Risk Assessment Form

Department: : CSA RA Leader : MAHMUDIN Approved by Reference Number

Process: : ALUMUNIUM SKIRTING REPLACEMENT AT UNPACKING ROOM RA Member 1:M. NURFADLI
Process/Activity Location: : UNPACKING ROOM RA Member 2:SUHENDA Signature:
STT-ID-JKT1-MOP-AD HOC-
Original Assessment date: : 10-Mar-24 RA Member 3: Name: Justhanto Mongan REPAIR-ALUMUNIUM
Last review date: : RA Member 4: Designation: SBCK Jr. HSE Manager SKIRTING REPLACEMENT
AT UNPACKING ROOM
Next review date: : RA Member 5: Date: 11/03/2024

HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Ref S L RPN S L RPN

(Severity (Likelihoo (risk (Severity (Likelihoo (risk
) d) ) d)
Potential Risk / priority priority
Work Activity Potential Hazard Existing risk controls number Additional Controls number Implementation Person Due Date Remarks
Possible Injury ) )

PREPARATION WORK

1 Permit To Work Submission
Lack Of Knowledge Wrong Information & 1. Only allow permits to be issued by 2 2 4 1. Describe the work and its location. 2 1 2 Suhenda 13/03/2024
instruction impacted authorised, competent personnel. Provide information about foreseeable
to 2. Prevent high-risk work being carried out risks.
without a risk assessment having been 2. Provide information necessary for
undertaken. working safely.
3. Consider whether any other work will 3. Set out requirements for personal
impact on, or be impacted by, the protective equipment.
permitted work. 4. Set out the time when the work can be
4. Ensure control measures and supervision carried out.
are in place. 5. Provide information about other
5. Ensure method statements and permits.
emergency procedures are prepared.
6. Ensure work is checked and returned to
a safe state.
7. Provide information to other parties that
might be affected by the work.
Include a system for handing back and
cancelling permits.

2 Preparation & Briefing Unhealthy and 1.Faint 1.Ensure workers is fit to work. 2 2 4 1. Fatic management system is well 2 1 2 Suhenda 13/03/2024
incompetent 2.Wrong in doing maintained
workers work 2. Periodically socialized to all employee
regarding how important to maintain
enough quality rest/ sleep & how is
fatuque leads to:poor performance, lack of
consentration, serious incident,
missed days from illness and poor mental
wellbeing
 HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Ref S L RPN S L RPN

(Severity (Likelihoo (risk (Severity (Likelihoo (risk
) d) ) d)
Potential Risk / priority priority
Work Activity Potential Hazard Existing risk controls number Additional Controls number Implementation Person Due Date Remarks
Possible Injury ) )

3 Work Groups Specific
Toolbox Meeting
Lack Of Knowledge Wrong Information & 1. Ensure Work groups TBM is lead by 2 2 4 1. Leading Effectively Toolbox Meeting: 2 1 2 Suhenda 13/03/2024
instruction is shared direct supervision (Supervisor/ Engineer/
Managers) which automatically gives the - Familiarize yourself with the content
talk the credibility it needs. It also ensures you’re going to talk about
that the team knows that any questions,
suggestions, and concerns they voice will - Choose an appropriate area to hold the
be heard and taken into consideration by meeting
the management.
- Select the right people to attend the
2. In case the toolbox talk is about specific meeting
machinery or field of study, you might
want to call in an expert to cover that - When applicable, use a prop
topic. Always keep in mind that the given
advice is concise, practical, and applicable - Always dedicate some time to answer
for your operating environment questions

3. TBM topic It could be something spakers - Document the meeting record

& team needs a refresher about, or
something you might have seen a team
member doing wrong during previous work
process.

4. TBM can cover a wide variety of HSE

topics that are necessary for the smooth
and accident-free functioning of your
workplace.

4 Manual handling - Wrong manual - Personal Injuries 1. Personnel must conduct visual 4 3 12 1. Safe manual handling techniques to be 2 1 2 Suhenda 13/03/2024
handling method - Crush and pinch examination prior to start the work to followed.
- Unsafe action points assess if the load and the size of the item
- Rushing - Slips, Trips and to be lifted are compared to their body 2. Ensure adequate supervising.
- Repetitive motion Falls shape and capability.
or other ergonomic
hazard 2. Check the weight and shape of the load
prior to lift.

3. Ensure the way is free from tripping

hazard.

4. Manual handling techniques need to be

explained to avoid ergonomic hazards.

5 Dismantle panel skirting - Falling material Fallen material, 1. To Ensure the work is executed by 3 2 6 1. Ensure to wear safety helmet, safety 2 1 2 Suhenda 13/03/2024
Personal injury, competent person. shoes & handgloves
scratched, property
damage 2. To conduct safe work toolbox meeting 2. Ensure adequate supervising.
before started to work

3. protect the work area so as not to

damage other area
 HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Ref S L RPN S L RPN

(Severity (Likelihoo (risk (Severity (Likelihoo (risk
) d) ) d)
Potential Risk / priority priority
Work Activity Potential Hazard Existing risk controls number Additional Controls number Implementation Person Due Date Remarks
Possible Injury ) )

6 Surface Cleaning
Dust 1. Respiratory 1. To ensure air curculation is well 2 2 4 1. Ensure all personnel involved attend 2 1 2 Suhenda 13/03/2024
symptoms & maintained. Placed blower for fresh air Short briefing / Safe work tool box
diseases & exhaust fan while needed. meeting before start to work which
highlited; Required PPE, Particularly
hazard, Preventive measure &counter
measure.

2. Ensure adequate supervision during

work process.

7 Fill the gaps between the
wall and alumunium skirting with chemical
using glue
Use of material 1. Irritation 1. MSDS is socialized to the workers
2. Skin alergic which contained information how is
contained 3. Respiratory ptotection related to hazardous
symptoms & chemical exposure and work safey with
diseases chemical products.
2. Toolbox to be carried out
3. MSDS Should be available.
4. Competent and trained person should
do the work.
5. Good supervision of the work should
be maintained.
6. Clean the hands before break or
before having food intake.
7. Don't clean hands with thinner.
Clean as per the instruction given in
MSDS.
8. Provide Eye wash close to the work
site.
3 2 6 1. Ensure all personnel involved attend 2 1 2 Suhenda 13/03/2024
Short briefing / Safe work tool box
meeting before start to work which
highlited; Required PPE, Particularly
hazard, Preventive measure &counter
measure.
2. Ensure adequate supervision during
work process.
3. Mandatory PPE is wear propely
• Safety helmet with chin strap
• Safety shoes with steel toe cap
• High-visibility vest / clothing
• Work Gloves
Specific PPE:
• Safety Glasses
• Respiratory Mask

4. MSDS Should be available & displayed

at site.

5. Provide Eve wash close to the work

site.
4 Instalation new panel skirting Falling equipment, Fallen material, 1. To ensure the work is executed by 3 2 6 1. Ensure to wear safety helmet, safety 2 1 2 Suhenda 13/03/2024
Personal injury, competent person. shoes, handgloves & face mask
scratched, out of
breath 2.Checking work tools and ptrotecting work 2. Ensure adequate supervising.
area

3. place chemical materials in a safe area

to prevent material spills
 HAZARD IDENTIFICATION RISK EVALUATION RISK CONTROL

Ref S L RPN S L RPN

(Severity (Likelihoo (risk (Severity (Likelihoo (risk
) d) ) d)
Potential Risk / priority priority
Work Activity Potential Hazard Existing risk controls number Additional Controls number Implementation Person Due Date Remarks
Possible Injury ) )

8 Using cordless drill
Using Cordless Drill 1. Ensure electrical portable tools has been 4 3 12 1. Ensure all personnel involved attend 2 1 2 Suhenda 13/03/2024
inspected by a technician before use Short briefing / Safe work tool box meeting
(labeled with updated inspection sticker). before start to work which highlited;
Required PPE, Particularly hazard,
Preventive measure &counter measure.
2. Ensure cable insulation condition is
good. 2. Ensure adequate supervision during work
Hand Injury - Ensure to unplug socket & cable removed process.
Contacted with while the works is done.
sharp object or 3. Mandatory PPE is wear propely
being pinched by an 3. Ensure electrical tools & work gloves is • Safety helmet with chin strap
object dry/not wet/ not exposed to rain. • Safety shoes with steel toe cap
• High-visibility vest / clothing
4. Ensure cable is places hanging on cable • Work Gloves
hanger with protective insulators. (when Specific PPE:
Eye injury aplicable to minimized tripping hazard) • Electrical Resistance Gloves
Contacted with
sharp object or 5. Ensure to Keep hands and fingers away
against foreign from sharp edges (blades, casing ends,
object or debris etc.).

6. Wear gloves that fit your hand and are

right for the work being performed.

7. Make sure that work using the tool is not

done above face level
4 Cleaning work area Dust 1. Respiratory 1. To ensure air curculation is well 2 1 2 1 1 1 Suhenda 13/03/2024
symptoms & maintained. Placed blower for fresh air
diseases & exhaust fan while needed.