JOB HAZARD ANALYSIS (JHA) WORKSHEET

PETRONA
S

JHA NO. PTWNO WORK PERMIT TYPE HOT/COLD

FACILITY LOCATPON SPECIFIP WORKSTATION

EQUIPMENT NO. WORK DESCRIPTION To perform backfilling work

NOTE
1. JHA Shall be applicable for all work activities which required PTW.
2. Personnel carrying out the work shall be fully familiar with the written Work/Operating Procedures develop for the job. The Work/operating procedures shall describe, ic step-by-step instructions, the correct method of executing the
specified wore.
3. Prior th commencemeni of wor/ the tas/specifin JHA shall be discussed amongsi all personnel invelved in the execution; and requirementh contained shall be fully understood and agreed by all involved personnel.

JOB
DESCRIPTION OF JOB STEP POTENTIPL HAZARD POTENTIPL CONSEQUENCES CONTROLBARRPERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
STEP

1. Site entry /inspection - Weather Hot weather -heavy - Stop all outdoor activities and - All Worker - first aid treatment
rain / Strong wind seek for safe shelter as soon as
you see dark thunder clouds
gather on the horizon or over the
hill.
- Work rotation
- Stop / postpone until weather
improves for all activities

sting personal injury - Be vigilant when working

- All Worker - First Aid Treatment
animal/insect - Inform operation if seen any
(Hornet, bee, biological hazard
snake) - Designated / approved work
area / location
- Proper disposal area

Ope
n
 JOB HAZARD ANALYSIS (JHA) WORKSHEET
PETRONA
S

JOB
DESCRIPTION OF JOB STEP POTENTIPL HAZARD POTENTIPL CONSEQUENCES CONTROLBARRPERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
STEP

2. Check Proposed Workstations / Slip, trip and fall / - use alternative walkway - All worker - Medical treatment
Worksite condition Tempat kerja personal injury - Remove all obstructions at
worksite and aware at soil
surface when wet

3. Worksite pinch point / Personal Injury / hand - Identify and avoid sharp - all worker - medical treatment
preparation - install sharp edge and finger injurie edges area,cover the sharp
barricade, display edges area with cutton rag
signage and to
remove all
unwanted object
obstruction from
site
4. Transferring tool Manual back pain, muscle pain - buddy system - all worker - medical treatment
and material to materials - correct body posture
work site handling
pinch point / hand and finger injury - correct hand placement. - all worker - medical treatment
sharp edge - use a hand protection.
- remove / cover sharp edge.

Ope
n
 JOB HAZARD ANALYSIS (JHA) WORKSHEET
PETRONA
S

JOB
DESCRIPTION OF JOB STEP POTENTIPL HAZARD POTENTIPL CONSEQUENCES CONTROLBARRPERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
STEP

5. Lay down the soil manual eye & skin irritation - Improve/Correct posture. - all worker - first aid treatment
and gravel to the materrial - Correct manual material
identified area transfering handling procedures.

6. back filling egronamic Muscle strain and - Use correct tools - all worker - first aid treatment
aggregates, soil and back pain - Buddy Systems
quary dust - Correct Posture
7. compacting activity Manual Hand injury, strains, - Correct finger placement - all worker - first aid treatment
using road roller materials sprains and fractures - use proper handglove
handling - Consider pinch point area

8. Housekeeping Slippery/ trip and fall/asset - Proper clean out/dry off of - all worker - first aid treatment
activity uneven floor damage slippery area
surface/gratin - Ensure footwear is in good
g/step condition with adequate grip

Ope
n
 JOB HAZARD ANALYSIS (JHA) WORKSHEET
PETRONA
S

JHA APPROVAL DURING PTWAPPLICATION

REVIEWED BY APPRRVEVDB
NAME NNAM

DEEGNNTION WORK(LEADER DESSON/IDO PRODUCTION SUPERVISOR /MATTENANCE SUPERViSSR /BASE SUPERVISOWFUNCTIONAL SUPERVISOR
SIONATTUE SSONTUUR

DDTT DATE

AFTER PTW HAS BEEN APPROVED WORK TEAM (CONFIRMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PRE_JOB/TOOLBOX MEETING _ AFTER PTW HAS BEEN APPROVED)

Name (S) Desigion Signature Signature Signature Signature Signature Signature Signature Name S) Designation Signatur Signatur Signatur Signatur Signatur Signature Signature

Ope
n