MUARA TAWAR COMBINED CYCLE POWER PLANT BLOCK 2, 3

& 4 ADD-ON PROJECT, DKI JAKARTA, INDONESIA KSO DOOSAN – HUTAMA KARYA

JOB SAFETY ANALYSIS & RISK ASSESSMENT

JSA no. (Nomor JSA) KDH-JSA-01 DEPARTMENT :
Construction
Date (Tanggal) Juni 2017 (Bagian/Fungsi)
SUPERVISOR :
JOB (Pekerjaan) Soil Test & Investigation M. Irfan. B & Syarif
(Pengawas)
LOCATION Muara Tawar CCPP Add On 2,3,4 Project, Bekasi
(Lokasi)

PROTECTIVE EQUIPMENT REQUIRED TO PERFORM THIS JOB

(ALAT PELINDUNG YANG DIPERLUKAN UNTUK MELAKSANAKAN PEKERJAAN)

SAFETY HELMET X EAR PLUG/EAR MUFF X RUBBER GLOVES FIRE EXTINGUISHER X

SAFETY SHOES X RUBBER BOOT X FULL BODY HARDNESS X LOCK OUT/TAG OUT
SAFETY GLASSES X FACE SHIELD CHEMICAL COAT OIL SPILL KIT

COTTON GLOVES X APRON RESPIRATOR/SCBA WORK PERMIT REQUIRED X

LEATHER GLOVES DUST/GAS MASKER WELDING CAP OTHER :

SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
1. Mobilisasi peralatan
2 Pemesangan pagar seng pembatas
POTENTIAL ACCIDENT OF HAZARDS
(POTENSI DAPAT TERJADI
KECELAKAAN/ MENIMBULKAN
BAHAYA)
1. Kecelakaan Lalu lintas.
2. Menabrak Orang.
3. Mobil Terbalik.
1. Terluka
2. Tangan terjepit
3. Tertabrak kendaran
RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBLE
LEVEL PERSONAL
(TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUNG
RESIKO) JAWAB)
H 1. Pengemudi harus memiliki SIM dan mengetahui
batas rambu-rambu lalu lintas. Foreman
H 2. Memastikan Kendaraan yang di
gunakan dalam kondisi yang baik dan aman.
M 1 Lakukan toolbox meeting sebelum mulai kerja
M 2 Pastikan pekerja sudah di induksi dari kontraktor Foreman
H 3 Pastikan traffic sign sudah terpasang pada tempatnya
4 Diawasi langsung sama pengawas

1 of 21
 SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
3. Unloading Peralatan Bore Hole.
POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBLE
LEVEL PERSONAL
(POTENSI DAPAT TERJADI (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUNG
KECELAKAAN/ MENIMBULKAN RESIKO) JAWAB)
1. Terjepit. BAHAYA) H 1. Memakai Alat Pelindung Diri ( Helm, Kaca mata
sarung tangan, coverall)
2. Kejatuhan benda keras M 2. Melakukan Safety Talk sebelum bekerja. Foreman
3. Mengetahui berat beban yang diangkat.
H 4. Mengetahui cara pengangkatan manual.
2 of 21
 SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
4. Pemasangan instalasi bor pile.
5. Proses pengeboran
- Injeksi air ke rod bore
6. Demobilisasi Equipment
PELAKSANA PEKERJAAN
POTENTIAL ACCIDENT OF HAZARDS
(POTENSI DAPAT TERJADI
KECELAKAAN/ MENIMBULKAN
BAHAYA)
1. Peralatan Kerja mengenai pekerja.
2. Pemasangan tidak sempurna.
3. Peralatan Bore Pile rusak
4. Bore Pile Tumbang
- Terkena / merusak Fasilitas Bawah
Tanah.
- Sling Putus
- Pipa bor / Rod bore patah.
- Mata bor rusak.
- Percikan air mengenai muka
- Kecelakaan Lalu lintas.
- Menabrak Orang.
- Peralatan Terjatuh.
DIPERIKSA OLEH
3 of 21
RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBLE
LEVEL PERSONAL
(TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUNG
RESIKO) JAWAB)
M - Memakai Alat Pelindung Diri ( Helm, Kaca Mata
coverall, sarung tangan ) Foreman
- Melakukan Safety Talk sebelum bekerja.
M - Cek semua unit bore pile dan pastikan terpasang
dengan lengkap dan sempurna Foreman
M - Inspeksi semua unit bore pile seperti tripod, sling,
genset, as bored, drum, Chain block.
M - Pastikan Bore pile berdiri kokoh dan lengkap
semua unit peralatannya. Foreman
H - Lakukan survey terlebih dahulu.
- Tanyakan kepada pemilik area tentang fasilitas Foreman
fasilitas bawah tanah.
M - Pakai sling yang masih bagus ( tidak berserabut
tidak ada bending.
- Jangan gunakan sling yang tidak layak pakai. Foreman
M - Pastikan pipa telah di inspeksi terlebih dahulu
dan dalam kondisi yang baik ( tidak ada crack ).
M - Pastikan mata bor telah sesuai dengan kondisi /
jenis lapisan tanah .
L - Pastikan kondisi slang dalam keadaan baik Foreman
( Tidak bocor ).
- Pastikan klam sambungan slang terpasang
dengan baik
M - Pengemudi harus mematuhi rambu-rambu
lalu lintas.
M - Memastikan kendaraan yang di Foreman
gunakan dalam kondisi yang baik .
M - Memastikan peralatan tersusun dengan rapi
dan terikat dengan baik. Foreman
PENGAWAS PEKERJAAN
 SEQUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBLE
LEVEL PERSONAL
(URUTAN LANGKAH DASAR PEKERJAAN) (POTENSI DAPAT TERJADI (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUNG
KECELAKAAN/ MENIMBULKAN RESIKO) JAWAB)
BAHAYA)

Bapak Syarif Muhammad Irfan Baharuddin Reza Faisal Benny Lesmana ( )

Lead Surveyor HSE Engineer Deputy HSE Manager HSE Manager PT. PLN (Persero)
KONSORSIUM DOOSAN - HUTAMA KARYA

4 of 21
 MUARA TAWAR COMBINED CYCLE POWER PLANT BLOCK 2, 3
& 4 ADD-ON PROJECT, DKI JAKARTA, INDONESIA KSO DOOSAN – HUTAMA KARYA

JOB SAFETY ANALYSIS & RISK ASSESSMENT

JSA no. (Nomor JSA) KDH-JSA-01 DEPARTMENT :
Construction
Date (Tanggal) Juni 2017 (Bagian/Fungsi)
SUPERVISOR :
JOB (Pekerjaan) Soil Test & Investigation M. Irfan. B & Syarif
(Pengawas)
LOCATION Muara Tawar CCPP Add On 2,3,4 Project, Bekasi
(Lokasi)

PROTECTIVE EQUIPMENT REQUIRED TO PERFORM THIS JOB

(ALAT PELINDUNG YANG DIPERLUKAN UNTUK MELAKSANAKAN PEKERJAAN)

SAFETY HELMET X EAR PLUG/EAR MUFF X RUBBER GLOVES FIRE EXTINGUISHER X

SAFETY SHOES X RUBBER BOOT X FULL BODY HARDNESS X LOCK OUT/TAG OUT
SAFETY GLASSES X FACE SHIELD CHEMICAL COAT OIL SPILL KIT

COTTON GLOVES X APRON RESPIRATOR/SCBA WORK PERMIT REQUIRED X

LEATHER GLOVES DUST/GAS MASKER WELDING CAP OTHER :

SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
1. Mobilisasi peralatan
2 Pemesangan pagar seng pembatas
POTENTIAL ACCIDENT OF HAZARDS
(POTENSI DAPAT TERJADI
KECELAKAAN/ MENIMBULKAN
BAHAYA)
1. Kecelakaan Lalu lintas.
2. Menabrak Orang.
3. Mobil Terbalik.
1. Terluka
2. Tangan terjepit
3. Tertabrak kendaran
RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBLE
LEVEL PERSONAL
(TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUNG
RESIKO) JAWAB)
H 1. Pengemudi harus memiliki SIM dan mengetahui
batas rambu-rambu lalu lintas. Foreman
H 2. Memastikan Kendaraan yang di
gunakan dalam kondisi yang baik dan aman.
M 1 Lakukan toolbox meeting sebelum mulai kerja
M 2 Pastikan pekerja sudah di induksi dari kontraktor Foreman
H 3 Pastikan traffic sign sudah terpasang pada tempatnya
4 Diawasi langsung sama pengawas

5 of 21
 MUARA TAWAR COMBINED CYCLE POWER PLANT BLOCK 2, 3 & 4
ADD-ON PROJECT, DKI JAKARTA, INDONESIA
KSO DOOSAN – HUTAMA

JOB SAFETY ANALYSIS & RISK ASSESSMENT

JSA no. (Nomor JSA) KDH-JSA-01 DEPARTMENT :
Engineering, Construction
Date (Tanggal) Juli 2017 - Agustus 2017 (Bagian/Fungsi)
SUPERVISOR :
JOB (Pekerjaan) Soil Test & Investigation (Geotechnical Activities) M. Irfan. B & M. Ekky Gigih
(Pengawas)
LOCATION Muara Tawar CCPP Add On 2,3,4 Project,
(Lokasi)

PROTECTIVE EQUIPMENT REQUIRED TO PERFORM THIS JOB

(ALAT PELINDUNG YANG DIPERLUKAN UNTUK MELAKSANAKAN PEKERJAAN)

SAFETY HELMET X EAR PLUG/EAR MUFF X RUBBER GLOVES FIRE EXTINGUISHER

SAFETY SHOES X RUBBER BOOT X FULL BODY HARDNESS LOCK OUT/TAG OUT
SAFETY GLASSES X FACE SHIELD CHEMICAL COAT OIL SPILL KIT

COTTON GLOVES X APRON RESPIRATOR/SCBA WORK PERMIT REQUIRED

LEATHER GLOVES DUST/GAS MASKER WELDING CAP OTHER : LIFE VEST/ PELAMPUNG

SEQUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES RE
LEVEL P
(URUTAN LANGKAH DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PE
MENIMBULKAN BAHAYA) RESIKO)
1. Mobilisasi peralatan 1. Kecelakaan Lalu lintas. H 1. Pengemudi harus memiliki SIM dan mengetahui
2. Menabrak Orang. batas rambu-rambu lalu lintas. Forem
Con
3. Mobil Terbalik. H 2. Memastikan Kendaraan yang di
gunakan dalam kondisi yang baik dan aman.
2 Pemasangan pembatas trap aktivitas 1. Terluka M 1 Lakukan toolbox meeting sebelum mulai kerja
Soil Investigation 2. Tangan terjepit M 2 Pastikan pekerja sudah di induksi dari kontraktor/ Owner Forem
3. Tertabrak kendaraan/ Kecelakaan H 3 Pastikan traffic sign sudah terpasang pada tempatnya Con
4 Diawasi langsung sama pengawas

6 of 21
 SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
3. Unloading Peralatan Bore Hole.
POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES RE
LEVEL P
Forem
(POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) Con
(PE
MENIMBULKAN BAHAYA) RESIKO)
1. Terjepit, tersandung H 1. Memakai Alat Pelindung Diri ( Helm, Kaca mata
sarung tangan, dst)
M Forem
2. Kejatuhan benda keras 2. Melakukan Safety Talk/ TBM sebelum bekerja.
Con
3. Mengetahui berat beban yang diangkat.
H 4. Mengetahui cara pengangkatan manual (Lifting).
7 of 21
 SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
4. Pemasangan instalasi bor pile.
5. Proses pengeboran
- Injeksi air ke rod bore
6. Pekerjaan Surveying Soil Investigation
- Surveying dan Topografi
- Hydro-Oceanography Survey
- Bathimetry/ Test of Seawater Quality
7. Demobilisasi Equipment
POTENTIAL ACCIDENT OF HAZARDS
(POTENSI DAPAT TERJADI KECELAKAAN/
MENIMBULKAN BAHAYA)
1. Peralatan Kerja mengenai pekerja.
2. Pemasangan tidak sempurna.
3. Peralatan Bore Pile rusak
4. Bore Pile Tumbang
- Terkena / merusak Fasilitas Bawah
Tanah.
- Sling Putus
- Pipa bor / Rod bore patah.
- Mata bor rusak.
- Percikan air mengenai muka
- Peralatan Kerja mengenai pekerja
- Pemasangan peralatan tidak sempurna
- Terjatuh ketika proses pengambilan sampling
berlokasi di laut
- Kecelakaan Lalu Lintas
- Menabrak Orang/ Makhluk hidup lainnya
- Peralatan Terjatuh.
8 of 21
RISK RECOMMENDED SAFE JOB PROCEDURES RE
LEVEL P
(TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PE
RESIKO)
M - Memakai Alat Pelindung Diri ( Helm, Kaca Mata
sarung tangan )
- Melakukan Safety Talk sebelum bekerja.
M - Cek semua unit bore pile dan pastikan terpasang
Forem
dengan lengkap dan sempurna
Con
M - Inspeksi semua unit bore pile seperti tripod, sling,
genset, as bored, drum, Chain block, dst.
M - Pastikan Bore pile berdiri kokoh dan lengkap
semua unit peralatannya.
H - Lakukan survey terlebih dahulu di Lokasi Kerja
- Tanyakan kepada pemilik area tentang fasilitas
fasilitas bawah tanah.
M - Pakai sling yang masih bagus ( tidak berserabut
tidak ada bending.
- Jangan gunakan sling yang tidak layak pakai.
M Forem
- Pastikan pipa telah di inspeksi terlebih dahulu
Con
dan dalam kondisi yang baik ( tidak ada crack ).
M - Pastikan mata bor telah sesuai dengan kondisi /
jenis lapisan tanah .
M - Pastikan kondisi slang dalam keadaan baik
( Tidak bocor ).
- Pastikan klam sambungan slang terpasang
dengan baik
M - Memakai Alat Pelindung Diri ( Helm, Kaca Mata
sarung tangan )
M - Cek semua unit peralatan dan pastikan terpasang Forem
sempurna Con
H - Pastikan disediakannya perahu/ jenis dengan kelengkapan
Life Vest/ Pelampung, Pastikan pekerja mengerti Prosedur Kerja
di air (Working Over Water)
M - Pengemudi harus mematuhi rambu-rambu
lalu lintas.
M - Memastikan kendaraan yang gunakan dalam kondisi Forem
yang baik & siap untuk digunakan. Con
M - Memastikan peralatan tersusun dengan rapi
dan terikat dengan baik.
 SEQUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES Forem
RE
LEVEL ConP
(URUTAN LANGKAH DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PE
MENIMBULKAN BAHAYA) RESIKO)

PELAKSANA PEKERJAAN DIPERIKSA OLEH PENGAWAS PEKERJAAN

( ) ( ) ( ) ( ) (
Lead Engineering/ Construction KSO HSE Manager Project Manager
KONSORSIUM DOOSAN - HUTAMA KARYA PT. PLN (Persero) PT. PJB UP PLTGU

9 of 21
 MUARA TAWAR COMBINED CYCLE POWER PLANT BLOCK 2, 3 & 4
ADD-ON PROJECT, DKI JAKARTA, INDONESIA
KSO DOOSAN – HUTAMA KARYA

JOB SAFETY ANALYSIS & RISK ASSESSMENT

(Nomor JSA) KDH-JSA-01 DEPARTMENT :
Engineering, Construction
anggal) Juli 2017 - Agustus 2017 (Bagian/Fungsi)
SUPERVISOR :
ekerjaan) Soil Test & Investigation (Geotechnical Activities) M. Irfan. B & M. Ekky Gigih
(Pengawas)
LOCATION Muara Tawar CCPP Add On 2,3,4 Project, Bekasi
(Lokasi)

CTIVE EQUIPMENT REQUIRED TO PERFORM THIS JOB

PELINDUNG YANG DIPERLUKAN UNTUK MELAKSANAKAN PEKERJAAN)

Y HELMET X EAR PLUG/EAR MUFF X RUBBER GLOVES FIRE EXTINGUISHER

Y SHOES X RUBBER BOOT X FULL BODY HARDNESS LOCK OUT/TAG OUT
Y GLASSES X FACE SHIELD CHEMICAL COAT OIL SPILL KIT

N GLOVES X APRON RESPIRATOR/SCBA WORK PERMIT REQUIRED

ER GLOVES DUST/GAS MASKER WELDING CAP OTHER : LIFE VEST/ PELAMPUNG

QUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBL
LEVEL PERSONAL
AN LANGKAH DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUN
MENIMBULKAN BAHAYA) RESIKO) JAWAB)
isasi peralatan 1. Kecelakaan Lalu lintas. H 1. Pengemudi harus memiliki SIM dan mengetahui
2. Menabrak Orang. batas rambu-rambu lalu lintas. Foreman, Engine
Construction Te
3. Mobil Terbalik. H 2. Memastikan Kendaraan yang di HSE Team
gunakan dalam kondisi yang baik dan aman.
asangan pembatas trap aktivitas 1. Terluka M 1 Lakukan toolbox meeting sebelum mulai kerja
nvestigation 2. Tangan terjepit M 2 Pastikan pekerja sudah di induksi dari kontraktor/ Owner Foreman, Engine
3. Tertabrak kendaraan/ Kecelakaan H 3 Pastikan traffic sign sudah terpasang pada tempatnya Construction Te
4 Diawasi langsung sama pengawas HSE Team

10 of 21
QUENCE OF BASIC JOB STEPS
AN LANGKAH DASAR PEKERJAAN)
ading Peralatan Bore Hole.
POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBL
LEVEL PERSONAL
Foreman, Engine
(POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) Construction
(PENANGGUN Te
MENIMBULKAN BAHAYA) RESIKO) HSE Team
JAWAB)
1. Terjepit, tersandung H 1. Memakai Alat Pelindung Diri ( Helm, Kaca mata
sarung tangan, dst)
M Foreman, Engine
2. Kejatuhan benda keras 2. Melakukan Safety Talk/ TBM sebelum bekerja.
Construction Te
3. Mengetahui berat beban yang diangkat. HSE Team
H 4. Mengetahui cara pengangkatan manual (Lifting).
11 of 21
QUENCE OF BASIC JOB STEPS
AN LANGKAH DASAR PEKERJAAN)
asangan instalasi bor pile.
es pengeboran
eksi air ke rod bore
rjaan Surveying Soil Investigation
urveying dan Topografi
ydro-Oceanography Survey
athimetry/ Test of Seawater Quality
obilisasi Equipment
POTENTIAL ACCIDENT OF HAZARDS
LEVEL
(POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT
MENIMBULKAN BAHAYA) RESIKO)
1. Peralatan Kerja mengenai pekerja.
2. Pemasangan tidak sempurna.
3. Peralatan Bore Pile rusak
4. Bore Pile Tumbang
- Terkena / merusak Fasilitas Bawah
Tanah.
- Sling Putus
- Pipa bor / Rod bore patah.
- Mata bor rusak.
- Percikan air mengenai muka
- Peralatan Kerja mengenai pekerja
- Pemasangan peralatan tidak sempurna
- Terjatuh ketika proses pengambilan sampling
berlokasi di laut
- Kecelakaan Lalu Lintas
- Menabrak Orang/ Makhluk hidup lainnya
- Peralatan Terjatuh.
12 of 21
RISK RECOMMENDED SAFE JOB PROCEDURES RESPONSIBL
PERSONAL
(REKOMENDASI PROSEDUR KERJA SECARA AMAN) (PENANGGUN
JAWAB)
M - Memakai Alat Pelindung Diri ( Helm, Kaca Mata
sarung tangan )
- Melakukan Safety Talk sebelum bekerja.
M - Cek semua unit bore pile dan pastikan terpasang
Foreman, Engine
dengan lengkap dan sempurna
Construction Te
M - Inspeksi semua unit bore pile seperti tripod, sling, HSE Team
genset, as bored, drum, Chain block, dst.
M - Pastikan Bore pile berdiri kokoh dan lengkap
semua unit peralatannya.
H - Lakukan survey terlebih dahulu di Lokasi Kerja
- Tanyakan kepada pemilik area tentang fasilitas
fasilitas bawah tanah.
M - Pakai sling yang masih bagus ( tidak berserabut
tidak ada bending.
- Jangan gunakan sling yang tidak layak pakai.
M Foreman, Engine
- Pastikan pipa telah di inspeksi terlebih dahulu
Construction Te
dan dalam kondisi yang baik ( tidak ada crack ).
HSE Team
M - Pastikan mata bor telah sesuai dengan kondisi /
jenis lapisan tanah .
M - Pastikan kondisi slang dalam keadaan baik
( Tidak bocor ).
- Pastikan klam sambungan slang terpasang
dengan baik
M - Memakai Alat Pelindung Diri ( Helm, Kaca Mata
sarung tangan )
M - Cek semua unit peralatan dan pastikan terpasang Foreman, Engine
sempurna Construction Te
H - Pastikan disediakannya perahu/ jenis dengan kelengkapan HSE Team
Life Vest/ Pelampung, Pastikan pekerja mengerti Prosedur Kerja
di air (Working Over Water)
M - Pengemudi harus mematuhi rambu-rambu
lalu lintas.
M - Memastikan kendaraan yang gunakan dalam kondisi Foreman, Engine
yang baik & siap untuk digunakan. Construction Te
M - Memastikan peralatan tersusun dengan rapi HSE Team
dan terikat dengan baik.
QUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK RECOMMENDED SAFE JOB PROCEDURES Foreman, Engine
RESPONSIBL
LEVEL Construction
PERSONAL Te
AN LANGKAH DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ (TINGKAT (REKOMENDASI PROSEDUR KERJA SECARA AMAN) HSE Team
(PENANGGUN
MENIMBULKAN BAHAYA) RESIKO) JAWAB)

PELAKSANA PEKERJAAN DIPERIKSA OLEH PENGAWAS PEKERJAAN

( ) ( ) ( ) ( ) ( )
Engineering/ Construction KSO HSE Manager Project Manager
KONSORSIUM DOOSAN - HUTAMA KARYA PT. PLN (Persero) PT. PJB UP PLTGU Muara Taw

13 of 21
 MUARA TAWAR COMBINED CYCLE POWER PLANT BLOCK 2, 3 & 4 ADD-ON
PROJECT, BEKASI, INDONESIA

JOB SAFETY ANALYSIS & RISK ASSESSMENT

JSA no. (Nomor JSA) JSA/MRT-CV/171/I/2020 DEPARTMENT :
En
Date (Tanggal) Tuesday, January 07, 2020 (Bagian/Fungsi)
SUPERVISOR :
JOB (Pekerjaan) Concreting work Sampling System Foundation
(Pengawas)
LOCATION
(Lokasi)

PROTECTIVE EQUIPMENT REQUIRED TO PERFORM THIS JOB

(ALAT PELINDUNG YANG DIPERLUKAN UNTUK MELAKSANAKAN PEKERJAAN)

SAFETY HELMET X EAR PLUG/EAR MUFF RUBBER GLOVES FIRE

SAFETY SHOES RUBBER BOOT FULL BODY HARNESS LOC
X
DOUBLE LANYARD
SAFETY GLASSES X FACE SHIELD CHEMICAL COAT OIL S

COTTON GLOVES X APRON RESPIRATOR/SCBA WOR

LEATHER GLOVES DUST/GAS MASKER WELDING CAP X OTH

SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
1. Equipment/material mobilziation
POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROC
RISIKO)
(POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA S
MENIMBULKAN BAHAYA)
1. Existing crossing road drainage culvert damage 3 2 M 1. Protect crossing drainage culvert using steel plate
2. Soil from equipment tires 2. Conduct routine road access cleaning
2 2 R
3. Hit by equipment maneuver 3. Provide signal man to direct equipment maneuve
3 1 M

4. Hit by material maneuver 4. Install 2 (two) tagline while mobilize rebar/formwo

3 1 M

14 of 21
 SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
2. Rebar installation
3. Formwork installation
POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROC
RISIKO)
(POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA S
MENIMBULKAN BAHAYA)
1. Stumble by material 2 1 R 1. Conduct good housekeeping before and after fini
2. Scratch by material 2 2 R 2. Use cotton glove while working at rebar fabricatio
3. Hit by rebar material 2 2 R 3. Conduct TBM and inform regarding work commun
4. Lightning strike 5 1 E 4. Stop the work when rain potentially occur
5. working at height 5. Conduct safety briefing before work, remind work
5 2
E harness and tuck on strong structure
6. Conduct housekeeping before and after work, no
6. Material fall 5 2 E
the edge of working area
7. Conduct housekeeping before and after work, bin
7. Strong wind 3 2 M
thrown off by wind
8. Hot work 3 2 M 8. Provide fire extinguisher at welding point
1. Stumble by untidy material 2 1 R 1. Conduct good housekeeping before and after fini
2. Scratch by material 2 2 R 2. Use cotton glove while working at rebar fabricatio
3. Hit by formwork material 2 2 R 3. Conduct TBM and inform regarding work commun
4. Lightning strike 5 1 E 4. Stop the work when rain potentially occur
5. working at height 5. Conduct safety briefing before work, remind work
5 2
E harness and tuck on strong structure
6. Material fall 6. Conduct housekeeping before and after work, no
5 2
E the edge of working area
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 SEQUENCE OF BASIC JOB STEPS
(URUTAN LANGKAH DASAR PEKERJAAN)
4. Concreting work
5. Working platform scaffolding installation
POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROC
RISIKO)
(POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA S
MENIMBULKAN BAHAYA)
7. Strong wind 7. Conduct housekeeping before and after work, bin
3 2 M
thrown off by wind
1. Stumble by untidy material 2 1 R 1. Conduct good housekeeping before and after fini
2. Concrete material exposure 2 2 R 2. Provide glove for worker who directly contact with
3. Hit by concrete mixer maneuver 2 2 R 3. Provide signal man to direct concrete mixer truck
4. Hit by concrete pump maneuver 2 2 R 4. Provide signal man to direct concrete pump mane
5. Concrete spill below concrete pump inlet 5. Put plastic sheet below CP inlet to avoid direct co
2 2 R
and existing ashpalt road
6. Unergonomic working position 1 2 R 6. Brief worker regarding ergonomic way to work
1. Stumble by untidy material 1. Conduct good housekeeping before and after fini
2 1 R

2. Scratch by material 2. Use cotton glove while working at rebar fabricatio

2 2 R

3. Hit by formwork material 3. Conduct TBM and inform regarding work commun
2 2
R
4. Lightning strike 5 1 E 4. Stop the work when rain potentially occur
5. working at height 5 2 E 5. Conduct safety briefing before work, remind work
6. Material fall harness andhousekeeping
6. Conduct tuck on strongbefore
structure
and after work, no
5 2
E the edge of working area
7. Strong wind 7. Conduct housekeeping before and after work, bin
3 2 M
thrown off by wind
8. Wrong platform installation 5 2 E 8. Scaffolding working platform installation by certifie
9. Wrong scaffolding installation use 9. Provide scaffolding tagging to inform whether it is
5 2 E

6. Formwork removal and curing
1. working at height 1. Conduct safety briefing before work, remind work
5 2
E harness and tuck on strong structure
2. Stumble by untidy material 2. Conduct good housekeeping before and after fini
2 1 R

3. Hit by formwork material 3. Conduct TBM and inform regarding work commun
2 2
R
4. Material fall 4. Conduct housekeeping before and after work, no
5 2
E the edge of working area
7. Finishing work 1. working at height 1. Conduct safety briefing before work, remind work
5 2
E harness and tuck on strong structure
16 of 21
 SEQUENCE OF BASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROC
RISIKO)
(URUTAN LANGKAH DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA S
MENIMBULKAN BAHAYA)
2. Stumble by untidy material 2. Conduct good housekeeping before and after fini
2 1 R

3. Hit by formwork material 2 2 R 3. Conduct TBM and inform regarding work commun
4. Material fall 4. Conduct housekeeping before and after work, no
5 2
E the edge of working area
5. Construction waste 2 2 R 5.Conduct general housekeeping after work finish a
Keterangan : R : Rendah M: Moderat T: Tinggi E: Ekstrim

DISIAPKAN OLEH DIPERIKSA OLEH MENYETUJUI

( ) ( ) ( ) (
Supervisor Construction Manager Project HSE Manager Konsultan super
KONSORSIUM DOOSAN - HUTAMA KARYA

17 of 21
 MUARA TAWAR COMBINED CYCLE POWER PLANT BLOCK 2, 3 & 4 ADD-ON
PROJECT, BEKASI, INDONESIA
KSO DOOSAN – HUTAMA KA

JOB SAFETY ANALYSIS & RISK ASSESSMENT

JSA/MRT-CV/171/I/2020 DEPARTMENT :
Engineering, Construction
Tuesday, January 07, 2020 (Bagian/Fungsi)
SUPERVISOR :
Concreting work Sampling System Foundation WOWO SUWARSO
(Pengawas)
LOCATION HRSG
(Lokasi)

ENT REQUIRED TO PERFORM THIS JOB

NG DIPERLUKAN UNTUK MELAKSANAKAN PEKERJAAN)

X EAR PLUG/EAR MUFF RUBBER GLOVES FIRE EXTINGUISHER

RUBBER BOOT FULL BODY HARNESS LOCK OUT/TAG OUT
X
DOUBLE LANYARD
X FACE SHIELD CHEMICAL COAT OIL SPILL KIT

X APRON RESPIRATOR/SCBA WORK PERMIT REQUIRED

DUST/GAS MASKER WELDING CAP X OTHER : BARRICADE

ASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROCEDURES
RISIKO)
DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA SECARA AMAN)
MENIMBULKAN BAHAYA)
obilziation 1. Existing crossing road drainage culvert damage 3 2 M 1. Protect crossing drainage culvert using steel plate
2. Soil from equipment tires 2. Conduct routine road access cleaning
2 2 R
3. Hit by equipment maneuver 3. Provide signal man to direct equipment maneuver
3 1 M

4. Hit by material maneuver 4. Install 2 (two) tagline while mobilize rebar/formwork material using crane
3 1 M

18 of 21
ASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROCEDURES
RISIKO)
DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA SECARA AMAN)
MENIMBULKAN BAHAYA)
1. Stumble by material 2 1 R 1. Conduct good housekeeping before and after finish work everyday
2. Scratch by material 2 2 R 2. Use cotton glove while working at rebar fabrication/installation
3. Hit by rebar material 2 2 R 3. Conduct TBM and inform regarding work communication
4. Lightning strike 5 1 E 4. Stop the work when rain potentially occur
5. working at height 5. Conduct safety briefing before work, remind worker to always use full body
5 2
E harness and tuck on strong structure
6. Conduct housekeeping before and after work, not to place any material on
6. Material fall 5 2 E
the edge of working area
7. Conduct housekeeping before and after work, bind material which easy to
7. Strong wind 3 2 M
thrown off by wind
8. Hot work 3 2 M 8. Provide fire extinguisher at welding point
1. Stumble by untidy material 2 1 R 1. Conduct good housekeeping before and after finish work everyday
2. Scratch by material 2 2 R 2. Use cotton glove while working at rebar fabrication/installation
3. Hit by formwork material 2 2 R 3. Conduct TBM and inform regarding work communication
4. Lightning strike 5 1 E 4. Stop the work when rain potentially occur
5. working at height 5. Conduct safety briefing before work, remind worker to always use full body
5 2
E harness and tuck on strong structure
6. Material fall 6. Conduct housekeeping before and after work, not to place any material on
5 2
E the edge of working area

Fo
C

19 of 21
ASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROCEDURES
RISIKO)
DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA SECARA AMAN)
MENIMBULKAN BAHAYA)
7. Strong wind 7. Conduct housekeeping before and after work, bind material which easy to
3 2 M
thrown off by wind
1. Stumble by untidy material 2 1 R 1. Conduct good housekeeping before and after finish work everyday
2. Concrete material exposure 2 2 R 2. Provide glove for worker who directly contact with concrete material
3. Hit by concrete mixer maneuver 2 2 R 3. Provide signal man to direct concrete mixer truck maneuver
4. Hit by concrete pump maneuver 2 2 R 4. Provide signal man to direct concrete pump maneuver
5. Concrete spill below concrete pump inlet 5. Put plastic sheet below CP inlet to avoid direct contact between concrete Fo
2 2 R
and existing ashpalt road C
6. Unergonomic working position 1 2 R 6. Brief worker regarding ergonomic way to work
olding installation 1. Stumble by untidy material 1. Conduct good housekeeping before and after finish work everyday
2 1 R

2. Scratch by material 2. Use cotton glove while working at rebar fabrication/installation

2 2 R

3. Hit by formwork material 3. Conduct TBM and inform regarding work communication
2 2
R
4. Lightning strike 5 1 E 4. Stop the work when rain potentially occur
5. working at height 5 2 E 5. Conduct safety briefing before work, remind worker to always use full body
6. Material fall harness andhousekeeping
6. Conduct tuck on strongbefore
structure
and after work, not to place any material on
5 2
E the edge of working area
7. Strong wind 7. Conduct housekeeping before and after work, bind material which easy to
3 2 M
thrown off by wind
8. Wrong platform installation 5 2 E 8. Scaffolding working platform installation by certified scaffolder
9. Wrong scaffolding installation use 9. Provide scaffolding tagging to inform whether it is safe or not safe to use
5 2 E

d curing 1. working at height 1. Conduct safety briefing before work, remind worker to always use full body
5 2
E harness and tuck on strong structure
2. Stumble by untidy material 2. Conduct good housekeeping before and after finish work everyday
2 1 R

3. Hit by formwork material 3. Conduct TBM and inform regarding work communication
2 2
R
4. Material fall 4. Conduct housekeeping before and after work, not to place any material on
5 2
E the edge of working area
1. working at height 1. Conduct safety briefing before work, remind worker to always use full body
5 2
E harness and tuck on strong structure
20 of 21
ASIC JOB STEPS POTENTIAL ACCIDENT OF HAZARDS RISK LEVEL(TINGKAT RECOMMENDED SAFE JOB PROCEDURES
RISIKO)
DASAR PEKERJAAN) (POTENSI DAPAT TERJADI KECELAKAAN/ SEV PROB EXPOSURE (REKOMENDASI PROSEDUR KERJA SECARA AMAN)
MENIMBULKAN BAHAYA)
2. Stumble by untidy material 2. Conduct good housekeeping before and after finish work everyday
2 1 R

3. Hit by formwork material 2 2 R 3. Conduct TBM and inform regarding work communication
4. Material fall 4. Conduct housekeeping before and after work, not to place any material on
5 2
E the edge of working area
5. Construction waste 2 2 R 5.Conduct general housekeeping after work finish all
Rendah M: Moderat T: Tinggi E: Ekstrim

AN OLEH DIPERIKSA OLEH MENYETUJUI

) ( ) ( ) ( )
ervisor Construction Manager Project HSE Manager Konsultan supervisi
KONSORSIUM DOOSAN - HUTAMA KARYA

21 of 21