Doc - No. Ta2839 Wp3b BMGP PTW 001 r0 - Site Office Preparation

PT.
BANGUN MITRA GRAHA PERSADA ( BMGP )Ruko Golden Madrid Block G N
FORM OF ISSUE
Client : PT Unilever
Project : Marvel 2
To : PT. BANGUN MITRA GRAHA PERSADA
Subject : IFC - Various Substation / MCC Dwg (FOR CONSTRUCTION)
Dear BMGP Team,
We hereby issue you the following:
Doc. No. Subject

Refer to File Please refer to the attached drawing list for document breakdown list
Reference & Notes:

Issued by by: Ackowledged by
PT. Bangun Mitra Graha Persada Unilever/Owner
Original to  Addressee
Copy to  Addressee  CM (RHDHV)
 Client  Site Representative (RHDHV)
 PM (RHDHV)
Ruko Golden Madrid Block G No. 10 BSD Tangerang - SelatanPhone & Fax : +62 ( 021 ) 53164882 - 83bmgp2@ymail.com
Tel. Fax. Email
TA2839-BMGP-WP3B-SDS-001-R0
Date : 11 Nov 2022

Project no. : TA2839
From : BMGP
Version File Type
Refer to File Exel
Acknowledgement of receipt
Royal HaskonongDVH
WORK PERMIT FOR CONSTRUCTION SITE
Doc. No. TA2839-WP3B-BMGP-PTW-001-R0 Project No. TA2839
Works SITE OFFICE & WORKSHOP PREPARATION Coordinator Ibnu Khaldun
Nr RA/JSA Supervisor Faturochman
Spesific Location SITE OFFICE & WORKSHOP PREPARATION - ( Area - 9 Ha ) Safety Officer Denny Prayogi
Date 21/11/2022 Number of Workers
PPE to be used
Standard Gloves
Safety Harness Face Shield Other :
Shoes, Hard Hat, High Vis Vest Rubber/Cotton/Leather
Work Permit - Work Preparation Submittal Documents Checklist

No. Submittal Items for Approval Approved (Yes/No)* Date Approval Sign Issuer (Consultant) Co-Sign (Client) Remarks**
1 Work planning and works mapping (layout, sequence)
2 Work Method Statements
All Staff Vaccinated. Periodic PCR
3 Safety, Health and Environment Plan (incl C-19 measure)
Test
4 Work inspections previous works (rebar, formwork, et.al.)
5 Survey report/stake out of the works (planned works)
6 ITP Inspection Test Plan document for the works (QC)
7 Material Approval
8 Workshop/Prefabricator/Factory Inspection (FAT)
9 Material Delivery, handling, laydown and storage plan
10 Material Delivery Inspection (Material needs to be on site)
11 Material sample lab test 3rd party as required by Eng.
12 Material Test Certificates (from manufacturer/supplier)
13 Shop design drawings
14 Equipment planning (hand-tools, tools, heavy equipment)
15 Equipment testing (operator and equipment certified)
16 Manpower planning (per activity step, show rate of prog.)
17 Mock-up approved (if applicable)
18 Coordination plan (if applicable)
19 Lifting Plan (if applicable)
20 Supervision & Quality Control personnel planning
*If the above are answered with "Yes" and documents and requirements have been fulfilled complete and signed above, please invite Consultant and Client for Pre-Installation
meeting to present the works and gain approval sign off of this Work Permit before any commencement of works.
(*Apabila hal di atas dijawab dengan "Ya" dan dokumen serta persyaratan telah dipenuhi secara lengkap dan ditandatangani, silakan undang Konsultan dan Klien untuk rapat Pra-Instalasi
untuk mempresentasikan pekerjaan dan mendapatkan persetujuan dari Izin Kerja ini sebelum dimulainya pekerjaan.)
**If Not Applicable (N/A) note under 'Remarks'
(**Jika tidak, beri catatan di kolom 'Remarks')
Note Permit to Work Applicant Work Permit Issuer

The contractor is required to attach documents related to the work permit. Contractor CM/SM Contractor Safety Manager RHDHV PM/CM UOI
The work permit will not be approved if the supporting documents are incomplete
( ) ( ) ( ) ( )
PT. Bangun Mitra Graha Persada
Ruko Golden Madrid 2, Blok G. No 10.BSD
Tangerang Selatan - Jawa Barat Tel.
+62 21 53164882 - 83 Fax.
bmgp2@ymail.com Email
REQUEST FOR APPROVAL TA2839-WP3B-BMGP-MSC-001-R0
Client : PT. Unilever Oleochemical Indonesia Date : 23 November 2022

Project : MCC - MARVEL 2 Project no. : TA2839
To : Royal HaskoningDHV From : PT. BMGP
Subject : Method Statement Civil Site Office & Workshop Preparation
We submit the following for your approval:

¨ Work Planning And Work Mapping
¨
Description: Work Planning And Works Mapping
Attachment and or Reference: Method Statement Civil Site Office & Workshop Preparation
Signature:
Name: Ibnu Khaldun
To the Contractor, Date:

Your request is:
¨ Approved ¨ Returned for correction
¨ Approved on condition as noted ¨ Disapproved as noted
Notes:
PMC UOI
Signature: Signature:
Name: Name:
Original to ¨ RHDHV's site representative (to be returned to contractor)

Copy to ¨ CM (RHDHV)
¨ Client to be issued after RHDHV's
¨ PM (RHDHV) site representative's decision

MCC - MARVEL 2 PROJECT
PT. Unilever Oleochemical Indonesia
KEK Sei Mangkei - North Sumatera
TITLE OF DOCUMENT :
METHOD STATEMENT CIVIL FOR SITE OFFICE AND WORKSHOP PREPARATION
01 November 2022
Document No : TA2839-WP3B-BMGP-MSC-001-R0
Work Package : MCC MARVEL 2 PROJECT CIVIL STRUCTURAL
REV ISSUED DATE STATUS PREPARED BY REVIEWED BY APPROVED BY APPROVED BY

CM / APM / PM
0 BMGP HSE / PC PMC UOI
PMC
TABLE OF CONTENTS
Agreement Sheet .1
Introduction .2
Lay Out Assesment .3
Table Of Contens .4
I. Purpose
II. Scope
III. PERSONIL IN CHARGE AND MANPOWER
IV. EQUIPMENT, TOOLS AND MATERIALS
V. PERSONAL PROTECTIONS
VI. TECHNICAL INSTRUCTIONS
VII. MONITORING
VIII. ATTACHEMENT
2. Introduction
Before the construction work begins, the contractor is required to establish a keet board of directors,
a material warehouse and a workshop.
The implementation of construction work in the field can be successful in terms of time and quality if managed
properly. One of the means to be able to manage projects properly is the availability of a place for project
supervisors and contractors in the form of keet directors, to:
a. Making reports, studying drawings, making working drawings and all project administration.
b. Placement of communication tools, so that the relationship/communication between owners,
supervisors and contractors can run well
The building material for the directors keet field uses wooden rafters, the wall covering is made
of 9 mm multiplex and the roof covering uses corrugated asbestos or corrugated zinc, floors with discreeding.
In addition to the keet field directors building, a warehouse building is also needed to store work tools and
materials that are vulnerable to weather and which are easily lost like :
electric drill, electric grinder, vibrator, cement, ceramics, paint, cable, sanitary tools and others.
The warehouse building uses rafter wood frames, wall coverings of 9 mm multiplex and corrugated
asbestos/corrugated zinc roof coverings, floors with discreeding. Field and warehouse keet directors are
established in areas that do not interfere with the ongoing process of carrying out work.
Site Office &

Workshop
LAY OUT AREA - 9 Ha

I. PURPOSE
The purpose of this work method is as a guideline for carrying out work from preparation to completion of work.
The job of making directors keet aims to be a place to coordinate the implementation of work and assess work
in terms of HSE, Quality, Quantity, and work time efficiency so that from the work method attached it can be
concluded that this work is feasible or not to be carried out.
II. SCOPE
The purpose of this document is to show how the project site offices, warehouse, and workshop will be set up.
for the office of the keet directors is equipped with facilities, worker toilets, working electricity and clean water supply.
III. PERSONNEL IN CHARGE AND MANPOWER

The personnel in charge responsible for the following work is as follows :
• Construction Manager : Ibnu Khaldun
( Appoint all personnel in charge and number of mainpower )
• Site Supervisor : Faturochman
( Supervision during work on site to comply with approved documents )
• Engineer : Ibnu Khaldun
( Inspection during and after work )
• HSE Officer : Denny Prayogi
( Supervision of safety during work on site to comply with safety requirements )
Personnel in charge above are subject to changes as per registered personnel assigned for the position.
The required amount of manpower for the following work is :
• Supervisor :1 Personnel
• Foreman :1 Personnel
• Operator Foco Crane ( Yap Crane ) :1 Personnel
• Workers ( Preparation of material, tools, ) : 6 Personnel
IV. EQUIPMENT, TOOLS & MATERIALS

The required equipments for the following method are :
• Container Office 20 Feet
• Sand
• Cement
• Wood
• Zincalume
• Nail
• Paint
• Cable
• PVC pipe
• Foco Crane
• Compactor
• Hoe
• Hammer
• Saw
• hand drill
• Water Pass
• Thread

V. PERSONAL PROTECTIVE EQUIPMENT

• Helmet + Chin Strip With Face Shield Attached
• Long Sleeve Work Uniform + Long Trousers
• Safety Shoes
• Safety Glass
• Hand Gloves
• Safety Vest ( Bright Green ) With Reflector
VI.1 Preliminary Works

a. Ensure reference documents ( Method statement, shop drawing, PTW, and RFI ) has been signed,
and approved for construction by Project Management Consultant ( PMC ) and Project Owner prior,
to excavation earth work.
b. Prepare the required tools, material, adequate amount of proper safety gear and equipment.
VI.2 Inspection
a. Inspect preparation activities
b. Examination of the work of cleaning and leveling the land of directors keet
c. Examination of land compaction work in the office of directors keet
d. Inspect the plaster work of the hall directors keet
e. Inspect container office unloading and lifting work.
f. inspect the work of roof trusses and roof coverings of directors keet
g. Inspect the work of electrical installations and clean water installations for directors keet.
VII. MONITORING
a. Supervisors must monitor and supervise during the process of unloading and lifting work.
b. Delimit the construction area from unauthorized personnel by installing safety line barricades,
where necessary.
VIII. ATTACHMENT
a. JSA ( Job Safety Analysis )
b. HSE Risk Assesment


TABLE OF CONTENTS
COVER 1
COMMENT RESOLUTION SOLUTION 2
TABLE OF CONTENTS 3
I. PURPOSE
II. SCOPE
III. PERSONIL IN CHARGE AND MANPOWER
IV. EQUIPMENT, TOOLS AND MATERIALS
V. PERSONAL PROTECTIONS
VII. MONITORING
VII. ATTACHEMENT
I. PORPOSE
The following method statement serves as a technical reference for demolition work existing room.
Before the demolition work is carried out, coordinate with the supervisory consultant and the employer,
for demolition materials.
II. SCOPE
The scope of this method statement is the first stage of work implementation that must be carried out,
before work begins.
Before the demolition work is carried out, protection is carried out for the work area.
For materials that have been unloaded, coordination must be made for the placement of unloaded
materials and demolition waste.
III. PERSONNEL IN CHARGE AND MANPOWER

The personnel in charge responsible for the following work is as follows :
• Construction Manager : Ibnu Khaldun

( Appoint all personnel in charge and number of mainpower )
• Site Supervisor : Faturochman

( Supervision during work on site to comply with approved documents )
• Engineer : Ibnu Khaldun

( Inspection during and after work )
• HSE Officer : Denny Prayogi

( Supervision of safety during work on site to comply with safety requirements )
Personnel in charge above are subject to changes as per registered personnel assigned for the position.
The required amount of manpower for the following work is :
• Supervisor :1 Personnel
• Surveyor :1 Personnel
• Foreman :1 Personnel
• Driver :1 Personnel
• Workers ( Preparation of material, tools, ) :6 Personnel
IV. EQUIPMENT, TOOLS & MATERIALS

The required equipments for the following method are :
• Water Pass
• Meter
• Hammer
• Saw
• Hoe
• Nail
• Paint
• Thread
V. PERSONAL PROTECTIVE EQUIPMENT

• Helmet + Chin Strip With Face Shield Attached
• Long Sleeve Work Uniform + Long Trousers
• Safety Shoes
• Safety Glass
• Hand Gloves
• Safety Vest ( Bright Green ) With Reflector
VI.1 Preliminary Works

a. Ensure reference documents ( Method statement, shop drawing ) has been signed,
and approved for construction by Project Management Consultant ( PMC ) for demolition work,
existing room.
b. Prepare the required tools, material, adequate amount of proper safety gear and equipment.
VI.2 Inspection
a. Inspect the implementation of existing room demolition work, to ensure materials and electrical installations
b. Coordinate the placement of materials and demolition work waste so that the room is clean and tidy.
c. Collect data on materials that will be reused and record materials that are not used.
e. Document the inspection reports in Request for Inspection to be Approved : The copy of Approfed
VII. MONITORING
a. Supervisors must monitor and supervise during the process of demolition work.
b. Delimit the construction area from unauthorized personnel by installing safety line barricades,
where necessary.
VIII. ATTACHMENT
a. JSA ( Job Safety Analysis )
b. HSE Risk Assesment

PT. Bangun Mitra Graha Persada
Ruko Golden Madrid 2, Blok G. No 10.BSD
Tangerang Selatan - Jawa Barat Tel.
+62 21 53164882 - 83 Fax.
bmgp2@ymail.com Email
REQUEST FOR APPROVAL TA2839-WP3B-BMGP-JSA-001-R0
Client : PT. Unilever Oleochemical Indonesia Date : 23 November 2022

Project : MCC - MARVEL 2 Project no. : TA2839
To : Royal HaskoningDHV From : PT. BMGP
Subject : JSA & HIRA Site Office & Workshop Preparation
We submit the following for your approval:

¨ Job Safety Analysis
¨
Description: Job Safety Analysis
Attachment and or Reference: Job Safety Analysis Site Office & Workshop Preparation
Signature:
Name: Ibnu Khaldun
To the Contractor, Date:

Your request is:
¨ Approved ¨ Returned for correction
¨ Approved on condition as noted ¨ Disapproved as noted
Notes:
PMC UOI
Signature: Signature:
Name: Name:
Original to ¨ RHDHV's site representative (to be returned to contractor)

Copy to ¨ CM (RHDHV)
¨ Client to be issued after RHDHV's
¨ PM (RHDHV) site representative's decision

No. Dok
PT.UNILEVER OLEOCHEMICAL INDONESIA No. Doc UOI-HSE-012
FORMULIR JOB SAFETY ANALISA No. Terbitan
(JSA) Issue Date 1:00
JOB SAFETY ANALISYS FORM (JSA) No. Halaman
Page No 1-
No Izin/Permit no : SHE/PTW/JSA/9-Ha/BMGP/XI-2022/001-R0
Dibuat oleh Diperiksa oleh
Perusahaan/Company : PT.BANGUN MITRA GRAHA PERSADA
Tanggal/Date : Prepared by Review by SHE PT.UOI Area Owner
Nama/Name
Waktu/Time : 08.00 - 17. 00 WIB Denny Prayogi
Aktivitas/Activity : Pekerjaan Pembangunan Direksi Keet, Gudang Dan Tempat Fabrikasi TTD/Signature
Lokasi Pekerjaan/Work Location : SITE OFFICE ( Area - 9Ha ) TGL/Date
Tahapan Pekerjaan Bahaya Akibat Tindakan Pengendalian
No Action by (PIC)
Sequence of Basic Job Steps Hazard Consequence Recommended Action
1 Melakukan TBM Jarak terlalu dekat Terpapar covid 19 - Pastikan jarak antar pekerja tidak saling berdekatan,min 2 meter Safety
- Lakukan cuci tangan secara berkala
- Gunakan double masker (Masker kain dan medis)
2 Perencanaan kerja Komunikasi tidak baik ( Montion ) Kegagalan rencana kerja ( FAC ) - Penyampaian materi pekerjaan dengan jelas
- Mencatat hasil diskusi materi pekerjaan
- Pastikan seluruh pekerja memahami rencana kerja dan gambar kerja
3 Persiapan alat dan material Tersandung Bebatuan Luka memar/ Lebam - Pastikan tidak ada material/alat yg menghalang akses jalan & Pekerjaan SPV,Safety
- Perhatikan langkah kaki saat berjalan di area kerja
- Memastikan pekerja menggunakan APD sesuai kebutuhan
- Pasang safey sign
4 Langsir material Ergonomi Cidera otot - Mengangkat material sesuai kemampuan pekerja SPV,Safety
- Menggunakan alat bantu kerja
- Bekerja dengan posisi tubuh dengan baik
Tersandung - Perhatikan langkah
- Bersihkan akses dari material berserakan
- Menggunakan APD
Tertimpa material - Hindari posisi terjatuhnya material
- Lakukan kordinasi atau aba - aba yang baik saat mengangkat dan meletakan material
5 Perataan tanah dan pemadatan Tergores alat kerja Luka sobek - Periksa alat kerja sebelum digunakan SPV,Safety
- Pastikan peralatan terkunci dengan baik anatar mata cangkul dengan gagang cangkul
- Pastikan mesin pemadat / campacktor sudah di periksa dan dinyatakan layak pakai
- Posisikan bagian tubuh pada posisi aman
- Menggunakan APD
Terpapar cuaca panas Dehidrasi, pingsan - Pastikan pekerja dalam keadaan sehat
- Menyediakan cukup air minum
- Menyediakan tempat istirahat sementara
- Istirahat berkala
Cuaca gerimis dan hujan Fatality - Menghentikan pekerjaan saat cuaca mendung sebelum turun hujan
- Berteduh di tempat yang aman dari gerimis dan hujan
- Matikan alat komunikasi elektronik saat cuaca hujan dan petir
6 Plester lantai Tergores alat kerja Luka sobek - Periksa alat kerja sebelum digunakan SPV,Safety
- Pastikan peralatan terkunci dengan baik anatar mata cangkul dengan gagang cangkul
- Pastikan mesin molen / mixing sudah di periksa dan dinyatakan layak pakai
- Menggunakan APD
Terpapar cuaca panas Dehidrasi, pingsan - Pastikan pekerja dalam keadaan sehat
- Menyediakan cukup air minum
- Menyediakan tempat istirahat sementara
- Istirahat berkala
Cuaca gerimis dan hujan Fatality - Menghentikan pekerjaan saat cuaca mendung sebelum turun hujan
- Berteduh di tempat yang aman dari gerimis dan hujan
- Matikan alat komunikasi elektronik saat cuaca hujan dan petir
7 Pemotong kayu Tergores gergaji Luka sobek - Penggunaan sarung tangan

- Posisikan jari tangan pada posisi aman
- Pastikan pekerja terampil menggunakan alat
Tertusuk serpihan kayu pembengkakan - Penggunaan sarung tangan
- Posisikan tangan pada kayu yg halus
- Pastikan pekerja berpengalaman
8 Pemasangan Seng Pagar Tergores matirial Luka sobek - Penggunaan APD
- Perhatikan matirial tajam saat handing
9 House keeping/clearing Digigit binatang berbisa Luka memar - pastikan area kerja aman
(bioligi) - Bongkar tumpukan sampah/semak belukar secara perlaha
- Gunakan safety boot
- Perhatikan area kerja sekitar
Tergores Luka sobek - Perhatikan matirial tajam saat handing
PT.
KE
RISK A
PENIL
Activity / Product / Services

No
Aktivitas / Produk / Jasa Hazard / Bahaya Risk & Severity Prabobility
Opportunities
1 Melakukan TBM Jarak Terlalu Terpapar Covid -19 2 6

dekat (FAC)
( Motion )
2 Perencanaan kerja / rapat kordinasi Komunikasi Kegagalan 2 6

Tidak Baik Rencana
( Motion ) Kerja
(FAC)
3 Persiapan alat dan material Tersandung Luka memar / Lebam 4 6

bebatuan (FAC)
(Motion)
4 Langsir material Ergonomi Cidera otot 4 6

(motion) (LTI)
Tersandung Luka memar 4 4

(motion) (FAC)
Tertimpa Luka memar 4 4
matirial (FAC)
(grafitasi)
Terperosok galian Terkilir/patah tulan 4 6

(montion) (LTI)
5 Perataan tanah dan pemadatan Tergores alat Luka sobek 2 6

kerja (FAC)
Terpapar cuaca Dehidrasi 2 6

(montion) (FAC)
Cuaca gerimis terpeleset/terjatuh 4 6

dan hujan (FAC)
(montion)
6 Plester lantai Tergores alat Luka sobek 2 6

kerja (FAC)
(Montion)
Terpapar cuaca Dehidrasi 2 6

(montion) (FAC)
Cuaca gerimis terpeleset/terjatuh 4 6

dan hujan (FAC)
(montion)
7 Pemotongan kayu Tergores gergaji Luka sobek

(Montion) (FAC) 2 6
Terusuk serpihan pembengkakan 4 6

kayu (LTI)
8 Pemasangan sengf pagar Tergores matirial Luka sobek 2 6

(motion) (FAC)
9 House keeping/clearing Digigit binatang Keracuran/Fatality 8 4

berbisa (Singgle Death)
(Biologi)
RISK ASESSMENT AND OPPORTUNITIES
PENILAIAN RESIKO DAN PELUANG
Risk Factor Responsibility Documented Risk & Risk Factor

(PxS) ( Person In Charge ) Information Opportunities Severity Prabobility (PxS)
( Form, SOP, IK )
M DENNY Metod Kerja Delay 1 4 VL

PTW, JSA Only
SHE PLAN
M DENNY Metod Kerja Delay 1 4 VL

PTW, JSA Only
SHE PLAN
M+ DENNY Metod Kerja FAC 2 2 VL

PTW, JSA
SHE PLAN
M+ DENNY Metod Kerja FAC 2 2 VL

PTW, JSA
SHE PLAN
M DENNY Metod Kerja FAC 2 2 VL

PTW, JSA
SHE PLAN
M DENNY Metod Kerja FAC 2 2 VL
PTW, JSA
SHE PLAN
M+ DENNY Metod Kerja FAC 2 4 L

PTW, JSA
SHE PLAN
M DENNY Metod Kerja FAC 2 4 L

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN

PTW, JSA
SHE PLAN
H DENNY Metod Kerja LTI 4 4 M

PTW, JSA
SHE PLAN
a
a
NITIES Dibuat oleh/Prepared by
SPV/HSE
NG Nama/Name
TTD/Signature
TGL/Date
Apa / What Dimana / Whare Kapan / Whan Siapa / Who Bagaimana /

How
1. Menyampaikan materi Site Offce & Selama Construction Pastikan

dengan jelas Workshop pembuatan Team, HSE pemateri
2. Catat hasil diskusi lalu 9 - Ha Site Office & menguasai
di tanda tangani Workshop PTW, JSA
3. Pastikan seluruh pekerja Work Method
memahami rencana kerja
1. Menyampaikan materi Site Offce & Selama Construction Pastikan

dengan jelas Workshop pembuatan Team, HSE pemateri
2. Catat hasil diskusi lalu 9 - Ha Site Office & menguasai
di tanda tangani Workshop PTW, JSA
3. Pastikan seluruh pekerja Work Method
1. Pastikan tidak ada material / Site Offce & Selama Construction kelengkapan alat
alat yg menghalang akses Workshop pembuatan Team, HSE Work Method
jalan & Pekerjaan 9 - Ha Site Office & PTW, JSA
2. Perhatikan langkah kaki Workshop
saat berjalan di area kerja
3. Memastikan pekerja
menggunakan APD sesuai
kebutuhan
4. Pasang safey sign
1. Mengangkat matirial sesuai Workshop Selama Construction kelengkapan alat

kemampuan pek 9 - Ha pembuatan Team, HSE Work Method
2. Gunakan alat bantu Site Office & PTW, JSA
3. Gunakan APD Workshop
1. Gunakan APD Workshop Selama Construction kelengkapan alat

2. Bersihkan akses 9 - Ha pembuatan Team, HSE Work Method
3. perhatikan langkah Site Office & PTW, JSA
Workshop
2. Pengecekan are kerja 9 - Ha pembuatan Team, HSE Work Method
3. hindari posisi jatuh matirial Site Office & PTW, JSA
Workshop

2.baricade galian 9 - Ha pembuatan Team, HSE Work Method
3.pasang rambu Site Office & PTW, JSA
Workshop

2. Posisi jari aman 9 - Ha pembuatan Team, HSE Work Method
3. pekerja profesional Site Office & PTW, JSA
Workshop
2.Minum air 9 - Ha pembuatan Team, HSE Work Method
3.istirahat Site Office & PTW, JSA
Workshop
2.berteduh 9 - Ha pembuatan Team, HSE Kelayakan alat
Site Office & Work Method
Workshop PTW, JSA
2. Posisi jari aman 9 - Ha pembuatan Team, HSE Kelayakan alat
3. pekerja profesional Site Office & Work Method
Workshop PTW, JSA
1. Gunakan APD Workshop Selama Construction Work Method
2.Minum air 9 - Ha pembuatan Team, HSE PTW, JSA
3.istirahat Site Office &
Workshop
2.berteduh 9 - Ha pembuatan Team, HSE Kelayakan alat
Site Office & Work Method
Workshop PTW, JSA

2. Posisi jari aman 9 - Ha pembuatan Team, HSE Kelayakan alat
3. pekerja profesional Site Office & Work Method
Workshop PTW, JSA
2.Pekerja profesional 9 - Ha pembuatan Team, HSE Work Method
Site Office & PTW, JSA
Workshop

2. perhatikan matirial tajam 9 - Ha pembuatan Team, HSE Work Method
Site Office & PTW, JSA
Workshop
1. Pastikan area kerja aman Workshop Selama Construction kelengkapan alat

2. bongkar tumpukan sampah 9 - Ha pembuatan Team, HSE Work Method
dan semak secara perlahan Site Office & PTW, JSA
3.gunakan safety boots Workshop
No. Dok
No. Doc UOI-HSE-012
No. Terbitan
Issue Date 1:00
No. Halaman
Page No 1-
Diperiksa oleh/Review by SHE PT.UOI
PMC
Tindakan Pencegahan Keterangan

( Preventive ) Remark
1. Melakukan tanya jawab

setelah rapat kordinasi
untuk memastikan pekerja
1. Melakukan tanya jawab

setelah rapat kordinasi
untuk memastikan pekerja
1. pengecekan alat
2. list matirial
3. pengechekan APD
1. Lakukan Tool Box Meeting

2. pasang rambu-rambu
3. pastikan cara pengangkatan
ergonomi sesuai SOP
4. pelatihan manual handling
ergonomi

3. membuat program house
keeping setiap hari untuk
area kerja
3. membuat program house
keeping setiap hari untuk
area kerja

2. pasang rambu
3. tutp galian yang tidak perlu

2 memilih pekerja yang terampil
3.melatih cara kerja aman

2.penyedian air minum di area
kerja
3.istirahat secara bergantian
2. berhenti bekerja
3.cari lokasi yang aman
(berteduh)

2.penyedian air minum di area
kerja
3.istirahat secara bergantian
2. berhenti bekerja
3.cari lokasi yang aman
(berteduh)

4. membuat cheklis peralatan

2. Pemasangan Rambu
3. Pastikan metode handling baik

2. Pemasangan Rambu
3. pastikan antidote ada di klinik
terdekat
: Demolition Wall

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BANGUN MITRA GRAHA PERSADA ( BMGP )Ruko Golden Madrid Block G N

Doc. No. Subject

Reference & Notes:

Tel. Fax. Email

Date : 11 Nov 2022

Version File Type

Refer to File Exel

Work Permit - Work Preparation Submittal Documents Checklist

Note Permit to Work Applicant Work Permit Issuer

REQUEST FOR APPROVAL TA2839-WP3B-BMGP-MSC-001-R0

Client : PT. Unilever Oleochemical Indonesia Date : 23 November 2022

Subject : Method Statement Civil Site Office & Workshop Preparation

We submit the following for your approval:

Description: Work Planning And Works Mapping

To the Contractor, Date:

¨ Approved ¨ Returned for correction

¨ Approved on condition as noted ¨ Disapproved as noted

Original to ¨ RHDHV's site representative (to be returned to contractor)

¨ Client to be issued after RHDHV's

¨ PM (RHDHV) site representative's decision

REV ISSUED DATE STATUS PREPARED BY REVIEWED BY APPROVED BY APPROVED BY

Lay Out Assesment .3

III. PERSONIL IN CHARGE AND MANPOWER

IV. EQUIPMENT, TOOLS AND MATERIALS

VI. TECHNICAL INSTRUCTIONS

a material warehouse and a workshop.

supervisors and contractors in the form of keet directors, to:

b. Placement of communication tools, so that the relationship/communication between owners,

supervisors and contractors can run well

Site Office &

LAY OUT AREA - 9 Ha

III. PERSONNEL IN CHARGE AND MANPOWER

IV. EQUIPMENT, TOOLS & MATERIALS

MCC - MARVEL 2 PROJECT

V. PERSONAL PROTECTIVE EQUIPMENT

VI. TECHNICAL INSTRUCTIONS

VI.1 Preliminary Works

b. HSE Risk Assesment

MCC - MARVEL 2 PROJECT

MCC - MARVEL 2 PROJECT

COMMENT RESOLUTION SOLUTION 2

III. PERSONIL IN CHARGE AND MANPOWER

IV. EQUIPMENT, TOOLS AND MATERIALS

VI. TECHNICAL INSTRUCTIONS

III. PERSONNEL IN CHARGE AND MANPOWER

• Construction Manager : Ibnu Khaldun

• Site Supervisor : Faturochman

• Engineer : Ibnu Khaldun

• HSE Officer : Denny Prayogi

The required amount of manpower for the following work is :

IV. EQUIPMENT, TOOLS & MATERIALS

V. PERSONAL PROTECTIVE EQUIPMENT

VI. TECHNICAL INSTRUCTIONS

VI.1 Preliminary Works

b. HSE Risk Assesment

REQUEST FOR APPROVAL TA2839-WP3B-BMGP-JSA-001-R0

Client : PT. Unilever Oleochemical Indonesia Date : 23 November 2022