HAZARD IDENTIFICATION

CARD

DESCRIBE HAZARD(S) / BAHAYA

Power cable
Laptop Radiation

CORRECTIVE ACTIONS / TINDAKAN

Action taken immediately/ tindakan yang dilakukan
Clean up installation
Eyeglasses

Any follow-up action required? / Apakah ada tindakan lain diperlukan ?

WORK DETAILS / KETERANGAN

• Location / Area:
Office

• Describe Job being done and Equipment / Pekerjaan yang sedang dilakukan :
Drawing

Observers Name (Print)/ Nama : Yulman Houlan Panjaitan

Observers Name (Signature)/ Tanda tangan :
Date Observed / Tanggal : 31-05-2018
Supervisors Name (Print):
Date Received / Tanggal dilaporkan :
 HAZARD IDENTIFICATION
CARD

Check Hazard and Risks

HAZARD CHECKLIST
□ Housekeeping
□ Procedures Inadequate / None
□ Chemicals Exposure / Inhalation
□ Atmospheric Contamination
□ Fire
□ Spills / Pollution
□ Tools Equipment / Damaged / Inadequate
□ Electrical Equipment Faulty / Damaged/Exposed
□ Lifting Equipment Faulty / Damaged / Inadequate
□ Missing or Inadequate Guarding / Barriers / Warning Signs
□ Work Station Office / Workshop
□ Health / Hygiene
□ Temperatures Cold / Hot Exposure
□ Noise
□ Lighting Damaged / Inadequate
□ Environmental
□ Biological Hazards / Diseases
□ Road Conditions/ Kondisi Jalan
□ Motor Vehicle Damaged / Inadequate / Kerusakan Kendaraan
□ Training / Job Certification Inadequate / Pelatihan
□ Security / Keamanan
□ PPE / Inadequate / Not Wearing (e.g. gloves, etc)
□ Cluttered / Slippery / Inadequate Walking / Working Surfaces
□ Other (High Risk, High Hazard Work, stored energy)
HAZARD ID CATEGORY
□ Mechanical/ Mekanik
□ Electrical/ Listrik
□ Pressure/ Tekanan
□ Temperature/ Suhu
□ Chemical/ Kimia
□ Biological/ Biologi
□ Radiation/ Radiasi
□ Sound/ Suara/ Kebisingan
□ Gravity/ Gravitasi
□ Motion/ Pergerakan