JOB SAFETY ANALYSIS (JSA)
ANALIS KERJA AMAN
Date/Time Project Company
During Project Standard Penetration Test Dewata Makmur Bersama
Tanggal / Waktu Proyek Proyek
Work Location Supervisor HSE Officer
Sei Baloi Substation Angra P Ronny G
Lokasi Kerja Pengawas Petugas HSE
Task / Pekerjaan:
Cone Penetration Test
Put a cross sign (X) in the following column □/ Berilah tanda silang (X) pada kolom □ berikut ini:
Area of work involved /Daerah kerja yang terlibat: Tools and equipment involved/ Alat kerja yang terlibat :
☐At closing room/ Di ruang tertutup atau ☐ At close water/ Di dekat air 1. CPT Machine 6.
sempit
☐ On the vessel/ Di atas kapal 2. Wrench 7.
☒ At open yard/ Di ruang terbuka
☐ At Workshop/ Di ruang kerja
☐ At height / Di ketinggian 3. Pump 8.
☐ Other/Lain-lain: ……………………… ☐ …………………………………. 4. Tripod 9.
5. Accessories 10.
Work Personnel Members/ Anggota Kelompok Kerja
Name Designation Name Designation
No No
Nama Jabatan Nama Jabatan
Nazri Helper
1 Mulyono Engineer 5
2 Bakir Technician 6
3 Kasino Technician 7
4 Nazri Helper 8
JOB SAFETY ANALYSIS (JSA)
ANALIS KERJA AMAN
Completion Date
No/ Job Steps Potential Risk Control Measures
Tanggal
No Tahapan Pekerjaan Hazards Resiko Tindakan Pengendalian
Pemenuhan
Potensi Bahaya
1 Tool Box Meeting -n/a- -n/a- Use PPE
Daily Check list Stuck down by equipment Physical Hazar Use PPE
2
3 Machine Turn on Stuck down by equipment Hematoma Physical hazard Performing activity follow sop
Pinched by equipment Use PPE
4 Perform Boring/ Drilling Stuck down by equipment Hematoma Physical hazard Performing activity follow sop
Pinched by equipment Use PPE
5 SPT Test Stuck down by equipment Hematoma Physical hazard Performing activity follow sop
Pinched by equipment Use PPE
6 Finish Testing Stuck down by equipment Hematoma Physical hazard Performing activity follow sop
Pinched by equipment Use PPE