Safety, Health & Environment

SITE RISK ASSESSMENT FINDING REPORT

Site Location: PROJECT INA ONE Time of Assessment: 09.00 – 10:00 Assessed Area: MRT-B7
Date of Assessment: 27 December 2018 SRA Rating: Assesed by:

No Location of PIC Description of Finding Photo of Finding Corrective Action Corrective Action Target Corrective Photo of Corrective Action Take Status Remarks
Finding Taken by Closure Date Action Status

SHE Site Risk Assessment Report Form Published Date: 30 Oct 2017 Page 1 of 6
 Location of Corrective Action Target Corrective
No PIC Description of Finding Photo of Finding Corrective Action Photo of Corrective Action Take Status Remarks
Finding Taken by Closure Date Action Status

Segera lakukan tagging alat

27 Desember
1 MRT GBP Alat (gerinda) belum ditagging dan jangan gunakan alat SHE, MEK 2018 Close
sebelum ditagging

Breifing pekerja agar tidak

Terdapat putung rokok di area
2 MRT GBP kerja MRT
merokok sembarangan SHE Open
(Merokok di rest area)

Segera tutupi galian tanah

Tidak ada proteksi pada galian dengan terpal agar tidak
3 MRT GBP tanah longsor dan barikade (safety
SPV Open
line)

Ganti warna helm dan

Menggunakan warna helm 27 Desember
4 MRT PT. DIKA yang sama dengan BINKEI
mengikuti warna helm PT. DIKA (JO)
2018 Open
perusahaan tersebut

SHE Site Risk Assessment Report Form Published Date: 30 Oct 2017 Page 2 of 6
 Location of Corrective Action Target Corrective
No PIC Description of Finding Photo of Finding Corrective Action Photo of Corrective Action Take Status Remarks
Finding Taken by Closure Date Action Status

5 B2, B4, B5, B7 PGI Kabel yang melintang Rapihkan dan kabel digulung SPV Open

6
Basement 4 TTI Penataan material yang kurang Buatkan rak dan rapihkan LOG Open
(Gudang) rapih

7
Basement 4 GBP Penataan material yang kurang Buatkan rak dan rapihkan LOG Open
(Gudang) rapih

SHE Site Risk Assessment Report Form Published Date: 30 Oct 2017 Page 3 of 6
 Location of Corrective Action Target Corrective
No PIC Description of Finding Photo of Finding Corrective Action Photo of Corrective Action Take Status Remarks
Finding Taken by Closure Date Action Status

8
Basement 4 EFFRESI Tidak ada penerangan di area Pasang lampu di area gudang LOG Open
(Gudang) NDO gudang

9
Basement 4 GBP Pipa berantakan Rapihkan dengan diberi rak, LOG Open
(Gudang) baricade dan PIC

Susun ducting yang rapih dan

10 B6 TTI Ducting yang kurang rapih
beri barikade, PIC
LOG Open

Ganti disc gerinda dengan

11 B7 TTI Disc gerinda tidak layak pakai
yang baru
SPV Close

Gunakan alat sesuai dengan

Rekayasa alat bor dijadikan fungsinya dan langsung 27 Desember
12 MRT PT. DIKA gerinda dilakukan training kepada
PT. DIKA (JO)
2018 Close
pekerja

Dibuat Oleh, Disetujui Oleh, Diketahui Oleh,

SHE Site Risk Assessment Report Form Published Date: 30 Oct 2017 Page 4 of 6
 Location of Corrective Action Target Corrective
No PIC Description of Finding Photo of Finding Corrective Action Photo of Corrective Action Take Status Remarks
Finding Taken by Closure Date Action Status

Budi Apriyansyah Meitika Triyustitia Yulius Bahar

(SHE OFFICER) (KOORDINATOR SHE) (PROJECT MANAGER)

*) Kolom "Corrective Action Status" harus diisi dengan: Summary of Corrective Action Status:

1 Open : Jika belum dimulai sama sekali proses perbaikannya Open: 7 100%
2 In Progress : Jika sedang dalam proses perbaikan In Progress: 7
0%
3 Close : Jika proses perbaikan sudah selesai dilakukan Close: 0 0%

SHE Site Risk Assessment Report Form Published Date: 30 Oct 2017 Page 5 of 6
 Safety, Health & Environment
SITE RISK ASSESSMENT RATING
Site Location: PROJECT INA ONE Time of Assessment: 09.00 – 10:00 Assessed Area: MRT-B7

Date of Assessment: 43461 SRA Rating: 0 Assesed by: 0

Demerit Point Reference Demerit Points

No Description
In one area In some areas Almost in all In one area In some areas Almost in all
areas areas
1 Fall of Persons Hazards • Floor/lift shaft openings & open sides are covered or barricaded. 10 20 30
• Provide/use proper access, working platform, scaffoldings, PPE, etc 10 20 30
2 Struck by Falling Objects Hazards • Equipment, tools & materials are stored away from building edges. 10 20 30
• Equipment/materials are properly stacked and safely secured. 10 20 30
3 Lifting Operation Hazards • Only trained and competent persons are involved in lifting operation. 10 20 30
• Lifting plan is developed, communicated to all involved personnel and implemented properly. 10 20 30
4 Exposed/Contact with Electricity Hazards • Electrical equipment & hand tools are in good working condition. 10 20 30
• Earth Leakage Circuit Breakers (ELCBs) are provided at all distribution panels. 10 20 30
5 Fire/Explosions Hazards • Flammable materials are stored at predetermined locations. 10 20 30
• Hot work operations adhered to safety requirements. 10 20 30
6 Excavation • Shoring provision in place, and installed according to Professional Engineer design/calculation. 10 20 30
• Provision of safe measures to prevent excess stress on the slopes. 10 20 30
7 Scaffolding/Temporary Structure Works • Scaffold structures and safety net in good condition. 10 20 30
• The accumulation of debris on platforms and netting are regularly removed. 10 20 30
8 Site Traffic Management Control • Provision of safe traffic management and infrastructure on site. 5 10 15
• Safe control for public safety (pedestrian walkways and road traffic control) is in place. 5 10 15
9 Step on, Strike against or by Objects Hazards • Protruding objects or machineries are properly covered up/barricaded. 5 10 15
• Equipment/materials are properly handled. 5 10 15
10 Permit To Work System • Permit to Work and Checklist displayed. 5 10 15
• Endorsed by all necessary persons. 5 10 15
11 Equipment & Tools Hazards • Equipment & tools are in good working condition. 5 10 15 10
• Equipment & tools are regularly inspected by competent person. 5 10 15
12 Exposed/Contact with Hazardous Substance • Proper storage of harmful substances is being provided. 5 10 15
• Containers for all hazardous substances are appropriately labeled. 5 10 15
13 Housekeeping • Materials are properly stored & not obstructing the access way. 5 10 15 10
• Construction wastes are disposed at designated locations. 5 10 15
14 Personal Protective Equipment (PPE) • PPE (e.g. Helmet, vest, safety shoes, safety harness) are in good condition. 5 10 15 10
• Appropriate PPE is being use and used correctly for the work activity. 5 10 15
15 Physical hazards • Adequate illumination at work location and access/egress. 5 10 15
• Safe manual handling practice on site. 5 10 15
16 Others • First aid provision, health facilities, welfare, etc are provided properly. 5 10 15
• Display of safety signs/safety information, safety campaign, emergency plan, etc are provided sufficiently. 5 10 15
• Safety Induction, tool box meeting, daily inspection, incident sharing & cleaning day are regularly conducted 5 10 15
Total Demerit Point 30
Rating Total Demerit Points Category Remarks SRA Rating C
A 10 or less Satisfactory Some strengths but also some moderate weaknesses
B 11 to 25 Fair Some strengths but at least one major weaknesses
C 26 to 40 Need Improvement A few strengths and a few major weaknesses
D 41 or more Poor Very few strengths and numerous major weaknesses

SHE Site Risk Assessment Rating Form Published Date: 30 Oct 2017 Page 6 of 6