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JOB SAFETY & ENVIRONMENTAL ANALYSIS (JSEA)

ANALISA KESELAMATANKERJA&LINGKUNGAN(JSEA)
Department & Section or Contractor / Departemen& Section atauKontraktor: PT TRIMITRA WISESA ABADI Date of JSEA / TanggalJSEA: 13-01-2020
Location of work / LokasiKerja : subang
Description of job / UraianPekerjaan: Pekerjaan Instalasi pembesian

JSEA AUTHORISATION / KEWENANGANJSEA


(Signed by appropriate authority as per Risk Analysis)This JSEA identifies all significant hazards and corresponding controls that are required to protect workers doing the Job. In the
absence of a current Standard Operating Procedure, this JSEA defines the mandatory controls that must be in place before work commences. /
(Ditandatangani oleh yang berwenangsesuaidengan Analisa terhadapresiko) JSEA inibertujuanuntukmengidentifikasisemuapotensibahaya dan pengendalianyang terkaityang
diperlukanuntukmelindungipekerja yang melakukanpekerjaan.Ketiadaandari pada prosedurpengoperasian yang standar (SOP), JSEA inimenetapkanpengendalian yang diwajibkan yang
harusadasebelummelakukanpekerjaan.
Date /
Name & ID / Nama & ID: Signature / TandaTangan: Position / Jabatan:
Tanggal:

1. JSEA
RESIDUAL
RISK
RISK
RATING /
No RATING/
JOB STEPS / LANGKAH KERJA HAZARDS / BAHAYA NILAIRESI CONTROLS / PENGENDALIAN NILAI
RESIKO
KO
YANG
TERSISA

1 Persiapan 1.1. Cidera Tulang Belakang 17 1.1.1 Pastikan pekerja memahami prosedur manual
handling
1.1.2 Pastikan pekerja dengan pegalaman
1.1.3 Gunakan APD Standar dan sesuai area kerja

1.2 Tersandung 13 1.2.1 Pastikan memasang barikade pada tumpukan


material besi
1.2.2 House Keeping
1.2.3 Gunakan APD standar termasuk sepaty safety

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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
RESIDUAL
RISK
RISK
RATING /
No RATING/
JOB STEPS / LANGKAH KERJA HAZARDS / BAHAYA NILAIRESI CONTROLS / PENGENDALIAN NILAI
RESIKO
KO
YANG
TERSISA

2 Instalasi Pembesian 2.1 Terjepit 12 2.1.1 Pastikan pekerja berpengalaman


2.1.2 Pastikan pekerja menghindari titik jepit
2.1.3 Gunakan APD standar termasuk sarung tangan

2.2 Terluka Gores 12 2.2.1 Pekerja harus menggunakan baju lengan Panjang
2.2.2 Gunakan APD Standar

2.3 Tertimpa Material 13 2.3.1 Pastikan pekerja memahami kapasitas beban


Handling Material
2.3.2 Gunakan APD Standar termasuk sarung tangan

2.4 Tertusuk 13 2.4.1 Pasang cap pada titik benda tajam


2.4.2 Pasang barikade disekitar area kerja
2.4.3 Gunakan APD standar, sepatu, dan sarung tangan
safety

3 Pemotongan Besi 3.1 Terkena Percikan 12 3.1.1 Menggunakan APD, Face Shield, Sarung Tangan
3.1.2 Pekerja kompeten dan berbadan sehat
3.1.3 Peralatan dan mata gerinda layak pakai

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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
2. COMMON SAFETY & HEALTH HAZARDS/ BAHAYA UMUM KESELAMATAN & KESEHATAN
List indicates examples of hazards. List these or other detailed hazards in the appropriate column of the JSEA. / Daftar berikutinimenunjukkancontoh–contohbahaya.
Masukkan bahaya–bahayainiataubahayaterperincilainnya pada kolom yang sesuaidarilembaranJSEA.
Work at height / Bekerja pada Working with Loads / Working with Electricity / Pekerjaan
Hot Work / PekerjaanPanas
Ketinggian BekerjaMengangkat Beban Listrik
❑ Lifting equipment / ❑ Molten metal / Metal meleleh ❑ Faulty electrical equipment /
❑ Fall from height / Jatuhdariketinggian
Mengangkatperalatan ❑ Peralatanlistrikrusak
❑ Workers above or below / Pekerja ❑ Manual lifting / Pengangkatan
❑ Heat radiation / Radiasipanas ❑ Worn cables / Kabel terkelupas
❑ diatasataudibawah ❑ manual
❑ Hit by falling object/ Tertimpa oleh ❑ Suspended loads / Beban ❑ Fire or explosion / ❑ Power lines (within 10m)/ Jalurtegangan
benda yang jatuh menggantung Terbakarataumeledak (dalam 10 m)
❑ High voltage equipment /
❑ Open holes / Lubangterbuka ❑ Supported loads / Beban didukung ❑ Sparks / Percikanapi
Peralatanlistriktegangantinggi
❑ ❑ Rigging loads / Beban Rigging ❑ Intense light / Cahayatajam ❑ Lightning / Kilat
Working with Equipment / Working in Trenches / Contact with Chemicals / Work in Confined Spaces / Bekerja di
BekerjaMenggunakanPeralatan PekerjaanPenggalian PenggunaanBahan Kimia RuangTerbatas
❑ Release of Stored energy / Pelepasan ❑ Buried services / Tertimbun ❑ Toxic gases / Gas beracun ❑ Release of Stored energy /
energy yang tersimpan ❑ Pelepasanenergitersimpan
❑ Solvents, paints etc / Bahanpelarut,
❑ Loss of control / Lepas kendali ❑ Excavator Proximity / Jarak Excavator ❑ Contaminants / Gas beracun
❑ cat, dll
❑ Pinched/crushed/caught / ❑ Loss of control by operator / Operator ❑ Pesticides, herbicides etc/ Pestisida,
❑ Lack of oxygen / Kurangoksigen
Terjepit/terlindas/terperangkap lepaskendali herbisida, dll
❑ Exposed to cutting edges / ❑ Buried by collapse / Operator ❑ Fuels, oils and greases / Bahanbakar, ❑ Limited access for rescue /
Terkenapinggiranpisaupotong lepaskendali ❑ oli dan greas Ruangmasukuntukpenyelamatanterbatas
Natural Environment / Lingkungan Tools / Peralatan Industrial Hygiene / Hygiene Industri Water / Air
❑ Rain / Hujan ❑ Exposed to cutting edges / ❑ Noise & vibration / ❑ Fall into water / Terceburkedalam air
Terkenapinggiranpisaupotong ❑ Kebisingan&getaran
❑ Wind / Angin ❑ Vibration / Getaran ❑ Heat / Panas ❑ Release of water / Pelepasan air
❑ Loss of control while diving / Lepas
❑ Sun-glare / Matahari–Sinar ❑ Pinching / Terjepit ❑ Dust & fumes / Debu& asap
kendalisewaktumenyelam
❑ Malaria ❑ Flying metal / Metal melayang ❑ Infectious materials / Benda menular ❑ Loss of control of boat / Lepas Kendali
❑ Caught clothing or hair / Baju
❑ Snake bite / Gigitanular ❑ Radiation / Radiasi ❑ Sinking / Tenggelam
ataurambuttersangkut
Process Hazards / Proses Bahaya Umum / Housekeeping Other / Lain - lain
❑ Cyanide / Sianida ❑ Gases / Gas ❑ Poor housekeeping / housekeeping ❑ Blasting / Peledakan
buruk
❑ Hydrogen Peroxide /
❑ Diesel ❑ Ergonomics / Ergonomis ❑
❑ HidrogenPeroksida
❑ Manual handling /
❑ Acid / Asam ❑ High Voltage / Tegangan Tinggi ❑
❑ PenangananManual
❑ Lime / Kapur ❑ Oxygen / Oksigen ❑ Lighting / Pencahayaan ❑
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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
3. COMMON ENVIRONMENTAL HAZARDS / BAHAYA UMUM LINGKUNGAN
❑ Hydrocarbon spill / ❑ Release of process gases/ ❑ Damage to flora/fauna /
❑ Waste /Sampah
TumpahanHidrokarbon ❑ Pelepasan proses gas ❑ Pengrusakanhewan/tumbuhan
❑ Chemical spill / ❑ Release to a waterway / ❑ Sediment in runoff /
❑ Dust /Debu
❑ Tumpahanbahankimia ❑ Pelepasankealiran air ❑ KebocoranSedimen
❑ ❑ ❑

4. RATE THE RISK / NILAI RESIKO


Consequence / Konsekuensi JSEA Sign Off Levels / TandaTangan
1 2 3 5 JSEA dariSemua Level
Likelihood / Kemungkinan 4
Insignificant / Minor / Moderate /
Major / Berat
Catastrophic / 1 – 5 LOW / RENDAH Area Supervisor
Kecil Ringan Sedang Bencana
A 6 – 10 MODERATE / Area Supervisor
Almost Certain / 11 16 20 23 25 SEDANG
HampirPasti
B 11 – 17 HIGH / TINGGI Superintendent
7 12 17 21 24
Likely / MungkinSekali
C 18 – 25 Manager
4 8 13 18 22 EXTREME/EKSTRIM
Possible / Mungkin
D
Unlikely / 2 5 9 14 19
Kemungkinankecil
E
1 3 6 10 15
Rare / Langka

6 – 10 MODERATE / 11 – 17 HIGH / 18 – 25 EXTREME /


1 – 5 LOW / RENDAH
SEDANG TINGGI EKSTRIM
Significant Risks / Resiko yang Signifikan

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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
Consequence Table – Safety, Health / TabelKonsekuensi – Keselamatan, Kesehatan
Insignificant / Kecil Minor / Ringan Moderate / Sedang Major / Berat Catastrophic / Bencana
First aid treatment, no lost time. / Medical Aid. / Lost Time Injury. / Permanent disability or Multiple fatalities/Life threatening or
Penangananpertolonganpertama, Pengobatanmedis. Ciderahilangwaktu. fatality. / disabling illness. / Fatality
tidak lost time. Cacatpermanenatau lebihdarisatu/Mengancamnyawaataulumpuh.
fatality.

Consequence Table – Environmental / TabelKonsekuensi – Lingkungan


Insignificant / Kecil Minor / Ringan Moderate / Major / Berat Catastrophic /
Sedang Bencana
Little Impact. The Environmental impact is fully recoverable with Minimal damage to Off-site impact to Major Impact–immediate Impact on a
no permanent effect on the environment. / Benturankecil. environment/ Immediately fauna and flora. and/or long term significant regional scale-
Dampaklingkungansepenuhnyadapatdipulihkantanpaadaefekperm contained on-site. / Minimal Impact may extend harm to the environment. / outside of the
anen pada lingkungan. kerusakan pada beyond the Berdampakberat–segera Tapsel District
lingkungan/Segeraterkandu exploration lease dan/ataukerugian yang and further. /
ng di site. boundary. / berarti pada Berdampak
Berdampak pada lingkungandalamjangkawa pada skala
fauna dan flora di ktu yang lama. regional–
luar diluardistrikTaps
site.Dampaknya el dan
bias bahkanlebihjauh
meluasmelebihibat .
as area eksplorasi.

Likelihood Table / TabelKemungkinan

A – Almost Certain / B – Likely / MungkinSekali C – Possible / Mungkin D – Unlikely / E – Rare / Langka


HampirPasti Kemungkinankecil
The consequence will occur/ The consequence will occur The consequence has The consequence has The consequence has
Akibat yang akanterjadi. under some circumstances. / happened elsewhere. / Akibat happened elsewhere. / Akibat rarely occurred in the
Akibat yang yang terjadi di tempatlain. yang terjadi di tempatlain. industry and is not expected
Probability approximately 99%.
akanterjadidalambeberapasituasi. in the life of the mine. /
/ Kemungkinanterjadi99%. The consequence typically The consequence is expected
Akibat yang jarangterjadi di
Probability approximately 90%. occurs every 5 years. / to occur once in life of the mine.
area industry dan
/Kemungkinanterjadi 90%. Khususnyaakibat yang / Akibat yang
tidakdiharapkanterjadidalam
terjadisetiap 5 tahun. diperkirakanterjadisekali di area
area tambang.
tambang.

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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
5. JSEA TEAM SIGN-OFF / TANDA TANGAN TEAM JSEA
Name / Nama ID # / No. ID Signature / TandaTangan: Position / Jabatan: Date / Tgl:

6. PRE-WORK CHECKLIST / CHECKLIST SEBELUM MELAKUKAN PEKERJAAN


(Must be completed at the beginning of each shift /Harusdilengkapi pada permulaandarisetiap shift)
Done /
# Task / Tugas TelahDila
kukan
1 Identify the nature of the work and the location of the job to be performed. / Identifikasisifatpekerjaan dan lokasipekerjaan yang akandilakukan.
2 Read out the relevant JSEA steps, to the work team. / Bacakanlangkah – langkahJSEA kepada team kerja.
Consider validity due to; abnormal conditions, process changes, weather conditions etc. / Pertimbangkankeabsahankarena; kondisitidak normal,
3
perubahan proses, kondisicuaca, dll.
4 Clarify work team, roles, competencies and appropriate time allocated. / Perjelasteam kerja, peran, kompetensi dan alokasiwaktu yang tepat.
Discuss lessons learned – previous accidents, delays or other setbacks. / Diskusikankecelakaan yang berlalusebagaipembelajaran,
5
penundaanataukemunduranlainnya.
6 Confirm Hazard awareness amongst team. / Tegaskanpada teamkerja agar memilikikesadaran yang tinggiterhadapbahaya.
Confirm work equipment available, in good condition and fit for purpose. / Periksaperalatankerjatersedia, dan
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dalamkondisibagusuntukdipergunakan.
8 Confirm PPE is available, in good condition and fit for purpose. / PeriksabahwaAPDtersedia dan dalamkondisibagusuntukdipergunakan.
9 Confirm controls identified in JSEA are available. / Periksabahwapengendalianyang telahdiidentifikasi pada lembaran JSEAtelahtersedia.
10 Team completed briefing sheet. / Team kerjatelahmelengkapilembaran briefing.
All items on this checklist have been completed / Semua item pada checklist initelahdilengkapi.
Signature / Date / Time /
Name / Nama ID # / No. ID Position / Jabatan
TandaTangan Tanggal: Waktu:
Supervisor:

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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
7. BRIEFING TO WORKERS / BRIEFING UNTUK PEKERJA
I have read (or have been informed) about the controls outlined in this JSEA and I fully understand and will comply. I will report any additional hazards to my Supervisor if they
occur during the work. / Saya telahmembaca (atautelahdiberitahukan) tentangpengendalian–pengendalian yang telahdijelaskan di dalam JSEA dan sayabenar–benarmengerti
dan mematuhinya. Saya akanmelaporkanbahaya-bahayatambahan pada Supervisor sayajikabahaya–bahayatersebutmunculketikamelakukanpekerjaan.
Name / Nama ID # / No. ID Signature / TandaTangan Name / Nama ID # / No. ID Signature / TandaTangan

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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020
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OHS-TNS-FRM-00408-IE JSEA FORM Version 1.3
UNCONTROLLED COPY IF PRINTED. VALID ON DAY OF PRINTING ONLY - Printed on: 13 January 2020