HIRARC FORM Doc.

No :

LEKIR BULK TERMINAL EXPANSION PROJECTPACKAGE 1 – DEDICATED BYPASS CONVEYOR SYSTEM (“LEXPRO P1”)
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TASK/JOB DESCRIPTION: METHOD STATEMENT FOR THE INSTALLATION OF CABLE TRAY

VALIDITY PERIOD: ………………………
Purpose of
Type of HIRARC: / New Revised / Non Routine Work Routine Work Projects Other: ……………
HIRARC :

CONTRACTOR (Tecgates) SUB-CONTRACTOR (Syswell)

Name Position Company Signature Date Name Position Company Signature Date

Reviewed by: Action by:

1 Rao Project Manager Tecgates 1 Luqman Safety Supervisor Syswell
2 Ravi Project Director Tecgates 2
3 Syahir Safety Officer Tecgates 3
4 4
5 5

Approved for Submission as attachment of MOS: Sub-Contractor Management:

1 Rao Project Manager Tecgates 1 Eric Project Manager Syswell

Workers : I acknowledge receiving these instruction, understand the instruction, and fully comply with this HIRARC (Toolbox after approval of this HIRARC)
Company Name Signature I/C No. Date Company Name Signature I/C No. Date

Work Supervisor : I Certify that I have explained HIRARC to all Name: …………………………………. Signature: ……………………………. Date: ……………………………
workers :

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 HAZARD INDENTIFY RISK ASSESSMENT RISK CONTROLL (HIRARC) Doc.No :

LEKIR BULK TERMINAL EXPANSION PROJECTPACKAGE 1 – DEDICATED BYPASS CONVEYOR SYSTEM (“LEXPRO P1”)
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Potential Hazard Example for RISK RATING (Likelihood x Severity) RISK DESCRIPTION ACTION
Specific Categories :
LIKELIHOOD (L) PROBABILITIES RATING
A HIGH risk requires immediate
Worker action to control the hazard as
Struck/ Against Certain Expected to Happen (95~100%) 5 15- HIGH detailed in the hierarchy of control.
Overhead Work 25 Action taken must be documented on
Burn (Heat/ Chemical) Most Likely Can Happen Frequently (60~94%) 4 the risk assessment form including
Eye Injury
Radiation Hazard Likely Chances to Happen is Relatively High (10~59%) 3 date for complete.
Sharp Objects A MEDIUM risk requires a planned
Back Injury
Unlikely Could Happen, however very rare (1~9%) 2 approach to controlling the hazard
Hazardous Chemical 5-12 MEDIUM and applies temporary measures if
Very Unlikely The probability to happen is extremely small (<1%) 1
Contacted by/ with required. Actions taken must be
Caught/ in/ on/ between documented on the risk assessment
Strains SEVERITY (S) NATURE OF INCIDENT OR INJURY RATING form including date for completion
Electrical Hazard
Catastrophe Multiple fatalities/occupational illness/affecting 5 A risk identified as LOW may be
Equipment personal within and outside the factory considered as acceptable and further
1-4 LOW reduction may not be necessary.
Slip/ Trip/ Fall/Fire Critical Single fatality/permanent total disability from an 4
Damage (Physical) accident/ occupational illness/affecting personal However, if the risk can be resolved
Loss of Production in the factory quickly and efficiently, control
Explosion measures should be implement and
Major Major injury/health effect/affecting work 3
record.
Environment performance in longer term such as absent from
Gas Release work, hospitalized, disabling injury but SEVERITY (S)
Spill or Loss of Containment recovery/affecting only personal in local LIKELIHOOD 1 2 3 4 5
Dusty department (L)
Off-Site Impact Minor Minor injury/health effect including first aid case & 2 5 5 10 15 20 25
outpatient medical treatment/affecting work
4 4 8 12 16 20
performance such as restriction to activities, or
need a few days to recovery/affecting only 3 3 6 9 12 15
personal involve in the activity
2 2 4 6 8 10
Negligible No or slight injury/health effect first aid & medical 1
treatment/not affecting work 1 1 2 3 4 5
performance/affecting only personal in the activity

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 HAZARD INDENTIFY RISK ASSESSMENT RISK CONTROLL (HIRARC) Doc.No :

LEKIR BULK TERMINAL EXPANSION PROJECTPACKAGE 1 – DEDICATED BYPASS CONVEYOR SYSTEM (“LEXPRO P1”)
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1. Hazard Identification 2. Risk Analysis 3. Risk Control

Which can PIC
Existing Risk Control
No Work Activity Hazard cause/ Likelihood Severity Risk Recommended Control Measures (Due date/
(if any)
effect status)

1.Syswell
1. PPE Kevlar, eye protection & Basic PPE
1. Workers competency supervisor
1.1.1 Sharp Cuts, Sprain 2. First Aid Box
2. Machinery Inspection 2 2 4 2.Syswell
Surface
safety
supervisor

1.1 Installation of
1 Cable trays
1.Syswell
1. Workers competency 1. Lifting procedure/plan
1.1.2 Elevated supervisor
2. Machinery (stair) are inspected before 2. Dedicated and proper area for
work platform or Falls from height 2 2 4 2.Syswell
start work loading/unloading
stairs safety
3. Supervision 3. Proper footing/sleeper
supervisor

1. People,
1. Lightning and
2.1 Working at Open permanent
thunder, 1. Site
area expose to disability or 1. Stop work
2
Heat/Rain/Lightning/H
Worker might
irreversible 2. standby at shelter area
2 4 8 Continues supervision. supervisor
aze strike by
illness
lightning
(cut/bruise)

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 HAZARD INDENTIFY RISK ASSESSMENT RISK CONTROLL (HIRARC) Doc.No :

LEKIR BULK TERMINAL EXPANSION PROJECTPACKAGE 1 – DEDICATED BYPASS CONVEYOR SYSTEM (“LEXPRO P1”)
Page 4 of 4

1. People, 1. Resting area with good ventilation and

permanent drinking water.
2. Exposure 1. Site
disability or 2. Rest schedule
direct sunlight supervisor
irreversible 3. Ensure first aider available on site 2 4 8 Continues supervision.
in prolong time 2. HSE
illness. Heat 4. Toolbox briefing/educate workers
without shade. supervisor
stroke, about fatigue management.
fatigue

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