Updated: 04/10/2021

Incident Investigation Report  Prelim report Rev.09

Final report

Type of Incident:  Injury, Occupational Illness & Disease Near miss

Off the Job Accident LSR Violation no.
WHAT : Contractor got struck down by MCC panel
WHERE: In front of chiller PM 1 area TIME : 11:45 AM
WHEN: Wednesday, 29 September 2021

Machinery part that accident occurred : Department / Company that accident occurred :
MCC Panel Electric/Instrument MDP
Plant of injured person : Department / Company of injured person :
PT Fajar Surya Wisesa Tbk (FASW) PT Mega Energy Indonesia

Types of Work that Cause Incident:

Production Maintenance Project Services Logistics  Other Housekeeping
KPI affected:

 Personal injuries Occ. Illness Fire Property damage Chemicals spillage Other _______

Impact on worker  Yes No

Impact on asset  Yes No
Impact on Community Yes 
No
Chemical Spillage Yes 
No
 Details of the Incident
Impact on worker
Employees  Supervision Contractor
Under 3rd party

Company’s Clininc 
Hospital Medical Expense :

Hospital : Ridhoka Salma Hospital No. of injured person : 1 Prs

Injured Employee/ First Name Last Name Position Age (yrs/ Total Service Service Years of Company of
person contractor month) Years (Year, this position injured
ID Month, Day) (Year, Month, person
Day)

1 91100260 Mr. A Technician 25 years 1 year 11 months PT Mega

22 days 22 days Energy
Indonesia

Type of Level of Recovery Position Nature of Injury Medical Treatment Start Date Returning Total Lost
Accident Severity time of Injury Date day
Fatality High NA Head - Left Forehead was Call ambulance and 29 Sep 21 NA NA
and Leg attacked by panel evacuate Mr. A to
- back head attacked Ridhoka Salma
to ground Hospital
- Both legs was hit by
panel

Accident involved with other company not involved with other company
Accident
 Details of the Incident
Impact on asset
Production Process Machine / Equipment
Stop Process Medical Expense

 Non Stop Process Estimated Damage Value (Direct cost)

< 2.5 million IDR

Impact on Community
NA

Chemical Spillage
Level of Severity
NA
Level 1 : Chemical spill out of container or primary container
but still in bund
Estimate damage value (direct cost)
Level 2 : Chemical spill out of bund but still in company area
Chemical name : Level 3 : Chemical spill out of company area and effect to
outside company
NA
Quantity of Spillage :
NA
 Fact / sequence of Events / Work Procedure
Time Detail of Accident
Supervisor - EI 1 was asked by Department Head - EI 1 to transfer 6 MCC panels from PM 2 broke reel to
28 Sept
electric workshop in engineering area, because there was a request from production team.
29 Sept – 08:10 Supervisor - EI 1 informed MEI team on morning meeting. After that, Mr. A (MEI planner) assigned Mr. B
(Contractor MEI) and Mr. C (Contractor MEI), to transfer the 6 MCC panels.
08:20 Mr. A, Mr. B and Mr. C borrowed one hand lift [capacity: 3 t; dimension: width 52.5 cm, length: 107 cm,
height: 9-12 cm from Electric Motor Dept. and use the hand lift to transfer 6 MCC panels.
Mr. A, Mr. B and Mr. C went to PM 2 broke reel and started to transport first MCC panel by inserting the hand
lift from the front side of MCC panel [the fork position was between the wooden beams]. The distance to
transport the MCC panels from PM 2 broke reel to electric workshop in engineering area was around 72 m.
08:30
During transporting the first MCC panel, they took the right side of the road. The road was uneven, rough,
and slope, so they took left turn to avoid the rough road and go on the left side of the road and successfully
enter engineering building safely
When Mr. A, Mr. B and Mr. C were transporting the second MCC panel, Supervisor - EI 1 observed the
09:30 transport process. After successfully transfer the second MCC panel, Supervisor - EI 1 went to SAVE ALL SP
1&2 to do other job.
09:30 - 11:00 Mr. A, Mr. B and Mr. C continue to transport MCC panel no. 3 to no. 5 in the same method used previously
Mr. A, Mr. B and Mr. C were about to transport the MCC panel no.6. Mr. B and Mr. C aware that the MCC
panel no. 6 pallet position is different from other MCC panels, when they discover that the wooden pallet
11:00 – 11:15 width is less than other 5 MCC panels [the width is 50 cm, meanwhile other pallet width is 55-70 cm]. So,
they were trying to insert the hand lift from another side of MCC panel by using another wooden block to
support. But they were not succeed.
Then, they asked Mr. D (Group Leader EI 1) for advice on how to insert the hand lift. Mr. D guided them by
using another hand lift to help and successfully insert the hand lift below the wooden beams and start to
move. [At this moment: the front of the panel was on the right side of movement] Mr. D help the transport
11.15-11.30 process. So, there were 4 people when transporting the no.6 MCC panel.

Mr. C was holding the hand lift handle with both hands and move forward. The MCC panel was behind him.
Mr. A was on the right side of the MCC panel, and Mr. D was on the left back and Mr. B was behind.
 Fact / sequence of Events / Work Procedure

Time Detail of Accident

Mr. A, Mr. B, Mr. C and Mr.D started to move MCC panel from broke reel PM 2 to engineering. After moving
around 50 m on the right side of the road they found uneven road near chiller PM 1 area. While, Mr. C was
turning the hand lift to the left to avoid uneven road, suddenly the MCC panel was started tilting down to
11:44 right side. Mr. A who was on the right side was trying to support and push the MCC panel, while the others
were trying to help pull the MCC panel from falling. However, the panel still falling and hit Mr. A on the left
forehead and rest on both legs. Also the back side of the head hit the ground. [During this accident all 4
people were wearing helmet with chin strap]
11:46 Mr. B, Mr. C, and Mr. D, moved the MCC panel to the side to release Mr. A’s legs

11:50 People around the accident location informed Security team to call ambulance

12:00 Ambulance arrived on the site and evacuate Mr. A to Ridhoka Salma Hospital
 Process Flow Diagram/Machine Diagram/
Lay out of Incident

Destination

Accident location
Back side –fac
e up

Distance from start

to accident location:
Front side
±50 m – face down

Start

Please specify for who those follow up CA/PA and approve accident report
Section Manager Review 1 (Safety)

Muhammad Taufiq Lukito Hadisantoso

Reviewer 2 Approver (Director, Mgr. Director)

Suteephong Sumphaophok Peerapol Mongkolsilp

 Process Flow Diagram/Machine Diagram/
Lay out of Incident

MCC Panel Composition MCC Panel Position on Hand Lift

Note:
1st – 5th MCC Panels 6th MCC Panels
• Most of weight at the front panel,
consist of circuit breaker ,switches,
magnetic contactors.
er • C.G. (center of gravity is not
et
M t
ui Fro center) ,it is at the front side
ri c ker nt nt
C ea Fro • 5 panels (go to blue arrow
Br
direction when inserting hand lift
(successful)
e lay • The last panel (6th) go to red arrow
R
direction when inserting hand lift
tic
gne tor
a c
M nta
C o

Hand Lift Dimension

Note:
Unit in cm
51.
5
70
55-
 Process Flow Diagram/Machine Diagram/
Lay out of Incident
Position of worker when transporting MCC panel no. 1-5 [Side View] [Rear View]
Back Front
Center of gravity
Back Front Back (C.G.) was in the
Mr. C middle of the panel
Mr. B Mr. A
Left

Front
Back
80
100
Right

Hand lift fork was in between wooden beam

Position of worker when transporting MCC panel no. 6 [Side View] [Rear View]
Front Center of gravity
(C.G.) was in the right
Right Front Left Back Right Front side of MCC panel
Mr. D
Mr. A Back
Mr. C
80
Mr. B

100
Right Left

Front

Hand lift was below the wooden beam

 Process Flow Diagram/Machine Diagram/
Lay out of Incident

Position of worker when MCC panel falling (REAR VIEW)

Mr. D Mr. C Mr. A Mr. C

Mr. B Mr. D Mr. A
Mr. B

11:44 AM 11:45 AM

When the hand lift turned to the left to avoid Mr. A (Contractor MEI) who was on the right side was trying
uneven road, suddenly the MCC panel was started to support and push the MCC panel, while the others were
tilting down to right side trying to help pull the MCC panel from falling. However, the
panel still falling and hit Mr. A (Contractor MEI)
 Fact / sequence of Events / Work Procedure

More details / support details Pictures show (if any)

Specification of hand lift used during the accident:
1. Hand lift capacity: 3000 kg = 3 t
2. Fork length: 107 cm
3. Fork width: 18 cm
4. Fork to fork width: 52.5 cm
5. Fork height: 9-12 cm

Specification of MCC panel being transported during the

accident:
1. Weight: 465 kg
2. Width: 80 cm
3. Length: 100 cm
4. Height: 220 cm
 Determining the key factor

Accident Investigation Tools

Why Tree Analysis Fault Tree Analysis Other (Please specify)_____________

Contractor got struck down by MCC panel while transferring with hand lift
Observation
The panel fell down to the ground Contractor was hit by the panel
Hypothesis
Hand lift is not C.G. (Center of gravity) The panel on hand Unable to resist In position
proper tool for was out of limit lift was not stable the weight of Line of Fire
the job the falling panel
Left turning to The panel tilted C.G. is high The panel was not The panel slightly
avoid uneven road down to right side fixed on hand lift sliding on hand lift
Physical
Factor The panel The road was Most weight was Panel height Hand lift is beneath Slope of Vibration The panel is too
easily fell down uneven, damaged on right side (2.2 m) wooden beams the road heavy (465 kg)
and not smooth

Most weight The front of the Distance between Hand lift is too Road
was on the panel was on wood beams is wide for the 6th condition
front of panel right side too narrow panel
Human
Factor Selecting the Not repair the The Panel was Put the panel in lack of knowledge No tighten Support the Tried to push
improper tool road to safe designed to cross direction and experience to while moving panel during the panel
condition install all of hand lift use hand lift safely objects transferring while falling
equipment at
the front Change working Prevent the
method without panel from
consulting supervisor 2 falling down
System
Factor No guideline Inefficient safety No safe procedure for No guideline for Inefficient hazard identification
for lifting tools site inspection and transporting MCC operating hand and incomprehensive risk
selection 4 follow up system 5 panel. lift safely assessment
4 4 1,3
 Systems to be Strengthened
Failure Layer (  can specify more than one)

 Risk Assessment & Control Safety Rules Violation

Management of New Project or Initial Phase Management of Change

Pre Start up Safety Review Registration & Regulation Compliance

Incident Investigation & Analysis Emergency Preparedness & Response

Housekeeping General Safety Inspection

Machine & Equipment Inspection Industrial Hygiene Measurement

Health Program Ergonomic

Vender & Contractor Control Product Safety Control

Off the Job Safety Plant Isolation/ Log out-Tag out/ Line Break

Hazardous Chemical Control Radioactive Control

Confined Spaces Safety Work Permit System

Driving Safety Work at Height Safety

Lifting Safety Visitor Safety Control


Process Safety Information (PSI)  Operating Procedures/ Work Instruction

 Training/ On the job Training (OJT)  Unsafe Action

 Type of Accident

Injury Hazard Type (  specify only one type)

Rotating point, nip point  Collapse, Falling Object

Falling from Height (≥ 1.8 Meters) Forklift, Clamp lift, Wheel loader

Cutting, Shearing hazard Spark, Fire

Chemicals (Gas, Liquid, Solid) Flying Object

Confined Space High pressure, vacuum

Crash or Rolling object Excessive exertion

Slip, Trip or obstruct object Explosion

Electricity Drowning

Radiation Motor Vehicle Accident

Hot, Cold Surface Poisonous animals Hazard

Other (Please specify_________________)

 Corrective and Preventive Actions

Cause of accident Corrective & preventive action PIC Due Date

1. Change standard working Analyse hazard and risk assessment every time when changing standard Lukito , All DM, all 8-Oct-21
method from initial design working method from initial design by creating Safety Alert memo DH
without analysis of hazard and regarding this matter and socialize
risk assessment

2. Change working method by Strictly workers to follow SOP of work control system All DM ,All DH 5-Oct-21
himself without consulting Communicate to all subordinates in safety morning meeting
supervisor

3. Lack of knowledge in hazard Provide training of hazard identification and risk assessment to all Lukito 2-Nov-21
identification and risk workers
assessment Review SOP : JSA Talk to coverage all activities both routine and non Lukito 30-Nov-21
routine
Socialize/ Workshop SOP :JSA talk including hazard identification

4. No safe procedure for Create safe procedure for transferring MCC panel and socialize Lukito, M. Taufiq 8-Oct-21
transferring MCC panel.
No guideline for operating hand Create guideline for operating hand lift safely and socialize Lukito 7-Oct-21
lift safely
No guideline for lifting tools Create guideline for lifting tools selection and socialize Lukito 21-Oct-21
selection

5. Inefficient safety site Repair and improve the road Dharmaguna 8-Oct-21
inspection and follow up system Survey and input the data of the road was damaged in all FASW area into
the site inspection program (SAFEsave) and follow up % improved in
biweekly meeting
 Corrective and Preventive Actions

Leverage safety practice from SCGP to Fajar (start Jan’2020)

Master plan consist of 6 categories / 35 action plans
Safety Medium Term Plan 5 years (Rev.1) 01 Feb 2021 Plan Delay or Condition % In Progress ≤ 50% % In Progress > 50% % Complete 100%

Actual
100% 51%
Objective : To enhance safety management thru SPAP system PIC : Lukito and Fajar Safety Team coordinate with PP safety

Target
: Zero Fatality case with 2021, Zero LTIFR within 2024
: SPAP self verified by Fajar and PP Safety in Q4/2021
(Remark SCG Safety Framework version 2020): Zero Fatality case with 2021, Zero LTIFR within 2024: Zero Fatality case
Update
: April 2020
: Revised 01 October 2020
: Revised 01 February 2021: April 2020
Plan 22 Jun 21Actual
with 2021, Zero LTIFR within 2024 : Revised 01 October 2020 22 Jun 21Actual
2020 2021
Status
No. Achievement Plan Activities Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Progress as of 4 Nov 2021 Progress as of 11 Nov 2022 Progress as of 25 Nov 2023
Jan Feb Mar Apr May Jun Jul Aug Sep

1. Achieve and maintain Zero Fatality from working

P A Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4 Wk1-2 Wk3-4
1 Achieve and maintain Zero 1. LSR Implementation
fat ality case from working 1. Annoucement di rector's decree to implementation 100% 100% 100%
2. Review supporti ng procedure (Working at height, loto, ptw,
2.1 Working at Height Plan Trai ning Wk4 Feb 2022
- SOP Progress 100% 100% 100% 100% 100%
- Trai ning 100% 69% 69% 69%
- Impl ement 100% 70% 50% 70%
2.2 Permi t to Work (New System)
- SOP Progress 100% 100% 50% 50% 80% 100% 0% 0% 0% Work permit have dulation 8 hours or once shift
2.2.1 WI Work at Height 100% 100% 100% 100%

2. Enhance Safety Leadership and operational discipline

2.2.2 WI Excavation and trenching permit 100% 100% 100% 100% Have the checklist of excavation
Radiation Checklist : Fajar have 3 persons for
2.2.3 WI working near radi oactive sources permi t 100% 100% 100% 100%
radioactive officers
2.2.4 WI Hot Work Permi t 100% 100% 100% 100% Hot Work Checklist have fire watcher lease 30 min
2.2.5 WI speci fic hot work for worki ng at coal powerplant 100% 100% 100% 100%
FSO to prepare traini ng schedule: 7 Nov 2020 Plan socialization to Dept Head and Manager: 25
Prepare trai ning material: 2 – 12 Nov 2020 Nov 2020.
Trai ni ng for trai ner (FSO):  14 Nov 2020 Plan implementation: 30 Nov 2020
Trai ni ng at the field for super visor and group leaders
Plan socialization to Dept Head and Manager: 25
- Trai ning 100% 0% 0% 0% 0% 0% 0% by FSO: 16 – 28 Nov 2020

3. Zero LTIFR for Employees & Contractors

Nov 2020.
Trai ni ng for dept manager and Dept head by Central
Safety: 17 – 19 Nov 2020FSO to prepare training Plan implementation: 30 Nov 2020
schedul e: 7 Nov 2020 Plan socialization to Dept Head and Manager: 25
Prepare trai ning material: 2 – 12 Nov 2020 Nov 2020.
- Impl ement 100% 0% 0% 0%
2.3 LOTO
LOTO: waiting delivery of new individual tag. Work
- SOP Progress 100% 100% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% Plan Trai ning Wk4 Jan 2022
Instruction: 80%
- Trai ning 100% 70% 0% 0% 0% 0% 0% 0% 0% 20% 20% 50% 60% 70% 70%
- Impl ement 100% 70% 0% 0% 0% 0% 0% 0% 20% 20% 50% 60% 70% 70%

4. Enhance Safety Culture : Develop to Care for Self

2.4 Confi ned Space
- SOP Progress 100% 0% 0% 0% 0% 0% 0% 0% 0% 0%
- Trai ning 100% 0% 0% 0% 0% 0%
- Impl ement 100% 0% 0% 0% 0% 0%
2.5 Impai rment 100% 0% 0% 0% 0% 0% 0% 0%
3. Conduct trai ning to Supervisor & Group Leader 100% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 0% 0%
4. Moni toring compli ance of LSR 100% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 0% 0% 0% 0%
2. Strict ly 100% basic PPE as safety dicipline
1. Review procedure 100% 100% 100%
2. Conduct soci al ization for revi sed procedure 100% 100% 100%
3. Preparation procurement for basic PPE 100% 100% 100% 100% 100%

5. SPAP self verified by Fajar and PP Safety (SCG Safety Framework 2021)
4. Prepare si gn & boundary mandatory area 100% 100% 100% 100%
5. Implementation & monitoring 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 0% 0% 0% 0% 0% 0% 0% 0%
5.1 While entering gate (Safety shoes, Safety helm, chi ns strap) 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
5.2 While operational (Safety shoes, Safety hel m, chin strap,
100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 0% 0% 0% 0%
safety glasses, masker, reflective vest)
5.3 For specifi c activi ty (weldi ng, gri nding, cutting, chemical
prep, radiation, cleaning inci, boil er, steam, el ectricity/rack in 100% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 80% 0% 0% 0% 0%
rack out)
3. Incident Investigation Report (handling)
1. Review & revi se procedure 100% 100% 100% 100%

6. Enhancement Capability of Safety officers and related function

2. Conduct soci al ization related to revi sed procedure 100% 100% 100% 100%
3. Implementation the revi sed procedure 100% 100% 100% 100% 100% 100%
4. Trai ning : Report Acci dent and Man-hour on SAFEsave
100% 80% 0% 80% 80%
Program
4 Incident Investigation Report (investigation)
1. Review & revi se procedure 100% 100% 100% 100% 0%
2. Conduct soci al ization related to revi sed procedure 100% 100% 100% 100%
Organization l earni ng materi als from i nci dents:
3. Implementation the revi sed procedure 100% 100% 100% 100% 100% 100% continuation of new Inci dent Handling, reporting and
i nvestigation SOP.
5. STOP program
1. Coordinate & input template date to SCG Safety 100% 100% 100%
2. Conduct trai ning STOP Program to all Line Manager & Dept. 100% 100% 100% 100% 100% 100% 100% 100% 100%

High light activity

3. Conduct trai ning STOP Program to Supervisor 100% 100% 100% 100% 100% 100% 100% 100% 100%
Deploy Supervi sory Safety Accountabi lity Program Have STOP Analysis and send STOP analysis file to
(SSAP): dail y safety i nspection, pl anned safety Noodee for help analysis other dimention
4.Impl ementaton & moni tori ng program 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
i nspection, planned safety meeting, STOP, SSAP review
by li ne management.
2 Enhance Safety Leadership
6. Safety Leadership / Rule & Responsibility (R & R)
& Operational Dicipline :
Obtain SPAP Self verified 1. Conduct trai ning Safety leadershi p/ R&R to Line Manager,
100% 100% 100% 100%
Dept. Head

Remaining in Q4’2021 and Y2022

Complete decentralization process: organization re-
2. Conduct trai ning safety leadershi p/ R&R for supervi sor level 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% structuring, incl ude safety in the line management
rol es, responsi bility and job descri ption

2020
7. Strengthen of safety capability of Safety Officer (Safety

• Announce 11 LSR (Apr15 ,2020)

1. Prepare materi al training Safety Frame Work 100% 100% 0% 0% 0% 0% 0% 80% 80% 100% 0% 0% 0% 0% 0% 0% 0% 0%
2. Conduct trai ning Safety Frame Work for Safety Officer 100% 20% 0% 0% 0% 0% 0% 0% 80% 20% 0% 0% 0% 0% 0% 0% 0% 0%
8. Workplace design & engineering
Create checklist for standard design (Y/N)
Workplace design & engineering: New design

• LOTO Implementation (70%)

standard for equipments already given to
engineering design team (Pak Idham)Create
checklist for standard design (Y/N)
Workplace design & engineering: New design
standard for equipments already given to

• Basic PPE 100%

engineering design team (Pak Idham)Create

• SAFEsave program : Site inspection, Near miss (50%)

checklist for standard design (Y/N)
Workplace design & engineering: New design
standard for equipments already given to
engineering design team (Pak Idham)Create
checklist for standard design (Y/N)

•
Workplace design & engineering: New design

Hazard identification and risk assessment ( Nov2021)

1. Review Desi gn & Engineering Standard of Work Pl ace 100% 100% 80% 80% 80% 80% 80% 80% 80% 80% 100%
standard for equipments already given to
engineering design team (Pak Idham)Create
checklist for standard design (Y/N)

• Safety leadership ,R&R for DM,DH

Workplace design & engineering: New design
standard for equipments already given to

•
engineering design team (Pak Idham)Create

Contractor safety management (10%)

checklist for standard design (Y/N)
Workplace design & engineering: New design
standard for equipments already given to
engineering design team (Pak Idham)Create
checklist for standard design (Y/N)

• MOC (Management of change)

Workplace design & engineering: New design

• PPE matrix
standard for equipments already given to
engineering design team (Pak Idham)Create
2. Conduct socialization new procedure 100% 100% 80% 80% 80% 80% 80% 80% 100%
3. Improvement according to new standard 100% 100% 80% 80% 80% 80% 80% 80% 100%
9. Management of Change (MOC)

•
Management of change: to be moved to July 2021

Workplace design and engineering standard (10%)

1. Review and revise procedure 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% to be moved to Jul y 2021 from Nov 2020
2. Conduct soci al ization new procedure 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% to be moved to Jul y 2021 from Nov 2020
3. Implementation & monitoring procedure 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% to be moved to Jan 2021 from Sep 2021
10. Emergency prepardness & response
1. Review procedure 100% 0% 0% 0% 0%

•
2. Review & team evaluation

Work permit system

100% 0% 0% 0%
3. Conduct socialization revised procedure

•
100% 0% 0% 0% 0% 0%

Emergency preparedness and response (10%)

4.Implementation revised procedure 100% 0% 0% 0% 0% 0% 0% 0% 0% 0%
5. Upgrade flood pump capacity at GT 3 100% 0%
6. Upgrade flood pump capacity at GT 1,2 100% 0%
7. Project canal rain water step 2 100% 0%
3 Achieve Zero LTIFR for 11. LOTO Implementation
Employees & Contractors 1. Review procedure 100% 100% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 100%

• Value protection (Fire :Raw material, Electrical room,

2. Identification needs of padl ocks 100% 100% 100%
3. Submit i nvestment proposal 100% 100% 100%

•
4. Conduct trai ning, si mul ation to use padlocks 100% 88% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 88%

Work at height
LOTO system: tri al of usi ng lock and LOTO group new
5. Implementation & hand over padlocks to owners (Step 1) 100% 20% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 20%
SOP
Project St ep 2

Finished goods warehouse) (30%)

Project St ep 3
12. Hazard recognition, Risk Assessment & control 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
13. Value protecti on (Fire: raw material/warehouse/paper
1. Re-identification hazard and ri sk assesment 100% 0% 0% 0% 0% 0% 0% 0%
2. Coordinate wi th area owner to i mprove, project etc 100% 0% 0% 0% 0% 0% 0% 0%
3. Create i nvesment proposal at each area owner 100% 0% 0% 0% 0% 0% 0% 0%

• Fall protection/ caught by machine • Road safety work procedure

4. Project execution step 1 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Project St ep 2
Project St ep 3
Project St ep 4
14. Implement Fall protection structure, caught by machine 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Project St ep 1 (fast track):

• Develop safety culture : Develop to care for self

1. Conduct inspection with area owner 100% 100% 100%
2. Report, budget & IP for i mprovement 100% 100% 100%
Fall protection structure, caught by machine:

2021
3. Executi on of project improvement 100% 90% 80% 80% 80% 80% 80% 80% 80% 80% 90% 90% 90% already on-going. Progress reported on production

• Confine space
bi-weekly meeting

• Training SPAP version 2021 and SPAP self verified(40%)

Project St ep 2 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
Project St ep 3
15. Implement SA FEsave application (safety inspection, nearmiss &
other modules)
Site Inspection Program
1. Site Inspection training for safety admin 100% 100% 100%

• General safety rule work procedure (20%)

2. Safety Admin input data 100% 100% 100%
3. Tri al Phase 100% 100% 0% 0%

• Hot work
Deploy Supervi sory Safety Accountabi lity Program Provided Fajar meeting and define solutions of
(SSAP): dail y safety i nspection, pl anned safety site inspection program and feedback
4. Site Inspection i mplement plant wide 100% 80% 0% 0% 0% 0% 0% 0% 80% 80% 80% 80% 80% 80% 80% 80% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
i nspection, planned safety meeting, STOP, SSAP review
by li ne management.

• Electrical safety work procedure

Near-miss Program
1. Near-miss training for safety admi n 100% 0% 0% 0%
2. Near-miss input data 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
3. Tri al Phase 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
4. Near-miss impl ement pl ant wide 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
4 Enhance Safety Culture : 16. Merubah peri laku dan si kap mel al ui proses IBE 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

• Specific hot work for powerplant • Lifting safety work procedure (Nov 2021)
Develop to Care for Self
17. Competency awareness & training 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
18. Safety COP : safety function & li ne supervisor/manager 100% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%
5 SPAP self verified by Fajar
and PP Safety in Q4/2021
(Remark SCG Safety 19. SPAP self veri fied by Fajar and PP Safety 100% 0% 0% 0% 0% 0% 0% 0% Plan Trai ning Wk1 Apr 2022
Framework versio n

• Competency awareness and training

2021)SPAP self verified by
Fajar and PP Safety in 20. E2 : Structure, Roles & Responsi bil ities 100% 0% 0%
Q4/2021
(Remark SCG Safety 21. E3 Performance Management & Continuous Inprovement) 100% 0% 0% 0% 0% 0% 0% 0% 0% 0%

• Radiation control
Framework versio n
2021)SPAP self verified by 22. E4 : Competency, Awareness & Trai ning 0% 0% 0% 0%
Fajar and PP Safety in 23. E5 System Assessment 100% 0% 0% 0% 0% 0%

• Occupation health
Q4/2021 24. E10 Machi ne Integrety 100% 0% 0% 0% 0% 0%
(Remark SCG Safety 25. E11 Occupational Health 100% 0% 0% 0% 0%
Framework versio n
26. E12 Contractor Safety Management 100% 0% 0%
2021)SPAP self verified by
27. E13 Electri cal Safety Work Procedure 100% 0% Plan Trai ning Wk2 Mar 2022
Fajar and PP Safety in
Q4/2021 28. E13 Li fting Safety Work Procedure 100% 0% Plan Trai ning Wk2 Feb 2022

•
(Remark SCG Safety 29. E13 General Safety Rule Work Procedure 100% 0% 0% 0% 0% 0%

Chemicals control
Framework version 2021) 30. E13 Hot Work 100% 0% Plan Trai ning Wk4 Mar 2022

• STOP program
31. E13 Road Safety Work Procedure 100% 0% 0%
32. E13 Radi ation Control 100% 0% 0% 0% 0% 0%
33. E13 Chemical Control 100% 0% Plan Trai ning Wk2 Jan 2022
34. E13 Visitor Control 100% 0%

•
6 Enhancement Capability of Trai ning & Test: SPAP version 2021 100% 0%

Training safety leadership R&R for supervisor level

0%
Safety officers and related Trai ning & Test: Inci dent i nvestigation 100% 100% 100%
function
35. Trai ning & Test: Safety rul es (LSR/ GSR) 100% 100% 100% 0%
Trai ning & Test: KPI deployment 100% 100%
Trai ning & Test: Work permit concept 100% 100% 100%

•
100% 51%

Incident investigation report

Summary

•
100% 100% 100% 98% 93% 95% 94% 87% 89% 75% 78% 66% 56% 50% 52% 31% 31% 29% 28% 34% 37% 42% 41% 28% 23% 20% 16% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Training SCG safety framework 2021 :safety officer

• Procurement PPE / stock minimum
 List of Participants in Incident Investigation

No Name Position Department Signature

1 Suteephong Sumphaophok General Manager Engineering
2 Muhammad Taufiq Manager Electric
3 P.L. Muralikrishna Manager Project & Design
4 Agus Salim Manager MRM
5 Danang Subagyo Manager Mechanic
6 Manickam Arumugam Department Head Electric/Instrument Motor
Power Distribution
7 Stefan Adhityawan Department Head Maintenance System &
Technology
8 Lukito Hadisantoso Manager Sustainable Development

9 Galih Purwanto Department Head Health & Safety

10 Eric Faustine Safety Officer Engineering
11 Nur Site Manager PT Mega Energy Indonesia
12 Arif Bayu Safety Officer PT Mega Energy Indonesia