“> apriL® ew JOB SAFETY ANALYSIS (JSA) FORM PMO Zapr as 1 — _ se “vi AN ARCHITECTURAL WORKS OF | DATE: "BAN: mev0 PaGRAGE 8 498 0F Bl PROIECT !wsaon/oayusyiva023 ‘ATEN (Se Nome =5h Team de) Nae rosin “SIGNATURE "ACHMVAD ORARSYAW CONSTRUCTON MANAGER ZB ‘Y.BBRAMANTHO/HENRICO TARIGAN | CIVIL CONSTRUCTION PMO | AL ‘ADRIAN/DEPIT/ANDRI/AFRIZAL/FATI | HSE PMO | Ap. 04 / sens Pengukuran level gas dan oksigen nena i “Monitoring pekerjaan di area confined space ee enon I Emergeney Response ANON ENGINEER =e 'SUGENG PURWANTO/FERI LUBIS. sev ‘Mam O/C HR Ses REFERENCE ANO OTHER RELEVANT INFORMATION: £24: requred, Competency requirements, Tools ‘aulpmant PTW, Drawings. Ling Pan Procedures, PIDs, Cereates, PPE required ete ene Tools & Equipment ‘LF Etinguser 1 Papan CSE 2h Agee 2 Radio MT 3. Blower 4 Uhting (mo) 5. 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Tage BCS Haare pears | TraRreanais ro Sp rasan reyeiian ait kourias ja eal] Handa(SPTON) | pees pean. at esdtan torwnkes saa sand by son den pekeye | Sige P(Spv (sual communication dn alt bart iya) Coa Sa dandy porn ok meningakan has plan, HSE NSH Ser noytlerertnes pop conreeracey | Nokes igs ory pon yrgscnrenarten Seba anges tn onan v Sprnonassaent io ett ea tan 7 Spunsnahn ped erie a eeshon hom lenanen tf Soin at nran)ey ea sec poete yo Spor Sone ida in etn 2 pan tpt iby pn eng re sinteweotsn ete ot el sian 5 Sp Tanaka} — atk —|7ey emo a tp nan! a ng an _ingatkan pekeja untuk mawas dn dan memperratikan tangkah moans aria Spumenacan pj os bere sat tte ‘vane i 1 | eSpermeinneriom ata cent peimpnn | AeroaM _sabelum menirggakcan area kerja ‘Hamdan(SPTON), | JSpmcncem in ecihtaeatoyonn | Sum | masons cn P Pinch Point "Sov memastikan pekesa fdek meletalxan bagian wbuhnys di HSE MSM tk jt den menggunakan hard owes | Aor | [aaa Spvimaran feta Fy Hanes | | | Zomesutoenches woeurcat | mlsanceergone | Pages1SA WORK SHEET s08 TITLE ‘CONFINED SPACE Yaar denaiieation — [Risk Evaluation ‘Segre (Unser Pate) azar Desi Pesan Bay) asa et (Dampat Baba) (otaktan die) |), “| Wa Caer ]> Bionic Sp measian pa Ws naan bra pst bana petesanpenborgaran fama - Sprmerasian star can bce pang ut smear prgatn tha [saree > Manual Haring Fae Spr merase peteta marggtaian APD yenlegiap (eargguatan ran ges set ousting) Spy manasian 6239 kurpuhan dst oroat morggvakan bo tag dan tot barca. Spi manasa pte merratan lk al handing yong eat, Ga Tesora wate diosa Cae Tetaeak Prepay Dana Fatal ‘Spy én Hs rasan prt pembuangan aH cea. ie menasan ak aca pee yng bere eka aus ‘ving aie oe sot pngeghtan aan rmerggutakan eo care Testi ' Rigger seta sirinan step parr sina ‘pada cpr sul prgagtatonsanpah. > Gas Cinaon > SipsTip anc Fa eset Treatment iy N ian Tp, Cer aac Seal pra oak | resco Cones Spec pata sas emergent dala agh | ‘Meek Team CSE Rest SPY, HSE, dn peer yong wba dn pekoren) alam eneency spo ‘Mlhutan TraPng Emergency Response hepeds Team CSE | Rescue ‘Team CSE Reson patum trtang Emergency Reso d bla an tas. \Hubirg Tear ERP fa ada teadson emererey paca eran dla sng Tats, (651357476088 (Eon Why), 0827258161. Jotanyah), 8137108695 "(Hamdan 061600195 urn, (08217817118 (nam ian), 08591EE201 (Ri Henan) Spr memasan aes yang aman unk meni he ae ssi pot A dbaayatioay Handan(SPTON), | ‘agen P (Sev Oni) HSE NSA AWeers ror Hseon ragesSA WORK SHEET JOB TITLE ‘CONFINED SPACE azar identification ik Bvaluation ‘eine of Job ar eserpton | usa Penis) Papasan Baa) Hare “ Dewey (ota ah) | nti, > Baa Weaber > Ugting wn 75) Renan a REPO rea fat hat atl an eancag vr manattan ama tk panko lunes pit yng wh elon + Sosalss tondl dan poser Enoppry Respuse area hea Spr meat APAR da ‘Hott ERT or FRE STATION eats zu OTBLAITIRNT 158730 PEC)IEO 1S (HSE Payot zieees (HSE PO) Spy marasttn poten hertkan seertara aati jan ‘Sov mension penwangin emacs epals pekerson Ioan aan hat Paget