Risk

Consequence / Result Risk*)

Sequence of Basic Job Steps Hazard Risk Assessment* Recommendation action
NO severity
Tahapan pekerjaan Bahaya Resiko P S Tindakan Pengendalian P S R
Akibat RR PIC
R V R V R

I Memindahkan Boiler dan

Softener

1.1 Pasang ganjal dari tiap ban Motion Tangan terjepit Tangan terluka 3 2 6 Gunakan sarung tangan 1 2 2
trailer (muka dan belakang)

JOB SAFETY ANALYSIS (JSA) AND RISK ASSESSMENT FORM

DOC.
1.2 NO.:HSE-FF-A.1
Set prime mover ke trailer Mekanikal Tubuh terlindasHealth Safety
Cedera,Environment
kematian 4 5 20 Jauhi line of fire 1 1 1Page 1 of 2
yang akan dipindahkan prime mover
Company : PT. OAS SG#01 Prepared By Approved by
Project : HUFF AND PUFF Performing Autority Site Autority Area Autority
1.3 Yakinkan lock
Person in charge name pin prime
: SabaruddinMotion Kepala tersandung
NAME Cedera 3 Sabaruddin
2 6 Gunakan helm keselamatan 1 2 2
mover sudah terkunci landasan boiler
Position/ Title job
(dengan jalan : Supervisor SIGNATURE
Job activity
maju/mundurkan prime : Moving Steam Unit BG 19 to Work
mover Shop PT.OAS di Duri
Date : 04 Maret 2018 DATE

1.4 Angkat/naikkan kaki landing Motion Fatique Tangan keram, 4 2 8 Putar perlahan engkol 1 2 2
gear dengan cara memutar cedera landing gear dan lakuakn
engkol landing gear secara bergantian
Risk Rangking (RR) Recommendation Action
Severity / consequence Tingkat Risiko Tindakan Pengendalian
Probability (PR) X =
Keparahan
1.5 Angkat papan landasan dari Motion Tangan terjepit Score Tangan terluka Level3 2 6 Gunakan sarung tangan
Tingkat pengendalian 1 Hierarchy
1 1 of Control
Frequentlanding
=5 gear Catastrophic = 5 19-25 Extreme high E= 1+2+3+4+5 1= Eleminasi
Probable = 4 Major = 4 13-18 High Angkat papan landasan2= Substitusi
H= 3+4+5
Occasional = 3 Moderate / serious = 3 6-12 Medium dengan dua orang
M= 4+5 3= Technik
Unlikely = 2 Minor = 2 1-5 Low L=5 4= Administrasi
Improbable = 1 Negligible = 1 5=APD
1.6 Angkat ganjal ban dari Motion Tangan terjepit Tangan terluka 3 2 6 Gunakan sarung tangan 1 1 1
masing-masing trailer

II Memindahkan Storage
Tank

2.1 Pasang
Controlled Copy ganjal dari tiap ban Motion Tangan terjepit Tangan terluka 3 2 6 Gunakan sarung tangan 1 1 1
trailer (muka dan belakang) Do Not Duplicate

2.2 Set Prime Mover ke trailer Mekanikal Tubuh terlindas Cedera, kematian 4 5 20 Jauhi line of fire 1 1 1
yang akan dipindahkan prime mover
 JOB SAFETY ANALYSIS (JSA) AND RISK ASSESSMENT FORM
DOC. NO.:HSE-FF-A.1 Health Safety Environment Page 2 of 2

Note : * : Tanpa control

*): Dengan control

Controlled Copy
Do Not Duplicate