PT. PP (PERSERO) TBK.

DIVISI EPC
IDENTIFIKASI BAHAYA DAN PENGENDALIAN RESIKO
NPK CHEMICAL 500.000 MTPY PROJECT
No.IBPR : IBPR
Revisi :3
Tanggal Issued : 30-Aug-2019
Tanggal Revisi : 05-Feb-2020
Step 3: Penilaian Resiko Area : NPK Chemical
Dept. : Project

Step1 : Kemungkinan (Likeliho Step2: Keparahan (Consequency) Step 4:

1 Tak Berarti (Insignificant) 1 Tak Berarti (Insignificant) Menentukan kontrol resiko yang akan di lakukan
2 Rendah (Low) 2 Rendah (Low)
3 Sedang Rendah (Medium Lo 3 Sedang Rendah (Medium Low) Step 5: Risiko sisa setelah dilakukan pengendalian
4 Sedang Tinggi (Medium High 4 Sedang Tinggi (Medium HIgh) 15-25 = High
5 Tinggi (High) 5 Tinggi (High) 8-12 = Medium High
4-6 = Medium Low
2-3 = Low
1 = Insignificant

Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

A External Hazard

A.1.1 PIM Production (Urea Toxic Chemicals Exposure
Plant) Risks
(- Asphyxia due to inhalation
of simple Exposure Risks
asphyxiants like CO2 and
chemical asphyxiant, NH3.
Solution of Urea,
Ammonium carbamate
and ammonium
carbonate containing high
NH3 content.
- Irritation due to inhalation
of urea dust)
FAC, MTC Enviromental 3 4 12 1. Monitoring 1. Socialization Ammonia Gas masks for use 1 2 2 Ya Eye contact: Immediately UU No: 18 /1999
Pollutant Exposure by Procedure and JSA in leakage of Gases flush the eye with water. tentang Jasa
Ammonia detector like Ammonia, etc. Exposure to ammonia Konstruksi
are available in all vapour may cause serious
the Site eye damage, so call for UU No 1/1970
medical help. Keselamatan
Kerja
Skin contact: Wash off
with soap and water. If Qanun No.7 thn
there are any signs of skin 2017 tentang
damage, call for first aid. Keselamatan dan
Kesehatan Kerja
If inhaled: Call for
immediate medical help.

A.1.2 Contract with Injury to personnel (struck by FAC, MTC, LTI Enviromental Property 4 3 12 People / plant People / Plant Wearing of PPE 2 1 2 Ya UU No: 18 /1999
equipment/vehicle of / struck against) Pollutant damage segregation segregation measures in Mandatory tentang Jasa
another project in the measures in place place Konstruksi
same area (PT Alhas Safe site access Safe site access ways to
Jaya Group) ways to be in place. be in place UU No 1/1970
Induction and training of Keselamatan
personnel. Kerja

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

A.1.3 Driving Increased traffic specific to FAC, MTC, LTI Enviromental Property 5 3 15 Spot checks on 1. Create a Journey 2 2 4 Ya Peraturan Kepala
activity of project vehicles on Pollutant damage speed and vehicle Management Planb. Kepolisian RI No.9
other project and public maintenance 2. Do preinspect the Tahun 2012
roads condition. vehicle before use Tentang Surat Izin
3. Ensure that vehicle Mengemudi
operators have a driving
license UU No 1/1970
Keselamatan
Kerja

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

B PREPARATION WORKS

B.1 SOIL INVESTIGATION

B.1.1 Soil Investigation Works Hand injury FAC, MTC 3 3 9 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya UU No: 18 /1999
machine must be method statement, JSA, PPE (Helm, Safety tentang Jasa
covered and Permit Glassess, Hand Konstruksi
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
Keselamatan
Kerja

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

Electrical shock FAC, MTC 4 4 16 1. Use electrical 1. Conduct pre-mob Wear mandatory 2 2 4 Ya UU No: 18 /1999
equipment with inspection for equipment PPE (Helm, Safety tentang Jasa
water proof 2. Perform daily pre-use Glassess, Hand Konstruksi
installation inspection gloves, Safety
Shoes) UU No 1/1970
Keselamatan
Kerja

Permenaker
12/2015 K3 Listrik
di tempat kerja

Fire FAC, MTC Oil spill Property 4 5 20 1. Conduct pre-mob Wear mandatory 2 3 6 Ya Provide Fire Ex arround UU No: 18 /1999
damage inspection for equipment PPE (Helm, Safety the activities tentang Jasa
2. Perform daily pre-use Glassess, Hand Konstruksi
inspection gloves, Safety
Shoes) UU No 1/1970
Keselamatan
Kerja

B.2 SITE DEVELOPMENT

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

B.2.1 Land Clearing & Traffic accident MTC, FAT Property 3 3 9 1. Conduct defensive 2 3 6 Ya PerMen No.05
Compaction damage driving awareness to all Tahun 1985
heavy vehicle & tentang pesawat
equipment operator angkat angkut
2. Assign a personel as
flagman and spotter PER.09/MEN/VII/2
3. Ensure all operator & 010 Tentang
driver have valid license operator dan
& certificate Petugas Pesawat
4. Install safety signage Angkat dan Angkut

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

UU No 1/1970
Keselamatan
Kerja

Damage to flora and Enviromental 3 4 12 1. See AMDAL 2 2 4 Ya UU No. 32 Tahun

disturbance to fauna, damage 2. Remove top 15-20 cm 2009 tentang
including rare and of Valuable soil and Perlindungan dan
endangered species stockpile at designated Pengelolaan
area Lingkungan

PP No. 21 Tahun
2010 tentang
Perlindungan
Lingkungan
Maritim

UU No 1/1970
Keselamatan
Kerja

Oil & chemical spill Water & soil 3 4 12 1. Provide 1. Fueling & Re-fueling 2 1 2 Ya UU No. 32 Tahun
pollution secondary activities must be done 2009 tentang
containment during in impermeable area. Perlindungan dan
maintenance & Pengelolaan
fueling/re-fueling Lingkungan
activities
PP No. 21 Tahun
2010 tentang
Perlindungan
Lingkungan
Maritim

UU No 1/1970
Keselamatan
Kerja

B.2.2 Temporary Facility Hand injury FAC, MTC 4 3 12 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya UU No 1/1970
machine must be method statement, JSA, PPE (Helm, Safety Keselamatan
covered and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes)

Electrical shock FAC, MTC 3 4 12 1. Use electrical 1. Conduct pre-mob Wear mandatory 2 2 4 Ya UU No 1/1970
equipment with inspection for equipment PPE (Helm, Safety Keselamatan
water proof 2. Perform daily pre-use Glassess, Hand Kerja
installation inspection gloves, Safety
Shoes) Permenaker
12/2015 K3 Listrik
di tempat kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Fire FAC, MTC Oil spill Property 3 3 9 1. Conduct pre-mob Wear mandatory 2 3 6 Ya Provide Fire Ex arround .UU No. 32 Tahun
damage inspection for equipment PPE (Helm, Safety the activities 2009 tentang
2. Perform daily pre-use Glassess, Hand Perlindungan dan
inspection gloves, Safety Pengelolaan
Shoes) Lingkungan

PP No. 21 Tahun
2010 tentang
Fall from height MTC, FAT 4 4 16 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya Permenaker
Perlindungan
scaffolding method statement, JSA, PPE (Helm, Safety 9/2016
Lingkungan
and Permit Glassess, Hand Keselamatan
Maritim
2. Socialization work gloves, Safety Pekerjaan di
method, JSA, & Permit Shoes) Ketinggian
UU No 1/1970
3. Personel who perform Keselamatan
working at height must Wear spesific PPE UU No 1/1970
Kerja
be attend working at (Full body harness) Keselamatan
height training Kerja

C CIVIL WORK
C.1 Building & storage Hand injury FAC, MTC 4 3 12 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya Permen No.
machine must be method statement, JSA, PPE (Helm, Safety PER.01/MEN/198
covered and Permit Glassess, Hand 0 tentang
2. Socialization work gloves, Safety keselamatan dan
method, JSA, & Permit Shoes) Kesehatan Kerja
pada Konstruksi
Bangunan

Permen No :
05/PRT/M/2014
tentang Pedoman
SMK3 Konstruksi
Bidang Pekerjaan
Umum

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

UU No 1/1970
Keselamatan
Kerja

Electrical shock FAC, MTC 3 4 12 1. Use electrical 1. Conduct pre-mob Wear mandatory 2 2 4 Ya Permenaker No 12
equipment with inspection for equipment PPE (Helm, Safety Tahun 2015
water proof 2. Perform daily pre-use Glassess, Hand Tentang
installation inspection gloves, Safety Keselamatan dan
Shoes) Kesehatan Listrik
di Tempat Kerja

UU No 1/1970
Keselamatan
Kerja

Fire FAC, MTC Oil spill Property 3 3 9 1. Conduct pre-mob Wear mandatory 2 3 6 Ya Provide Fire Ex arround UU No 1/1970
damage inspection for equipment PPE (Helm, Safety the activities Keselamatan
2. Perform daily pre-use Glassess, Hand Kerja
inspection gloves, Safety
Shoes)

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya Permenaker
scaffolding method statement, JSA, PPE (Helm, Safety 9/2016
and Permit Glassess, Hand Keselamatan
2. Socialization work gloves, Safety Pekerjaan di
method, JSA, & Permit Shoes) Ketinggian
3. Personel who perform
working at height must Wear spesific PPE UU No 1/1970
be attend working at (Full body harness) Keselamatan
height training Kerja
4. Scaffolding must
install & inspect by
competence person

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Drop object MTC, FAT 4 5 20 Install toe board on 1. Scaffolding must Wear mandatory 3 2 6 Ya Permenaker
scaffolding install & inspect by PPE (Helm, Safety 9/2016
competence person Glassess, Hand Keselamatan
gloves, Safety Pekerjaan di
Shoes) Ketinggian

Wear spesific PPE UU No 1/1970

(Full body harness) Keselamatan
Kerja

Heavy equipment (crane) MTC, FAT 3 4 12 Provide base plate 1. Conduct pre-mob Wear mandatory 3 3 9 Ya Permenaker
collapse for out rigger inspection for heavy PPE (Helm, Safety 9/2010 Operator &
equipment Glassess, Hand petugas pesawat
2. Perform daily pre-use gloves, Safety angkat angkut
inspection for all heavy Shoes)
equipment Permenaker
3. Ensure all operator 5/1985 Pesawat
have valid license angkat angkut

UU No 1/1970
Keselamatan
Kerja

Excavation activities Slide & errosion MTC, LTI 3 4 12 1. implementation 1. Prepare the work Wear mandatory 2 3 6 Permen No.
shoring/ benching method statement, JSA, PPE (Helm, Safety PER.01/MEN/198
2. Provide and Permit Glassess, Hand 0 tentang
emergency access 2. Socialization work gloves, Safety keselamatan dan
method, JSA, & Permit Shoes) Kesehatan Kerja
pada Konstruksi
Bangunan

Permen No :
05/PRT/M/2014
tentang Pedoman
SMK3 Konstruksi
Bidang Pekerjaan
Umum

UU No 1/1970
Keselamatan
Kerja

C.2 PiILLING
C.2.1 Loading and Unloading Struck down by things MTC, LTI Property 3 4 12 Analizing the Load ( 1. Make sure the sling is 3 2 6 Ya PerMen No.05
Materials Damaged weight, shape, lift tied/binded correct and Tahun 1985
point, etc) and the tighten tentang pesawat
lifting device 2. Check the lifting angkat angkut
device (slings, shackle,
etc) is proper to use and PER.09/MEN/VII/2
safety 010 Tentang
operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

Squeezed by sling MTC, LTI 3 4 12 Tighten the slings Use the hand 3 2 6 Ya
before lifting done gloves when tighten
slings

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Hit by equipment/crane MTC, LTI 3 4 12 1. Keep clear 1. Analizing the 3 2 6 Ya PerMen No.05
distance from the Load ( weight, Tahun 1985
swing and working shape, lift point, etc) tentang pesawat
load and the lifting angkat angkut
device
2. Use tag line to PER.09/MEN/VII/2
control the load 010 Tentang
operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

Squeezed by material Property 3 4 12 1. Use the wooden 3 2 6 Ya PerMen No.05

Damaged bar , put on the Tahun 1985
ground for support tentang pesawat
the angkat angkut
pile/equipment/thing
s PER.09/MEN/VII/2
2. Make sure the 010 Tentang
ground is flat and operator dan
hard to put the Petugas Pesawat
material Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

Crane fall accidently MTC, FAT Property 3 4 12 1. Using steel plate 3 2 6 Ya PerMen No.05
Damaged if the location not Tahun 1985
hard enough tentang pesawat
2. Analizing the angkat angkut
Load ( weight,
shape, lift point, etc) PER.09/MEN/VII/2
and the lifting 010 Tentang
device is suitable operator dan
with crane capacity Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Crane fall accidently MTC, FAT Property 3 4 12 1. Using steel plate 3 2 6 Ya PerMen No.05
Damaged if the location not Tahun 1985
hard enough tentang pesawat
2. Analizing the angkat angkut
Load ( weight,
shape, lift point, etc) PER.09/MEN/VII/2
and the lifting 010 Tentang
device is suitable operator dan
with crane capacity Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

C.2.2 Generator set operation Contact withEquipment FAC, MTC Property 3 4 12 Always shut down 1. Operators to Wear PPE 2 2 4 Ya UU No 1/1970
resulting burns or electric Damaged machine before ensure barrier mandatory Keselamatan
shock carrying out any erection and distant (especially rubber Kerja
inspections or from work areas. hand gloves and
adjustments 2. Always use earth rubber shoes) Permenaker
stake supplied 12/2015 K3 Listrik
di tempat kerja

Leaking fuel causing fire or FAC, MTC Property 3 4 12 Switch engine off 1. Operators to Firm footwear to be 2 2 4 Ya UU No 1/1970
slipping hazard Damaged before refueling and check machine worn and care taken Keselamatan
make sure fuel cap dailyfor fuel and oil to prevent slips and Kerja
is replaced leaks trip
2. Fuel storage to Permenaker
be secure and well 12/2015 K3 Listrik
clear of engine and di tempat kerja
any hot areas
3. Ground to be
checked and any
spills rectified

Oil spill occur when refuelling FAC Enviromental 3 4 12 1. Provide 1. Fueling & Re-fueling Wear PPE like a 2 1 2 Ya UU No. 32 Tahun
damage secondary activities must be done safety glass, hand 2009 tentang
containment during in impermeable area. gloves, and safety Perlindungan dan
maintenance & shoes Pengelolaan
fueling/re-fueling Lingkungan
activities
PP No. 21 Tahun
2010 tentang
Perlindungan
Lingkungan
Maritim

UU No 1/1970
Keselamatan
Kerja
C.2.3 Site Preparation Work Hot Weather FAC, MTC 3 3 9 Used cover 2 2 4 Ya PerMen No.05
- Surveying (umbrella, hat, Tahun 1985
- Construct helmet) tentang pesawat
workshop/office/access angkat angkut
road
PER.09/MEN/VII/2
010 Tentang
operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Structed by sharp material 3 3 9 Follow the working Using Hand gloves 2 2 4 Ya

(nail, knife, etc) procedure and safety tools

C.2.4 Pilling Work

Handling first section & PC Pile Slip
as follow section PC Pile broken when lifting
Swing/hit by PC Pile
Struck down by PC Pile
MTC, FAT Property 3 4 12 Keep clear distance 1. Bind the lifting 1. Conduct pre-mob Using helmet 3 3 9 Ya PerMen No.05
Damaged and carefully sling twice to pc pile inspection for heavy Tahun 1985
2. Bind sling/wire equipment tentang pesawat
rope at liftying point 2. Perform daily pre-use angkat angkut
(1/3-1/5 Length Pile) inspection for all heavy
equipment PER.09/MEN/VII/2
3. Ensure all operator 010 Tentang
have valid license operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

Pitching Pile first section Squeeze by pc pile MTC, FAT Property 3 4 12 Keep clear distance Use guidance bar Use Hand gloves 3 3 9 Ya
& as follow section Damaged and carefully when pitch onto the
pile
First driving and continue Pile broken MTC, FAT Property 3 3 9 Keep clear distance Use Helmet 3 3 9 Ya PerMen No.05
driving and driving with Struck down pc material Damaged (min : length of pile) Tahun 1985
follower cause top pile broken tentang pesawat
angkat angkut

PER.09/MEN/VII/2
010 Tentang
operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

Joint / splicing pile Electrical Shock MTC, FAT Property 3 3 9 Make sure the cable 1. Use the cap 3 3 9 Ya PerMen No.05
Hit material/gram by Damaged not hurt and the welding/grinding Tahun 1985
welding/grinding ground not stagnate 2. Use appron tentang pesawat
by water (welding dress) angkat angkut

PER.09/MEN/VII/2
010 Tentang
operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Taking final set Struck Material PC MTC, FAT Property 3 3 9 Stop the HSPD Use Helmet 3 3 9 Ya PerMen No.05
Pile/soil/sand Damaged when the pc pile will Tahun 1985
broke tentang pesawat
angkat angkut

PER.09/MEN/VII/2
010 Tentang
operator dan
Petugas Pesawat
Angkat dan Angkut

UU No. 28/2002
TentangBangunan
Gedung

UU No 1/1970
Keselamatan
Kerja

C.3 New Jetty Heavy equipment (crane) MTC, FAT 3 4 12 1. Provide base 1. Conduct pre-mob Wear mandatory 3 3 9 Ya UU No 1/1970
collapse plate for out rigger inspection for heavy PPE (Helm, Safety Keselamatan
equipment Glassess, Hand Kerja
2. Perform daily pre-use gloves, Safety
inspection for all heavy Shoes) Permenaker
equipment 9/2010 Operator &
3. Ensure all operator petugas pesawat
have valid license angkat angkut

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

Permenaker
5/1985 Pesawat
angkat angkut

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding method statement, JSA, PPE (Helm, Safety Keselamatan
and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training Ketinggian
4. Scaffolding must
install & inspect by
competence person

Man over board MTC, FAT 4 4 16 1. Install hard 1. Prepare the work Wear mandatory 3 2 6 Ya Provide life buoy and PER.08/MEN/VII/2
barricade method statement, JSA, PPE (Helm, Safety assign stanby personnel 010 Tentang Alat
and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
3. Personel who perform Keselamatan
work near water must be Wear spesific PPE Kerja
attend work near water (Life Jacket)
training.

D ELECTRICAL &
INSTRUMENT

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

D.1 Instalation electrical Hand injury FAC, MTC 4 3 12 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya UU No 1/1970
equipment & instrument machine must be method statement, JSA, PPE (Helm, Safety Keselamatan
covered and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Qanun No.7 thn
2017 tentang
Keselamatan dan
Kesehatan Kerja

Permenaker
12/2015 K3 Listrik
di tempat kerja

Electrical shock FAC, MTC 3 4 12 1. Use electrical 1. Install ELCB on 1. Conduct pre-mob Wear mandatory 2 2 4 Ya UU No 1/1970
equipment with electrical panel inspection for equipment PPE (Helm, Safety Keselamatan
water proof 2. Perform daily pre-use Glassess, Hand Kerja
installation inspection gloves, Safety
Shoes) Permenaker
12/2015 K3 Listrik
di tempat kerja

D.2 Cable pulling Slip, Trip, Fall FAC, MTC 3 3 9 1. Prepare the work Wear mandatory 1 2 2 Ya PER.08/MEN/VII/2
method statement, JSA, PPE (Helm, Safety 010 Tentang Alat
and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
3. Ensure area free from Keselamatan
obstacle while pulling Kerja
cable
4. Assign one personnel
as standby man

0
D.3 Wiring activities Slip, Trip, Fall FAC, MTC 3 3 9 1. Prepare the work Wear mandatory 1 2 2 Ya PER.08/MEN/VII/2
method statement, JSA, PPE (Helm, Safety 010 Tentang Alat
and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
3. Ensure area free from Keselamatan
obstacle while pulling Kerja
cable
4. Assign one personnel
as standby man

0
D.4 Termination Electrical shock FAC, MTC 3 4 12 1. Use electrical 1. Install ELCB on 1. Conduct pre-mob Wear mandatory 2 2 4 Ya UU No 1/1970
equipment with electrical panel inspection for equipment PPE (Helm, Safety Keselamatan
water proof 2. Perform daily pre-use Glassess, Hand Kerja
installation inspection gloves, Safety
3. Only competence Shoes) Permenaker
personnel can perform 12/2015 K3 Listrik
the activities di tempat kerja

0
D.5 Tie In & Test Electrical shock FAC, MTC 4 4 16 1. Use electrical 1. Install ELCB on 1. Conduct pre-mob Wear mandatory 2 2 4 Ya UU No 1/1970
equipment with electrical panel inspection for equipment PPE (Helm, Safety Keselamatan
water proof 2. Perform daily pre-use Glassess, Hand Kerja
installation inspection gloves, Safety
3. Only competence Shoes) Permenaker
personnel can perform 12/2015 K3 Listrik
the activities di tempat kerja

E MECHANICAL WORKS

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

E.1 Loading & Unloading Heavy equipment (crane) MTC, FAT 3 4 12 1. Provide base 1. Conduct pre-mob Wear mandatory 3 3 9 UU No 1/1970
Material collapse plate for out rigger inspection for heavy PPE (Helm, Safety Keselamatan
equipment Glassess, Hand Kerja
2. Perform daily pre-use gloves, Safety
inspection for all heavy Shoes) Permenaker
equipment 9/2010 Operator &
3. Ensure all operator petugas pesawat
have valid license angkat angkut

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

Permenaker
5/1985 Pesawat
angkat angkut
Traffic accident MTC, FAT Property 3 3 9 1. Separation 1. Conduct defensive Wear mandatory 2 3 6 UU No 1/1970
damage between people and driving awareness to all PPE (Helm, Safety Keselamatan
vehicle/ equipment heavy vehicle & Glassess, Hand Kerja
access equipment operator gloves, Safety
2. Assign a personel as Shoes) Permenaker
flagman and spotter 9/2010 Operator &
3. Ensure all operator & petugas pesawat
driver have valid license angkat angkut
& certificate
4. Install safety signage Permenaker
5/1985 Pesawat
angkat angkut

Drop Object MTC, FAT Property 3 3 9 1. Installed hard 1. Install safety signage Wear mandatory 3 2 6 Ya UU No 1/1970
damage barricade 2. Prohibition other PPE (Helm, Safety Keselamatan
people to walking under Glassess, Hand Kerja
the load gloves, Safety
Shoes) Permenaker
9/2010 Operator &
petugas pesawat
angkat angkut

Permenaker
5/1985 Pesawat
angkat angkut

E.2 Structure erection Heavy equipment (crane) MTC, FAT 3 4 12 1. Provide base 1. Conduct pre-mob Wear mandatory 3 3 9 Ya UU No 1/1970
collapse plate for out rigger inspection for heavy PPE (Helm, Safety Keselamatan
equipment Glassess, Hand Kerja
2. Perform daily pre-use gloves, Safety
inspection for all heavy Shoes) Permenaker
equipment 9/2010 Operator &
3. Ensure all operator petugas pesawat
have valid license angkat angkut

Permenaker
5/1985 Pesawat
angkat angkut

Drop Object MTC, FAT Property 3 3 9 1. Installed hard 1. Install safety signage Wear mandatory 3 2 6 Ya UU No 1/1970
damage barricade 2. Prohibition other PPE (Helm, Safety Keselamatan
people to walking under Glassess, Hand Kerja
the load gloves, Safety
Shoes) Permenaker
9/2010 Operator &
petugas pesawat
angkat angkut

Permenaker
5/1985 Pesawat
angkat angkut

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding method statement, JSA, PPE (Helm, Safety Keselamatan
and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training Ketinggian
4. Scaffolding must
install & inspect by
competence person

E.3 Lifting & instalation Heavy equipment (crane) MTC, FAT 3 4 12 1. Provide base 1. Conduct pre-mob Wear mandatory 3 3 9 Ya UU No 1/1970
collapse plate for out rigger inspection for heavy PPE (Helm, Safety Keselamatan
equipment Glassess, Hand Kerja
2. Perform daily pre-use gloves, Safety
inspection for all heavy Shoes) Permenaker
equipment 9/2010 Operator &
3. Ensure all operator petugas pesawat
have valid license angkat angkut

Qanun No.7 thn

2017 tentang
Keselamatan dan
Kesehatan Kerja

Permenaker
5/1985 Pesawat
angkat angkut

Drop Object MTC, FAT Property 3 3 9 1. Installed hard 1. Install safety signage Wear mandatory 3 2 6 Ya UU No 1/1970
damage barricade 2. Prohibition other PPE (Helm, Safety Keselamatan
people to walking under Glassess, Hand Kerja
the load gloves, Safety
Shoes) Permenaker
9/2010 Operator &
petugas pesawat
angkat angkut

Permenaker
5/1985 Pesawat
angkat angkut

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding method statement, JSA, PPE (Helm, Safety Keselamatan
and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training Ketinggian
4. Scaffolding must
install & inspect by
competence person

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

E.4 Piping works Slip, Trip, Fall FAC, MTC 3 3 9 1. Prepare the work Wear mandatory 1 2 2 Ya PER.08/MEN/VII/2
method statement, JSA, PPE (Helm, Safety 010 Tentang Alat
and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Qanun No.7 thn
3. Ensure area free from 2017 tentang
obstacle while pulling Keselamatan dan
cable Kesehatan Kerja
4. Assign one personnel
as standby man UU No 1/1970
Keselamatan
Kerja

E.5 Painting Toxic gas MTC, FAT 3 4 12 1. Installed air 1. Prepare the work Wear mandatory 2 2 4 Ya Permen No.
blower method statement, JSA, PPE (Helm, Safety PER.01/MEN/198
and Permit Glassess, Hand 0 tentang
2. Socialization work gloves, Safety Keselaman dan
method, JSA, & Permit Shoes) Kesehatan Kerja
pada konstruksi
Wear spesific PPE bangunan
(Respirator Masker)
Permen No.310
thn 2016 tentang
kategori konstruksi
golongan
konstruksi khusus
pada jabatan kerja
tukang cat
bangunan gedung

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding method statement, JSA, PPE (Helm, Safety Keselamatan
and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training if painting at height Ketinggian
4. Scaffolding must
install & inspect by
competence person

E.6 Repair & fabrication Hand injury FAC, MTC 4 3 12 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya PER.08/MEN/VII/2
machine must be method statement, JSA, PPE (Helm, Safety 010 Tentang Alat
covered and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
Keselamatan
Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

E.7 Scaffolding instalation Scaffolding collapse MTC, FAT Property 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Y Permenaker
damage scaffolding (tubular method statement, JSA, PPE (Helm, Safety 9/2016
with BS standard) and Permit Glassess, Hand Keselamatan
2. Socialization work gloves, Safety Pekerjaan di
method, JSA, & Permit Shoes) Ketinggian
3. Personel who perform
working at height must Wear spesific PPE Qanun No.7 thn
be attend working at (Full body harness) 2017 tentang
height training Keselamatan dan
4. Scaffolding must Kesehatan Kerja
install & inspect by
competence person UU No 1/1970
Keselamatan
Kerja

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding (tubular method statement, JSA, PPE (Helm, Safety Keselamatan
with BS standard) and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training Ketinggian
4. Scaffolding must
install & inspect by
competence person

E.8 Welding & cutting Hand injury FAC, MTC 4 3 12 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya PER.08/MEN/VII/2
activities machine must be method statement, JSA, PPE (Helm, Safety 010 Tentang Alat
covered and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Per.02/MEN/1982,
tentang kualifikasi
juru las ditempat
kerja

UU No 1/1970
Keselamatan
Kerja

Fire FAC, MTC Property 3 3 9 1. Conduct pre-mob Wear mandatory 2 3 6 Ya Provide Fire Ex arround PER.08/MEN/VII/2
damage inspection for equipment PPE (Helm, Safety the activities 010 Tentang Alat
2. Perform daily pre-use Glassess, Hand Pelindung Diri
inspection gloves, Safety
Shoes) Per.02/MEN/1982,
tentang kualifikasi
juru las ditempat
kerja

UU No 1/1970
Keselamatan
Kerja

E.9 Grinding activities Hand injury FAC, MTC 4 3 12 1. All part of rotating 1. Prepare the work Wear mandatory 1 2 2 Ya PER.08/MEN/VII/2
machine must be method statement, JSA, PPE (Helm, Safety 010 Tentang Alat
covered and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
Keselamatan
Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

Fire FAC, MTC Property 3 3 9 1. Conduct pre-mob Wear mandatory 2 3 6 Ya Provide Fire Ex arround PER.08/MEN/VII/2
damage inspection for equipment PPE (Helm, Safety the activities 010 Tentang Alat
2. Perform daily pre-use Glassess, Hand Pelindung Diri
inspection gloves, Safety
Shoes) UU No 1/1970
Keselamatan
Kerja

E.10 Working at Height Scaffolding collapse MTC, FAT Property 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
damage scaffolding (tubular method statement, JSA, PPE (Helm, Safety Keselamatan
with BS standard) and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Qanun No.7 thn
3. Personel who perform 2017 tentang
working at height must Wear spesific PPE Keselamatan dan
be attend working at (Full body harness) Kesehatan Kerja
height training
4. Scaffolding must Permenaker
install & inspect by 9/2016
competence person Keselamatan
Pekerjaan di
Ketinggian

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding (tubular method statement, JSA, PPE (Helm, Safety Keselamatan
with BS standard) and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training Ketinggian
4. Scaffolding must
install & inspect by
competence person

E.11 Confined Space Activities Asphyxia MTC,FAT 4 5 20 1. Installed blower 1. Prepare the work Wear mandatory 2 2 4 Ya UU No 1/1970
method statement, JSA, PPE (Helm, Safety Keselamatan
and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Kepdirjen
3. Personel who perform 113/2006 Petugas
confined space must be Wear spesific PPE Ruang Terbatas
attend confined space (Respirator Masker)
training

E.12 Radiography activities Radiation exposure MTC,FAT 3 4 12 1. Installed 1. Prepare the work Wear mandatory 2 3 6 Ya PP No.58 Thn
barricade around method statement, JSA, PPE (Helm, Safety 2015 tentang
the activities area and Permit Glassess, Hand Keselamatan
2. Socialization work gloves, Safety Radiasi Dan
method, JSA, & Permit Shoes) Keamanan Dalam
3. Personel who perform Pengangkutan Zat
radiography activities Radioaktif
and tools must have
certificate PP No.3 Thn 2007
tentang
Keselamatan
Radiasi Pengion
dan Keamanan
Sumber Radioaktif

UU No 1/1970
Keselamatan
Kerja

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko

 Diterima (Ya/Tidak)
Kontrol Resiko : Pengendalian bahaya yang telah dilakukan dan rencana yang akan dilakukan/
Dampak HSE/ HSE Impact

Risk Assessment

Risk Assessment
Referensi /

Penilaian Risiko/
Penilaian Risiko/
Risk Control : Hazard control that has been done and the plan to be carried out

Kemungkinan/

Kemungkinan/
Peraturan

Consequence

Consequence
Aspek HSE Tambahan kontrol resiko/

Konsekuesi/
Konsekuesi/
No Aktifitas/ Activities Remark
(Risiko) / HSE Aspect (Risk) Additional risk control

Possibility

Possibility
Refference/
Lingkungan/ Properti/ Eliminasi/ Subsitusi/ Rekayasa Teknik/ Administrasi/ APD/
Manusia/ Human Regulation
Environment Property Elimination Subtitution engineering control Administration PPE

E.13 Working near water Heavy equipment (crane) MTC, FAT 3 4 12 1. Provide base 1. Conduct pre-mob Wear mandatory 3 3 9 Ya UU No 1/1970
collapse plate for out rigger inspection for heavy PPE (Helm, Safety Keselamatan
equipment Glassess, Hand Kerja
2. Perform daily pre-use gloves, Safety
inspection for all heavy Shoes) Permenaker
equipment 9/2010 Operator &
3. Ensure all operator petugas pesawat
have valid license angkat angkut

Permenaker
5/1985 Pesawat
angkat angkut

Fall from height
MTC, FAT 4 5 20 1. Using standar 1. Prepare the work Wear mandatory 3 2 6 Ya UU No 1/1970
scaffolding method statement, JSA, PPE (Helm, Safety Keselamatan
and Permit Glassess, Hand Kerja
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Permenaker
3. Personel who perform 9/2016
working at height must Wear spesific PPE Keselamatan
be attend working at (Full body harness) Pekerjaan di
height training Ketinggian
4. Scaffolding must
install & inspect by
competence person

Man over board MTC, FAT 4 4 16 1. Install hard 1. Prepare the work Wear mandatory 3 2 6 Ya Provide life buoy and PER.08/MEN/VII/2
barricade method statement, JSA, PPE (Helm, Safety assign stanby personnel 010 Tentang Alat
and Permit Glassess, Hand Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) UU No 1/1970
3. Personel who perform Keselamatan
work near water must be Wear spesific PPE Kerja
attend work near water (Life Jacket)
training.

F TEST &
COMMISSIONING

F.1 Commissioning activities Fire & Explotion MTC, FAT Air pollution Property 4 4 16 1. Install hard 1. Prepare the work Wear mandatory 2 3 6 Ya Fire truck and ambulance PER.08/MEN/VII/2
damage barricade method statement, JSA, PPE (Helm, Safety stand by during 010 Tentang Alat
and Permit Glassess, Hand commissioning Pelindung Diri
2. Socialization work gloves, Safety
method, JSA, & Permit Shoes) Qanun No.7 thn
3. Personel who perform 2017 tentang
commissioning must a Keselamatan dan
competence personnel. Kesehatan Kerja
4. Conduct
commissioning safety UU No 1/1970
training Keselamatan
5. Socialization of Kerja
commissioning activities

PIC QSHE PM/SM/CM

Reza Murby Hermawan Hot Raja Siboro Toni Indra Kusuma

F-FDH-HSE-001 Rev.00 Identifikasi Bahaya dan Pengendalian Risiko