DOWNGRADED SITUATION AUDIT

SOUTH PROCESSING UNIT

Name / Dept of person carrying out audit Nama/ Dept pelaku audit : _____________________________ / ____________________________________________

Location Lokasi : __________________________________________________________________________________________________________________________

Date / Time of audit tanggal / jam dilakukan audit : _____________________________________ / ___________________________________________________
Name of entities or contractor auditee Entity atau contractor yang diaudit: _____________________________________________________________________
Personnel Awareness
NO SUBJECT YES NO REMARKS

1 Does personnel on working location understand what downgraded situation is?

Apakah personel paham mengenai Downgraded Situation?

2 Does personnel know how many DGS exist at SPU area? Example?
Apakah personel tahu jumlah Downgaded Situation di SPU? Contoh?

3 Does personnel aware on where to find Downgraded Situation information?

Apakah personnel mengetahui dimana bisa didapat informasi mengenai Downgraded Situation?

4 Have personnel ever been notice regarding downgraded situation tagging?

Apakah personel pernah melihat dan membaca tagging Downgraded Situation?
Does personnel know downgraded situation list register and where is it displayed?
5 Apakah personel mengetahui tentang Downgraded situation list dan dimana dipasang?

6 Does personnel get information from their hierarchy regarding downgraded situation?
Apakah personnel mendapatkaninformasi dari hierarchy mengenai Downgraded Situation?

7 Does personnel aware any downgraded situation in their working area perimeter?
Apakah personnel mengetahui Downgraded Situation yang berada di area tempat kerjanya?

8 Are Downgraded situations have been shared during pre job meeting?
Apakah Downgraded Situation disampaikan pada saat pre job meeting?

Does operating authority and performing authority have informed job performer regarding
9 Downgraded Situation in the working area perimeter?
Apakah Operating Authority dan Performing authority telah menginformasikan adanya
Downgraded situation kepada pekerja?

Audit of Downgraded Situation case

No DGS No DGS Subject

Assessment and declaration

1 Are the precaution of Downgraded situation above match with actual condition?
Apakah precaution Downgraded situation diatas sesuai dengan kondisi aktual?

Do you think any additional precaution needed for Downgraded situation above?
2 Apakah ada precaution tambahan yang menurut anda perlu dilakukan untuk Downgraded
situation diatas?

Mitigation action implementation

Does all mitigation for downgraded situation above are in place (refer to mitigation on DGS list)?
1 Apakah semua mitigasi dari downgraded Situation sudah dilakukan (mengacu mitigasi pada
daftar DGS)?

SUGGESTION: Visa auditor Visa Auditee

PLEASE SUBMIT THIS AUDIT FORM TO SPU/S&E FOR REGISTRATION AND FOLLOW UP
Hasil Audit harap diserahkan kepada SPU/S&E untuk diregistrasi dan ditindak lanjuti.
Declaration and Risk Assessment
Is Declaration form opened as soon the situation declared as downgraded?
Is formal "Risk Assessment" perform following declaration of downgraded situation?
are both Downgraded declaration form & Risk Assessment are validated by RSES for issuance?
Is the Risk Assessment is inline with matrices of sOP 04-601 Job Risk Assessment?
Corrective Measures
During down grade Situation Is the RSES defined and implement Compensatory Measures (temporary measures) to maintain the
installation work in safe condition even the simultaneity of downgraded situation?
Is the RSES defined Remedial measures (plan) to restore the installation to its normal operating mode?
In the case of Residual Risk = "Acceptable"; does RSES authorized/decide to proceed with defined measures

Is the line management AMB, AMT, etc. involved to make a common decission in the case of residual risk = "Tolerable".

In the case of Residual Risk = "Unacceptable"; no activities allow under this condition. Is the Activity suspended or other control
measures defined?

Implementation & Close Out

Does the RSES monitor the implementation of compensatory measures?
The original declaration mus be stored in specific safety file, under custody of the RSES, is this rule implemented?
Are the copies of declaration form distributed to the concerned personnel and under control of RSES?
Are the Downgraded situations and action lists recorded and reported in the SYNERGI?
Is the status list of Downgraded situation maintained and updated on a real time basis?
Is the tabel integrated in the monthly report of the site?
is the model of status list inline with appendix 3 of SOP 04-605 "Downgraded Situation"?
Downgraded situation shall be duly reported in writing at the time of hand over. It is not only the concern of control room, but also
concern supervisors, superintendents and managers at the end of their respective rotation. Is this rule implemented?

Does the RSES monitor the return to normal situation?

After situation has been brought back to normal, does RSES complete the bottom part of the original declaration form?
Name / Dept of person carrying out audit Nama/ Dept pelaku audit : ____________________
Location Lokasi : _______________________________________________________________
Date / Time of audit tanggal / jam dilakukan audit : __________________________________
Name of entities or contractor auditee Entity atau contractor yang diaudit: _______________

NO SUBJECT

Does personnel on working location understand what downgraded situation is?

Apakah personel paham mengenai Downgraded Situation?

Does personnel know how many DGS exist at SPU area? Example?
Apakah personel tahu jumlah Downgaded Situation di SPU? Contoh?

Does personnel aware on where to find Downgraded Situation information?

Apakah personnel mengetahui dimana bisa didapat informasi mengenai Downgrade

Have personnel ever been notice regarding downgraded situation tagging?

Apakah personel pernah melihat dan membaca tagging Downgraded Situation?

Does personnel know downgraded situation list register and where is it displayed?
Apakah personel mengetahui tentang Downgraded situation list dan dimana dipasan

Did you get information from your hierarchy if any new downgraded situation case?
Apakah personnel mendapatkaninformasi dari hierarchy mengenai Downgraded Situ
 Do you know Downgraded situation displayed in GIS mahakam?
Apakah personnel mengetahui bahwa Downgraded Situation dapat diakses melalui G

Does personnel aware any downgraded situation in their working area perimeter?
Apakah personnel mengetahui Downgraded Situation yang berada di area tempat ke

Does personnel ensure that all mitigation measure / precaution of Downgraded Situ
area have been implemented?
Apakah personel yakin bahwa semua precaution dari Downgraded situation di area k

Does operating authority and performing authority have informed job performer reg
Situation in the working area perimeter?
Apakah Operating Authority dan Performing authority telah menginformasikan adan
kepada pekerja?

Are Downgraded situations have been shared during pre job meeting?
Apakah Downgraded Situation disampaikan pada saat pre job meeting?

Responsibility
A1 Is the Operating authority responsible for :
assessing and managing any downgraded situations,
enforcing compliance with procedures to deal with such situation until normal conditions
are reinstated,
implementing the necessary measures (compensatory) to keep control of nonroutine
activities or bring back the situation back to the normal operating mode,
closely monitor the full implementation of compensatory and corrective actions,
inform the RSES of the progress to reinstate normal conditions.

A2 Is the Safety Authority responsible for

reviewing and approving the measures taken during the risk assessment exercise
and at any time during the persistence of downgraded situations
ensuring corrective actions are implemented in the right way and at the soonest
 ensuring that HSE Manager is informed of Tolerable if ALARP and Unacceptable
downgraded situations
reporting the downgraded situations status during the regular site HSE Committees

B Detection of Downgraded Situations

Is the RSES informed in every Down Graded situation detected?
Does RSES takes measures within his/her level delegation to ensure safe condition?
Does RSES apply SOP 04-605 "Down graded Sitionation" and declare the situation as "down

Do you know Inhibition/override on a safety system (e.g. fire and gas system, emergency sh
etc.) not removed within 1 day (24 hours) shall be declared as downgraded situations

C Declaration and Risk Assessment

Is Declaration form opened as soon the situation declared as downgraded?
Is formal "Risk Assessment" perform following declaration of downgraded situation?
are both Downgraded declaration form & Risk Assessment are validated by RSES for issuanc
Is the Risk Assessment is inline with matrix as defined in CR EP HSE 041 (5X5) ?

D Initial Risk Level

Is initial risk level inline with matrix as defined in CR EP HSE 041?

D Compensatory and Corrective Measures and Residual risk level

During down grade Situation Is the RSES defined and implement Compensatory Measures (t
maintain the installation work in safe condition even the simultaneity of downgraded situati
Is the RSES defined Remedial measures (plan) to restore the installation to its normal opera
In the case of Residual Risk = "Level-3"; does RSES authorized/decide to proceed with define
Is the line management involved to make a common decission in the case of residual risk = "

In the case of Residual Risk = "Level-1" Is the Activity suspended or other control measures

E Implementation & Close Out

Does the RSES monitor the implementation of compensatory measures?
The original declaration mus be stored in specific safety file, under custody of the RSES, is th
Are the copies of declaration form distributed to the concerned personnel and under contro
Are the Downgraded situations and action lists recorded and reported in the SYNERGI?
Is the status list of Downgraded situation maintained and updated on a real time basis?
Is the tabel integrated in the monthly report of the site?
is the model of status list inline with appendix 5 of SOP 04-605 "Downgraded Situation"?
Downgraded situation shall be duly reported in writing at the time of hand over. It is not on
room, but also concern supervisors, superintendents and managers at the end of their respe
implemented?

Does the RSES monitor the return to normal situation?

After situation has been brought back to normal, does RSES complete the bottom part of th

SUGGESTION:

PLEASE SUBMIT THIS AUDIT FORM T

Hasil Audit harap diserahkan kepad
 DOWNGRADED SITUATION AUDIT

SOUTH PROCESSING UNIT

Nama/ Dept pelaku audit : _____________________________ / ______________________________________

__________________________________________________________
kan audit : _____________________________________ / _________________________________________
ntity atau contractor yang diaudit: _______________________________________________________

SUBJECT YES NO

tion understand what downgraded situation is?

nai Downgraded Situation?

y DGS exist at SPU area? Example?

owngaded Situation di SPU? Contoh?

e to find Downgraded Situation information?

dimana bisa didapat informasi mengenai Downgraded Situation?

e regarding downgraded situation tagging?

t dan membaca tagging Downgraded Situation?

ded situation list register and where is it displayed?

ntang Downgraded situation list dan dimana dipasang?

ur hierarchy if any new downgraded situation case?

ninformasi dari hierarchy mengenai Downgraded Situation?
 tion displayed in GIS mahakam?
bahwa Downgraded Situation dapat diakses melalui GIS?

ngraded situation in their working area perimeter?

Downgraded Situation yang berada di area tempat kerjanya?

mitigation measure / precaution of Downgraded Situation in their working

emua precaution dari Downgraded situation di area kerjanya telah dilakukan?

erforming authority have informed job performer regarding Downgraded

rimeter?
n Performing authority telah menginformasikan adanya Downgraded situation

e been shared during pre job meeting?

disampaikan pada saat pre job meeting?

ble for :
graded situations,
ures to deal with such situation until normal conditions
ures (compensatory) to keep control of nonroutine
n back to the normal operating mode,
ation of compensatory and corrective actions,
reinstate normal conditions.

for
ures taken during the risk assessment exercise
nce of downgraded situations
plemented in the right way and at the soonest
med of Tolerable if ALARP and Unacceptable

ns status during the regular site HSE Committees

ns
n Graded situation detected?
his/her level delegation to ensure safe condition?
n graded Sitionation" and declare the situation as "down graded"?

n a safety system (e.g. fire and gas system, emergency shutdown system,
hours) shall be declared as downgraded situations

n the situation declared as downgraded?

m following declaration of downgraded situation?
form & Risk Assessment are validated by RSES for issuance?
h matrix as defined in CR EP HSE 041 (5X5) ?

as defined in CR EP HSE 041?

asures and Residual risk level

RSES defined and implement Compensatory Measures (temporary measures) to
afe condition even the simultaneity of downgraded situation?
ures (plan) to restore the installation to its normal operating mode?
l-3"; does RSES authorized/decide to proceed with defined measures
o make a common decission in the case of residual risk = "Level-2".

l-1" Is the Activity suspended or other control measures defined?

entation of compensatory measures?

ored in specific safety file, under custody of the RSES, is this rule implemented?
distributed to the concerned personnel and under control of RSES?
d action lists recorded and reported in the SYNERGI?
uation maintained and updated on a real time basis?
hly report of the site?
h appendix 5 of SOP 04-605 "Downgraded Situation"?
y reported in writing at the time of hand over. It is not only the concern of control
s, superintendents and managers at the end of their respective rotation. Is this rule

to normal situation?

ack to normal, does RSES complete the bottom part of the original declaration form?

SUGGESTION:

PLEASE SUBMIT THIS AUDIT FORM TO SPU/S&E FOR REGISTRATION AND FOLLOW UP
Hasil Audit harap diserahkan kepada SPU/S&E untuk diregistrasi dan ditindak lanjuti.
UATION AUDIT

NG UNIT

__________________

_______________
_________

REMARKS
LOW UP
lanjuti.