You are on page 1of 1

JOB SAFETY ANALYSIS FORM

Job Safety Analysis


[Tt] Trouble Ticket / [Mcm] Date :
Change Management
Number Ref Number: January 04, 2023

Company : Subcontractor: Location Of Work :


PT. Indokomas PT. Surya Marga Luhur Cooling Tower Room Operation
(Sml) Area
Description Of Work :
Loading Pipe and Lifting Cooling Tower Mechine in Cooling Tower Room Operation Area
Required And/Or Recommended Personal Protective Authorised By:
Equipment:

Safety Shoes, Safety Glassess, Helmet Vest, Face Mask,


Measuring Tape, Varnier Calliper, Leather Gloves.

Sequence Of Basic Job Potential Hazards Recommended Action


Steps Or Procedure
1. Loading Pipe and 1. Pinched 1. Do Briefings
Lifting Cooling Tower 2. Fallen Personal 2. Make Sure The Area Is Clean
Mechine in Cooling 3. Exposed To Dust And Not Wet
Tower Room 4. Aids Fall 3. Ensure Workers Use
5. Exposed To Shard Approriate Personal Protective
Of Material Equipment When Working
4. Ensure That Workers Carry
Out Work According To
Dettermned Standars

You might also like