Contoh Manajemen Resiko.xls

DATE : 06.11.02

REVISION : 00

TITLE : Job Safety Analysis Worksheet

Job Safety Analysis Worksheet Lembar Analisa Keselamatan Kerja Reference No.: No. Referensi:

Contract No.: No. Kontrak:

Division, Department / Contractor Company: Divisi, Departemen / Perusahaan Kontraktor:

COM-TS-TK-TKS Managers, coordinators, and supervisors

Title of Person who does Job: Jabatan orang yang Mengerjakan Pekerjaan: Job: Pekerjaan:

Production Line / Project: Lini Produksi / Proyek:

Telkomsel- TINEM Project

New / Activites Revision: Baru / Revisi Aktivitas :

New

Logistic, SITAC, CME, and Implementation Activity

Work Location: Lokasi Kerja:

Site RAGUKLAMPITAN (JPA024)

Date: Tanggal:

2-Aug-07 Signature / Tanda Tangan

Name, position and signature of the JSA team members. Nama, jabatan dan tanda tangan dari anggota tim JSA Hadi Suprayitno

:

CME Coordinator

(

Signature / Tanda Tangan

Name, position and signature of the person reviewed and approved: Nama, jabatan dan tanda tangan dari orang yang telah meninjau dan menyetujui:

Arief Wibisono yohanes ( Area manager Mid Java & DIY )

Distribution: Line Manager, Corporate Safety Distribusi: Manager Lini, Corporate Safety Scoring Table of Effect "E", Probability "P" and Frequency "F" Tabel Penilaian Akibat "E", Kemungkinan "P" dan Frekwensi "F" Scoring Penilaian

1 2 3 6 7 10 40

Risk Assessment Score "R" Angka Penilaian Risiko "R"

Effect "E" Akibat "E" Harm Luka

Probability "P" Kemungkinan "P" Unlikely Kecil kemungkinan

Sickness Sakit

Not normal Tidak biasa Possible Mungkin

Frequency "F" Frekwensi "F" Seldom (yearly) Jarang (setahun sekali) Sometimes (monthly) Kadang-kadang (sebulan sekali) Weekly Seminggu sekali Regularly (daily) Teratur (setiap hari)

Expected can happen Diperkirakan bisa terjadi Expected will happen Diperkirakan akan terjadi

Always Selalu Continuously Terus menerus

Serious invalidity Cacat berat Fatal Fatal Catastrophe Bencana

Basic Job Steps Langkah Dasar Pekerjaan

)

Potential Hazards Bahaya Potensial

E

P

F

R

a. Site Acquisition

- Community problem

7

10

2

19

b. Technical site survey

- neighbour problems that close with

7

6

1

14

7 3

6 6

1 1

14 10

6 6

1 1

10 10

3

1

11

R=E+P+F

R < 10

Low risk Risiko rendah Medium risk Risiko sedang

10  R < 19

High risk Risiko tinggi

19  R

Solutions / Risk Control Plans Solusi / Rencana Pengendalian Risiko

SITAC Activity

site

Use the right permit procedure, held on appropriate community sociallization, make sure that all problem which related with all CME work are clear before CME activity started.That problems including land and access clearing from tree

LOGISTIC Activity a. Material unloading

- Hit by fallen heavy material - twisted muscle

Use the right procedure and methods, use the relevant PPE Use the following Dop : - Ergonomic : ( Dop 06-16 )

a. Material unwraping -

- injured due too using tools

checking

- scratched by wraping wood

3 3

c. Material lifting

- hit by fallen materials and scratched

7

Author : BE Printed Date : 11/12/2013

- Loading and unloading : ( Dop 06-33 ) - Safety sign : ( Dop 06-46 ) Use The relevant PPE - Manual Handling : ( Dop 09-01 ) Use The relevant PPE

BE/027/Int/0095 1 of 12

DATE : 06.11.02

REVISION : 00

TITLE : Job Safety Analysis Worksheet Job Safety Analysis Worksheet (continued) Lembaran Analisa Keselamatan Kerja (lanjutan) Basic Job Steps Langkah Dasar Pekerjaan

Reference No.: No. Referensi: Potential Hazards Bahaya Potensial

E

P

F

R

Solutions / Risk Control Plans Solusi / Rencana Pengendalian Risiko

a. Site Survey

- Neighbour problem (near site)

b. soil test ( sondir and boring)

- Injury due to using tools

7 7

1 3

1 1

9 11

Use the right permit procedure and appropriate community sociallization Use the manual, use PPE, use the right methods

7 10 3

3 3 6

2 1 2

12 14 11

CME Activity Pre Reconstruction Requirments

Civil, Mechanical, Electrical works a. Tower Foundation construction - Exavation

- fall into exavation area - Hesped up by landslide - Exavation waste soil

use the right methods with appropriate supervision, provide a safety area signs Prepare a proper area for that soil exavation

- Steel bar reinforcement preparation

- Injury due to using tools

1

6

2

9

work carefully and use glove and safety shoes

- Formwork / Bekisting

- Injury due to using tools - Fall from height

3 7

6 3

2 1

11 11

work carefully and use glove and safety shoes, need appropriate supervision

- Concrete Pouring

- Injury due to using tools

3

1

1

5

Use the right methos, use glove, safety shoes, need appropriate supervision too

- Forms stripping and soil bacfilling

- Injury due to using tools

3

3

1

7

Use the right methos, use glove, safety shoes, need appropriate supervision too

10 10

10 10

1 1

21 21

Recommended to be done by quilified personals. Use the right methods and PPE need appropriate supervision work carefully, use helmet, make sure that erection area are clear

10 10

10 10

1 1

21 21

Recommended to be done by quilified personals. Use the right methods and PPE need appropriate supervision work carefully, use helmet, make sure that erection area are clear

10 10

10 10

1 1

21 21

Recommended to be done by quilified personals. Use the right methods and PPE need appropriate supervision work carefully, use helmet, make sure that erection area are clear

10 3 3

6 6 3

1 3 1

17 12 7

Avoid rainy when installation

- Injury due to using tools

3

3

1

7

- Injury due to using tools

3 7 10

1 3 1

1 1 1

5 11 12

- Injury due to using tools

1

3

1

5

- Shocked by Lightning

7

3

1

11

- Scratched

3

3

1

7

Work carefully and use safety glove

- Backfilling and soil compaction

- Injury due to using tools

- Fence construction

- Injury due to using tools - Injury due to using tools

3 3 3

1 1 1

7 5 5

Recommended check every single equipments, use the right methods, use safety shoes, gloves, prepare good skafolding

- Paving block Installation

3 1 1

b. Tower Construction - Tower erection

- Fall from height - hit by fallen materials

- Ascesorris Installation

- Fall from height - hit by fallen materials

- Tower painting

- Fall from height - hit by fallen materials - ahocked by lightning - Dehidration - Scratched

prepare dringkin water, Work carefully and use glove

c. Base frame construction - base frame foundation construct

work carefully, use the right methods and relevant PPE

d.Base Frame Installation - Base frame member installation

- Fall from height - Electric Shock when using bore tool

work carefully, use the right methods Recommended to be done by quilified personals. Use the right methods and relevant PPE

e. Grounding Installation - Tower, base frame and fence grounding

Check the equipment always, use the right methods Avoid working when rainy day

f. Fence, paving and Yard

Author : BE Printed Date : 11/12/2013

BE/027/Int/0095 2 of 12

DATE : 06.11.02

REVISION : 00

TITLE : Job Safety Analysis Worksheet

Job Safety Analysis Worksheet (continued) Lembaran Analisa Keselamatan Kerja (lanjutan)

Reference No.: No. Referensi:

Basic Job Steps Langkah Dasar Pekerjaan

Potential Hazards Bahaya Potensial

E

P

F

R

Solutions / Risk Control Plans Solusi / Rencana Pengendalian Risiko

f. KWH meter installation, and PLN

- Injury due to using tools

1

3

1

5

work carefully, and check every equipments that used

- Shocked by Electricity

10

10

1

21

Work carefully, recommended to not working at rainy day

- Fall from height

10

3

1

14

Use relevant PPE, prepare good stair

Connection

Author : BE Printed Date : 11/12/2013

BE/027/Int/0095 3 of 12

SITE ID : 0 SITE NAME : 0

HEALTH & SAFETY CHECKLIST Item Nr. Description I.

Risk Rating

Finding

Score

GENERAL

1001

Emergency call numbers displayed on site (police, hospital, fire brigade)

E

U

8

1002

Fire estinguisher is available on site (if required)

M

U

2

1003

First aid kit & First Aider is available on site

H

U

4

1004

Health & Safety related issues (e.g. accident/incident) has been reported to project management

H

U

4

1005

Health & Safety responsible person on site

H

U

4

1006

Risk assessment and job safety analysis (JSA) are conducted with appropriate control and submitted to NSN representatives and EPM system.

H

U

4

1007

Safety sign is available on site (signboards)

M

U

2

1008

Personnel on site has a copy or understand the objectives of Nokia Siemens Networks Health & Safety Policy

M

U

2

1009

Barriers to access the site have been erected.

H

U

4

H

U

4

H

N/A

H

U

1010 1011 1012

Team understands the Nokia Siemens Networks Safe working practices & procedures. Electromagnetic Radiation Hazards are known by personnel on site. Daily prestart briefing must be conducted prior to commencement of work activities.

Total Score General II.

4 38

SITE ACCESS

1101

Access by unauthorized persons to site is prevented.

H

U

4

1102

Access to site is in safe condition for every circumstances

M

U

2

1103

Designated walkpath routes free of tripping and sliping hazards

M

U

2

1104

Emergency exits are clearly visible and free of obstacles

M

U

2

1105

Access by unauthorized persons to site is prevented.

H

U

4

1106

Access lighting to BTS is working and sufficient

H

U

4

Total Score Site Access

November 2007

Observation

Print date: 11/12/2013

18

NSN-PSI-002 Health and Safety Inspection

SITE ID : 0 SITE NAME : 0

III.

PERSONNEL

1201

All personnel have undergone health assessment prior to work on site.

H

U

4

1202

Personnel on site must be fit to work

H

U

4

H

U

4

H

U

4

1203 1204

Personnel must be competent to perform work safely (Safety trained) Individuals are supervised according to their capabilities and the degree of risk of the task

1205

No underage workers employed

E

U

8

1206

General public individuals shall not be allowed on site without safety Induction or PPE.

H

U

4

1207

Personnel from other companies and contractors, not under the responsibility of the assessed subcontractor, shall be advised about the Safety requirements of working on site.

M

U

2

Total Score Personel IV.

30

WORKING TOOLS & EQUIPMENTS

1301

Hand tools are in good and safe condition

H

U

4

1302

Hand tools are used properly

M

U

2

1303

Machinery tools & rigging equipment are in good and safe condition

H

U

4

1304

Power tools are in good and safe condition

M

U

2

1305

Lifting equipment must be safe & checked prior to use.

H

U

4

Total Score Working Tools & Equipments V.

12

PERSONAL PROTECTIVE EQUIPMENT

1401

Personal Protective Equipment is standardize, functioning and maintained

H

U

4

1402

All personnel on site are using Hard Hat (helmet).

H

U

4

1403

All personnel on site are using Safety Shoes

H

U

4

E

U

8

H

U

4

1405 1406

All personnel working at height are using the full body harness per NSN specifictions. All personnel are using additional specific required PPE according to the work hazard

Total Score Personal Protective Equipment VI.

12

ANTENNA/FEEDER ACCESS

1501

Safe access to antenna & feeder and other are enabled

H

U

4

1502

Pole ladder reaching working height on antenna level

H

U

4

1503

Positions of safety systems (ladders, anchor points, platforms, and etc) is practical and safe for use

M

U

2

1504

Radiation meter on site.

H

N/A

1505

EMF Hazards are clearly marked on site.

M

N/A

Total Score ANTENNA/FEEDER ACCESS

November 2007

Print date: 11/12/2013

6

NSN-PSI-002 Health and Safety Inspection

SITE ID : 0 SITE NAME : 0 VII.

1601 1602 1603

MATERIAL HANDLING Appropriate storage system is in place Loading area is clearly defined, marked and free from obstacles. Site is clear from hazardous substances (or under controlled storage) in line with MSDS

M

U

2

M

U

2

M

U

2

Total Score Material Handling

6

122

SUMMARY OF INSPECTION SCORING

Item / Area

Maximum Score

Score

I.

GENERAL

42

38

II.

SITE ACCESS

18

18

III.

PERSONNEL

30

30

IV.

WORKING TOOLS & EQUIPMENTS

12

12

V.

PERSONAL PROTECTIVE EQUIPMENT

12

12

VI.

ANTENNA/FEEDER ACCESS

12

6

VII.

MATERIAL HANDLING

6

6

132

122

92%

A

B

B/A*100

OVERALL RATING

Total

Project Baseline Health & Safety Performance Indicator: Maximum of 30% of total score is acceptable

November 2007

Print date: 11/12/2013

NSN-PSI-002 Health and Safety Inspection

Observation

November 2007

Print date: 11/12/2013

NSN-PSI-002 Health and Safety Inspection

November 2007

Print date: 11/12/2013

NSN-PSI-002 Health and Safety Inspection

122

r: Maximum of 30% of total score is acceptable

November 2007

Print date: 11/12/2013

NSN-PSI-002 Health and Safety Inspection

DATE : 14.07.03

REVISION : 00

TITLE : Hazards Identification Sheet / Lembar Identifikasi Bahaya

P.T. SIEMENS INDONESIA

Hazards Identification Sheet Lembar Identifikasi Bahaya Reference No. : No. Referensi :

Contract No. No. Kontrak

GL - COM - TKS - 0001 - 00

: :

Division, Department / Contractor Company : Divisi, Departemen / Perusahaan Kontraktor :

COM - TKS

Production Line / Project : Lini Produksi / Proyek :

Telkomsel - National Region

Title of Person who does Job : Jabatan orang yang Mengerjakan Pekerjaan :

Managers, Coordinators, and Supervisors

New / Revision Baru / Revisi

: :

Revision - 01

: :

February 15, 2006

Job Pekerjaan

: :

Work Location : Lokasi Kerja :

Logistic, SITAC, CME, and Implementation Activity Date Tanggal

On site

Name, position and signature of the Hazards Identification team members. Nama, jabatan dan tanda tangan dari anggota tim Identifikasi Bahaya.

Signature / Tanda tangan

Moerhadi

:

QHSE Manager for Telkomsel

(

)

Didiet Priatmadji

:

Tinem OSP QHSE Officer

(

)

Atri Bolivar

:

Tinem BMN PM

(

)

Ishak Halim

:

Tinem OSP PM

(

)

Name, position and signature of the person reviewed and approved : Nama, jabatan dan tanda tangan dari orang yang telah meninjau dan menyetujui :

Distribution: Line Manager, Corporate Safety Distribusi : Manager Lini, Corporate Safety

( Herman Santoso ) COM Safety Representative

Scoring Table of Effect "E", Probability "P" and Frequency "F" Tabel Penilaian Akibat "E", Kemungkinan "P" dan Frekwensi "F" Scoring Penilaian

1

Effect "E" Akibat "E" Harm Luka

3 6 7 10 40

Serious invalidity Cacat berat Fatal Fatal Catastrophe Bencana Potential Hazards Bahaya Potensial

)

( K. H. Koesters GPM Tinem BMN

)

Risk Assessment Score "R" Angka Penilaian Risiko "R"

Probability "P" Kemungkinan "P" Unlikely Kecil kemungkinan

Not normal Tidak biasa Possible Mungkin

Frequency "F" Frekwensi "F" Seldom (yearly) Jarang (setahun sekali) Sometimes (monthly) Kadang-kadang (sebulan sekali) Weekly Seminggu sekali Regularly (daily) Teratur (setiap hari)

Expected can happen Diperkirakan bisa terjadi Expected will happen Diperkirakan akan terjadi

Always Selalu Continuously Terus menerus

2 Sickness Sakit

( Karsten Isenbeck GPM Tinem OSP

E

P

F

R

7

3

1

11

7

1

1

9

R=E+P+F

Low risk Risiko rendah

Medium risk Risiko sedang

High risk Risiko tinggi

R < 10

10  R < 19

19  R

Solutions / Risk Control Plans Solusi / Rencana Pengendalian Risiko

Machinery Permesinan

Soil Test - Sondir & boring

Define the right and safe place.

Excavation work : - Excavator back hoe

Author : BE Printed Date : 11/12/2013 187773339.xls.ms_office

Define the right and safe place, make sure the excavation area is clear.

Sheet / Lembar 10 / 12 BE/096/Int/0186 10 of 12

Concrete work : - Ready mix truck

3

1

1

5

- Ready mix pump

3

1

1

5

- Molen / Concrete mixing

3

1

1

5

- Vibrator

1

1

1

3

1 1

1 3

1 1

3 5

- Mattock/Hoe (cangkul) - Electric Drill (bor listrik)

1 3

6 3

1 1

8 7

- Tackle (katrol) - Electric Saw (gergaji listrik)

7 7

3 3

1 1

11 11

- Underbrush & rural area, far from town

1

3

1

5

- Hill, gulch area (bukit, jurang)

7

3

1

11

Work carefully, prepare first aid kit, safety sign, relevant PPE and provide JSA (if necessary).

- Work at hight / tower

10

10

1

21

Work Carefully, use safety harness and other relevant PPE, safety sign and provide JSA.

- Inside Shelter

3

1

1

5

- Machine operator (operator mesin)

7

3

1

11

License permit (SIM, if required), proper training and PPE.

- Tower erector

10

10

1

21

Proper training, provide right PPE.

- Shelter constructor - M&E installer - BTS installer - BTS inspector/troubleshooter - BTS commisioner

1 10 1 7 1

3 3 3 6 1

1 1 1 1 1

5 14 5 14 3

Work Carefully, use relevant PPE.

- Microwave installer - Microwave inspector/troubleshooter - Microwave commisioner

10 10 10

6 6 3

1 1 1

17 17 14

Work Carefully, use safety harness, safety shoes, gloves.

- Survery (SITAC / CME)

3

6

1

10

Health check, personal medication, provide appropriate communication equipment, transportation and first aids.

- Sondir & Boring

7

3

1

11

Work Carefully, check Equipment, right technique.

- Tower foundation excavation

10

6

1

17

Check equipment, right technique, work carefully, safety signs and provide relevant PPE.

- Tower erection

10

10

1

21

Done by qualified personnel, provide safety signs, safety harness and other relevant PPE.

- Shelter installation

1

3

1

5

- M&E installation - Fencing & Paving block installation

10 1

3 3

1 1

14 5

Supervise, define the right and safe place.

Maintenance, define the right and safe place.

Other: - Compactor - Genset

Maintenance, define the right and safe place.

Equipment Perlengkapan

Check Equipment, routine maintenance.

Workplace Tempat Kerja

Appropriate communication equipment and transportation, local information briefing, provide JSA (if necessary).

Use relevant PPE, safety sign and provide JSA.

Workers Pekerja

Work Pekerjaan

Author : BE Printed Date : 11/12/2013 187773339.xls.ms_office

Work Carefully, Check Equipment, right technique, safety signs.

Sheet / Lembar 11 / 12 BE/096/Int/0186 11 of 12

- BTS installation - BTS inspection/troubleshooting

1 7

3 6

1 1

5 14

- BTS commisioning

1

1

1

3

- Microwave installation - Microwave inspection/troubleshooting

10 10

6 6

1 1

17 17

- Microwave commisioning

10

3

1

14

- Material Storage

1

6

1

8

Provide segregate area for storage, safety signs.

- Handling of waste

1

6

1

8

Provide waste disposal box and label it, keep the area always clean.

Work Carefully, Check Equipment, right technique.

Housekeeping Housekeeping

Author : BE Printed Date : 11/12/2013 187773339.xls.ms_office

Sheet / Lembar 12 / 12 BE/096/Int/0186 12 of 12