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lOR NO· LNGC-TAS-IDR-0140

INTERDISCIPLINE DISTRIBUTION REVIEW

DOCUMENT NO LNGC-REK-1800-CT-PR-018 IRESPONSIBLE PERSON Anthony OF
DOCUMENT TITLE Construction Method For Drainage System
REV 0 IDATE : 25-11-2013
STATUS : IFP

<<< >> <:> : : <~ ~ ::.:::.::::~ ~ :: ><< < ·>:<•>:::.: •• iNJTiA~ :<< : :SrAru~ >> . bAtE: . >6A:i6> cbMM~Nts .·. . iNil"I~L{. > .
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Construction Manager LKS V
2 Dep. Construction Manager ADF V
3 Project Control Manager
4 QA I QC Manager

5 HSE Manager JML \

6 Civil Engineer IP v
7 Site Representatif Engineer (Civil) HDS v
8 Offshore Engineer
7 Site Representatif Engineer (Offshore) BZD
8 Piping Engineer ( )
9 Piping Engineer ( ) HNN
10 Site Representatif Engineer (Piping) JLT
11 Electrical Engineer ( · t ) SM
12 Site Representatif Engineer (Electrical) FEL
13 Instrument Engineer ( 1 ·}

14 Mechanical Engineer (,;L. HJ)

15 Site Representatif Engineer (Instrument) FEL

16 Site Representatif Engineer (HSE) TSD
17 Site Representatif Engineer (HSE) ZKM
18 Document Control MSN
19 Site Representatif Document Control BIM
20

COMMENTS I SPECIAL INSTRUCTION :

DOCUMENT REVIEW STATUS

/1 1
/~~
c:::J 1 No Comment Work may Proceed SIGNATURE

c:::J 2 Minor Comment Work may Proceed

CJ 3 Major Comment Work may not Proceed DATE : 25-11-2013

c:::J 4 For Information Only

FLOATING STORAGE REGASIFICATION UNIT (FSRF)LAMP UNG

 ~
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B
(<:.::,..:·"', 1: ,· ~, _ ::::_:-;,, ;~ HO EGH LNG .,.,,.,,
HQEGH LNG- REKIND CONSORTIUM
TECHN ICAL ASSISTANT SERVICES CONSOR.liUM OF HOEGH LNG LTD AND PT REKAYASA INOUSTRI
ih>rsHGl Tbk

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. Rev. Rekind Job No.

Page 1 of 9
LNGC-REK-1800-CT -PR-018 0 12-1605

CLIENT PT. PERUSAHAAN GAS NEGARA (PERSERO) Tbk.

PROJECT LABUHAN MARINGGAI LNG FLOATING STORAGE AND

REGASIFICATION FACILITIES

LOCATION LABUHAN MARINGGAI, LAMPUNG- INDONESIA

~ A -
"~ 7fi - lu
0 Issued for Implementation 21/11/2013 BS/AP 7 FAR F~ V(sl ..,. EML JHS
c Re-Issued for Approval 22/1 0/2013 BS/AP FAR ISL EML JHS
1
B Issued for Approval 14/06/2013 BS/AP FAR ISL EML JHS
A Issued for Review 12/02/2013 BS/AP FAR ISL EML JHS
PREP'D CHK'D APP'D
REV DESCRIPTIONS DATE TAS PGN
HOEGH - REKIND
 pgn
~ PGAS SOLUTION
HOEGH LNG REI<I>ri\SI
HOEG H LNG- REKIND CONSORTIUM
TECHNICAL ASSISTANT SERVICES CONSOR TI UM OF HOEG H LNG LTD AND PT REKAYASA INOUS TRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. Rev . Rekind Job No.

Page 2 of 9
LNGC-REK-1800-CT -PR-018 0 12-1605

REVISION HISTORICAL SHEET

Rev No Date Description

A 12/02/2013 Issued for Review

·--·-·-------··-·--····- · · · - - - · - -- - - - - · -- · · . . . . ········-----·----·-·····-·-····-------·-··-···-····-··
8 14/06/2013 Issued for Approval
- - - - · - · - · - · · · - · · · - · · - · - · - - - · - - - - - - - · - - - - - - - · - - - · - -- ···-- ----------··--·---·--·····-·--·------····-
• Item 1.2 Revise Definition
- - - - · - - - - · · - . ··--····-···--··--····-····--·-· -··------·----·------·· · · - - - - - - -------·--··--·----------- · - -- - · - - - - ·- - - - -

• Item 3 Revise Scope of Work

• Item 3.1 Revise Preparation
• Item 3.3 Revise Excavation and Compaction Work
..... ···········--- --------- -------------------------- - - -----········----------- -----------········----------- ---- - ------ -------------------~ ------····---- --···- · ·····-·-------------- -----------------------······
• Item 3.4 Revise Leveling Concrete
····-·-·--···---·-· - ·--·--···· ·--- ·······-·-----·--- -------·--··-·-··--------------·---·-·--···-·--·----- · - - ---- - ·---- -- - -1
• Item 3.5 Revise Installation Culvert
-·-·----··· - · - - -
-- - - - - - - - - · - · -----·----··-·--·-·----···· ···--- · - · · - - - - · · - · · - - - - - · - -···-·----··

•
Item 3.9 Revise Backfilling and Compaction Work
--·c·-·-··-·-- ·---2
-::-c2::-:-/1·.--o:-,=-=2~
0..,.,
13:c-·--+-=R=-e--,-
-ls-s- ued for Approval

0 21/11/2013 Issued for Implementation

·····-····--·······-··-···-----r-- ----·--·-·---··---- · · - - - · - - ---······-··---· - - - - · -- · - -- - - · --··--·-·- ········-··-···---···-··---- -··---- - - - · -

- -· - · - - - · ·-· ······-·--····-·--·····---- - - · · · - - · -- - - · - - - - - - - - --·-· -

·- - · - --·--·····-····· .... ················-·--·-·--··-·---·- -

· - - - - - - - - - -· · · · - - - - · - -
 PGAS SOLUTION
HOEGH LNG RE KAYM•

HOEGH LNG- REKIND CONSORTIUM

TECHNI CAL ASS ISTANT SERVICES CONSORTIUM OF HOEGH LNG LTD AND PT REKAYASA INOUSTRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. Rev . Rekind Job No.

Page 3 of 9
LNGC-REK-1800-CT -PR-018 0 12-1605

TABLE OF CONTENT

1. GENERAL .................................................................................................................................................4
1.1. SCOPE ..............................................................................................................................................4
1.2. DEFINITIONS ..................................................................................................................................... 4
2. REFERENCE SPECIFICATION ................................................................................................................ 4
2.1. STANDARD SPECIFICATION .......................................................................................................... 4
2.2. DOCUMENT DRAWINGS ................................................................................................................. 5
3. SCOPE OF WORK .................................................................................................................................... 5
3.1. PREPARATION ................................................................................................................................ 5
3.2. SETTING OUT .................................................................................................................................. 6
3.3. EXCAVATION AND COMPACTION WORK .................................................................................... 6
3.4. LEVELING CONCRETE ................................................................................................................... 6
3.5. INSTALLATION OF CULVERT ........................................................................................................6
3.6. INSTALLATION OF PIPE CULVERT ............................................................................................... ?
3.7. SEWERAGE INSTALLATION .......................................................................................................... ?
3.8. STONE MASONRY FOR OPEN DRAINAGE STRUCTURE ............................................................ ?
3.9. BACKFILLING & COMPACTION WORK ......................................................................................... 7
APPENDIX ................................................................................................................•..................................... 9
JOB SAFETY ANALYSIS FORM .............................................................................................................. 9
 PGAS SOLUTION
HOEGH LNG ' IIAYASA

HOEGH LNG- REKIND CONSORTIUM

TECHNICAL ASSISTANT SERVICES CONSORf iUM OF HOEGH LNG LTD AND PT REKAYASA INDUSTRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. I Rev. Rekind Job No.

Page 4 of 9
LNGC-REK-1800-CT-PR-018 I 0 12-1605

1. GENERAL

1.1. Scope
This method procedure covers general requirement for sewer and drainage construction and relevant items to
be performed for EPCIC of the Pipeline System for Lampung LNG Floating Storage and Regasification
Facilities Project owned by PT Perusahan Gas Negara (Persero) Tbk., on Labuhan Maringgai, Lampung ,
Indonesia.
1.2. Definitions
The following words shall have the meaning indicated when used herein:
PGN PT Perusahaan Gas Negara (Persero) Tbk
ASSISTANT Technical assistant who is assigned to assist Client (PGN) during this Project to
advice or service provide all or a specified part of the work or material required
PROJECT EPCIC of the Pipeline System for Lampung LNG Floating Storage and
Regasification Facilities
CONTRACTOR PT REKAYASA INDUSTRI
SUB-CONTRACTOR The party(s) that carry(s) out all or part of the procurement, installation and testing
of the system specified by CONTRACTOR
SUPPLIERNENDOR The party which supply materials, equipments, technical documents/drawings and
services to perform the duties specified by PGN
SHALL Indicated a mandatory requirement
SHOULD Indicates a strong recommendation to comply with the requirement of this
document

2. REFERENCE SPECIFICATION

The requirements contained in the latest editions of the following codes and standards shall form an integral
part of this method.

2.1. Standard Specification

ASTM C 76 Reinforced concrete culvert, storm drain and sewer pipe

LNGC-REK-1800-CV-SP-001 Design Specification for Civil and Structural
LNGC-REK-1800-CV-CS-003 Construction Specification for Earth Work
LNGC-REK-1800-CV-CS-005 Construction Specification for Concrete Work
LNGC-REK-1800-CV-CS-009 Construction Specification for Sewer and Drainage
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PGAS SOLUTION
Cl~ : •. ;.,.; .!.: ,· ::: •..:~·.:~ .., ;~
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HO EGH LNG """",
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F"' <~AS NEGs>,Rt\
TECHNICAL ASSISTANT SERVICES CONS ORTI UM OF HOEGH LN G l T O AND PT REKAYASA INDUSTR I
fP':iSc·,o) T:.li'

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. Rev. Rekind Job No.

I Page 5 of 9
LNGC-REK-1800-CT -PR-018 0 12-1605
I

2.2. Document Drawings

LNGC-REK-1800-CV-DG-001 Site Preparation and Rough Grading Plan (1) Are

Labuhan Maringgai Station.
LNGC-REK-1800 -CV-DG-1 01 General Area Road Pavement, Sewer & Drainage Layout
Area- 1
LNGC-REK-1800 -CV-DG-1 02 General Area Road Pavement, Sewer & Drainage Layout
Area- 2
LNGC-REK-1800 -CV -DG-103 General Area Road Pavement, Sewer & Drainage Layout
Area- 3 (2 Sheets)
LNGC-REK-1800 -CV-DG-1 04 General Area Road Pavement, Sewer & Drainage Layout
& Detail - 1 (2 Sheets)
LNGC-REK-1800 -CV-DG-1 05 General Area Road Pavement, Sewer & Drainage Layout
& Detail - 2_(2 Sheets)
LNGC-REK-1800 -CV-DG-106 General Area Road Pavement, Sewer and Drainage
Layout Detail, Section, Manhole Schedule
LNGC-REK-1800-CV-SD-024 Standard Drawing For Detail of Ditch, Crossing Road &
Piping Protection
LNGC-REK-1800-CV-SD-026 Standard Drawing For Typical Detail of Man Hole

3. SCOPE OF WORK
Scope of work for this work are shown below:
a. Constructed all drainage system of inside plant (open drainage, man hole and culvert) .
b. Relocation of existing irrigation channel and road (see dwg no LNGC-REK-1800-CV-DG-001 for detail
new route) .

3.1. Preparation
In this case, there will be two items must be prepared. They are working drawing and material to be used.
3.1.1. Working drawing
Working drawings shall be submitted to TAS and PGN and shall show at least the following :
a. Section of excavation
b. Detail of demolition of existing obstacles
c. Detail of reinstatement of existing facilities
d. Detail of protection of existing facilities
e. Detail of temporary safety protection for the work
f. Plan drawing for drainage system .
3.1 .2. Materials
a. All materials to be used for this work shall refer to engineering specification and manufacture
standards. Catalogs and/ or samples of the materials shall be submitted to PGN for approval prior
to commencement of the work.
b. Provide mix design concrete and conduct trial mix for all required grades of concrete.
 PGAS SOLUTION
HOEGH LNG """'"'
HOEGH LNG- REKIND CONSORTIUM
TECHNICAL ASSISTANT SER VICES CONSORT IUM OF HOEGH LN G LTD AND PT REKAYASA IN DUSTRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

;
Document No. i
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Rev. Rekind Job No .
Page 6 of 9
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LNGC-REK-1800-CT -PR-018 0 12-1605
i
3.2. Setting Out
To get the precise position of the drainage the following items shall be carried out,
a. Set alignment of center line of drain and length of drain by CONTRACTOR Surveyor, refer to reference
drawings.
b. Establish marking at the edge of intended drain line for indicating depth of excavation as per reference
drawings.
3.3. Excavation and Compaction Work
In order to get properly earth work execution, the following activities are required:
a. Before start excvation , underground facilities shall be checked.
b. Excavate existing soil to get intended elevation of drainage using excavator.
c. Soft soil , obstacles and other unsuitable material that encountered in the sub-grade shall be removed and
replaced with suitable material as approved by PGN. Compaction of replacement materials shall be as
specified in Construction Specifications for Earthworks.
d. Once the formation level is achieved , the bed of excavation shall be compacted immediately.
e. The slope and shape of excavation of the drainage shall be such to minimize erosion and sedimentation
or as specified on engineering drawing .
f. All excavations shall be provided with stable side slopes to minimize slope collapse and to ensure safety
at all times.
g. Part of excavated soil to be dumped offsite and the remaining quantity to be used as backfilling materials.
Excavated material must be stacked at least 1 m clear of edge of trench .
h. Sequences work of excavation old and new river see attachment 1.
i. Provide safety tape surrounding excavation pits as safety measurement. Hard barricades shall be
provided where necessary.
3.4. Leveling Concrete
The following activities shall be performed :
a. The intended level of bottom of excavation to be checked and hand compacted prior to laying of concrete
for pipe culvert and prior to laying of sand for manhole or precast ditch I box culvert.
b. Install sufficient formwork at boundary of leveling concrete or sand bedding if necessary.
c. Apply sand bedding for manhole, precast ditch and RC pipe I PVC pipe or culvert with thickness as
shown on the engineering drawings.
d. Check level, thickness and compaction of sand bedding by CONTRACTOR Quality Control (QC) and PGN
Quality Control (QC).
e. Pouring ready-mix concrete for leveling concrete. Leveling concrete is applied as specified on drawings.
f. Compact and level the concrete using manual tools.
g. All phase of leveling concrete work shall be inspected by CONTRACTOR and shall be approved by
TASIPGN.

3.5. Installation of Culvert

The following activities shall be performed:
a. All materials shall be conformed to Engineering spceification
b. Mark centerline of culvert
c. Lay the drain from higher end to lower end.
 ~
pgn PGAS SOLUTION
HO EGH LN G , """""
HOEGH LNG- REKIND CONSORTIUM
TECHNICAL ASSISTANT SERVICES CONSOR TIUM OF HOEG H LN G LTD AND PT REKAYASA INOUSTRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

i
Document No . Rev. Rekind Job No.
; Page 7 of 9
LNGC-REK-1800-CT -PR-018 I 0 12-1605

d. Check the invert level of the drain and record it section by section by CONTRACTOR and shall be
approved by TAS/PGN. The tolerance for invert level shall be conformed to engineering specification.
e. All joints between the precast units shall be filled.
f. Joint inspection for drainable slope of drainage partially between CONTRACTORS, TAS/PGN .
3.6. Installation of Pipe Culvert
The following activities shall be performed :
a. All Materials shall be inspected by CONTRACTOR based on engineering spcification and shall be
approved by TAS/PGN.
b. Pipe culvert for road crossing normally installed is of spigot and socket type unless specified otherwise.
c. Make sure that bedding has been accepted including its elevation prior to installation.
d. Pegging area of drainage to guide centerline, elevation, and left-right border as necessary.
e. Provide a recess on the bedding material to accommodate the socket. The width of the recess of the
socket shall conform to manufacture spec.
f. Pipes shall be laid in upstream direction with the socket towards the inlet.
g. Check the alignment of pipe or drainage section by section, partially, by CONTRACTOR and shall be
approved by TAS/ PGN.
h. Prior to jointing, rubber rings and jointing surfaces shall be cleaned of all contaminants.
i. Rubber ring joints shall be installed strictly in accordance with the manufacturer's instruction.
j. The care must be taken to ensure the rubber ring is adequately compressed to seal the joint.
k. After all pipes for certain section of road crossing is completely installed, the survey on the intended invert
level of pipes to be checked and must be within the tolerance given in the specification before backfilling
can be started.
I. All phase of leveling concrete work shall be inspected by CONTRACTOR and shall be approved by
TAS/PGN.
3.7. Sewerage Installation
The installation sewerage system consists of piping and septic tanks which wi ll be described on detailed
engineering drawing.
3.8. Stone Masonry for Open Drainage Structure
The following activities shall be performed:
a. Make sure the alignment and elevation of open drainage refer to engineering drawing .
b. Provide leveling concrete or sand bedding at the bottom level of drainage prior to arrangement of stone
masonry.
c. Use cement mortar at 1:3 mixture for stone masonry work refers to engineering soec (LNGC-REK-1800-
CV-CS-009).
d. Ensure slope of drainage is achieved section by section during construction work.
e. All phase of levelling concrete work shall be insected by CONTRACTOR and shall be approved by
TAS/PGN.
3.9. Backfilling &Compaction Work
The following activities shall be performed:
a. For pre-cast Ditch, the backfilling material is taken from the original suitable materials .
b. Use approved compactor to compact the backfi lling material.
 PGAS SOLUTION
HO EGH LNG R .. ,~,
HOEGH LNG- REKINO CONSORTIUM
TECHNICAL ASSISTANT SERVICES CONSORTI UM OF HOEGH LNG LTD AND PT REKAYASA INOUSTRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. I Rev. Rekind Job No.

Page 8 of 9
LNGC-REK-1800-CT -PR-018 0 12-1605

c. For pipe culvert on road crossing , sand to be used as backfilling material until 150mm (or as specified on
engineering drawing) above pipe top level, then suitable materials from the original ground to be used to
complete the backfilling.
d. Backfilling material shall be compacted layer by layer not exceeding 300mm in thickness as specified in
the Construction Specification for Earth Work to achieve the specified compaction requirements .
e. The final layer of soil is compacted together with road sub-grade material.
f. Backfilling and compaction work shall be inspected by CONTRACTOR and shall be approved by TAS and
PGN.
 PGAS SOLUTION
HOEGH LN G """""
HOEGH LNG- REKIND CONSORTIUM
TECHNICAL ASSISTANT SERVICES CO NSOR TIUM OF HOEG H LNG LTO AND PT REKAYASA INDUSTRI

CONSTRUCTION METHOD FOR DRAINAGE SYSTEM

Document No. Rev. Rekind Job No .

Page 9 of9
LNGC-REK-1800-CT -PR-018 0 12-1605

APPENDIX

JOB SAFETY ANALYSIS FORM

 PGAS PROSEDUR OPERAS I/ OPERATING PROCEDURE
pgn ANALISA KESELAMATAN KERJA/ JOB SAFETY ANALYSIS
!,· . . .' '{

PT. Perusahaan Gas Negara (Persero) Tbk.

No.Dok/ Doc.No: Revisi Ke/ Rev.No: 0 Tanggal Dibuat:/ Issue date:

PT. Perusahaan Gas N egara (Persero) Tbk

SBU Transmisi Sumatra - Jawa
Lampung Floating Storage Regasification Facilities Project
FORMULIR ANALISA KESELAMATAN KERJA I JOB SAFETY ANALYSIS FORM

Company PT. Rekayasa Industry Prepared By Approved By

Chief / MGR
Project FSRU Lampung SPY HSE GSI PGAS PGN
Person In Charge Name : Muhammad Saiful Badri NAME
Position I Tittle of Job : Area Superintendent
SIGNATURE
Job Activity : Drainage System
Date - DATE

Hazard Consequences Risk Assesment Result of Risk

No Sequence of Basic Job Steps Recommended Action
Bahaya Akibat PR sv RR PR sv RR
A. PEKERJAAN PERSIAP AN
I. Pekerjaan setting out dan pengukuran • Kondisi lokasi Terpeleset 3 2 M • Kenakan sepatu safety 2 I L
di lapangan. becek dan licin. anggota tubuh karet, buat akses jalan
• Patok galian terluka. yang aman, upgrade jalan
• Tripod Tersandung terlebih dahulu bila
Tersambar petir mungkin
• Perhatikan tempat
berpijak sebelum
melangkahkan kaki.
Lakukan house keeping.
2. Pengecekan peralatan dan kendaraan • Cipratan oli, Terluka, cacat, 2 5 M • Gunakan PPE (hand I I L
(dump truck, excavator, vibro roller grease dan bahan sakit sampai glove& safety glasses)
dan mini molen) bakar (solar). kematian. • Pastikan kondisi
• Gear pada mini peralatan dan kendaraan
mol en dalam posisi off.
 PROSEDUR OPERAS!/ OPERATING PROCEDURE
pgn ANA LISA KESELAMA TAN KERJA/ JOB SAFETY ANALYSIS
PT. Perusahaan Gas Negara (Persero) Tbk.

No .Dokl Doc.No: Revisi Ke/ Rev.No: 0 Tanggal Dibuat:/ Issue date :

3. Mobilisasi alat-alat • Kecelakaan lalu Sakit, cacat I 5 M • Driver harus punya SIM 1 2 L
lint as sampai Kepolisian dan dalam
kema tian. kondisi fit, sehat lahir
batin.
• Pengecekan kondisi
kendaraan sebelum
berkendara.
• Sural KIR kendaraan dari
instansi berwenang masih
berlaku.
4. Memposisikan dump truck dan • Truk saat Tertabrak, 2 5 M • Pasang traffic cone pada 1 2 L
excavator mundur. terbentur depan dan belakang area
• Excavator saat mengakibatkan kerja.
mundur dan sakit, cacat • Penempatan flagman-
swing sampai, man yang mengawasi
kematian pergerakan
excavator/dump truck.
• Retreat horn supa ya
berfungsi.
• Pastikan hanya yang
berkepentingan yang
berada di lokasi sekitar
area kerja excavator.
B . PEKERJAAN PERSIAP AN
1 Penggalian tanah Alat berat Tertabrak, 2 5 M • Ada isyarat suara saat 2 2 L
(excavator) . terbentur unit bergerak/maneuver.
mengakibatkan • Ada personil flagman
sakit, cacat untuk mengawasi
sampai, pergerakan unit.
kematian • Pastikan selama
penggalian tidak ada
orang berlalu lalang
kecuali flagman dan
 PROSEDUR OPERAS!/ OPERATING PROCEDURE
pgn ANALISA KESELAMATAN KERJA/ JOB SAFETY ANALYSIS
PT. Perusahaan Gas Negara (Persero) Tbk.

No.Dok/ Doc.No: Revisi Ke/ Rev.No: 0 Tanggal Dibuat:/ Issue date:

operator alat berat.

2. Loading tanah ke dump truck • AI at berat (dump Tertabrak, 3 3 M • Pastikan selama loading 1 2 L
truck dan terbentur tanah tidak ada orang
excavator) mengakibatkan berlalu lalang kecuali
sakit, cacat flagman dan operator alat
sampai , be rat.
kematian • Ada isyarat suara saat
unit bergerak/manuver
(swing excavator dan
dump truck mundur) .
• Pastikan jarak bak dump
truck dengan radius
swing excavator aman.

3. Hauling dan unloading tanah • Alat berat (dump Tertabrak, 2 5 M • Gunakan APD standar 2 2 L
truck) . terbentur saat membuka bak dump
• Kecelekaan lalu mengakibatkan truck (helmet, hand glove
lintas sakit, cacat safety shoes, safety
sampai, glasses) selama pekerjaan
kematian. berlangsung.
Kecelakaan • Pastikan ada flagman
lalu lintas untuk mengawasi selama
membuka bak huck.
• Driver hams punya SIM
Kepolisian dan dalam
kondisi fit, sehat lahir
batin.
• Pengecekan kondisi
kendaraan sebelum
berkendara.
• Surat KIR kendaraan dari
instansi berwenang masih
berlaku.
 ~
~ PROSEDUR OPERAS!/ OPERATING PROCEDURE
PGAS SOLUTION
pgn ,;'.>.: ~:< J ANALISA KESELAMATAN KERJA/ JOB SAFETY ANALYSIS
PT. Perusahaan Gas Negara (Persero) Tbk.

No.Dok/ Doc.No: Revisi Ke/ Rev.No : 0 Tanggal Dibuat:/ lssue date:

c. PEMADATAN DASAR SALURAN

I Pemadatan dasar saluran • Vibro roller Terbentur, 2 5 M • Pastikan alat dalam 2 2 L
menggunakan vibro roller tergilas kondisi layak pakai dan
mengakibatkan operator dalam keadaan
sakit, cacat sehat.
sampai • Ada isyarat suara saat
kematian . unit bergerak/manuver
mundur.
• Pastikan selama
pemadatan tidak ada
orang berlalu lalang '

kecuali flagman dan

operator alat berat.
D. PEKERJAAN PENCAMPURAN MORTAR DAN PASANGAN BATU KALI -
I Penuangan material mortar ke mini • Mini molen Terbentur, 3 3 M • Pekerja diwajibkan I 2 L
mol en • Material mortar terjepit menggunakan APD
mengakibatkan (masker, sarung tangan,
sakit, cacat safety shoes, safety
sampai glasses, safety helmet).
kematian .
2. Penuangan campuran mortar ke • Mini molen Sakit, cacat 2 5 M • Peke1ja diwajibkan I 2 L
angkong • Material mortar sampai menggunakan APD
kematian. (masker, sarung tangan,
safety shoes, safety
glasses, safety helmet).
3. Pemasangan batu kali Material batu kali Sakit, cacat 2 4 M • Pekerja diwajibkan I 2 L
Dan mortar menggunakan APD
(masker, sarung tangan,
safety shoes, safety
glasses).
E. PEKERJAAN PEMASANGAN CULVERT
1 I Penyusunan culvert Alat lifting I Terbentur, Perhatikan kondisi II
tertnnpa
12 15 IM I • II IL
I sekitar saat bekerja serta
 ~ PGAS SOLUTION PROSEDUR OPERAS II OPERATING PROCEDURE
pgn Y·:. •:·.~ ANALISA KESELAMATAN KERJA/ JOB SAFETY ANALYSIS
' PT. Perusahaan Gas N egara (Persero) Tbk.

No.Dok/ Doc.No : Revisi Ke/ Rev.No: 0 Tanggal Dibuat:/ Issue date:

terjepit koordinasi yang baik

mengakibatkan
sakit, caca t
sampai
kematian.

A. PEKERJAAN AKHIR & HOUSE KEEPING

1 Membersihkan bekas lokasi kerja Cacat, 1 5 L Berhenti ke1ja saat awan I 1 L
Bahaya Sambaran
kematian mendung tebal
Petir
menggelantung
2. Membersihkan sisa material bekas Tumpukan material Luka dan cacat, 2 3 M Konsentrasi saat bekerja, I I L
tidak terpakai. bekas yang belum debu yang perhatikan tempat berpijak
diatur menggangg u sebelum me langkahkan kaki .
. penempata1mya kesehatan - - - - - - - · --

Risk Ra nking (RR) ~

Probabilit • I Likel ihood (PH.) X SEVE RITY I CONSEQUENCE (SV)
Score Level Probabilit y Description Severi ty Inde.x Description
13- 25 1-iigh 5 Frequent The event is expec ted to occur in most circ um stance 5 Catastrophic Death, Permanent seriou s env. damage, Mul tipl e fatalities damage, toxic release off site, huge financial loss

6-12 Medium 4 Probable Will Occur Frequen tly 4 Major Lost Time Accident, permanent/partial disability, non permanent environm ental damage, high financial loss

1- 5 Low 3 Occasional Will Occur Several Tim e 3 Moderate I Serious Medical Treatment req uired/work restriction , high financial loss, on site release contained with outside assistance

2 Unlikely Unlikely. but can reaso nable be expected to occ ur 2 Mino1 First Aid Treatmen t, on site release immediately contained medium financial loss

I Improbable Unlik ely to occu r. but poss ible 1 Neglig ible No affecting work performance. No injury, Low fi nancial loss
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