hadiah
Award will be given to all workers who has
Best HSE Valuable gift
Monthly shown evidence of excellent HSE attitude and
Achievements & Certificate
implementation
Best Spot Award or Do Award will be given directly to the worker
the Right Thing or who found on the work places is doing good Valuable gift
Monthly
Improvement on HSE things or give the best input for improvement & certificate.
best practise related to HSE implementation
Milestone Award will be given to all level
Safety performance Valuable gift
(i.e: 1 million safe Project/Contract personnel involved in
achievement (Group) & Certificate
manhours NO LTI) achievement

COMPANY also implement a punishment for individual and group. Various hands out punishment
category as below table but not limited to:

Table 2 Punishment Category

Punishment type Violations Punishment Category
Jenis Hukuman Jenis Pelanggaran Kategori Hukuman
Given to someone who violates mandatory regulations, - Warning Letter
ie;
Individual - Suspended from
- Does not use safety body harness when working above
punishment height work within 6 days
- Use expired ID, etc. - Terminate
- Reprimand to
Neglecting of Responsibility based on contract., ie; Contractor Mgt.
Group punishment - Bad House keeping - Fine/Penalty according
- Damage / eliminate company goods / equipment to Contract
- Contract terminate

1.2.7 Control of Work

All work carried out shall be controlled by Control of Work system/permit to work system and in
accordance with statutory safety regulation. CONTRACTOR shall undertake such Job safety Analysis as
will ensure safe working. COMPANY will engage COMPANY Authorized HSE Persons/team who will
oversee the effective implementation of the CoW and safety systems.
 All Persons involved in the CoW process shall be appropriately trained and competent to carry out
their roles,
 Planning and scheduling of work shall identify individual tasks and their interaction,
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 Tasks shall not conducted without being risk assessed,
 Before conducting work that involves confined space entry, work on energy systems, ground
disturbance, hot work or other hazardous activities, a permit shall be obtained,
 The scope, hazards, controls and mitigations shall be communicated in writing and signed off by all
involved in the task,
 All ongoing work requiring a permit shall be regularly monitored and managed by a responsible
person,
 The work site shall be left in a safe condition on completion or interruption of the work,
 Internal and External lessons learned that impact the CoW process shall be captured, incorporated
and shared,
 The CoW Policy and associated procedures shall make it clear to everyone that they have the
obligation and authority to stop unsafe work.
1.3 TRAINING & COMPETENCY
CONTRACTOR shall supply, as necessary, the HSE personnel as described in paragraph 1.1.2 HSE
Resources and Personnel Qualifications. If there are CONTRACTOR’s HSE Personnel who do not take
part in the Training then the CONTRACTOR will be subject to a fine amount to Rp. 500.000/person
1.4 Basic Training
CONTRACTOR shall at its own expense ensure that all CONTRACTOR personnel have been given the
necessary safety and job related training prior to the start the works. This training shall include that
required by law, by COMPANY regulations, and by CONTRACTOR’s own HSE policy and HSE MS.
CONTRACTOR will provide original and copies of relevant certificates to COMPANY prior to
mobilization of personnel to project site. Details of required Training may be found in Table below.
 The content is similar to that required by COMPANY,
 The original certificate is available,
 It has been refreshed..
CONTRACTOR is responsible for highlighting the personnel who may require additional or
complementary training in technical or HSE areas before performing the works.
Table 3 Competancy Training and Certification Minimum Requirement
MIN. COURSE
COURSE TITLE ATTENDANCE VALIDITY
DURATION
All personnel who involved in
Scaffolder As required 2 years
scaffolding construction activity.
Personnel who assigned as Assessor for
Scaffolding Assessor any erection scaffolding activity As required 2 years

All personnel who involved in the

Rigger & Signalman As required 2 years
rigging and lifting activity
Who assigned to operate lifting crane
Crane operator As required 2 years
including overhead crane

Authorized Gas Tester All personnel who assigned as AGT As required 2 years
Note :
Specific training for all categorie shall be complied with Government Regulation and delivered by approved/
licensed Training Provider by Disnaker

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Table 4 Mandatory Training Recommended by COMPANY
MIN. COURSE
COURSE TITLE ATTENDANCE GROUP VALIDITY
DURATION
All personnel who involve and assigned to
Project HSE Induction 2 hours Per project
this project

All personnel who involve and assigned to

Lifting Assessment and
lifting activity (crane operator, signalman 4 hours Per project
Authorization
& rigger)
All personnel who involve and assigned to
Scaffolder Assessment and
scaffolding activity (scaffolder & 4 hours Per project
Authorization
scaffolding assessor)
All personnel who involve and assigned for
Working At Height (WAH) 4 hours Per project
working at height
All personnel who working and use power
Electrical Safety 4 hours Per project
electric

All personnel who involve and assigned for

Grinding Safety 4 hours Per project
Grinding
Note:
 COMPANY will provide training instructor and place
 If any registered personnel do not attend on this training, COMPANY has the right to charges a cancellation
fee Rp. 500,000/person

1.4 SECURITY SYSTEM

1.4.1 Security Requirement
In principal all security related issue during execution of the project will be consulted and made align
with COMPANY Security Policy. The Security Policy in the project will include:
 Security of people who will be working with project as COMPANY staff and/or CONTRACTOR
personnel either in COMPANY premises.
 Security systems of COMPANY’s asset and hired equipment.
1.4.2 Security Guard requirement
Project Security Guard allocated to the Project shall demonstrate (as minimum) the following levels of
qualifications and experience:
 High School – preferably ex army.
 Experience – Minimum of three (3) years in construction experience,
 Will demonstrate good communications and training skills,
 Hold Security Certificate from Police
 Preferably have martial arts abilities
1.4.3 Security Plan
A security plan including the security risk assessment, and procedure will be developed for the project
area once designated and a security risk matrix will be implemented. The security of all people working
on this project and the security of equipment and facilities will be an integral part of the HSE MS.
Each CONTRACTOR will submit a Security Plan to COMPANY. The aim of this plan is to describe
how project personnel and equipment will be made secure when on site. This plan will be reviewed by
the project and the COMPANY’s HSE Manager.

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Security Plan developed by CONTRACTOR shall comply with COMPANY’s Security Plan. Number of
security officer involved and the standard operation procedure of Security Officer also included.
CONTRACTOR shall provide their own Security Personnel/Security Guard (Penjaga Keamanan) who
are on duty in construction site to secure CONTRACTOR’s site office, laydown area, workshop,
equipment, including but not limited to facilities which has been located by COMPANY.
The number of Security Guard that must be fulfilled is at least 2 (two) persons for day and night
assignments in each location. CONTRACTOR’s Security must have a competency certificate.
CONTRACTOR must pay a fine of Rp. 1,000,000 (one million rupiah) / day to COMPANY if the
required Security Guard is not available from the date of the first day CONTRACTOR occupies the area
specified by the COMPANY.
In the event of loss or damage to COMPANY assets stored in CONTRACTOR territory and based on
the results of a joint investigation concluding loss or damage caused by CONTRACTOR's negligence,
CONTRACTOR shall replace the same material or replace the cost of material prices as mentioned in
Contract.
1.4.4 CONTRACTOR Security Operation and Command Center
The CONTRACTOR’s security team will coordinate with Mill Security Command Centre (UCCC) for
any activities entering the COMPANY’s premises and if required a kick-off meeting will be held prior
pre-job activities and work in progress. Security system during construction phase will follow
COMPANY Security Policy and system.
As part of COMPANY policy for people visiting construction site, a security clearance and check will be
regularly made at control point prior to enter. This security check is also conducted along with safety
induction for site visit.
1.4.5 CONTRACTOR’s Security Operation
This guidance is issued to ensure security guard operations are performed in a safe and proper manner.
The security guard operation is under direct control of the COMPANY’s HSE Manager.
Security personnel are to avoid confrontation and violence with unauthorized people in COMPANY.
Their personal guard equipment may only be used as a means of self-defence.
1.5 ENVIRONMENT
1.5.1 General
CONTRACTOR shall pay due regard to the environment by acting to preserve air, water, land, animal
and plant life from adverse effects of CONTRACTOR’s activities, and to minimize any nuisance which
may arise from such operations.
1.5.2 Housekeeping
CONTRACTOR will be responsible for maintaining good housekeeping continuously throughout the
duration of the project with due regard being paid to tidiness, ensuring that access ways and emergency
exits are kept clear at all times and without exception. All gaps such as that caused by the removal of
gratings must be securely fenced off and the grating stored so that it does not become an obstruction or
“trip hazard".
Every day, CONTRACTOR must clean up its work locations, do Housekeeping activities while work is
in progress and before daily work is completed. If the COMPANY with the right reasons with evidences,
found the CONTRACTOR in a related location does not carry out its responsibilities, COMPANY will
impose a fine of Rp. 1,000,000 (one million rupiah) per day for one intended location to the relevant
CONTRACTOR, until corrective action is taken and re-evaluated by the COMPANY.
1.5.3 Safe Handling of Hazardous Substances
CONTRACTOR shall be responsible for the control and safe handling of all substances potentially
hazardous to health, stored on its facilities. CONTRACTOR shall maintain an up to date file or database
of all such substances and their Material Safety Data Sheets (MSDS). CONTRACTOR shall also supply
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COMPANY with copies of these MSDS as soon as they are despatched to the Worksite. MSDS will
contain the following information as a minimum:
 Chemical identification and data,
 Fire and explosion (flash point temperature, flammable limit range, auto ignition temperature),
 Health aspects (nature of hazards TLV-STEL, TLV-TWA),
 Emergency procedures (Fire fighting, agent, spillage, personnel exposure, first-aid),
 Environmental (emissions to atmosphere, spillage, neutralizer procedure, waste disposal),
 Transportation procedure,
 Personnel protective equipment to be worn,
 Storage requirements.
CONTRACTOR shall have in place a suitable means of communicating the safety requirements for
handling all substances that have the potential to be a health hazard and will ensure that appropriate
handling equipment, and PPE, as advised by the MSDS, is available and used each time such substances
are handled.
CONTRACTOR shall ensure that all substances are stored in compliance with its MSDS.
1.5.4 Waste Management Handling & Transportation
CONTRACTOR should follow and implement a COMPANY’s waste management procedure., The
procedure shall include, as a minimum, the following:
 Waste management objectives,
 Identification of the type, nature (e.g. solid, liquid, gas) and anticipated quantity of waste that will be
generated. Human wastes such as toilet effluent should also be included,
 Proposed measures to substitute, reduce, reuse or recycle each waste type,
 Identification of the means used to collect, segregate, store and transport waste prior to disposal,
 Segregation of different types of waste (hazardous, non hazardous etc.),
 Provide proper temporary storage for waste,
 Frequency of collection and disposal of waste,
 Open dumping or open burning the waste is prohibited in construction site without permission from
COMPANY.
CONTRACTOR shall be responsible for monitoring any Subcontractors specializing in waste disposal.
Temporary storage of hazardous waste shall be in accordance with COMPANY’s procedures, for
transporting the waste especially hazardous waste out from construction site should have a permit from
COMPANY’s HSE Manager.

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SECTION 2 : SAFETY REQUIREMENT ON TOOLS & EQUIPMENT

AND OPERATING STANDARDS

For the following items, CONTRACTOR shall supply to COMPANY, CONTRACTOR’s approved
operational standards which shall be used during the performance in the projct site. The following
descriptions are intended as minimum guidelines to be used in assessing these standards. Upon
COMPANY’s agreement of the standards, they shall be included as Attachments to this Document and
CONTRACTOR shall apply such standards throughout the course of the project. Equipment proposed
for use in the project shall be subject to COMPANY’s pre-mobilization inspection and COMPANY
shall may reject and require the replacement of any equipment it deemed unfit, unsafe or inadequate for
the project.
2.1 Tools & Equipment
All CONTRACTOR's and COMPANY’s equipment and tools shall only be operated by competent
personnel.
CONTRACTOR shall ensure that all CONTRACTOR's machinery, equipment, facilities, and other
items associated with or utilized in the construction site are maintained in a safe, sound and proper
condition, and comply with laws and regulation such as: certified and calibrated and comply with
COMPANY's requirement.
CONTRACTOR shall ensure that all tools and equipment and temporary facilities and other items used
in the project, whether purchased, rented or otherwise provided by CONTRACTOR are in a safe, sound
and good condition and are capable of performing the function for which they are intended.
If any tool or item of equipment is in the judgment of COMPANY unsafe or incapable of performing
the work for which it is intended, CONTRACTOR shall repair and/or replace such defective tools and
equipment with CONTRACTOR's own expense.
CONTRACTOR shall ensure that all rotating or moving parts of all tools and equipment are adequately
guarded to prevent accidental contact by personnel. Every power-driven machine should be provided
with adequate means, immediately accessible and readily identifiable to the operator, of stopping it
quickly, and preventing it being started again.
2.2 Abrasive Wheels (Including Portable Grinders)
CONTRACTOR shall ensure that safety protection in the form of goggles and/or face shields are
provided and utilized by the personnel working with grinding machines and/or abrasive wheels.
CONTRACTOR shall ensure that only trained and competent personnel are permitted to carry out
grinding work and change out discs to portable grinders. When changing discs on a portable grinder, it
is imperative that a suitable replacement disc is fitted and in the correct manner. CONTRACTOR shall
maintain a complete and current list of such personnel. CONTRACTOR shall make the list available to
COMPANY when required.
Portable grinders that can be used by CONTRACTOR in all project locations must meet specifications
that are equipped with Dead Man Switch systems and disc safety covers.. Portable grinders do not meet
these requirements should not be used.
2.3 Compressors, Welding Set, Hydroulic Power Unit, Etc.
Compressors, welding sets, Hydraulic Power Unit (HPU) and any other diesel engine driven equipment
must be located in a safe area. Any such equipment must be well maintained and in good operational
order and prior to use may be inspected by COMPANY's Representative. All equipment above
subjected to 3rd party inspection as required by government regulations.

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2.4 Electrically Powered Portable Tools and Equipment
CONTRACTOR shall ensure only trained and competent personnel shall use portable electrically
powered tools and equipment. Electrically powered portable tools and equipment shall be 110 volts
center-tapped or 240 volt tools subject to the following conditions:
 They shall be double insulated, and
 The power source shall be equipped with an earth leakage circuit breaker/ ground fault
interrupter (ELCB/GFI) with a trip sensitivity not exceeding ten milli-amps (10mA).
All CONTRACTOR's temporary junction boxes and those used in construction areas must be checked
periodically by competent electricians to ensure the breaker works if there is a short circuit.
CONTRACTOR shall ensure that all portable equipment is disconnected from the power supply when
not in use. All flexible cables shall be in good and safe working condition. Taped joints in cables shall
not be permitted.
CONTRACTOR shall have a written procedure for checking and maintaining portable electrically
powered hand tools and equipment in workplace. Any defective electrical tool and shall be immediately
prohibited from further use until it has been satisfactorily repaired. Defective items which are no longer
serviceable shall be removed from storage and scrapped.
CONTRACTOR shall maintain accurate records regarding the maintenance and disposal of such
equipment. The CONTRACTOR shall appoint a person(s) to be responsible for such maintenance.
2.5 Hand Tools
CONTRACTOR shall ensure that all tools supplied are in good condition and fit for their intended use.
Damaged tools which are unfit for use must be removed from workplace immediately and if it cannot
be repaired, they must be scrapped.
2.6 Cranes & other Lifting Equipments
Only experienced, competent and certified personnel shall be assigned as crane operators to operate
cranes. All crane operators shall be subjected to yearly medical examination and records of the
examination shall be made available to COMPANY when requested.
All cranes and lifting equipment supplied by the CONTRACTOR must be inspected (including all
associated safety equipment such as load indicator, brakes, etc.) by COMPANY’s Inspector and have
DISNAKER certificate.
CONTRACTOR must provide COMPANY a copy of the certificate issued by DISNAKER, for any
crane supplied from other country which should be used in Indonesia is subject to be certified by
DEPNAKER/DISNAKER.
Inspection and load testing of the crane(s) are required:
 Prior to commencement of the use in the project, and
 After any significant modifications or repairs.
If the certifying agent or COMPANY considers it necessary to supplement the visual inspection by
methods of non-destructive testing and/or the manufacturer's inspection and certification,
CONTRACTOR shall accede to such request at CONTRACTOR's expense.
Lifting Gear such as shackle, hook, sling, pad eye, lifting lug must be inspected periodically every 4
months according to Color Code (Jan-Apr is Yellow; May-Aug is Green; Sep-Dec is Blue) that has been
specified in COMPANY procedure. This periodic inspection must be carried out by competent and
experienced people appointed by CONTRACTOR and approved by COMPANY.
2.7 Lifting Appliances and Loose Lifting Tackle
CONTRACTOR shall ensure that any lifting appliances supplied by CONTRACTOR shall be load
tested and inspected by Third Party that has a license. In addition to these items being inspection before

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use, they shall be subjected to a six (6) monthly inspection by a COMPANY approved certifying
agency or by a person trained and duly authorized in writing to be competent to inspect lifting
appliances. Safe Working Load (SWL) and radius charts shall be available for all lifting equipment and
shall be marked on the equipment.
CONTRACTOR shall note its responsibilities to ensure the safety of the lifting appliances for the
duration of this Contract. Color coding systems that comply with COMPANY regulation shall be used
to demonstrate that a pre-hire inspection has been carried out.
CONTRACTOR shall keep a register or database detailing each lifting appliance and piece of loose
lifting equipment detailing the following:
 Identifying number,
 Equipment description,
 Certificate number,
 Date of last test or inspection,
 Result of test or inspection,
 Remarks.
2.8 Scaffolding and Access
All work performed at a height of 1.8 M above ground/ floor shall be executed from suitable means of
access. This will require the use of ladders and/or scaffolding dependent on the nature of the Work.
Where scaffold materials are used they shall be clean and corrosion free and free of incipient faults.
Timber scaffold boards is not allowed to be used, must use metal plank complying with the
COMPANY scaffold procedure and requirements of BS and JIS. Scaffold must be erected by persons
who have received training in scaffolding and are deemed competent by COMPANY. All of scaffolding
shall be assess and inspected by certified scaffolding assessor. Specific Personal Protective Equipment
for erection of scaffolding such as Full body harness, heavy duty gloves etc. should be provided by
CONTRACTOR.
Note: Any alteration to the above scaffolding material requirements shall have HSE Manager
COMPANY review and approval.
2.9 Personal Protective Equipment (PPE)
CONTRACTOR shall, at its own expense, supply CONTRACTOR employees, where required in
connection with the safe performance of the project activities, with adequate personal protective
clothing and other protective equipment, refer to table 5 below, which shall be maintained in good
condition and replace it whenever necessary.
PPE shall be worn on all relevant occasions as indicated by work instructions and good practice.
CONTRACTOR shall ensure that all personnel shall set the example by wearing such equipment in the
appropriate circumstances, even if not actively engaged upon the work, as the example set by this is of
paramount importance.
Safety helmets, safety footwear, eye protection, hearing protection, uniform, gloves shall be required as
described in COMPANY’s Safety Procedures. CONTRACTOR will ensure that these are worn where
required and when at Work.
CONTRACTOR shall ensure the avalaibility stock for consumable PPE at least for covering 2 weeks
during execution.

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Table 5 : Applicable Standard for PPE
Type of PPE Standards/Guidelines
All Head Protection with chinstrap SHALL meet the requirements set
Head Protection out in ANSI Z89.I and SNI. Color Code will follow COMPANY
Procedure
All Eye and Face Protection SHALL meet the requirements set out in
Eye and Face Protection
ANSI Z87.1 –2003 and SNI
The selection of the respiratory protection involves indentification of
hazard and evaluation of hazard therefore minimum requirement for
Respiratory Protection
the respiratory protection shall comply with BS 4275, BS EN 139
1995, BS EN 173. 1993 and SNI
All Hearing Protection SHALL meet the requirements set out in
Hearing Protection
ANSI S3.19 or BS EN 352 and SNI
All Hand Protection SHALL meet the requirements set out in BS EN
Hand Protection
420:2003 or BS EN 388:2003, BS EN 374:2003 and SNI
All Foot Protection SHALL meet the requirements set out in ANSI
Foot Protection
Z41 –1999 and SNI
All Fall Protection SHALL meet the requirements set out in ANSI
Fall Protection
A10.14 and SNI

2.10 Safety Equipment and Fire Protection

CONTRACTOR shall at its own expense provide sufficient fire extinguishers, and other safety
equipment, approved to Government Regulations or equivalent standards, and shall maintain this
equipment in a professional manner as prescribed by legal and industry standards. In addition,
CONTRACTOR shall keep up-to-date records of all said equipment and its maintenance.
Locations of such equipment must be clearly marked in line with safety equipment plans. All persons
shall have the basic knowledge of how to operate the equipment, and the procedures to be followed in
the event of fire. CONTRACTOR shall provide adequate safe storage for flammable substances in safe
locations.
2.11 Maintenance
CONTRACTOR shall maintain all its equipment to the standard required by the manufacturer. Current
and up to date records of all planned and breakdown maintenance will be kept by CONTRACTOR
which may be inspected by COMPANY at any reasonable time.
All equipment and structures both fixed and temporary are to receive regular routine maintenance. This
shall ensure that the safety of personnel who are responsible for operating the equipment is not
jeopardised. Particular attention shall be paid to handrails, safety chains and bars, access ladders and
raised platforms.
2.12 Site Facilities (Office, Workshop, Warehouse, Etc)
CONTRACTOR shall maintain facilities such as offices, workshops, house warehouses, and the
fabrication area always in a clean, secure fund. At the location of the CONTRACTOR facility there
must be adequate and adequate toilets, places of worship, temporary landfills and resting places and
having adequate facilities.
In the location of the CONTRACTOR facility there is a First Aid Box and a portable fire extinguisher
for use in emergencies.
2.13 Driving Safety
The vehicles (all light vehicles, large good vehicles or passanger vehicle) shall be fit for purposed and
maintained in safe working order, the load and number of passanger (aligned with safety belt vehicle
provided) does not exceed manufacturer specification.

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Competent and certified drivers must be assessed by COMPANY to assure that they have functional
capacity to operate a vehicle safely and must be hold valid driving license
2.14 Smoking Policy
Smoking is not permitted in any COMPANY premises except for the “designated smoking area”.
CONTRACTOR shall provide the designated smoking area in CONTRACTOR premises. Smoking
area proposed by CONTRACTOR should be assessed and approved by COMPANY’s HSE Manager.
CONTRACTOR are responsible for the enforcement of this smoking policy, refusal to do so will
constitute a violation of the policy and may lead to disciplinary action under the COMPANY’s
disciplinary procedures.
2.15 COMPANY’s Standing Order
Considering to COMPANY’s continual improvement in HSE MS and incident or accident lesson
learned, COMPANY it may issue the HSE standing order to all level CONTRACTOR’s personnel to
give them the clear information and instruction that should be followed and implemented.
CONTRACTOR shall encourage and responsible to ensure their personnel at all level to comply with
the COMPANY’s HSE standing order including any changes that impacted into working process and
activities, procedures and others construction or installation activities in COMPANY’s premises.
2.16 Portable Gas Detector & Authorized Gas Tester
The usage of portable gas detector shall be in accordance with COMPANY’s spec, personnel use the
portable gas detector subject to get Authorised Gas Tester (AGT) Training and assessed by
COMPANY.

SECTION 3 : HEALTH REQUIREMENTS

.
3.1 Drugs and Alcohol
CONTRACTOR and COMPANY shall enforce a drug and alcohol policy that prohibits the
consumption of any alcoholic liquor, narcotic or other intoxicating substance, while on duty in project
site, and prohibits personnel from being under the influence of any of the above items while on duty
during the performance of the project.
CONTRACTOR shall conduct the medical test during pre-employment to identify their crew are free
from the consumption of any Drugs and Alcohol
It shall not be a violation of this section for a person to consume medically prescribed medication so
long as he has informed on site medical personnel and it has been approved as not likely to impair his
ability to safely perform his assigned tasks. CONTRACTOR acknowledges COMPANY’s strong
commitment to the control of alcohol and narcotics in COMPANY’s operations.
3.2 Health and Fitness for Work
CONTRACTOR shall define the requirements and include provision of medical requirements for pre-
employment and periodic medical examination for their personnel.
Medical examination shall require for all CONTRACTOR personnel performing work at the worksite
and shall conduct by COMPANY approved health institution.
The medical requirements, scope and the criteria of medical fitness shall in consultation with the
COMPANY’s Medical team.

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3.3 Environmental Health and other Communicable Diseases
CONTRACTOR shall ensure the control of environmental health risks associated with potable water
supplies, sanitation, food hygiene and resulting communicable diseases.
CONTRACTOR shall promote the health and well being of the workforce by implementing programs
including, but not limited to: hazards communcations, exercise, drug and alcohol abuse prevention,
stress management, smoking cessation, nutrition, HIV, Covid-19, sexually transmitted infection and
other communicable disease prevention.
3.4 Occupational Health & Industrial Hygiene Program
CONTRACTOR shall identify health hazards in the work place; conduct a health risk assessment and
implement control and monitoring programs.
Health Hazard assessment shall include: physical hazards (noise, radiation, vibration, manual handling,
illumination, and temperature extremes), chemical hazards of materials and processes, biological
hazards, capability hazards (including physical fitness, alcohol, and drugs), ergonomics, and
psychosocial hazards.
CONTRACTOR shall implement a risk-based health programs (mitigation plan) with regular
monitoring of the working environment and the workforce and conduct periodic program review. The
program shall include engineering, administrative and PPE control. The result of review and monitoring
programs shall be documented and any findings raised during the programs shall be followed up. The
health risks and the mitigation plan shall be reviewed should there any significant changes on the
project activities.
CONTRACTOR shall provide the free issue of any PPE necessary to ensure all tasks can be undertaken
in a safe manner and training in its maintenance, cleaning, storage and use.
CONTRACTOR shall train workers about all health risks and control measures to be taken and use the
site wide notice boards and toolbox talks to distribute information on health hazards.
CONTRACTOR shall provide early detection, prompt treatment/response and notification to
COMPANY of occupational diseases and other illnesses. All occupational disease shall be recorded,
and shall be made available to the COMPANY on reasonable request.
CONTRACTOR shall establish a worker’s compensation and disability management program to meet
government legislation and COMPANY requirements.

SECTION 4 : PROJECT HSE PLAN REQUIREMENTS

4.1 Project HSE Plan
CONTRACTOR shall develop the Project HSE Plan to ensure that Project complies and strong
commitment to HSE COMPANY’s requirements.
The following items are HSE Criteria required that shall be considered and implemented within Project
HSE Plan:
 Leadership Commitment
These describe a commitment to HSE issues through COMPANY Project or CONTRACTOR
Senior Management personal style of leadership and employees at all level in organization.
 Policy Strategic & Objectives
This describes a confirmation of the existence of a formalized policy that has reference to
importance of HSE.
 Organization, Responsibilities, Resources, Standard & Documentation
This describes an organizational system explaining the set of practices in addressing HSSE issues.

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 Hazards and Effect Management
This describes an established scheme to clearly address hazard and effect management.
 Planning and Procedures
This describes an existence of, documented, review and updated plan and procedures that covers
HSE issues within the Project activities
 Implementation and Performance Monitoring
This describes a procedure established for HSE system implementation and performance measure
 Inspection & Audit and Review
This describes an existence of methodology for HSE inspection and audit of HSE Project
operations
 Emergency Response Plan
This describes a procedure, response team and how to managing the evacuation during
emergencies.
CONTRACTOR shall be responsible for ensuring that all Subcontractor work strictly in accordance
with a “Contractor’s approved” Project HSE Plan and HSE procedures.
CONTRACTOR shall review, inspect and audit all Subcontractors’ Project HSE Plan and close out all
non-conformances prior to permitting the work to start.
CONTRACTOR shall, within 14 days after Contract’s Effective Date, submit a typewritten Indonesian
language or English language copy of CONTRACTOR’s Project HSE Plan to COMPANY for its
review and approval.
4.2 Contractor Safety Management System
In line with the Contractor Safety Management System (CSMS) Guidelines, CONTRACTOR shall
understand, comply with and implement all procedures during period of the Contract. CONTRACTOR
must complete CSMS process with the relevant stages in the Project activities. As of effective date of
this Contract and during the Contract Implementation in the field, CONTRACTOR shall constitute the
following steps:
4.3 Pre-Job Activity
Prior to mobilization personnel and/or equipment, CONTRACTOR‟s and COMPANY‟s
Representatives and other related parties shall conduct a meeting to communicate work implementation
including but not limited to review the COMPANY‟s and Contractor:
 Project HSSE Plan,
 Control of Work,
 Risk Assessment,
 Project HSE KPI’s,
 Emergency Response,
 Accident & Incident reporting,
 People’s competencies,
 Readiness of equipment and tools,
 Waste management plan,

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4.4 Work In Progress
CONTRACTOR’s and COMPANY’s Representative shall conduct Interim Evaluation on a regular
basis to closely monitor and evaluate the Work In Progress (WIP). The schedule of this interim
evaluation shall be determined and agreed upon by CONTRACTOR’s and COMPANY’s
Representatives considering the work time period and the risks associated with the work. Company has
the right to inspect and review progress of the work at any time.
4.5 Final Evaluation
At the end of the Work, a Final Evaluation shall be evaluated. The Final Evaluation shall be based on
HSE Contractual obligations, pre-job activities reports, WIP Interim Evaluation Reports, corrective
action during interim evaluation and final Project HSE KPI’s figures.
COMPANY shall have the right to suspend or terminate the Contract if in COMPANY’s opinion
CONTRACTOR do not comply with the above steps including, but not limited to, follow-up to
conditional acceptance and/or complete the specific requirements which was obtained during Pre-
Qualification and/or Selection process, do not follow-up corrective action required during interim
evaluation.
In the event of suspension of the Contract, penalty as set in thee contract will be applied and will be
continued until CONTRACTOR fulfill all requirements needed.

4.6 HSE Performance

HSE Performance indicator shall refer to Contractor Performance Management. The HSE performance
indicator should include provision for COMPANY to suspend the work if the CONTRACTOR does not
observe the criteria spelled out in the Project HSE Plan, and in particular at mobilization, to withhold
permission to start execution and hold payments until a satisfactory pre-job audit has been achieved.
4.7 Emergency Preparedness
4.7.1 Emergency Response Plan
CONTRACTOR shall develop a Emergency Response Plan for COMPANY review and approval, and
liaise with COMPANY Project Incident Command System. The plan shall allow for the provision of all
suitable equipment on Site to respond to all identified emergency situations.
CONTRACTOR shall provide all necessary training to the emergency response tam and supply all
necessary PPE that shall allow them to undertake their duties in a safe manner.
CONTRACTOR shall establish an emergency response team by defining within the plan:
 Team structure, and qualifications,
 Personnel roles and responsibilities, and communication,
 Initial and refresher training requirements,
 Pre emergency preparation,
 Safe distances and places for muster point,
 Site security and control for emergency situations,
 Evacuation routes and procedures, including Medivac,
The team members and organization shall be posted on the site-wide notice boards, and updated, as
required, by change of personnel.
All training as required by the Emergency Response Plan should comply with the standards set by
COMPANY.

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5. ATTACHMENT

5.1 Attachment 1 : Contractor Safety Management System (CSMS) Flow cahrt

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5.2 Attachment 2 : Project HSEMS Manual and Procedure Register

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5.3 Attachment 3 : Project Commencement Flow Chart

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