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No.

Formulir

Analisa Keselamatan Pekerjaan


Job Order/ Work Reference No :
Departemen :

.........................

Revisi

Halaman

1 dari 1

1 .......................

3 ..........................

Dievaluasi :

.......................

2 .......................

4 .........................

Disetujui :

.......................

Disusun:
Seksi :

.........................
Safety Shoes

Welding gloves

Cotton gloves

Goggles

.........................

.........................

Safety Helmet

Safety glass

Ear Protector

Full body harness

.........................

.........................

APD Wajib :

No

Langkah Dasar Tahapan Pekerjaan

Potensi Bahaya

Prosedur Pencegahan

Jenis Bahaya
Terpukul Oleh (Struck By)
Terpukul Oleh (Struck By)
Terkena Oleh (Contacted By)
Terlalu Memforsir Tenaga (Overexertion (OE)

Terperangkap Pada (Caught On)


Jatuh Di Lvel Sama (Fall - Same Level)
Membentur (Struck Againts)
Ergonomi

Terkait Pada (Caught In)


Terjepit Di antara (Caught Between)
Jatuh ke bawah (Fall to below)

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