JOB RISK ASSESSMENT - FRONT SHEET

DATE : 27-Mar-2008 JOB NO. OF SHEETS : SYSTEM NO.

1 Sheets
INSTALLATION / SITE : REFERENCE:
SITE SURVEY FOR 18" NEW PIPE
SENIPAH FIELD LINE FROM PPA TO TPA
ASSESSED OVERALL RISK
A REASSESSMENT REQUIRED ? (Y/N) N

A. SCOPE OF WORK
1 Mobilization Personnel & Equipment
2 Site Survey

B. MAIN EQUIPMENT.
1 Theodolite
2 Autolevel

C. DURATION TIME = 7 DAYS

D. NOTE
1. List of assessed tasks as per attached sheets.
This RA shall reflect safety actions to be implemented for each specific job and equipment.
2. Toolbox talk / pre job briefing to be held with personnel who will take part in work activities.
This shall be conducted by crew supervisor and safety supervisor prior to work commencing.
3. All activities mentioned on RA should be covered by Work Permit.
4. Before starting the job, identification on site muster area.
5 The job shall be done in good weather.

ASSESSMENT REVIEWED AND ACCEPTED BY (COMPANY):

POSITION PRINT NAME SIGNATURE DATE

ENG/CST/PJC/CSR MAWARDI N. / YONI WIDODO

ENG/CST/OPB/SUPT SURYA G. / GULAM P.

FO/AMB/BSP/S&E AGUS W./ DADANG H.

FO/AMB/BSP/PRD BENNY S. / BAMBANG H.

FO/AMB/BSP F. JACOB / NOVYAL ERWIN

ASSESSMENT PERFORMED BY (CONTRACTOR):

POSITION PRINT NAME SIGNATURE DATE

CONSTRUCTION MANAGER ZUL HADRIANSYAH

HSE COORDINATOR DIDIT APRIYANTO

QA / QC MUARIPIN
 Installation : SURVEY OF EXISTING AND System :- Page : 1 of 1
NEW LINE Reff No : SNP-40-005-R Date : 29-Mar-08
Leader : Zul Hadriansyah Attendess : Site Visit : YES
Date : 29 Maret 2008 Duration : 1 week

JOB DESCRIPTION:
SITE SURVEY
RESIDUAL
INTIAL RISK COMPLETION
N0 TASK HAZARD RISK CONTROL MEASURIES RISK ACTION PARTY TARGET DATE FOLLOW UP
S P R S P R DATE
1 Survey, manual digging and marking 1. Snake bites Mo Po T Pre work briefing about safety awareness Mi Un A CTR
existing pipeline and cables 2. Touching / hit existing facilities Correct and proper PPE must be wear
3. Electrical cable Only trained personel to be employed
4. Splinter of the soil All equipment shall be checked regularly
First aid kit

Approval of JRA Conclusion (1) by : Signature : Date :

(1) If one answer "tolerable" then filled by Entity Management but if one answer "unacceptable" then a new JRA must be organized regarding a new proposal for the execution of the job
Note : The "OK" to start work will be given after completion of the last follow up column and use of the Work Permit
 JOB RISK ASSESSMENT - FRONT SHEET

DATE : 1-Apr-2008 JOB NO. OF SHEETS: SYSTEM NO.

1 Sheets
INSTALLATION / SITE : REFERENCE:
SITE SURVEY OF EXISTING AND
BP1, BA, BG, BL, BEKAPAI FIELD NEW LINE OFFSHORE
ASSESSED OVERALL A REASSESSMENT REQUIRED ? (Y/N) N
RISK

A. SCOPE OF WORK
1 Mobilization Personnel & equipment
2 Site Survey

B. MAIN EQUIPMENT.
1 Theodolite
2 Autolevel

C. TEAM WORK
1 PGM : Supervisor(1), Surveyor(1), Safety man(1), Helper (3)
2 ENG/CST/PJC : 1 Prs.
3 BKP/PRD : 1 Prs.
4 BKP/S&E : 1 Safety man.

D. DURATION TIME = 7 DAYS

E. NOTE
1. List of assessed tasks as per attached sheets.
This RA shall reflect safety actions to be implemented for each specific job and equipment.
2. Toolbox talk / pre job briefing to be held with personnel who will take part in work activities.
This shall be conducted by crew supervisor and safety supervisor prior to work commencing.
3. All activities mentioned on RA should be covered by Work Permit.
4. Before starting the job, identification on site muster area.
5 The job shall be done in good weather.

ASSESSMENT REVIEWED AND ACCEPTED BY (COMPANY):

POSITION PRINT NAME SIGNATURE DATE

ENG/CST/PJC/CSR MAWARDI N. / YONI WIDODO

FO/AMB/BSP BKP/S&E LUBIS / FAJAR

FO/AMB/BSP/BKP SUJJUD S. / BILLY T.

FO/AMB/BSP F. JACOB / NOVYAL ERWIN

ASSESSMENT PERFORMED BY (CONTRACTOR):

POSITION PRINT NAME SIGNATURE DATE

CONSTRUCTION MANAGER ZUL HADRIANSYAH

HSE COORDINATOR DIDIT APRIYANTO

QA / QC MUARIPIN
 Installation : SURVEY OF EXISTING AND System :- Page : 1 of 1
NEW LINE Reff No : Date : 1-Apr-08
Leader : Attendess : Site Visit : YES
Date : 29 Maret 2008 Duration : 1 week

JOB DESCRIPTION:
SITE SURVEY
RESIDUAL
INTIAL RISK COMPLETION
N0 TASK HAZARD RISK CONTROL MEASURIES RISK ACTION PARTY TARGET DATE FOLLOW UP
S P R S P R DATE
1 Transport of personnel & equipment Man overboard Hi Vu T - Wear life jackets on boat at all time Mi Un A CTR
- Live saving equipment on site (rightbuoy)
- Standby crewboat
- Before start, all equipment shall be checked
- Tool box meeting prior execute the works

2 Working on height & above water Falling Hi Un U - Wear safe harness / PPE Mi Un A CTR
- Wear workvest

3 Measurenment by using theodolite Intricly equipment Hi Vu T - Gas check Mi Un A CTR

infra red hazard - Follow equipment operating procedure

Approval of JRA Conclusion (1) by : Signature : Date :

(1) If one answer "tolerable" then filled by Entity Management but if one answer "unacceptable" then a new JRA must be organized regarding a new proposal for the execution of the job
Note : The "OK" to start work will be given after completion of the last follow up column and use of the Work Permit