Installation : SPU Small JRA Nb: S-JRA-109 Date : 28-Dec-21

Leader : Andrias W
Attendees : Ricky G/ S. Catur W/ Rendy A/ A Wildan
Manual Excavation and Backfilling at Shoreline, Onshore and Bundwall
Task Description
Penggalian dan Penimbunan Secara Manual di Shoreline, Onshore dan Bundwall
Follow Up by, Sign where Stipulated
Reduce Check by
Hazard Risk Control Measures (Tindak Lanjut Oleh, Paraf Setelah Dilakukan)
(diperiksa
(Bahaya) (Langkah Pengendalian Resiko) Date 1 Date 2 Date 3 Date 4 Date 5 Date 6 Date 7
S P oleh)
(Hari 1) (Hari 2) (Hari 3) (Hari 4) (Hari 5) (Hari 6) (Hari 7)

First aider on location with first aid kit & ready for evacuation to First Aider di lokasi kerja dilengkapi dengan first aid kit dan Check 1st day and have to be valid for PTW duration
Personnel injury due to: Personil cedera karena: 1 x OA & PA
closest clinic bersiap untuk evakuasi ke Klinik NPU Di check di hari pertama dan harus valid selama masa PTW

Discussed during Toolbox Talk and ensured during Supervision

1 Hit by hoe/ shovel Terhantam oleh cangkul/ sekop 2 Be aware of wild animals attack Waspada terhadap serangan binatang liar x PA
Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Discussed during Toolbox Talk and ensured during Supervision

2 Musculoskeletal disorder Cidera otot dan tulang 3 Use guard stick to see possibility of wild animals Gunakan/ sediakan tombak to mengusir binatang buas x PA
Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Tersengat listrik yang disebabkan Checked in WP front page precaution & Ensure permanently by PA
Electric shock due to hand tools hit
3 peralatan mengenai kabel listrik 4 Standby watchman Siaga penjaga x OA & PA Diperiksa dalam pencegahan pada halaman depan WP oleh OA &
the live electricity cable
bertegangan pastikan seterusnya oleh PA
Checked in WP front page precaution & Ensure permanently by PA
4 Wild animal Binatang Buas 5 Wear high impact gloves Gunakan sarung tangan high impact x OA & PA Diperiksa dalam pencegahan pada halaman depan WP oleh OA &
pastikan seterusnya oleh PA

5 Land slide Longsor / tertimbun 6 Wear safety rubber boot Gunakan sepatu karet safety x OA & PA

Check 1st day and have to be valid for PTW duration

6 Pressurized pipeline Pipa bertekanan 7 Valid excavation complementary permit Izin permit penggalian harus berlaku x OA & PA
Di check di hari pertama dan harus valid selama masa PTW

To perform land scanning and install stick marker if any Melakukan pemindaian bawah tanah dan pasang stick penanda Check 1st day and have to be valid for PTW duration
7 Slip and falling down Terpeleset dan jatuh 8 x OA & PA
underground facilities nearby jika ada fasilitas bawah tanah disekitar area kerja Di check di hari pertama dan harus valid selama masa PTW

Checked in WP front page precaution & Ensure permanently by PA

8 Facility blow down Pembuangan gas dari fasilitas 9 Install warning sign and barricade around working area Pasang tanda peringatan dan barikade di sekitar tempat kerja x OA & PA Diperiksa dalam pencegahan pada halaman depan WP oleh OA &
pastikan seterusnya oleh PA

Clear access way and surrounding working area from obstruct Bersihkan jalan akses dan sekitar area kerja dari benda2 yang Discussed during Toolbox Talk and ensured during Supervision
9 Back pain Cedera tulang belakang 10 x PA
object mengganngu Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Keep safe distance between worker when digging by hoe (min. Jaga jarak aman antara pekerja ketika menggali dengan Discussed during Toolbox Talk and ensured during Supervision
11 x PA
3 m) cangkul (min. 3 m) Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Discussed during Toolbox Talk and ensured during Supervision

Material damage due to: Kerusakan material karena: 12 Apply proper gesture and posture during the work Sikap posisi dan badan yang tepat selama bekerja x PA
Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Damage existing facilities Merusak fasilitas / instalasi yang ada Storage material and equipment properly. Minimum distance Menyimpan bahan dan peralatan dengan benar. Jarak Discussed during Toolbox Talk and ensured during Supervision
10 13 x PA
(underground pipe/cable) ( Pipa/kabel dalam tanah ) with the edge of excavation is 1 meter minimum dengan ujung galian adalah 1 meter Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Slooping excavation and to install temporary retaining wall if Buat kemiringan pada dinding galian dan memasang dinding Discussed during Toolbox Talk and ensured during Supervision
14 x PA
any soil movement penahan tanah sementara jika ada pergerakan Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Discussed during Toolbox Talk and ensured during Supervision

15 Work execution during low tide Pekerjaan dilakukan pada saat air surut x PA
Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

16 Check equipment and tools in good condition Cek peralatan dalam kondisi baik x PA

Pengangkatan secara manual maksimum 20 kg untuk setiap Discussed during Toolbox Talk and ensured during Supervision
17 Maximum manual handling 20 kgs per person x x PA
orang Didiskusikan ketika Toolbox Talk dan dipastikan melalui pengawasan

Initial risks (Risiko awal) Residual risks (Risiko akhir)

Approval of JRA Conclusion (Persetujuan Kesimpulan JRA) Consequences (Konsekuensi)
S P R S P R
PRJ/EXE HSSE RSES Human consequence Konsekuensi terhadap manusia Mo Po T Mi Un A
WIBOWO SUDARMA

ISKAND Digitally signed by ISKANDAR Rudy

DN: cn=ISKANDAR Rudy, ou=PHM,
Andrias NTO
Sudarmanto
Material Consequence Konsekuensi material Hi Un U Mo Vu A
ou=Users, dc=ad, dc=phm-pertamina,
2021.12.28
AR Rudy Environnement Consequence Konsekuensi terhadap lingkungan - - - - - -
dc=com
Digitally signed by: SUDARMANTO
16:43:59
Date: 2021.12.28 15:26:32 +08'00'

Sudarmanto
+08'00' Date: 2021.12.29 09:24:27 +08'00' NOTE: S = Severity Level: Mi (Minor), Mo (Moderate), Se (Serious), Hi (Major & Catastrophic); P = Probability: Pr (Probable), Po (Possible), Un (Unlikely), Vu (Very Unlikely); R = Risk: A (Acceptable), T (Tolerable), U (Unacceptable)