TANGGUH EXPANSION - PROJECT EXECUTE LNG EPC

Doc Ref: TEP-930-PLA-HS-BP4-0028 GENERIC RISK ASSESSMENT FORM Form No: FORM-TEP-HSSE-301
Date: 5 November 2020 (GRA FORM) Revision No: B02

TITLE OF THE ACTIVITY

Condition of Use
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Limitation of Use -This procedure does not cover:

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Hazards Controls / Actions

Authorization
I declare that the appropriate hazards and control measures have been identified to allow this task to be carried out safely, I
approved this routine activity for 1 year from today ( Signed ) with subsequent daily issue of an application to perform Low Risk
Work.
Name: Sign : SBC Manager Date :
Name : Sign : CSTS AIA Date :
Name : Sign : CSTS HSE Manager Date :
ONLY WORK COVERED UNDER THE DESCRIPTION OF THIS GRA CAN BE PERFORMED