Risk Assessment Work Sheet

Project Title: Lotte Indonesia New Ethylene (LINE) Complex

Risk Assessment No. Page Permit No.

Job Title TANK INSTALLATION
JEL/SMP2/RA/0023 of Revision Date 19-May-24 No.

Work Location WP - 01 Subcontractor PT. JEL SMP 2 Discipline SMP

Prepared by (RA Team) Name Position Date Signature

Subcontractor Discipline Manager / Engineer BONANG F K Engineer 19-Jun-23

Subcontractor HSE Engineer / Supervisor ANDRY KUSMANA HSE Coordinator 19-Jun-23

Subcontractor Discipline Supervisor ALI MAHFUDZ Supervisor 19-Jun-23

Checked by (Preliminary Review) Name Position Date Signature

Discipline Manager / Engineer J E BAE Construction Manager 19-Jun-23

Discipline Supervisor / Engineer H C CHO SENIOR ENGINEER 19-Jun-23

HSE Manager / Engineer H S LEE HSE Manager 19-Jun-23

HSE Supervisor / Engineer HENDRA G HSE Engineer 19-Jun-23

 Risk Assessment Work Sheet
Job Tittle : TANK ERECTION AND INSTALLATION
HSE equipment / facilities
Equipment & Tools to be used Materials to be used Inspection required Training / competency required
required
1 Crane 1 Steel plates 1 Crane 1 Induction 1 Mandatory PPE
2 Lifting gear 2 Scaffolding 2 Lifting gear 2 Permit To Work 2 Soft baricade
3 Handtools 3 3 Handtools 3 Working at height 3 Full body harness
4 Chainblock 4 4 Chainblock 4 4 Appron
5 Leverblock 5 5 Leverblock 5 5 Fire extenguishers
6 Welding machine 6 6 Scaffolding 6 6
7 Grinding machine 7 7 Grinding machine 7 7
8 Pressure gauge 8 8 Welding machine 8 8
9 Electrical funnel 9 9 Electrical tools 9 9
10 10 10 10 10

Number of Worker 10 Discipline Supervisor 2 Safety Supervisor 1

personnel required Other Discipline Foreman 1 Safety Officer / Inspector 1

Risk Assessment Matrix (RAM) and Hierarchy of Control

PROBABILITY [1 - 3] Can proceed with the task
HSE Risk Assessment of Incident Rare (1) Possible (2) Likely (3) Of ten (4) Frequent (5)
Encountered
in industry
Has occurred Has occurred
in HEC in HEC
Occurs Occurs
sev eral times sev eral times
[4 - 10] Can proceed with the task. Consider more controls.
SEVERITY People Assets Environment Reputation
but not in project within project within a y ear in a y ear at this
HEC projects last 5 y ears last 3 y ears HEC projects project [12 - 25] Stop work. Change work method or put more controls
Slight injury Slight ef f ect Slight ef f ect
or health (less than 500 (less than 50
1-Insignificant
ef f ects USD liter oil/
Slight impact 1 2 3 4 5
(FAC) Damage) Chemical)
Minor ef f ect Minor ef f ect
Minor injury or
(500 ~ 10,000 (less than 100
2-Minor health ef f ects
USD liter oil/
Minor impact 2 4 6 8 10
(MTC)
Damage) Chemical)

Major injury or Local damage Localized

health ef f ects (10,000 ~ ef f ect (100 ~ Considerable
3-Moderate (RWC; LTI <7 100,000 USD 200 liters of impact 3 6 9 12 15
day s) Damage) oil/Chemical)

Single f atality Major damage Major ef f ect

or permanent (100,000 ~ (200 ~ 1000 National
4 -Major disability or 500,000 USD liters of impact 4 8 12 16 20
LTI > 7 day s Damage) oil/Chemical)

Extensiv e Massiv e
damage ef f ect (more
Multiple International
5-Catastrophic
f atalities
(more than than 1000
impact 5 10 15 20 25
500,000 USD liters oil/
Damage) Chemical)
 Risk Assessment Work Sheet
Job Tittle : TANK INSTALLATION
Initial Risk Action Residual Risk
No. Description of Work Step Potential Hazards & Consequences Control and / or Recovery Measures Responsible
S P R Person S P R

Every work activity as per site condition should be discussed at TBM prior to start
and when deemed necessary (Setiap aktivitas kerja sesuai kondisi lapangan
harus didiskusikan di TBM sebelum dimulai dan bila dianggap perlu)

Provide flagman (Sediakan flagman)

Follow site speed limit (20 km/h) (Ikuti batas kecepatan site (20 km/jam)) SPV, Operator,
Rigger,
1.1 Vehicle collision. 2 3 6 Drive carefully especially at junction and narrow access (Berkendaralah dengan Banksman, 2 1 2
hati-hati terutama di persimpangan dan akses sempit) Flagsman,
HSE
Do not rush (Jangan terburu-buru)
All equipment shall be operated by competent operator / driver (Semua peralatan
Mobilization of tools and
1 harus dioperasikan oleh operator/pengemudi yang kompeten)
equipment to site.
Supervisor must be more attentive and responsible (Pengawas harus lebih
perhatian dan bertanggung jawab)
Ensure the potential hazard have been informed to the worker through TBM
(Pastikan potensi bahaya telah diinformasikan kepada pekerja melalui TBM)
Ensure all tools to be used passed internal inspection (Pastikan semua alat yang
akan digunakan lulus inspeksi internal) SPV, Operator,
Rigger,
Using of unsafe equipment, vehicles and Ensure no material blocking work access (Pastikan tidak ada material yang Banksman,
1.2 tools
2 3 6 2 1 2
menghalangi akses kerja) Flagsman,
Install barricade and signage (Pasang barikade dan rambu rambu) HSE

Discard / remove immediately defective equipment or tools from site (Buang /

segera keluarkan peralatan atau perkakas yang rusak dari lokasi.)
To secure all materials/tank during transportation using correct securing method
(Mengamankan seluruh bahan/tangki selama pengangkutan dengan SPV, Operator,
menggunakan metode pengamanan yang benar.) Rigger,
2.1 Materials/Tank fall from truck. 3 3 9 Banksman, 2 1 2
Follow site speed limit (20 km/h) (Ikuti batas kecepatan site (20 km/jam)) Flagsman,
HSE
To monitor on road surfaces (Untuk memantau permukaan jalan)
Ensure the potential hazard have been informed to the worker through TBM
Materials and workshop (Pastikan potensi bahaya telah diinformasikan kepada pekerja melalui TBM)
2 fabricated tank mobilization
to site Provide flagman (Sediakan flagman)
Drive carefully especially at junction and narrow access (Berkendaralah dengan SPV, Operator,
hati-hati terutama di persimpangan dan akses sempit) Rigger,
2.2 Vehicle collision 3 3 9 Banksman, 2 1 2
All equipment shall be operated by competent operator / driver (Semua peralatan Flagsman,
harus dioperasikan oleh operator/pengemudi yang kompeten) HSE

Competent drivers and to have good consideration while on the road (Pengemudi
yang kompeten dan mempunyai pertimbangan yang baik saat berada di jalan)
 Crane shall be operated by competent operator (valid driving licence and
registered with DOSH) (Crane harus dioperasikan oleh operator yang kompeten
(SIM yang masih berlaku dan terdaftar di DOSH))
Barricade the work area so that unauthorized persons do not cross the work area
(Barikade area kerja agar orang yang tidak berkepentingan tidak melintas di area
kerja)
No one shall be allowed to stay under the suspended load (Tidak seorang pun
akan diizinkan untuk berada di bawah beban yang ditangguhkan)
To check on ground strength before park the crane. To obtain green lift check list
(Untuk memeriksa kekuatan tanah sebelum memarkir crane. Untuk mendapatkan
green lift check list) SPV, Operator,
Rigger,
3.1 Crane topple Do not park the crane very close to drains, trenches or pits at least 610 mm Banksman, 2 1 2
(Jangan memarkir crane terlalu dekat dengan saluran air, parit, atau lubang Flagsman,
minimal 610 mm) HSE
Crane outrigger shall be fully extended and padded using proper outrigger
padding (Crane outrigger harus direntangkan sepenuhnya dan diberi bantalan
menggunakan bantalan crane yang tepat)
Do not lift any materials at unbalance condition of the crane (Jangan mengangkat
material apa pun saat kondisi crane tidak seimbang)
Do not perform lifting activity during heavy rain, strong wind and thunderstorm
(Jangan melakukan aktivitas pengangkatan pada saat hujan deras, angin
kencang, dan badai petir)
Swing the crane gently and moderately. Do not rush (Ayunkan crane dengan
lembut dan secukupnya. Jangan terburu-buru)
To apply at least two taglines to guide and reposition suspended load (Untuk
menerapkan setidaknya dua tagline untuk memandu dan memposisikan ulang
beban yang ditangguhkan)
Loading / unloading of SPV, Operator,
Avoid excessive work rates and tight deadlines. (Hindari waktu kerja yang Rigger,
3 materials / equipment and
3.2 Load hit nearby equipment or workers 3 3 9 berlebihan dan tenggat waktu yang ketat) Banksman, 2 1 2
fabricated tank using crane.
To provide competent rigger (Untuk menyediakan rigger yang kompeten) Flagsman,
HSE
To check on swing radius clearance and barricade the area with signages (Untuk
memeriksa jarak bebas radius ayunan dan barikade area tersebut dengan
rambu)
Set a safe distance when pulling takes place (Tetapkan jarak aman saat
penarikan berlangsung)
All lifting gears such as shackles, web slings, wire slings, hooks, plate clamps
and spreader beams shall be inspected and colour coded by authorized
inspector. Always aware on lifting gear’s SWL (Semua lifting gears seperti SPV, Operator,
shackles, sling web, sling kawat, kait, klem pelat, dan spreader beams harus Rigger,
3.3 Falling of suspended load 3 3 9 diperiksa dan diberi kode warna oleh pemeriksa yang berwenang. Selalu Banksman, 2 1 2
waspada terhadap SWL alat pengangkat.) Flagsman,
HSE
Shackles shall be fully locked while lifting (Shackles harus terkunci sepenuhnya
saat diangkat)
Discard / remove immediately all defective lifting gears (Buang/lepaskan segera
semua lifting gears yang rusak)
 To ensure no obstruction on all access / egress (Untuk memastikan tidak ada
halangan pada semua akses/keluar)

Road obstruction (by materials and
3.4 equipment).
Slipped, pinched feet or hands
3.5
(Terbentur/terjepit kaki dan tangan)
If need to close any roads, obtain road closure permit and display at designated SPV, Operator,
permit display board and to provide adequate signage or barrier (Jika ada jalan Rigger,
yang harus ditutup, mintalah ijin penutupan jalan dan pajanglah di papan ijin Banksman,
2 3 6 2 1 2
yang telah ditentukan dan berikan tanda atau penghalang yang memadai) Flagsman,
Do housekeeping before and after work (Melaksanakan bersih-bersih sebelum HSE
dan sesudah melakukan pekerjaan)
Do not put material which possible block an access (Tidak menempatkan
material yang memungkinkan menghalangi akses)
Ensure the potential hazard have been informed to the worker through TBM
(Pastikan potensi bahaya telah diinformasikan kepada pekerja melalui TBM)
Avoid pinch points (Hindari titik jepit) SPV, Operator,
Rigger,
3 3 9 Good coordination and communication during fitting up the material between Banksman, 2 1 2
worker and SPV (Koordinasi dan komunikasi yang baik selama fit up material Flagsman,
antara pekerja dan SPV) HSE

Loading / unloading of Wear appropriate PPE , and hand gloves (Kenakan APD yang sesuai dan sarung
3 materials / equipment and tangan)
fabricated tank using crane. Tools/equipment should be inspected and checked before use (Tools/equipment
yang akan digunakan diinspeksi dan dicek terlebih dahulu sebelum memulai
pekerjaan) SPV, Operator,
Rigger,
Check slings for rips and remove from service if faults are found (Periksa sling
3.6 Gears broke (Rantai rusak/putus) 3 3 9 Banksman, 2 1 2
apakah ada robekan lepaskan dari penggunaan jika ditemukan kesalahan)
Flagsman,
Barricade the work area so that unauthorized persons do not cross the work area HSE
(Barikade area kerja agar orang yang tidak berkepentingan tidak melintas di area
kerja)
All tools and equipment shall be inspected by authorized inspector (Semua peralatan dan
perlengkapan harus diperiksa oleh inspektur yang berwenang)
Using of uninspected/faulty tools and Discard / remove immediately all defective lifting gears (Buang/lepaskan segera SPV, Foreman,
4.1 equipment
2 3 6 semua lifting gears yang rusak) 2 1 2
Fitter, HSE
Inspection sticker shall be pasted on the body (Stiker inspeksi harus ditempel pada badan)

All electrical cords shall be hung properly at least 2 metres from ground (Semua kabel
listrik harus digantung dengan benar minimal 2 meter dari tanah)

Do no step on cables (Jangan menginjak kabel)

Do not submerge electrical cables in the stagnant water (Jangan merendam kabel listrik di
dalam genangan air)
4 Site tank fabrication Only use industrial type cords and connectors (Hanya gunakan kabel dan konektor tipe SPV, Foreman,
4.2 Electrocution 3 3 9 2 2 4
industri) Fitter, HSE
Provide safe distribution boards and generators equipped with ELCB and proper grounding
system (Menyediakan papan distribusi dan generator yang aman dilengkapi dengan ELCB
dan sistem grounding yang baik)
Distribution boards shall be covered or protected properly especially while raining. Do not
expose the conductors (Papan distribusi harus ditutup atau dilindungi dengan baik
terutama saat hujan. Jangan memaparkan konduktor)

Wear adequate suitable PPE (Kenakan APD yang sesuai dan memadai)
SPV, Foreman,
4.3 Body injury 3 3 9 Do not work in ‘Line of Fire’ (Jangan bekerja di 'Line of Fire') 2 2 4
Fitter, HSE
Only use safe tools (Gunakan hanya alat yang aman)
 To get suitable permit and display it at permit display board (Mendapatkan izin yang sesuai
dan memajangnya di papan pajangan izin)

Standby at least a firewatcher and equipped him/them with minimum dry powder
fire extinguisher (Siapkan setidaknya seorang petugas pemadam kebakaran dan
lengkapi dia dengan APAR minimum)
To remove all flammables and combustible materials from work area (Untuk
menghilangkan semua bahan yang mudah terbakar dari area kerja)
To protect all sparks and fireball using fire retardant blanket (Untuk melindungi
Fire (welding, grinding, cutting, hacking, semua percikan api dan bola api gunakan selimut tahan api) SPV, Foreman,
4.4 chipping and power brushing).
2 3 6 1 2 2
Oxygen / acetylene cylinder shall be fitted with safe regulator and flashback Fitter, HSE
arrestor at regulator and cutting torch (Tabung oksigen/asetilen harus dilengkapi
dengan pengatur pengaman dan penahan kilas balik pada pengatur dan obor
pemotongan)
Perform leak test on every connection using soapy water (Lakukan uji kebocoran
pada setiap sambungan menggunakan air sabun)
Keep safe distance from ignition sources or isolate it using solid isolator if sparks
go straight to the cylinder (Jaga jarak aman dari sumber api atau isolasi
menggunakan isolator padat jika percikan api langsung menuju ke silinder)
Wear welding shield while performing welding or plasma cutting and full face
4 Site tank fabrication shield while performing grinding, cutting, chipping, hacking and power brushing
SPV, Foreman,
4.5 Eye and face injury 2 3 6 (Kenakan welding shield saat melakukan pengelasan atau pemotongan plasma 1 2 2
Fitter, HSE
dan full face shield saat melakukan grinding, pemotongan, chipping, hacking,
dan power brushing)
Ensure use safe horizontal / vertical plate lifting clamp (Pastikan penggunaan
pelat pengangkat horizontal/vertikal yang aman)
Do not perform lifting activity during heavy rain, strong wind and thunderstorm
(Jangan melakukan aktivitas pengangkatan pada saat hujan deras, angin
kencang, dan badai petir)
Always ensure on load balance. Use proper spreader beam (Selalu pastikan
keseimbangan beban. Gunakan spreader beam yang tepat)

Steel plate or shell course fall during Avoid pinch points (Hindari titik jepit) SPV, Foreman,
4.6 lifting and hit worker below
2 3 6 2 1 2
Fitter, HSE
Ensure that workers to perform the task are well trained, competent and
knowledgeable (Pastikan bahwa pekerja untuk melakukan tugas terlatih dengan
baik, kompeten dan berpengetahuan)
Wear appropriate PPE , and hand gloves (Kenakan APD yang sesuai dan sarung
tangan)
Do not rush. Perform lifting activity safely with qualified supervision (Jangan terburu-buru.
Lakukan aktivitas pengangkatan secara aman dengan pengawasan yang mumpuni)
 To ensure all scaffold to be used is safe, inspected and green tagged (Untuk memastikan
semua perancah yang akan digunakan aman, diperiksa dan diberi tanda hijau)

All workers involve shall have to wear body harness with two lanyards and tie off
policy shall be adhered, and ensure 100% double hook tie off (semua pekerja
yang terlibat harus memakai body harness dengan dua lanyard dan ketentuan
pengikatan harus dipatuhi, dan pastikan 100% double hook dicantolkan)

If possibility of fall from height is high, always hook the lanyard at strong structure (Jika
kemungkinan terjatuh dari ketinggian tinggi, selalu kaitkan lanyard pada struktur yang kuat)
SPV, Foreman,
4.7 Working at height 3 3 9 2 1 2
Use proper / safe access while ascending or descending ladder. No shortcut is allowed Fitter, HSE
(Gunakan akses yang tepat/aman saat menaiki atau menuruni tangga. Tidak ada jalan
pintas yang diperbolehkan)
Do not carry anything on hand while ascending or descending ladder. Always keep ‘3 point
of contact’ (Jangan membawa apa pun saat menaiki atau menuruni tangga. Selalu
pertahankan '3 titik kontak')

Do not work outside working platform (Jangan bekerja di luar platform kerja)

Do not work on the scaffold during heavy rain and strong wind (Jangan mengerjakan
perancah saat hujan lebat dan angin kencang)

Do not overload the scaffold (Jangan membebani perancah secara berlebihan)

4 Site tank fabrication
Do not store or keep materials or tools on the scaffold excessively (Jangan menyimpan
atau menyimpan bahan atau alat pada perancah secara berlebihan)
SPV, Foreman,
4.8 Scaffold collapse 2 3 6 Always aware on scaffold category (Selalu waspada pada kategori perancah) 2 2 4
Fitter, HSE
Do not remove or modify the scaffold unless competent scaffolder (Jangan melepas atau
memodifikasi perancah kecuali perancah kompeten)
Do not use the scaffold for other purposes except for working platform (Jangan gunakan
perancah untuk tujuan lain kecuali untuk platform kerja)

Always work in correct body posture (Selalu bekerja dengan postur tubuh yang benar)

Always consider on repetitive activities (Selalu pertimbangkan aktivitas yang berulang)

SPV, Foreman,
4.9 Back injury (ergonomics). 2 3 6 Utilize adequate manpower (Memanfaatkan tenaga kerja yang memadai) 1 2 2
Fitter, HSE
Rotate all manpower (if necessary) (Rotasi semua tenaga kerja (jika perlu))

Always aware on human manual handling ability and limitation (Selalu sadar akan
kemampuan dan keterbatasan penanganan manual manusia)

4.10 Dehydration 2 3 6 To drink plenty of water (Untuk minum banyak air) All Workers 1 2 2
If exposed direct to the hot sun, please provide proper resting shed and involved workers
SPV, Foreman,
4.11 Heat stress 2 3 6 shall be rotated (Jika terkena sinar matahari langsung, sediakan tempat istirahat yang 1 2 2
layak dan pekerja yang terlibat harus dirotasi) Fitter, HSE
 To ensure no obstruction on all access / egress (Untuk memastikan tidak ada halangan
pada semua akses/keluar)
To coil properly all cords and hoses. Hoses and cables must be hung at least 2 metres SPV, Foreman,
4.12 Slip, trip and fall 2 3 6 above ground (Untuk menggulung dengan benar semua kabel dan selang. Selang dan 2 1 2
Fitter, HSE
kabel harus digantung minimal 2 meter di atas tanah)

To arrange all materials properly (Untuk mengatur semua materials dengan benar)
4 Site tank fabrication
To apply whip check and safety pins (Untuk menerapkan whip check dan safety pins)
Air hose accidentally dislodge from air SPV, Foreman,
4.13 supply coupler
2 3 6 2 1 2
To check on coupler condition. If found defected, immediately remove from site (Untuk
Fitter, HSE
memeriksa kondisi coupler. Jika ditemukan cacat, segera keluarkan dari lokasi)

SPV, Foreman,
4.14 Noise 2 3 6 To wear ear plug or ear muff (Untuk memakai ear plug atau ear muff) 2 1 2
Fitter, HSE
Only authorized entrant allow to enter confined space (Hanya authorized entrant yang
diperbolehkan memasuki ruang terbatas)

To display confined space entry signage adequately (Untuk menampilkan tanda masuk
ruang terbatas secara memadai)
SPV, Foreman,
5.1 Entering by incompetent persons 2 3 6 1 2 2
Holewatcher shall fully standby at entry point and record all movements (Holewatcher Fitter, HSE
harus bersiaga penuh di titik masuk dan mencatat semua pergerakan)

To cover all manholes after completion of activity (Untuk menutup semua manholes
setelah aktivitas selesai)

Work without valid confined space entry To get valid confined space permit and display at permit display board (Untuk SPV, Foreman,
5.2 permit
3 2 6 mendapatkan izin ruang terbatas yang sah dan dipajang di papan pajangan izin)
1 2 2
Fitter, HSE
Verify that the Gas Tester is qualified to perform the testing (Pastikan Penguji
5 Work in confined space Gas memenuhi syarat untuk melakukan pengujian)

Gas test initially at the opening of the confined space after the ventilation has
been turned off for a minimum of 15 minutes. If the readings indicate that it is
safe to do so, test further inside the confined space before allowing work to start
(Tes gas pada ruang terbatas setelah ventilasi dimatikan selama minimal 15
menit. Jika pembacaan menunjukkan bahwa aman untuk melakukannya, uji lebih SPV, Foreman,
5.3 Hazardous atmosphere 2 3 6 lanjut di dalam ruang tertutup sebelum mengizinkan pekerjaan dimulai) 1 2 2
Fitter, HSE
To provide adequate ventilators with continuous ventilation (Untuk menyediakan ventilator
yang memadai dengan ventilasi terus menerus)
Do not bring any compressed gas cylinders inside confined space (Jangan membawa
tabung gas bertekanan ke dalam ruang terbatas)
Do not put any internal combustion equipment closely to the manhole (Jangan letakkan
peralatan pembakaran internal di dekat manhole)
 SPV, Foreman,
5.4 Working in low light condition 2 3 6 To provide sufficient light (Untuk memberikan cahaya yang cukup) 2 1 2
Fitter, HSE
All workers involve shall have to wear body harness with two lanyards and tie off
policy shall be adhered, and ensure 100% double hook tie off for rescue purpose
(semua pekerja yang terlibat harus memakai body harness dengan dua lanyard
dan ketentuan pengikatan harus dipatuhi, dan pastikan 100% double hook
dicantolkan)

Provide the Entry Watch with a communication device to raise the alarm if there
is an emergency (Sediakan Entry Watch dengan perangkat komunikasi untuk
membunyikan alarm jika ada keadaan darurat.)
Gas test initially at the opening of the confined space after the ventilation has
been turned off for a minimum of 15 minutes. If the readings indicate that it is
safe to do so, test further inside the confined space before allowing work to start
(Tes gas pada ruang terbatas setelah ventilasi dimatikan selama minimal 15 SPV, Foreman,
5.5 Rescue difficulty 2 3 6 menit. Jika pembacaan menunjukkan bahwa aman untuk melakukannya, uji lebih Fitter, HSE 1 2 2
lanjut di dalam ruang tertutup sebelum mengizinkan pekerjaan dimulai)
Develop contingency and emergency rescue plans. Include the following in the
Rescue Plan (Kembangkan rencana darurat dan penyelamatan darurat. Sertakan
yang berikut ini dalam Rencana Penyelamatan) :
Procedures for reporting emergencies (Prosedur pelaporan keadaan darurat)
Emergency escape routes (Jalur evakuasi darurat)
5 Work in confined space Rescue equipment required (Peralatan penyelamatan yang diperlukan)
The designated emergency assembly area (Area perakitan darurat yang
ditunjuk)
Rescue and first aid procedures and duties (Prosedur dan tugas penyelamatan
dan pertolongan pertama)

To ensure no obstruction on all access or manhole (Untuk memastikan tidak ada halangan
Access or manhole obstruction or pada semua akses atau lubang got) SPV, Foreman,
5.6 blockage
2 2 4 1 2 2
Store or keep materials or tools at suitable place (Tempatkan atau simpan bahan atau alat Fitter, HSE
di tempat yang sesuai)
SPV, Foreman,
5.7 Dehydration 2 2 4 To drink plenty of water (Untuk minum banyak air)
Fitter, HSE
1 2 2
If exposed direct to the hot sun, please provide proper resting shed and involved workers
6 SPV, Foreman, 2 1 2
5.8 Heat stress 2 3 shall be rotated (Jika terkena sinar matahari langsung, sediakan tempat istirahat yang
layak dan pekerja yang terlibat harus dirotasi) Fitter, HSE

Ensure all tools and materials in good arrangement / order (Pastikan semua alat dan
bahan dalam susunan/tertata dengan baik)

5.9 Slip, trip and fall 2 2 4 All workers involve shall have to wear body harness with two lanyards and tie off SPV, Foreman, 2 1 2
policy shall be adhered, and ensure 100% double hook tie off(semua pekerja Fitter, HSE
yang terlibat harus memakai body harness dengan dua lanyard dan ketentuan
pengikatan harus dipatuhi, dan pastikan 100% double hook dicantolkan)

Using of unapproved or hazardous 3 6 To ensure paints and solvents accompanied with valid MSDS (Untuk memastikan cat dan SPV, Foreman, 2 1 2
6.1 materials
2 pelarut disertai dengan MSDS yang valid) Fitter, HSE
SPV, Foreman,
6.2 Paint or solvents splash to eye 2 2 4 Wear safety eyewear (Kenakan kacamata safety) Fitter, HSE
1 2 2
Ensure paint and solvent container always been kept close (Pastikan wadah cat dan
pelarut selalu tertutup)
6 Painting activity 2 4 Keep distance or protect properly from ignition sources (Jaga jarak atau lindungi dengan SPV, Foreman, 1 2 2
6.3 Fire 2
baik dari sumber api) Fitter, HSE
Fire extinguisher to be placed for control measure (Alat pemadam api harus ditempatkan
untuk tindakan pengendalian)
SPV, Foreman,
6.4 Paint and solvent fumes 2 3 6 To ensure good air movement (Untuk memastikan pergerakan udara yang baik) Fitter, HSE 1 2 2
 Paint and solvent containers incorrectly To dispose all schedule waste correctly (Untuk membuang semua limbah jadwal dengan SPV, Foreman,
6.5 dispose
2 1 2
benar) Fitter, HSE
1 3 3
 To ensure all involved workers undergone WAH training (Untuk memastikan semua
pekerja yang terlibat menjalani pelatihan WAH)
All workers involve shall have to wear body harness with two lanyards and tie off
policy shall be adhered, and ensure 100% double hook tie off(semua pekerja
yang terlibat harus memakai body harness dengan dua lanyard dan ketentuan
SPV, Foreman,
7.1 Fall from height 2 3 6 pengikatan harus dipatuhi, dan pastikan 100% double hook dicantolkan) 2 1 2
Fitter, HSE
If possibility of fall from height is high, always hook the lanyard at strong structure (Jika
kemungkinan terjatuh dari ketinggian tinggi, selalu kaitkan lanyard pada struktur yang kuat)

Do not work outside working platform (Jangan bekerja di luar platform kerja)

Barricades and signage shall be installed at ground level (Barikade dan rambu harus
dipasang di permukaan tanah)

Only use safe and inspected lifting gears (Hanya gunakan lifting gears yang aman dan
telah diperiksa)
Materials and tools fall to ground level SPV, Foreman,
7.2 during lifting and installation
2 3 6 2 1 2
Do not perform lifting activity during heavy rain, strong wind and thunderstorm Fitter, HSE
(Jangan melakukan aktivitas pengangkatan pada saat hujan deras, angin
kencang, dan badai petir)
Tools must have lanyard (Peralatan harus memiliki lanyard)

Verify that the Gas Tester is qualified to perform the testing (Pastikan Penguji
Gas memenuhi syarat untuk melakukan pengujian)
To protect all sparks and fireball using fire retardant blanket (Untuk melindungi semua
percikan api dan bola api gunakan selimut tahan api)
Installation of spiral stairways
7 and handrails Oxygen / acetylene cylinder shall be fitted with safe regulator and flashback arrestor at
regulator and cutting torch (Tabung oksigen/asetilen harus dilengkapi dengan pengatur
pengaman dan penahan kilas balik pada pengatur dan cutting torch)
SPV, Foreman,
7.3 Fire from welding and cutting activity 1 3 3 2 3 6
Perform leak test on every connection using soapy water (Lakukan uji kebocoran Fitter, HSE
pada setiap sambungan menggunakan air sabun)
Keep safe distance from ignition sources or isolate it using solid isolator if sparks
go straight to the cylinder (Jaga jarak aman dari sumber api atau isolasi
menggunakan isolator padat jika percikan api langsung menuju ke silinder)
Firewatcerh equipped with at least dry powder fire extinguisher must be in place
(Firewatcher yang dilengkapi dengan setidaknya alat pemadam api bubuk kering harus
ada di tempatnya)
SPV, Foreman,
7.4 Noise 1 3 3 To wear ear plug or ear muff (Untuk memakai ear plug atau ear muff)
Fitter, HSE
2 3 6

To check on ground strength (Untuk memeriksa kekuatan tanah)

Do not perform lifting activity during heavy rain, strong wind and thunderstorm
(Jangan melakukan aktivitas pengangkatan pada saat hujan deras, angin
kencang, dan badai petir)

7.5 Crane or equipment topple 1 3 3 Crane outrigger shall be fully extended and padded using proper outrigger SPV, Foreman, 1 3 3
padding (Crane outrigger harus direntangkan sepenuhnya dan diberi bantalan Fitter, HSE
menggunakan bantalan crane yang tepat)

Do not park the crane very close to drains, trenches or pits at least 610 mm
(Jangan memarkir crane terlalu dekat dengan saluran air, parit, atau lubang
minimal 610 mm)
 To wear suitable hand gloves (Untuk memakai sarung tangan yang sesuai)

8.1 Hand and finger injury
8 Installation blind flanges
To have good or proper communication and understanding (Untuk memiliki komunikasi SPV, Foreman,
2 3 6 1 2 2
dan pemahaman yang baik atau benar) Fitter, HSE
To ensure end flanges are fitted properly on the hinge (Untuk memastikan flanges ujung
dipasang dengan benar pada engsel)
Use correct method of bolts tightening (Gunakan metode pengencangan baut yang benar)

Use correct size of hammers and spanners (Gunakan palu dan kunci pas dengan ukuran SPV, Foreman,
8.2 Body injury (bolt tightening). 2 3 6 1 2 2
yang benar) Fitter, HSE

Do not work in ‘Line of Fire’ (Jangan bekerja di 'Line of Fire')

To segregate and discard all wastes, rubbish, surplus and unnecessary materials at
designated place or bins (Untuk memisahkan dan membuang semua limbah, sampah,
kelebihan dan bahan-bahan yang tidak perlu di tempat atau tempat sampah yang telah
ditentukan)
Work completed and
9 housekeeping
9.1 Slip, trip and fall 2 3 6 Clear all access / egress from any obstruction (Bersihkan semua akses/keluar dari segala All Workers 1 2 2
halangan)

To remove all barricades and signage and keep it at suitable place (Untuk menyingkirkan
semua barikade dan papan tanda dan menyimpannya di tempat yang sesuai)
 Risk Assessment Sozialization Sheet
Project Title: Lotte Indonesia New Ethylene (LINE) Complex
Page Permit No.
Job Title TANK INSTALLATION
of Revision Date 19-May-24 No.

Work Location WP - 01 Subcontractor PT. JEL SMP 2 Discipline SMP

INDUKSI / PENANDATANGANAN (INDUCTION / SIGNATURE) :

Saya mengkonfirmasi bahwa Risk Asessement telah dijelaskan dan isinya benar-benar dapat dipahami dan diterima
(I confirmed that the Risk Assessment has been explained and totally understandable and acceptable)
Saya benar-benar memahami kontrol-kontrol dalam Risk Assessment ini harus diterapkan sebagaimana yang didokumentasikan; apabila tidak, pekerjaan dihentikan segera
(I totally understood these controls in Risk Assessment should be implemented as documented; otherwise, the work will be stopped immediately)

No Name Position Company Signature Date

10

11

12

13

14

15

16

17

18

19

20
Name Position Date Signature

Subcontractor Discipline Manager / Engineer BONANG F K Engineer

Subcontractor HSE Engineer / Supervisor ANDRY KUSMANA HSE Coordinator

Subcontractor Discipline Supervisor ALI MAHFUDZ Supervisor