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JOB SAFETY ANALYSIS FORM

JOB SAFETY ANALYSIS [TT] Trouble Ticket / Date :


[MCM]Change management
Number Ref Number: 04 Jan 2023

COMPANY : SUBCONTRACTOR: LOCATION OF WORK :


PT.INDOKOMAS PT.ARGYA UTAMA DATA HALL ROMP01

DESCRIPTION OF WORK :

INSTALL SCAFFOLDING AT DATA HALL ROMP01 AREA FOR TEMPORARY DRY WALL

REQUIRED AND/OR RECOMMENDED PERSONAL PROTECTIVE EQUIPMENT: AUTHORISED BY:


HELMET,VEST, SAFETY SHOES,AFRON,SAFETY GLASSES,,WELDING
GUISE,WELDING GLOVES,WHITE GLASSES,LEATHER GLOVES

SEQUENCE OF BASIC JOB POTENTIAL HAZARDS RECOMMENDED ACTION


STEPS OR PROCEDURE

1. Install Scaffolding - Pinched - Prepare work permit


-Toolbox meeting before working
- Scaffolding - Not use scaffolding before inspection
- Slipped by Scaffolding Inspector HSE
Indokomas
- Fallen Personnel - Instal scaffolding follow regulation
- Dropped Materials standart
- Scaffolding installation by competent
- Aids fall personil ( certificate)
- The scaffolding collapsed - Personnel wearing PPE

- Work at heights must use PPE/Body


Haness, and be used
correctly/associated properly
Make sure other personnel are not
right under the scapolding
installation
- Standby Inspector
Scaffolding
- After Installation
Scaffolding inspect By
Inspector Scaffolding
or HSE Indokomas for
Tagging Safe ( Green
Tag )
- Housekeeping After
working
-
Working
-
- Personnel wearing PPE
- Concentration while working
7..Touch up / Finising - Slipped
- Fall - Prepare the 'Touch up' tool
- Aroma inhaled - Make sure the personnel when
working in a safe condition
- Wearing a mask

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