REV : 0 DATE : Mar 8, 2004

DUTA WASKITABAJA J/O Table of Hazard Identification and Risk Evaluation PAGE : 1 OF 1
Required Risk Control
1 Related manual/procedure/WIM 6 Proper facilities ###Rule work permit
ITEM : ISOLATION WORKs DOC NOC : TKD-HR-07 2 Check list 7 Toolbox meeting ###Health and hygiene control
3 Training 8 Regulation ###Fire figthing facilities
JOB ACTIVITY : Remove and Re-install Blind Plate 4 Supervision 9 Safety devices ###Other
5 PPE 10 Warning system

Current
Hazard Accident
REQUIRED Risk Control Contact Time Evaluation
NO STEP OF ACTIVITIES HAZARD RISK Level Experienced
RISK CONTROL Availability
(A) (B) (C) (D) ( A-B ) x ( CxD )
1 LOOSENING BOLT & NUT Supervision Work without authorization Contact with chemical 1 3 1 1 2
Check List Use unproper PPE Caught in, on & between
PPE Unproper work position
Proper Facilities

2 REMOVING CORRODED BOLT Supervision Work without authorization Contact with sharp surface 1 3 1 1 2
BY FIRE / GRINDER PPE Use PPE unproperly Contact with chemical
Rule/Work Permit Unsafe positioning Contact with extreme temp.
Fire figting facilities Burning or explosion

3 INSERTING BLIND PLATE Supervision Disobey warning signal Caught in, on & between 1 3 1 1.5 3
Rule/Work Permit Unproper setting Fall or fallen on
PPE Use unproper tools Entry of foreign object
Proper Facilities Use unproper PPE Contact with chemical

4 REMOVING BLIND PLATE Supervision Disobey warning signal Caught in, on & between 1 3 1 1.5 3
Rule/Work Permit Unproper setting Fall or fallen on
PPE Use unproper tools Entry of foreign object
Proper Facilities Use unproper PPE Contact with chemical

5 TIGHTENING BOLT & NUT Supervision Work without authorization Contact with chemical 2 3 3 1.5 5
Check List Use unproper PPE Caught in, on & between
PPE Unproper work position
Proper Facilities
 REV : 0 DATE : Mar 8, 2004
DUTA WASKITABAJA J/O Table of Hazard Identification and Risk Evaluation PAGE : 1 OF 1
Required Risk Control
1 Related manual/procedure/WIM 6 Proper facilities ###Rule work permit
ITEM : ISOLATION WORKs DOC NOC : TKD-HR-07 2 Check list 7 Toolbox meeting ###Health and hygiene control
3 Training 8 Regulation ###Fire figthing facilities
JOB ACTIVITY : Remove and Re-install Blind Plate 4 Supervision 9 Safety devices ###Other
5 PPE 10 Warning system

Current
Hazard Accident
REQUIRED Risk Control Contact Time Evaluation
NO STEP OF ACTIVITIES HAZARD RISK Level Experienced
RISK CONTROL Availability
(A) (B) (C) (D) ( A-B ) x ( CxD )
 REV : 0 DATE : Mar 8, 2004
DUTA WASKITABAJA J/O Table of Hazard Identification and Risk Evaluation PAGE : 1 OF 1
Required Risk Control
1 Related manual/procedure/WIM 6 Proper facilities ###Rule work permit
ITEM : ISOLATION WORKs DOC NOC : TKD-HR-07 2 Check list 7 Toolbox meeting ###Health and hygiene control
3 Training 8 Regulation ###Fire figthing facilities
JOB ACTIVITY : Remove and Re-install Blind Plate 4 Supervision 9 Safety devices ###Other
5 PPE 10 Warning system

Current
Hazard Accident
REQUIRED Risk Control Contact Time Evaluation
NO STEP OF ACTIVITIES HAZARD RISK Level Experienced
RISK CONTROL Availability
(A) (B) (C) (D) ( A-B ) x ( CxD )
DATE : Mar 8, 2004

Evaluation

( A-B ) x ( CxD )
DATE : Mar 8, 2004

Evaluation

( A-B ) x ( CxD )
DATE : Mar 8, 2004

Evaluation

( A-B ) x ( CxD )