HIRADC PENGANGKUTAN BBM 150 KL INDRAMAYU-SURABAYA
SECTION 1: TRAVEL DETAILS
Primary Driver Name: Bambang Reason for travel: Pengiriman BBM 150KL Departure Date & Time:
15 / 01 / 2020 , 19 :00
Journey Description (From/To, Via): Terminal BBM
Passenger Name/s: Wahyu Est Date & Time of Arrival:
Indramayu To Surabaya
16 / 01 / 2020 , 10:00
SECTION 2: RISK ASSESSMENT - STRIKE OUT CONTROLS WHICH ARE NOT APPLICABLE, TICK TO CONFIRM RISK
RATING AND AMEND AS APPROPRIATE
Hazard Causes Impact Controls Risk Rating
Mobil Tidak Terlalu banyak Kecelakaan Inspeksi kendaraan √
seimbang muatan dengan
Supir harus memiliki lisensi
kendaraan lain
Supir Amatir
Speed limiter
Cidera
Cuaca buruk
Kematian
Hazard Causes Impact Controls Risk Rating
Muatan Ngebut Kebakaran Inspeksi kendaraan √
tumpah
Kendaraan Lingkungan rusak Supir memiliki lisensi
rusak
Cidera Speed limiter
Supir amatir
Kematian
Hazard Causes Impact Controls Risk Rating
HIRADC PENGANGKUTAN BBM 150 KL INDRAMAYU-SURABAYA
Kebocoran Alat rusak Kebakaran Training pekerja √
pada saat
Pekerja lalai Lingkungan rusak Pengawasan pada saat bekerja
loading bbm
Tidak ada Inspeksi peralatan
pengawasan
Pekerja tidak
berkompetensi
SECTION 3: TRAVEL APPROVAL
Approver Name and Position: Approver Signature: Approved Date: Approved Time:
:
See over for Approver requirements and PPA Risk Matrix