Job information

  Job Activity Description: Repair Stairway (Install boltjoint) Date:

Work-order number: ZULU/007/TK/ Job Requestor: DODY R.M Work area:

Company: PT. PILAREN

Error Traps: (Check all that apply)

( ) Time Pressure, Stress, High Work load ( ) End of Shift or Work Cycle ( ) First time/Infrequent task ( ) Poor Verbal Communication
( ) Distractions ( ) First Day Back > 4 days ( ) Vague/poor work guidance ( ) Over-Confidence
( ) Simultaneous Tasks/Work in Vicinity ( ) Line of Fire
Social Distancing Considerations and Requirements
When work plan calls for individuals to be closer than 6ft (2m) from each other for longer than 15 min, the following requirements should be applied:
( ) Respiratory protection must be worn (facial covering) ( ) Must have a plan to minimize time within 6ft of each other
( ) Face and Eye protection shall be selected and available (glasses, goggles, face shield) ( ) Ensure that all participants are not symptomatic (no cough, fever, shortness of breath, or feeling ill)
( ) Hand and body protection must be selected and available (nitrile gloves, Tyvek suit, etc.) ( ) Post sanitation of equipment and tools as well as doffing plan created
During work, considerations must be taken to limit the potential spread of diseases. Hands should be washed pre & post task. It is also recommended whenever you leave the work zone
Step 1: Describe the job steps Step 2: Identify the Hazards of the Job Step in the field Step 3: Control Measures
1. Persiapan izin kerja dan PJHA 1.1. Tidak ada izin pekerjaan di stop 1.1.1. Pastikan izin kerja sudah divalidasi
1.2. Kesalahan dalam menganalisa bahaya 1.2.1. Pembuatan PJHA melibatkan tim EHS, supervisor,
dan pekerja

2. Persiapan alat/matrial 2.1. Alat/matrial terjatuh 2.1.1. Gunakan alat bantu pully
( Grinda dan Mesin Las ) 2.1.2. Pada saat menual handling menggunakan otot paha
2.1.3. Beban yang diangkat tidak boleh lebih dari
25kg berat badan

2.2. Kabel berserakan 2.2.1. Gunakan hanger cable

2.2.2. Gelar kabel diatas tray
2.2.3. Pastikan kabel tidak bocor

Is there any LIFEsaver or SIF precursor involved? ( ) No (Tier 1 - Move to step 8)  ( )
( ) Barge/Ship Operation
( ) Equipment Failure
( ) Machine/Conveyor Guarding
( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Mining Operation
Motor Vehicle Working at Lockout Tagout Mobile Ralicar Safety Electrical Work Hazardous Bulk Material Confined Excavation and Hot Work Lifting and ( ) Animal/Biological
Traffic Safety Height Equipment Materiais Handling/ Space Entry Trench Work Rigging
Storage ( ) Other
Is a PtW (Permit to Work) needed or any other additional check list? ( ) Yes ( ) No
If Yes, what are they?
Step 4: Define task specifics STOP criteria Step 5: What is the worst case scenario and its Step 6: Emergency preparedness Step 7: Quality Review
consequences?
1. Hujan/petir 1.1. Tersambar petir/terjatuh 1.1.1. Stop pekerjaan, evakuasi ketempat aman,
berikan perawatan oleh tim paramedic
1.2. Tergores/terpeleset 1.2.1. Siapkan P3K, lakukan pertolongan pertama

2. SIMOPS 2.1. Percikan api welding mengenai 2.1.1. Stop pekerjaan, lakukan koordinasi dengan
pekerja dibawah pekerja dibawah, sebelum melanjutkan Cargill Representative Quality Review
pekerjaan (Print Name)

3. Kabel berserakan/tidak digantung 3.1. Tersengat listrik 3.1.1. Stop pekerjaan, evakuasi ketempat aman,
berikan perawatan oleh tim paramedic.

4. APD tidak sesuai/tepat dengan pekerjaan
5. Perancah tidak standart
4.1. Percikan api mengenai pekerja 4.1.1. Siapkan P3K, lakukan pertolongan pertama
4.1.2. Gunakan APD yang tepat sesuai pekerjaan
Employees working in the area have
5.1. Scaffolding roboh 5.1.1. Stop pekerjaan, lakukan evakuasi pada korba been notified of this work?
berikan perawatan oleh tim paramedic,
larikan ke rumah sakit jika diperlukan.

Yes No
( ) ( )
Step 8: Workers accepting PJHA, and will work according the identified herein:
Task Leader: Name: Name:

Name: Name: Name:

Teams quickly debrief the task they planned and consider anything that they missed, would change, or even assumed correctly after the task is complete:
( ) Yes ( ) No

( ) 2nd shift Revalidation ( ) 3rd shift Revalidation ( ) 4th shift Revalidation ( ) 5th shift Revalidation
Have tools and equipment used during the
task been removed and accounted for as well __/__/____ __/__/____ __/__/____ __/__/____
as the area being cleaned and debris Starts at: Starts at: Starts at: Starts at:
removed upon completion? Finishes at: Finishes at: Finishes at: Finishes at:
( ) Yes ( ) No Cargill Rep.: Cargill Rep.: Cargill Rep.: Cargill Rep.:
Task Team Lead: Task Team Lead: Task Team Lead: Task Team Lead:

Step 1: Describe the job steps
1. Setting dan marking
2. Install bolt joint / stairway menggunakan traffo las
3. Finishing starway menggunakan grinda
4. Pengangkatan matrial menggunakan alat bantu pully
5. House Keeping
Step 7: Quality Review
If additional steps. Hazards and controls are needed for the task, use the area below labeled Annex
Step 2: Identify the Hazards of the Job Step in the field Step 3: Control Measures
1.1. Matrial mengayun 1.1.1. Komunikasi antar pekerja
1.1.2. Perhatikan jari dari pich point
2.1. Pekerja terjatuh 2.1.1. Gunakan FBH, kaitkan 100% pada anchor point
2.1.2 Pastikan FBH diperiksa terlebih dahulu sebelum
2.2. Pekerja terpeleset digunakan
2.2.1. Lakukan 3 point contact
2.3. Traffo las konslet/terbakar 2.3.1. Pastikan traffo las sudah diinspeksi
2.3.2. Dilakukan oleh kompeten persons
2.3.3. Melakukan pengecekan pada taffo sebelum digunakan
2.4. Kabel Terkelupas 2.4.1. Pastikan kabel las tidak bocor
2.4.2. Gunakan hanger cable
2.4.3. Gelar kabel diatas tray
2.5. Percikan api welding mengenai pekerja 2.5.1. Gunakan APD lengkap
2.5.2. Dilakukan oleh kompeten persons
2.5.3. Pastikan APAR, Fire Blanket, dan Fire Wathcer standby
2.5.4. Jauhkan dari bahan mudah terbakar
2.6. Welding holder pecah 2.6.1. Periksa alat sebelum digunakan
2.6.2. Pastikan APAR standby
3.1. Percikan api grinda mengenai pekerja 3.1.1. Pastikan grinda menggunakan cover
3.1.2. Pastikan grinda sudah diinspeksi dan layak digunakan
3.1.3. Pastikan APAR, fire wathcer, dan fire blanket standby
4.1. Terjepit/tergores 4.1.1. Gunakan sarung tangan
4.2. Tali putus 4.1.2.
4.2.1. Komunikasi antar
Pastikan tidak adapekerja
pekerja dibawah saat melakukan
pengangkatan matrial dengan pully
4.2.2. Pastikan tali yang digunakan layak
4.2.3. Melakukan inspeksi secara visual tali tambang
5.1 Sampah/Scrabe berserakan 5.1.1. Pastikan melakukan housekeeping setelah pekerjaan
selesai
Cargill Representative Quality Review Employees working in the area have been notified of this work?
(Name)
( ) Yes ( ) No
Step 8: Workers accepting PJHA, and will work according the identified herein
Task Name: Name:
Leader:

Name: Name: Name:

Name: Name: Name:

Name: Name: Name:

Name: Name: Name:

Is a PtW needed or any other additional check list? ( ) Yes ( ) No

If Yes, what are they?

Teams quickly debrief the task they planned and consider anything that they missed, would change, or even assumed correctly after the task is complete:
( ) Yes ( ) No

Have tools and equipment used during the ( ) 2nd shift Revalidation ( ) 3rd shift Revalidation ( ) 4th shift Revalidation ( ) 5th shift Revalidation
task been removed and accounted for as well __/__/____ __/__/____ __/__/____ __/__/____
as the area being cleaned and debris Starts at: Starts at: Starts at: Starts at:
removed upon completion? Finishes at: Finishes at: Finishes at: Finishes at:
( ) Yes ( ) No Cargill Rep.: Cargill Rep.: Cargill Rep.: Cargill Rep.: