JHA No : 2019/01504JHA

JOB HAZARD ANALYSIS (JHA) Risk Assessment Tier (RAT 1) PREPARED BY : ANDRY SASTRAWAN
PTW REFERENCE : 2019/01504SWP DATE/TIME PREPARED : 03/05/2019 – 10:48
UNIT/EQUIPMENT : Palu Kuningan, Palu 5 kg, Gergaji, Gunting Besi, Linggis, Sekop, Pacul, Waterpass (Autolevel) APPROVED BY : ANDRI SASTRAWAN
LOCATION : PLANT OFFSITE DATE/TIME APPROVED : 03/05/2019 – 16:30
WORK : Manual Excavation, Instalasi Formwork, Wiremesh/Rebar and Pouring Concrete for barier pole and concrete PAGE 1 OF 4
slab Fire Hydrant Area Condensate Tank
Safety Representative Signature:

MACHINE/EQUIPMENT INITIAL RESIDUAL

NO JOB S TEP TOOL INVOLVED POTENTIAL HAZARD/LOSS RISK RISK CONTROL MEASURES RISK REMARKS
IN EACH STEP (H,M,L) (H,M,L)
1  P e r s i a p a n dokumen kerja, material  Penanganan secara  Kesalahpahaman/ M  Semua dokumen pekerjaan telah disetujui (CMS, L
dan peralatan kerja/ manual/Handling Misunderstanding Drawing & Plot, JHA, PTW ) dan harus berada di
Preparation of work documents, manually  Dokumen kurang lengkap/ lokasi kerja / All work documents have been approved
materials and work equipment Document incomplete (CMS, Drawing & Plot, JHA, PTW ) and must be on
 Kegagalan fungsi alat/ Tool failure the job site
 Terserang panas/dehidrasi/ Heat  Semua pekerja harus mengikuti TBM / All workers
stress / dehydration must attend Toolbox Meeting
 Alat pelindung diri tidak cukup dan  Laporkan dan deskripsikan pekerjaan yang akan
rusak/ Insufficient and damaged dilakukan / Report and describe the work to be done.
personal protective equipment  Komunikasikan segala sesuatunya dengan pengawas
 Tersandung, terpeleset dan dan pihak-pihak terkait / Communicate everything with
tergores/ Tripping, slipping and supervisors and related parties
scratching  Persiapkan dokumen pekerjaan dan safety sesuai
 Cidera pada tangan/ Hand injuries dengan aturan yang berlaku / Prepare work documents
 Cidera tulang belakang/ Back and safety in accordance with applicable rules.
bone injuries  Pelajari dan implementasikan semua aturan yang
 Terjepit/Pinched berlaku / Learn and implement all applicable rules.
 Tertabrak truk Krane /Hit by a  Pastikan alat sudah diinspeksi dan dalam kondisi
truck Mobile Crane (TMC) layak pakai / Ensure the tool has been inspected and
 Tertimpah Material / Downfall of is in good condition.
material  Pastikan kondisi tubuh fit / Ensure the body condition
is fit.
 Cukup minum dan ketersediaan air minum / Sufficient
drinking and availability of drinking water
 Pastikan APD cukup dan dalam kondisi layak pakai/
Ensure that PPE is sufficient and is in a condition
suitable for use
 Gunakan APD yang sesuai (Helm safety dengan tali
dagu, kacamata safety, sarung tangan dan sepatu
safety dan coverall) / Use the appropriate PPE (safety
helmet with chin strap, safety glasses, hand gloves
and safety shoes and coverall)
 Cek area kerja dan pastikan tidak licin dan tidak ada
benda atau material yang berserakan dan menjadi
bahaya sandungan / Check the work area and make
sure it is not slippery and there are no objects or
materials that are scattered and become a danger of
stumbling.
 Memperhatikan posisi tubuh yang baik saat bekerja /
Pay attention to good body position while working.

1
 MACHINE/EQUIPMENT INITIAL RESIDUAL
NO JOB S TEP TOOL INVOLVED POTENTIAL HAZARD/LOSS RISK RISK CONTROL MEASURES RISK REMARKS
IN EACH STEP (H,M,L) (H,M,L)
 Pekerja perlu menjaga kewaspadaan yang konstan
akan kaki mereka sehubungan dengan benda yang
dipindahkan dan menghindari menempatkannya di
bawah bahan / W orkers need to maintain constant
awareness of their feet in relation to objects being
moved and avoid placing them under materials.
 Penanganan secara tidak melebihi 20 Kg/orang
/ handling not exceeding 20 kg / person.
 Pekerja yang lain dilarang mendekati mobil krane saat
melintas atau mundur / Other workers are prohibited
from approaching the crane when passing or retreating
 Hanya Operator T ruk Mobill krane yang bisa
mengoperasikan T r u k Mobile Kran / Only the Truck
Mobill Crane operator can operate the Truck Mobile
Crane.
2  Menggali manual dan  Linggis, Pacul, Sekop,  Cidera pada tangan/Hand injuries M  Semua peralatan yang digunakan harus layak dan L
mengangkut material galian/ Gerobak/Crowbar, Hoe,  Cidera tulang belakang/Back telah lolos inspeksi keselamatan / All equipment used
Manual Excavation and Hauling Shovel,and Cart bone injuries must be feasible and have passed safety inspection.
material excavation  Cidera kaki/ Foot injuries.  Perhatikan posisi tubuh yang baik saat bekerja/Pay
 Cidera Mata/ Eye injuries. attention to good body position while working.
 Terserang panas/ Heat stress  Memenuhi kebutuhan minum minimal 2 liter per
 Kerusakan pada layanan bawah hari/Meet the drinking needs of at least 2 liters per day
tanah / di atas tanah (seperti  Penggunaan APD yang sesuai (Kaca mata safety,
saluran kabel, kabel, dll) jika pelindung wajah, sarung tangan, helmet, dan sepatu
galian lebih dari 10 cm/ safety)/use of appropriate PPE (safety
 Damage to underground glasses,faceshield, gloves, helmet, and safety shoes).
/aboveground Services  Periksa layanan bawah tanah / atas tanah melalui
(suchpipeline, cables etc) if gambar dan detektor logam jika galian lebih dari 10
excavation is more than 10 cm. cm/Check for underground / aboveground services
throughmetal detectors amd drawing if excavation is
more than 10 cm.
 Penanganan secara tidak melebihi 20 Kg/orang/
handling not exceeding 20 kg / person
 Pekerja perlu menjaga kewaspadaan yang konstan
akan kaki mereka sehubungan dengan benda yang
dipindahkan dan menghindari menempatkannya di
bawah bahan./W orkers need to maintain constant
awareness of their feet in relation to objects being
moved and avoid placing them under materials.
3 Pekerjaan Bekisting / Formwork:  Palu Kuningan, Palu 5  Cidera pada tangan/Hand injuries M  Semua peralatan yang digunakan harus layak dan L
 P e n g u k u r a n Material Bekisting/ kg, Gergaji, Mistar  Cidera tulang belakang/Back telah lolos inspeksi keselamatan / All equipment used
Measurement of Formwork Material W aterpass, bone injuries must be feasible and have passed safety inspection.
 Pemotongan material sesuai Meteran/Brass hammer,  Cidera kaki/ Foot injuries  Pada Zona Merah harus menggunakan Palu kuningan
dengan kebutuhan/Cutting material hammer 5 kg, saw for  Tertusuk benda tajam/ Pierced saat menancapkan paku / In the Red Zone you have
according to needs wood, crossbar sharp objects. to use a brass hammer when you plug nails
 Memasang/merangkai waterpass, measure  Terserang panas/ Heat stress.  Semua pekerja harus kompeten dalam melakukan
bekisting/Instalation Formwork tape  Percikan Palu/Spark Hammer. pekerjaan ini / All workers must be competent in doing
 Cedera mata/Eye injuries this work
 Pekerja harus memperhatikan posisi dan
keseimbangan tubuh untuk menjaga ergonomic yang
baik/ W orkers must pay attention to the position and
balance of the body to maintain good ergonomics.

2
 MACHINE/EQUIPMENT INITIAL RESIDUAL
NO JOB S TEP TOOL INVOLVED POTENTIAL HAZARD/LOSS RISK RISK CONTROL MEASURES RISK REMARKS
IN EACH STEP (H,M,L) (H,M,L)
 Kerusakan pada layanan bawah M  Jauhkan penempatan kaki disaat menggergaji/Keep L
tanah / di atas tanah (seperti the foot placement when sawing.
saluran kabel, kabel, dll) jika  Pekerja yang lain dilarang berada didepan pekerja
menancapkan patok lebih dari 10 yang sedang memaku / Other workers are prohibited
cm/ from being in front of workers who are nailing.
Damage to underground  Paku harus di tempatkan pada satu wadah agar tidak
/aboveground Services berserakan / The nail must be placed in one container
(suchpipeline, cables etc) if stick so that it is not scattered.
the stake is more than 10 cm.  Periksa layanan bawah tanah / atas tanah melalui
gambar dan detektor logam jika galian lebih dari 10
cm / Check for underground / aboveground services
throughmetal detectors amd drawing if excavation is
more than 10 cm.
 Penanganan secara tidak melebihi 20
Kg/orang/handling not exceeding 20 kg / person
 Pekerja perlu menjaga kewaspadaan yang konstan
akan kaki mereka sehubungan dengan benda yang
dipindahkan dan menghindari menempatkannya di
bawah bahan / W orkers need to maintain constant
awareness of their feet in relation to objects being
moved and avoid placing them under materials.
 Gunakan APD yang sesuai (Helm safety dengan tali
dagu, kacamata safety, sarung tangan dan sepatu
safety, coverall) / Use the appropriate PPE (safety
helmet with chin strap, safety glasses, hand gloves
and safety shoes)
4 Pekerjaan pembesian:  Pengikat besi dan  Cidera pada tangan/Hand injuries M  Semua peralatan yang digunakan harus layak dan L
 Perakitan besi / Iron Installation, gunting besi / Iron  Cidera tulang belakang/Back telah lolos inspeksi keselamatan dengan tagging
 Pemotongan besi / Iron cutting binder and iron scissors bone injuries biru/All equipment used must be feasible and have
 Cidera kaki/ Foot injuries passed safety inspection with blue tagging.
 Tertusuk benda tajam/ Pierced  Memperhatikan posisi tubuh yang baik saat
sharp objects. bekerja/Pay attention to good body position while
 Terserang panas/ Heat stress. working.
 Terjepit Gunting/ Pinched  Memposisikan anggota tubuh dengan baik saat
Scissors memotong rebar/Position the limbs well when cutting
rebar.
 Memenuhi kebutuhan minum minimal 2 liter per
hari/Meet the drinking needs of at least 2 liters per
day
 Gunakan APD yang sesuai (Helm safety dengan tali
dagu, kacamata safety, sarung tangan dan sepatu
safety)/ Use the appropriate PPE (safety helmet with
chin strap, safety glasses, hand gloves and safety
shoes)

3
 MACHINE/EQUIPMENT INITIAL RESIDUAL
NO JOB S TEP TOOL INVOLVED POTENTIAL HAZARD/LOSS RISK RISK CONTROL MEASURES RISK REMARKS
IN EACH STEP (H,M,L) (H,M,L)
5 Pengecoran/ Pouring Concrete :  Mixer truck, peralatan  Cidera tangan/ Hand injuries M  Pekerja yang terlibat dalam pekerjaan ini harus L
 Concrete mixer truk di kawal masuk tangan (Sekop, cangkul,  Cidera tulang belakang/ Back kompeten/W orkers involved in this work must be
menggunakan Mobil Hilux Double sendok semen) dan bone injuries competent
cabin DN 8891 RF/Concrete mixer penanganan manual  Terjepit/ Pinched  Pekerja harus fokus dan komunikasi dengan baik
truck on escort in uses Hilux Double lainnya/Mixer truck,  Tertabrak truk mixer/Hit by a antara pekerja yang terlibat dalam pekerjaan
cabin Car DN 8891 RF hand tools (Shovels, mixer truck ini/W orkers must focus and good communication
 Memposisikan mixer truck/ Position hoes, cement spoons)  Terkena percikan semen/ between workers involved in this work.
the mixer truck and other manual Exposed to sparks of cement  Sopir truk mixer harus mengikuti instruksi flagman
 Membuka shalow mixer truck/Open handling. saat memposisikan mundur/The mixer truck driver
the shalow mixer truck must follow the flagman instructions when
 Penuangan semen cor ke titik repositioning
pengecoran/Cast cement to the  Flagman harus fokus dan memberi instruksi yang
point casting. aman kepada sopir mixer truk/Flagman must focus
 Menutup shalow mixer truck/Close and give safe instructions to the truck mixer driver.
shalow mixer truck.  Mixer truk harus 100% parkir sebelum menuangkan
 Concrete Mixer truck meninggalkan pengecoran/The truck mixer must be 100% parking
tempat / Concrete Mixer trucks before pouring casting.
leave the place  Pekerja yang lain dilarang mendekat disaat
 Concrete mixer truk di kawal keluar pembukaan shalow semen dan penuangan
menggunakan Mobil Hilux Double pengecoran/Other workers are prohibited from
cabin DN 8891 RF/Concrete mixer approaching when opening cement shalls and casting
truck on escort out uses Hilux concreting
Double cabin Car DN 8891 RF  Titik tumpah penuangan pengecoran harus tepat agar
 Penanganan setelah pengecoran/ tidak terjadi tumpahan kemana-mana dari semen
Handling after casting tersebut/The pouring point of the casting pouring
must be right so that there is no spill everywhere from
the cement
 Hanya menggunakan peralatan manual yang tepat
disaat meratakan tuangan pengecoran/Only use the
right manual equipment when casting casting leveling
 Menghindari terkena percikan semen/Avoid being
exposed to sparks of cement,
 Gunakan APD yang sesuai (Helm safety dengan tali
dagu, kacamata safety, sarung tangan dan sepatu
safety, dan coverall) / Use the appropriate PPE
(safety helmet with chin strap, safety glasses, hand
gloves and safety shoes dan coverall)

6  Pembersihan lokasi Kerja /  Penanganan secara  Terpeleset dan tersandung/ M  Membersihkan dan merapikan peralatan kerja setelah L
Housekeeping manual/ Slipping and tripping aktivitas kerja/ Clean and tidy up work equipment
Manual handling after work activities

7  Keadaan darurat/ Emergency  N/A  Tertimpah material, terjepit M  Tidak panik, matikan semua perlatan mesin, lakukan L Emergency contact number
peralatan, dan tertusuk benda pertolongan pertama sementara secepatnya, ikuti (5555/0461 3120000)
runcing / Material is abundant, rute darurat yang telah di setujui/Don't panic, turn off Muster Point 3
pinched of hand tool, punctured all engine equipment, do first aid as soon as possible,
by pointed objects follow the emergency route that has been approved.
 Memberikan pertolongan pertama dan Evakuasi atau
Hubungi kontak emergency jika terjadi kecelakaan
kerja/Provide first aid and evacuation or contact
emergency contacts in the event of a work accident.

Note : As a guideline to JHA RAT1 Risk Levels the following definitions apply :
H = High Risk : the likely outcome is one or more Fatalities or Property Damage could exceed 5 to 20 MM USD
M = Medium Risk : the likely outcome is one or more Days Away From Work Cases or Property Damage could exceed 500k to 5 MM USD 4
L = Low Risk : the likely outcome is one or more First Aid Cases or Property Damage would not exceed 500k USD