E-P-025001, Rev 0

PENGERANG TERMINALS SDN. BHD. RISK ASSESSMENT (JSA) FORM

Process / Activity:

fire fighting servicing

Area/Location

CEFS

Revision

Shafeeq bin Shahadan

Original Assessment
Date

Company / Department:
RA Team Leader (Name / Designation):
RA Team Members (Name / Designation):

~ Flow Fire Water Test & Support pressure from Fire Pump

~ Pressure water hit to eyes

~ Checking Fire Hose Boxes with Equipment

~ Projectile of hose / testing equipment.

~ Damage to Equipment
~ Body
Injury

~ Keep equipment in good condition before the

maintenance work carried out

~ High Pressure Test Fire Hose

~ Delivery Hose leak during pressurized

water test
~
Delivery Hose can not control when the
pressurized water test

~ Damage to Equipment
~ Body
Injury

~ Keep equipment in good condition before the

maintenance work carried out.
~ Make sure the valve
open slowly

~ High Pressure Test Fire Hose with Fire Nozzle

~ Fire Nozzle regardless of time of

delivery hose pressure water test.

~ Keep Nozzle installed tightly & properly

~ Checking & Service Fire Extinguishers & Foam Trolley

~ Body Injury

~ Damage to Equipment
~ Body
Injury
~ Damage to Equipment

~ Use proper PPE

~ Make sure the path to make tests on

equipment are not obstructed

~ Electric Shock

~ Slip / tripping

~ body injury
~ equipment damage

~ identify work area

~ remove oil/spillage from foor
~ Use anti-slip safety shoe

~ Exposed wiring

~ electrocution to worker/operator

~ workplace inspection before start work

~ Use proper PPE, eg glove

~ inspect equipment before using it

~ wear proper PPE, eg. Glove

~ Slip, trip & fall.

~ Damage to
Equipment

CEFS Management
Services Staff

CEFS Management
Services Staff

CEFS Management
Services Staff

CEFS Management
Services Staff

CEFS Management
Services Staff

CEFS Management
Services Staff

CEFS Management
Services Staff

CEFS Management
Services Staff
CEFS Management
Services Staff
CEFS Management
Services Staff
CEFS Management
Services Staff
CEFS Management
Services Staff
CEFS Management
Services Staff

~ Broken equipment

~ Damage to Equipment

~ Checking Hose , Nozzle , safety pin & Lever Handle

~ Broken equipment, rusty &

blocked

~ Checking Cylinder Body & Trolley

~ Broken equipment, rust & dents

~ Damage to Equipment
~ Equipment clogging
~ Inspect equipment before using it
~ Damage to Equipment
~ rusty and dented
Cylinder

~ Checking BOMBA CERTIFICATE

~ NA

~ Certificate missing, faded & has expired

16

~ Equipment Fire extinguishers put at original place

~ Equipment falling

~ Body Injury

~ Body Injury
~ Damage to
Equipment

~ Keep equipment in good condition before

placed the original place

Thi
s Risk Legend:
Se
1-4
Low
Type of Permits, Tick (/) which is applicable
cti 5-9
Medium
Cold Work
on
High
Hot Work
mu 10-25
st
Confined Space
be
co The Hazards, Control and Recovery Measures in this Assessment have been communicated to the persons involved in this activity:
mp Shafeeq bin Shahadan
SHE, Tech
let
Job Supervisor's Name
Designation
ed
wh
en
This Risk Assessment is reviewed by:
no
n
ro
PTSB Employee
Designation
uti
ne
job The Risk Assessment is approved by:
s
to
Permit Approver
Designation
be
car
rie
d
ou
t

CEFS Management
Services Staff

~ Checking Pressure Gauge

~ Inspection on equipment Fire extinguishers

~ Keep the workplace safe before the work

carried out

Re-Evaluated
Risk Level

CEFS Management
Services Staff

CEFS Management
Services Staff

~ identify work area / station

~ apply for work permit
~ appointed a standby person

~ Body Injury

Risk Control
Implementation
Due Date
Person (Name /
Designation)

~ head injury
~ body injury

~ Equipment falling

Additional Controls

Re-Evaluated
Likelihood

~ Come into contact with fluid under high

pressure

~ Checking / Testing for Fire Break Glass

~ Keep the workplace safe before the work

carried out

~ Slip, trip & fall.

Risk Level

Existing Controls

Likelihood

Possible Consequences
(injury or ill-health) /
Environmental Impact
(include Who or What might
be harmed)

~ Checking Fire Water Hydrant

~ Traffic hazard.

Risk Evaluation

Re-Evaluated
Severity

Next Review Date:

Hazard Identification
Hazards / Environmental
Aspect

Severity

Work Activities / Task Steps

5/19/2015

Last Review Date:

Approved By Area / Dept Manager (Name / Designation /

Signature):

No

ADMIN

Type of Certificates, Tick (/) which is applicable

Excavation

Lifting & Hoisting

0
0
0
0
0

Physical Isolation

Scafolding

Radiography

Fire Protection

Electrical Isolation

Vehicle Entry

Road Obstruction

5/19/2015
Signature

Date

Signature

Date

Signature

Date

Mitigation
Recovery Measures

E-P-025001, Rev 0

PENGERANG TERMINALS SDN. BHD. RISK ASSESSMENT (JSA) FORM

Process / Activity:

Area/Location

Company / Department:

Revision

Next Review Date:

Risk Evaluation
Possible Consequences
(injury or ill-health) /
Environmental Impact
(include Who or What might
be harmed)

Existing Controls

Risk Level

Hazard Identification
Hazards / Environmental
Aspect

Likelihood

Work Activities / Task Steps

Severity

No

Additional Controls

Risk Control
Implementation
Due Date
Person (Name /
Designation)

Re-Evaluated
Risk Level

Last Review Date:

Approved By Area / Dept Manager (Name / Designation /

Signature):

Re-Evaluated
Likelihood

RA Team Members (Name / Designation):

Re-Evaluated
Severity

Original Assessment
Date

RA Team Leader (Name / Designation):

0
0
0
4
0

0
5

0
0
0
0

0
0
0
0
0
0
0

Risk Legend:
1-4
5-9

Low
Medium

10-25

High

Type of Permits, Tick (/) which is applicable

Cold Work
Hot Work
Confined Space

Type of Certificates, Tick (/) which is applicable

Excavation

Lifting & Hoisting

Radiography

Fire Protection

Electrical Isolation

Vehicle Entry

Road Obstruction

The Hazards, Control and Recovery Measures in this Assessment have been communicated to the persons involved in this activity:
5/19/2015
Job Supervisor's Name

Designation

Signature

Date

Designation

Signature

Date

Designation

Signature

Date

This Risk Assessment is reviewed by:

PTSB Employee

The Risk Assessment is approved by:

Permit Approver

Physical Isolation

Scafolding

Mitigation
Recovery Measures

RISK MATRIX TABLE

1
Insignificant
Slight Injury, FA

2
Minor
Minor Injury, LTI

Slight Impact

Minor Impact

SEVERITY (S) RANKING

3
Moderate
Major Injury/Partial
Disability
Localised Impact

Slight Damage

Minor Damage

Local Damage

BUSINESS
(CUSTOMER)

Slight impact/Formal
customer complaint

Limited
impact/Customer
complaint result in
financial liability

Considerable
Impact/Loss of
customer

REPUTATION

Slight Impact

Limited Impact

Considerable Impact

IMPACT
PEOPLE
ENVIRONMENT
ASSET

LIKELIHOOD (L) RANKING

Most likely/Regular
Happened several
times at location
5
More than once per
year
Likely
Happened several
times
4
Once in 1 to 10 years

4
Major
Single Fatality

5
Catastrophic
Multiple Fatalities

Major National
Impact
Major Damage

Major International
Impact
Extensive
Damage/Unable to
Operate

Major Impact/Loss of Major Impact/Loss of

Key Global Customer
Key Global
Customers & Long
term reputation
damage
Major National
Impact

Major International
Impact

LIKELIHOOD (L) X SEVERITY (S)

10

15

20

25

12

16

20

Possible to occur in
the future
Happened at other
place
Once in 10 to 100
years (10-1 to 10-2)

12

15

Rarely/Seldom,
Heard of incident in
the industry
Once in 100 to 10000
years (10-2 to 10-4)
years

10

Unlikely
Never heard of in the
industry
Less than once in
10000 years (10-4)
years

Relative Risk = Likelihood (L) x Severity (S)

Risk Matrix Legend
1-4
5-9
10 - 25

Description
Low
Medium
High

Action
A risk considered LOW. However, control measures should be implemented and recorded
Risk requires a planned approach to control the hazard and applies necessary control measures
Requires immediate action to control the hazard

EXPLAINATION ON THE SEVERITY RATING

Rating
1
Insignificant

Impact on People

Impact on Environment
Impact on Asset
1. Spill/leak causing negligible impact 1. Slight Asset Damage
to local environment, contained
- Asset value less than RM 25,000
within the secondary containment
- No disruption to operation
First aid injury or slight health effects and does not reach water and soil ,
not affecting work performance or
and no volatilization to atmosphere
causing disability.
2. Noise, air emission, discharges
Example: first aid injury, exposure to not exceeding company or legislative
non hazardous dusts.
limits

Impact on Business
Impact on Reputation
1. Equipment failure will reduce the Slight Impact
level of performance as required by a - Public awareness may exist, but
customer. May result a formal
there is no public concern
complaint by a customer

2
Minor

1. Spill/leak contained within

secondary containment causing
Medical Treatment Case , Restricted volatilisation to atmosphere causing
limited contamination of soil or water
Work Case, Lost Time Injury or
minor health effects (involving health within the containment area causing
non-permanent impacts to the
hazards capable of minor health
environment.
effects which are reversible, e.g.
irritant agents, defatting agents, food 2. Noise , air emission, discharges
not exceeding legislative limit but
poisoning bacteria) affecting work
performance, such as restriction to exceeding company limit (where
available)
work activities or a need to take a
3. No immediate cumulative and/or
few days to fully recover.
delayed effect

1. Minor Asset Damage

Equipment failure may cause delay
- Asset value from RM 25,000 to
or interruptions but can be dealt with
RM100,000
by appropriate planned actions
- Shutdown of a single unit OR Brief
disruption to operation < 2 hours

Limited Impact
- Local public concern or complaints
- Local media and/or local political
attention with potentially negative
impact for company operations

3
Moderate

1. Spill/leak causing limited

contamination to soil or water
outside the secondary containment
but remain contained within facility
Permanent Partial Disability ,
significant health effects (capable of perimeter OR resulting in Potential
Consequence A, B or C below
irreversible health damage without
2. Noise , air emission, discharges
loss of life, e.g. noise, poor manual
handling tasks, hand/arm vibration, exceeding legislative limit OR
chemicals causing systemic effects, resulting in Potential Consequence A
below
sensitizers ) , exposure to possible
Note:
human or animal carcinogens, or
Potential Consequence
results of injury/illness in the lower
A). Cumulative and/or delayed
categories (category 1 & 2 above)
environmental impact,
which affect performance in the
B). Short term recovery action < 1
longer term such as prolonged
absence from work for more than 4 month
C). Rehabilitation period < 6 months
days

Local Asset Damage

- Asset value from RM 100,001 to
RM 1,000,000
- Shutdown of multiple units OR
disruption to operation < 1 day
- Reportable to government or
authority of the country

Considerable Impact
- Regional public concern. Extensive
adverse attention in local media.
- National media and/or regional
political attention resulting in
negative impact on company
operations
- Adverse stance of local government
and/or action Groups

Equipment failure may cause a delay

or non performance to customer for
extended period of time (> 1 week).
Probably results in financial liability

4
Major

1. Spill/leak spreading outside the

facility perimeter, managed to be
contained/recovered but causing
major contamination OR resulting in
Potential Consequence A, B or C
below
Permanent Total Disability, single
2. Noise , air emission, discharges
fatality from accident or occupational exceeding legislative limit with
illness or major health effects
possible prosecution OR resulting in
caused by health hazards capable of Potential Consequence A below
irreversible damage with serious
Note:
disability or death e.g. exposure to
Potential Consequence
corrosives, probable human
A). Immediate effect with serious
carcinogens, extreme heat and cold, damage to environment
psychosocial risk factors
B). Medium term recovery action (13 months)
C). Rehabilitation period 6 12
month

5
Catastrophic

Multiple fatalities or Multiple

Permanent Total Disability from
accident or occupational illness
caused by health hazards with the
potential to cause multiple fatalities,
e.g. chemicals with acute toxic
effects (hydrogen sulphide, carbon
monoxide), known human
carcinogens

1. Spill/leak spreading outside the

facility perimeter, causing massive
contamination OR resulting in
Potential Consequence A, B or C
below
2. Noise , air emission, discharges
resulting in legal prosecution with
possible shutdown of facility, OR
resulting in Potential Consequence A
below
Note:
Potential Consequence
A). Severe environmental damage
B). Long term recovery action (> 3
months)
C). Rehabilitation period > 12 month

1. Major Asset Damage

- Total facility shutdown OR
disruption to operation > 1 day
- Asset value from RM 1,000,001 to
RM10,000,000
- Terminal recovery within 1 6
months

Equipment failure will have a serious National Impact

impact on customers business for
- National public concern. Extensive
prolonged period (> 1 month)
adverse attention in the national
media.
- Regional/national policies with
potentially restrictive measures
and/or impact on grant of licenses.
- Mobilization of pressure or action
groups

Extensive Damage
- Asset value in excess of RM
10,000,000
- substantial or total loss of
operations
- Terminal recovery more than 6
months

Equipment failure will have a serious

impact on customers business for
prolonged period. Major loses and
may result in the loss of customers

International Impact
- International public attention.
Extensive adverse attention in
international media.
- National/international policies with
potentially severe impact on access
to new areas, grants of licenses
and/or tax legislation