PT.

Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 28-Jul-12

Team Leader : Soni Wowiling HSE Dept Team Members :

Reference Number :
Facilitator : Richard Douglas HSE General Supt :

Process/Activity : Team Members :

Changing Hydraulic Cylinders

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Required
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Changing Hydraulic Cylinders Helper Crew, Pinched Permanent disability, Long 4 3 1. TAKE 5 & daily pre start briefing 2 2
Mechanic Crew, term absence due to for clear instruction
Foreman, treatment, Soil/water
Supervisor, contaminated
Environment

2. Energy Isolation (LOTO)

3. Follow the OEM

12 4. Mechanical training/refresh 4
training for mechanic

5. Use correct tools

6. Check SWL if using stand jack

7. Avoid pinch point

Spill Oil Soil/water contaminated 3 3 9 1. Provide drip trays & spill kit 2 2 4

2. Provide drip trays

Fall down Permanent disability, Long 4 3 12 1. Three contact point 3 2 6

term absence due to
treatment

Uncontrolled Document When Printed 1 of 4 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 28-Jul-12

Team Leader : Soni Wowiling HSE Dept Team Members :

Reference Number :
Facilitator : Richard Douglas HSE General Supt :

Process/Activity : Team Members :

Changing Hydraulic Cylinders

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Required
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Uncontrolled Document When Printed 2 of 4 LCI-HSE-FM-001A(02)

Feb 2010
Team

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 3 of 4 LCI-HSE-FM-001A(02)

Feb 2010
Team

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 4 of 4 LCI-HSE-FM-001A(02)

Feb 2010