JOB SAFETY ANALYSIS (JSA) FORM PMO
PROJECT Recaust Project DATE : 05 Januari 2022 JSA NO.: 019/JSA/PMB-Recaust/22 REV. 0
JSA TEAM
CONTRACTOR PRAKARSALANGGENG MAJU BERSAMA
(First Named – JSA Team Leader)
JOB TITLE Cutting, Grinding & Welding NAME POSITION SIGNATURE
LOCATION FL#3B – ETP Habibie PMB SPV Construction
ITEM Rediel Sitohang PMB HSE Coordinator
JOB DESCRIPTION :
Sutardi HSE PMO
Preparation
1. Work Area Preparation
Sumarno PMO
2. Preparation and checking of tools and materials
3. Cutting, Grinding and Welding
4. Housekeeping
REFERENCE AND OTHER RELEVANT INFORMATION : JSA Team Leader confirm that the risk for job describe have been reviewed and the controls measures which are recommended
reduce the risk to tolerable level and I consider it is safe so the job can be proceed
- PPE Standard NAME Ismo Heru Diyanto
- Permit To Work POSITION Site Manager
- Grinding, Cutting unit and Welding Machine
- Crew certificate SIGNATURE Date:
I am satisfied that the controls measures identified when put into place will reduce the risk to tolerable level. The job/action
change is permitted to proceed. CONFIRMED & APPROVED BY PROJECT/SITE MANAGER/HSE MANAGER
STOP WORK IF FOUND UNSAFE NAME
POSITION
R. Damanik
Manager HSSE / Supervisor HSSE
SIGNATURE Date:
1 Persiapan area kerja Slip, strip, fall, manual MTI Membersihkan lokasi kerja dari material dan sampah- Khairul Amri
JSA WORK SHEET
JOB TITLE Cutting, Grinding & Welding Metal
Hazard Identification Risk Evaluation Risk Control
Seqience of Job Hazard Description Hazard Effect Done by Check
No. Control measures
(Urutan Pekerjaan (Penjelasan Bahaya) (Dampak Bahaya) (Dilakukan Oleh) ()
handling sampah yang berisiko kecelakaan Habibie
Pastikan tidak ada bahan yang mudah
terbakar/meledak pada saat pengelasan dan
penggerindaan
2 Persiapan dan pengecekan Moving equipment, manual MTI Inspeksi semua bagian dari mesin las yang dapat Khairul Amri
alat dan material handling Properti demage berisiko terjadinya korsleting dan tersengat listrik. Habibie
Lakukan inspeksi berkala serta pemasangan tagging
kelayakan sesua color code
3. Cutting, Welding dan Grinding Ionizing radiation MTI Untuk pengelasan Fuel Gas (ex Acytylene dan Elpigi) Khairul Amri
Fatality wajib menggunakan Flash Back Arrestor yang Habibie
Pressure Properti demage dipasang setelah regulator dan sebelum Torch Handle
Gunakan air sabun untuk memastikan kebocoran pada
Heat connector
Penempatan tabung gas pada keranjang yang dapat
Electricity menahan tabung gas tidak jatuh
Ikat tabung menggunakan bahan yang kuat (rantai,
Fume / Dust ratchet webbing)
Setiap pengelasan yang menghasilkan Spatter harus
Open Flame menggunakan cover yang mampu memadamkan
panas dari spatter
Rotating / Movement RPM disc harus lebih besar sama dengan RPM
machine
Machinery
Penempatan APAR pada area pengelasan dan
penggerindaan dengan radius maksimal 10 meter.
Mudah terlihat dan di raih/ambil
Semua mesin gerinda harus dilengkapi dengan safety
devices (Wheel Guard, Handle, Wrench) dan deadman
KDP-HSE-F033 Page 1 of 2
JSA WORK SHEET
JOB TITLE Cutting, Grinding & Welding Metal
Hazard Identification Risk Evaluation Risk Control
Seqience of Job Hazard Description Hazard Effect Done by Check
No. Control measures
(Urutan Pekerjaan (Penjelasan Bahaya) (Dampak Bahaya) (Dilakukan Oleh) ()
switch
Gunakan Alat Pelindung Diri (APD) sesuai dengan
jenis pekerjaan (Apron, sleeve, face shield, welding
cap,
Perhatikan posisi penggerindaan serta penggunaan
cover yang dapat melindungi pekerja dari gram serta
equipment yang terpasang.
sewaktu pengelasan posisikan diri searah dengan arah
angin
5 House keeping Manual handling MTI Bersihkan dan rapikan kembali alat kerja serta lokasi Khairul Amri
kerja. Habibie
Hindari cable berada di permukaan tanah, bentangan
cable tersusun rapi dan tergantung minimal 30 cm dari
permukaan tanah
Sisa welding rod dimasukkan pada ember yang telah
persiapkan
6 Emergency response Slip, trip & fall LTI Pastikan sudah dilakukan sosialisasi prosedur keadaan Khairul Amri
Habibie
darurat diarea kerja
Jangan panic, segera menuju ke assembly point
Laporkan ke ERT atau ke fire station, gunakan laporan
emergency Radio HT Repeiter Dengan
frekuensi :160125
KDP-HSE-F033 Page 2 of 2
Hazard Check List
GENERAL CONFINED SPACE ENTRY PROCESS
No Hazard Description No Hazard Description No Hazard Description
1 Asphyxiation 1 Adequacy of lighting within the CS 1 Asbestos gaskets
2 Barriers/access restrictions 2 Adequacy of ventilation 2 Chemical hazards
3 Biological agents 3 Comm. Difficulties within the CS or with the standby man 3 Chemical reactions with cleaning materials
4 Chemical hazard 4 Competency of standby man 4 Chemical reactions with cleaning materials
5 Cold/Heat 5 Danger of falling into CS boots or sumps 5 Electrical risk of using portable tools
6 Collision (impact from moving object to fixed object) 6 Disposal of CS cleanings 6 Environmental impact of spills or emissions
7 Electricity 7 Falling from height Residual gases/ vapors 7 Flammable or toxic vapors arising from sludge in vessel
8 Falling from height 8 Frequency of gas testing 8 Hazardous substances trapped around bends, linings etc.
9 Falling object/Drop Object 9 Ingress of gases/vapors from other nearby activities/systems 9 Inert atmospheres
10 Open flame 10 Ionizing radiation; nucleonic instrumentation 10 Liquids remaining from flushing
11 Flammable gas 11 Location of rescue kits 11 Hazardous Chemical Scale
12 Flammable liquid 12 Hazardous Chemical scale 12 Pyrophoric scale
13 Fume/dust 13 Need for air movers during entry. 13 Residual heat
14 Grit blasting 14 Noise when using power tools 14 Residual pressure
15 Hand tools 15 Noise, general 15 Trapped pressure
16 Ignition 16 Oxygen deficiency
17 Impact (force full contact) 17 Oxygen enrichment
18 Inert gas 18 Slip hazards within the CS or at the point of entry
19 Ionizing Radiation 19 Sludge which may give rise to vapors/gases when disturbed
20 Lifting operations 20 Standby man communication with the ERP
21 Lighting 21 Temperature effects
22 Machinery 22 Use of mechanical tools/power tools/electrical equipment
23 Manual Handling 23 Visibility within the Confined Space
24 Mental Stress
25 Noise
26 Potential for ignition
27 Power tools
28 Pressure
29 Static Electricity
30 Slip, Trip and Fall
31 Working at height
32 Bad Weather
