P2K3 PHYSICAL CONDITION TOUR

FLOW STATION : LIMA F/S (LCOM - Main Deck)

ASSESSMENT DATE : 13-Jun-15

ASSESSOR NAME : Dikdik PS

PHYSICAL CONDITION TOUR (PCT) WORKSHEET

BOBOT
KATEGORI HS E Q JUMLAH YANG DI PERIKSA (C) JUMLAH YANG TIDAK STANDAR (S) SCORE
NILAI
C-S
A KONDISI UMUM TEMPAT KERJA TOTAL "A" C = 28 S=2 x VF =
C

Lantai (Permukaan untuk Berjalan & Bekerja) :

1 x x x / -
1. Lantai Main Deck

Gang & Lintasan :

2 x x ///// // -
1. Tujuh gang atau lintasan

Anjungan / Perancah :
3 1. Tiga mini-platform (Crane, manhole crane & HVAC x /// -
upper control room)
Tangga & Anak Tangga : VF=
1. Lima tangga vertikal ( dua ke upper deck & 3 ke mini- (Dianjurkan 10.31
4 x ///// ///// // VF = 11.1)
platform) 2. Lima tangga akses (dua ke cellar deck, satu
ke upper deck & dua ke control room)

Pintu / Jalan Keluar :

1. Dua jalan keluar ke akses tangga Cellar Deck (refuge
5 x ///// -
muster point) 2. Dua jalan keluar pintu control room 3.
Satu jalan keluar ke area LSER

6 Jalan Kendaraan : x x x - -
Ventilasi, Penghisap & Cerobong Gas Buang :
7 x x // -
1. Dua exhaust Fan enclosure
C-S
B FASILITAS TOTAL "B" C = 79 S = 32 x VF =
C

Lampu & Paparan terhadap Kebisingan :

1. Tiga lampu sorot 2. Lima puluh lampu penerangan
///// ///// ///// ///// /////
(sepuluh di control room, satu di dog house, empat di ///// ///// ///// ///// /////
8 x x ///// ///// ///// ///// /////
enclosure & dua puluh tiga di main deck area) 3. Lima //
///// ///// /
lampu emergensi 4. Dua lampu Nav. Aid 5. Satu area
kebisingan dari turbin compressor VF=
Faktor Ergonomi :
(Dianjurkan 9.93
VF = 16.7)
9 1. Dua SDV fuel pilot turbin A&B 2. Dua strainer LP&HP x x //// ////
suction train A compressor

10 Drainase & Pengolahan Limbah Cair : x x ///// ///// //// /

1. Empat belas open drain
11 Instalasi & Sistem Uap : x x x - -
C-S
C MATERIAL TOTAL "C" C = 41 S=4 x VF =
C

Penumpukan & Penyimpanan :

1. Tujuh spare part (tiga wood box indoturbine, satu dog
house sebagai tempat penyimpanan material
station&indoturbine, satu wood box shaftindo tools &
12 x x x ///// ///// // //
satu control room sebagai penyimpanan indoturbine
peralatan ringan serta satu spare motor finfan di wood
box) 2. Satu basket cat shaftindo 3. Tiga basket
scaffolding 4. Satu Bidi Pig
VF=
Bahan Kimia & Bahan Bakar : (Dianjurkan 20.03
13 1. Satu chemical Tank 2. Satu turbo-lube oil Tank 3. Satu x x x ///// ///// / - VF=22.2)
NG-lube Tank 4. Delapan sabun pembersih lantai

Silinder Gas Bertekanan :

14 1. Dua tabung nitrogen 2. Empat belas tabung CO2 x x x ///// ///// ///// / //
Snuffing

Pembuangan Limbah :
15 x x /// -
1. Tiga tempat sampah (Organik, Anorganik & B3)

C-S
D PERALATAN / PERLENGKAPAN TOTAL "D" C = 43 S=2 x VF =
C

16 Perkakas Tangan & Ringan : 1. Satu indoturbine tool box x x / -

Peralatan Mesin & Pengaman :
17 x x /// -
1. Dua turbin compressor 2. Satu Crane
18 Peralatan Bergerak (Mobile Equipment) : x x - -
Alat Angkat Material & Perlengkapannya :
19 x x // -
1. Satu Crane 2. Satu alat angkat DMLR
Alat Penangan Material & Conveyor :
20 x x x ///// ///// ///// ///// -
1. Dua puluh Sling steel basket

21 Sistim Bejana (Vessels) Tekan : x x x - -

VF=
Sistem Tenaga Mekanis : (Dianjurkan 21.17
22 1. Satu Crane engine 2. Dua Turbin Engine 3. Empat gas x x ///// //// / VF=22.2)
boost compressor 4. Dua HVAC unit

23 Sistem Tenaga Hidrolis : 1. Crane x x x / -

Sistem Tenaga Pneumatik / Angin :

24 1. Dua SDV fuel pilot gas 2. Satu pompa chemical 3. x x //// -
Satu pompa lube oil

25 Sistim Tenaga Listrik : x x - -

Pengendalian Mekanis dan Kerangan :

26 1. Satu BV gas out V-40 2. Satu BV gas out V-30 to V-1 x x /// /
3. Satu BV HP Flare header cellar deck
C-S
E PENGENDALIAN BAHAYA TOTAL "E" C = 152 S=5 x VF =
C

Sistim Lock-out (Penguncian) : 1. Dua Turbin

27 x x //// -
Compressor 2. Satu Crane engine 3. Dua HVAC

Rambu & Label :

1. Tiga tempat sampah 2. Delapan fire-ex. 3. Satu fire ///// ///// ///// ///// /////
28 x x x -
host reels 4. Dua DMLR 5. Tiga life raft 6. Tujuh warning //
sign 8. Tiga life ring

Pemasangan Label pada Material :

1. Lima wooden box (satu shaftindo & tiga indoturbine VF =
29 x x x ///// /// -
serta satu spare motor finfan) 2. Dua elektric motor 3. (Dianjurkan 16.15
Satu Bidi Pig VF=16.7)

Sistim Peringatan (Warning) :

///// ///// ///// ///// /////
30 1. Dua general alarm 2. Tujuh Pressure switch 3. Dua x x x -
///// ///// /
puluh tujuh F&G system

///// ///// ///// ///// /////

Alat Pelindung Diri :
///// ///// ///// ///// /////
31 1. Lima ser fire suit 2. Empat puluh lima life jacket baltic x x /////
///// ///// ///// ///// /////
3. Dua puluh tujuh life jacket
//

C-S
F SISTIM TANGGAP DARURAT TOTAL "F" C = 66 S=1 x VF =
C

Petunjuk Keadaan Darurat :

1. Dua exit sign control room 2. Satu emergency layout
32 x x x ///// / -
3. Tiga MSDS (chemical, turbo lube oil, & NG lube oil
tank
Pelindung Kebakaran (Fire Protection) :
33 1. Lima portable fire-ex 2. Satu fire hose reels 3. Dua fire x ///// /// - VF =
blanket (Dianjurkan 10.93
Kotak P3K, Pencuci Mata & Pancuran : VF=11.1)
34 x /// /
1. Dua eye wash 2. Satu Kotak P3K di control room

Alat Penyelamatan Darurat :

///// ///// ///// ///// /////
35 1. Tiga Liferaft 2. Tiga Life Ring 3. Dua DMLR 4. Satu x -
///// ///// ///// ///// ////
SCBA 5. Tiga ELSA 6. Tiga puluh lima smoke Hood

C-S
G PENGELOLAAN PRODUK TOTAL "G" C= S= x VF =
C

36 Pengendalian Produk x x VF=

(Dianjurkan
37 Penyimpanan, Pengangkutan & Penggunaan Produk x x x VF=0)
C-S
H LAIN-LAIN TOTAL "H" C= S= x VF =
C

39
VF=
40

TOTAL SCORE (% COMPLIANCE) TOTAL VALUE FACTOR 100 88.52

 P2K3 PHYSICAL CONDITION TOUR

PHYSICAL CONDITION TOUR (PCT) WORKSHEET

FLOW STATION :

ASSESSMENT DATE :

ASSESSOR NAME :

PHYSICAL CONDITION TOUR (PCT) WORKSHEET

VALUE
CATEGORY HS E Q NUMBER CHECKED (C) NUMBER SUBSTANDARD (S) SCORE
FACTOR
C-S
A GENERAL WORKPLACE CONDITION TOTAL "A" C= S= x VF =
C

1 Floor (Walking & Working Surfaces) x x x

2 Aisles & Passageways x x

3 Platforms / Scaffollding x
VF=
4 Ladders and Stairs x (Suggested
VF = 10)
5 Exit / Egress x

6 Roadways x x x

7 Ventilation / Extract Ways & Gaseous Exhausts x x

C-S
B FACILITIES TOTAL "B" C= S= x VF =
C

8 Lightings & Noise Exposure x x

9 Ergonomic Factors x x
VF=
10 Drainage and Effluent Treatment x x (Suggested
VF = 15)
11 Steam Plant and Systems x x x

12 Steam Plant and Systems x x x

C-S
C MATERIALS TOTAL "C" C= S= x VF =
C

12 Stacking & Storage x x x

13 Chemicals and Fuels x x x VF=

(Suggested
14 Compressed Gasses x x x VF=20)
15 Waste Disposal x x

C-S
D EQUIPMENT TOTAL "D" C= S= x VF =
C

16 Hand & Portable Tools x x

17 Machine Tools & Guarding x x

18 Mobile Equipment x x

19 Lifting Gear & Equipment x x

20 Materials Handling Equipment (inc. conveyors) x x x

VF=
21 Pressure Vessel Systems x x x (Suggested
VF=20)
22 Mechanical Power System x x

23 Hydraulic Power System x x x

24 Pneumatic Power System x x

25 Electrical Power System x x

26 Valves and Mechanical Controls x x

C-S
E HAZARDS CONTROLS TOTAL "E" C= S= x VF =
C

27 Lock-out Systems x x

28 Signs, Tags and Color Coding x x x

VF =
29 Materials Labeling x x x (Suggested
VF=15)
30 Warning System x x x

31 Personal Protective Equipmenmt x x

C-S
F EMERGENCY SYSTEMS TOTAL "F" C= S= x VF =
C

32 Emergency Instruction x x x

33 Fire Protection x VF =
(Suggested
34 First Aid, Eye Baths and Shower x VF=10)
35 Emergency Rescue Equipment x

C-S
G PRODUCT MANAGEMENT TOTAL "G" C= S= x VF =
C

36 Product Control x x VF=

(Suggested
37 Product Storage, Transport and Use x x x VF=10)
C-S
H OTHERS TOTAL "H" C= S= x VF =
C

39
VF=
40

TOTAL SCORE (% COMPLIANCE) TOTAL VALUE FACTOR 100

DONE BY ACCEPTED BY

Maint/Plant/NUI Supervisor OIM

 P2K3 PHYSICAL CONDITION TOUR

FM00010B0006/NR/T210/2017
PHYSICAL CONDITION TOUR (PCT) WORKSHEET

LOCATION :

ASSESSMENT DATE :

ASSESSOR NAME :

PHYSICAL CONDITION TOUR (PCT) WORKSHEET

VALUE
CATEGORY HS E Q NUMBER CHECKED (C) NUMBER SUBSTANDARD (S) SCORE
FACTOR
C-S
A GENERAL WORKPLACE CONDITION TOTAL "A" C= 64 S= 8 x VF = 8.75
C

1 Floor (Walking & Working Surfaces) x x x 15 3

2 Aisles & Passageways x x 0 0
3 Platforms / Scaffollding x 3 1
VF=
4 Ladders and Stairs x 21 0 (Suggested
VF = 10)
5 Exit x 9 0
6 Roadways x x x 8 4
7 Ventilation / Extract Ways & Gaseous Exhausts x x 8 0
C-S
B FACILITIES TOTAL "B" C= 54 S= 5 x VF = 13.61
C

8 Lightings & Noise Exposure x x 32 0

9 Ergonomic Factors x x 15 5
VF=
10 Drainage and Effluent Treatment x x 3 0 (Suggested
VF = 15)
11 Permanently/temporary occupied building x x x 4 0

C-S
C MATERIALS TOTAL "C" C= 52 S= 1 x VF = 19.62
C

12 Stacking & Storage x x x 7 0

13 Chemicals and Fuels x x x 1 0 VF=
(Suggested
14 Compressed Gasses x x x 42 0 VF=20)
15 Waste Disposal x x 2 1
C-S
D EQUIPMENT TOTAL "D" C= 69 S= 3 x VF = 19.13
C

16 Hand & Portable Tools x x 2 0

17 Machine Tools & Guarding x x 6 0
18 Mobile Equipment x x 0 0
19 Lifting Gear & Equipment x x 2 0
VF=
20 Materials Handling Equipment x x x 6 0 (Suggested
VF=20)
21 Pressure Vessel Systems x x x 1 0
22 Mechanical Power System x x 5 0
23 Electrical Power System x x 5 0
24 Valves and Mechanical Controls x x 42 3
C-S
E HAZARDS CONTROLS TOTAL "E" C= 26 S= 0 x VF = 15
C

25 Lock0out Systems x x 1 0
26 Signs, Tags and Color Coding x x x 14 0
VF =
27 Materials Labeling x x x 1 0 (Suggested
VF=15)
28 Warning System x x x 1 0
29 Personal Protective Equipmenmt x x 9 0
C-S
F EMERGENCY SYSTEMS TOTAL "F" C= 21 S= 1 x VF = 9.52
C

30 Emergency Instruction x x x 7 1
31 Fire Protection x 9 0 VF =
(Suggested
32 First Aid, Eye Baths and Shower x 2 0 VF=10)
33 Emergency Rescue Equipment x 3 0
C-S
G PRODUCT MANAGEMENT TOTAL "G" C= 2 S= 0 x VF = 10
C

34 Product Control x x 2 0 VF=

(Suggested
35 Product Storage, Transport and Use x x x 0 0 VF=10)
C-S
H OTHERS TOTAL "H" C= S= x VF =
C

39
VF=
40

TOTAL SCORE (% COMPLIANCE) TOTAL VALUE FACTOR 100 95.63

DONE BY ACCEPTED BY

Maintenance/HSE Reliability
 DEFECT FINDINGS
TARGET COMPLETION DATE EFFECTIVENESS
DATE LOCATION DEFECT FINDING FOLLOW UP ACTION NO WR/WO CATEGORY SPA STATUS RESULT/EVIDENCES
PLAN ACTUAL Y/N