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HEALTH AND SAFETY

PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
Unit PT Jawamanis Rafinasi PROCEDURE Page : 1 of 21
WILMAR GROUP INDUSTRY HR & Admin / Health and Safety Section Revision No :0

Prepared By, Checked By, Approved By,

Oom Mukaromah Hari Suthya Tri Mintorogojati Oom Mukaromah


Health & Safety SH HR & Admin Manager Factory Manager MR

1. Tujuan dan Ruang lingkup


PURPOSE AND SCOPE
1.1 Tujuan
Purpose
1.1.1 Prosedur ini merupakan metode untuk mengidentifikasi dan mengevaluasi aspek dampak K3
dari aktivitas PT. Jawamanis Rafinasi.
This procedures to identify and evaluate the aspects impacts of HS from all activities business
unit in PT. Jawamanis Rafinasi
1.1.2 Memberi jaminan bahwa tingkat bahaya dan resiko yang akan terjadi untuk setiap jenis
pekerjaan dapat diketahui lebih dini.
To provide assurance that the level of danger and risk that will occur for each type of work
can be identified early
1.1.3 Untuk menentukan prioritas perbaikan yang mendasar pada penilaian resiko yang paling tinggi
sebagai pertimbangan untuk menentukan perencanaan pengelolaan program K3.
Determining the fundamental priority at the highest risk rating, as consideration for
determining planning HS management program

1.2 Ruang Lingkup


Scope
Ruang lingkup prosedur ini berhubungan dengan dampak Kesehatan Keselamatan Kerja, yang
diakibatkan oleh aktivitas/ operasional yang ada di PT. Jawamanis Rafinasi
This procedure applies to the process of identifying aspects and impacts of HS, due to the
activities /operations in PT. Jawamanis Rafinasi
2. Tanggungjawab
RESPONSIBILITY
2.1 HS Officer
Bertanggungjawab dalam melakukan identifikasi aspek dampak K3 untuk semua stasiun
kerja terkait.

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
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WILMAR GROUP INDUSTRY HR & Admin / Health and Safety Section Revision No :0

HS Officer
Responsible for identifying aspects impacts of HS for all work station related.
2.2 Petugas Dokumen
Bertanggungjawab dalam mengelola dan menginventarisasi dokumen aspek dampak K3.
Document Control
Responsible for manage and inventory aspects impact of HS document.
2.3 Ka. Dept/Bagian
Bertanggung jawab dalam melaksanakan identifikasi aspek dampak K3 distasiun kerja
terkait.
Dept/Section Head
Responsible for implementing idetification aspects impacts of HS in work station related
2.4 Pimpinan Unit
Bertanggungjawab dalam memantau pelaksanaan identifikasi aspek dampak K3 pada
masing-masing stasiun kerja.
Unit Head
Responsible for monitoring implementation identification aspects impacts of HS on each
work station.

3. Definisi
DEFINITION
3.1 K3 Officer
Personil yang bertanggungjawab dalam pengelolaan dan pemantauan K3 (Keselamatan dan
Kesehatan Kerja)
HS Officer
Person who responsible organize and controlling the occupational health and safety
3.2 Aspek K3
Elemen dari aktivitas organisasi, produk atau pelayanan jasa yang berinteraksi dengan
lingkungan dan K3.
Aspect of HS
Elements of the organization's activities, products or services that interact with the health and
safety
3.3 Dampak K3
Perubahan lingkungan baik yang merugikan maupun yang menguntungkan yang diakibatkan

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
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WILMAR GROUP INDUSTRY HR & Admin / Health and Safety Section Revision No :0

oleh aktivitas organisasi, produk ataupun jasa secara sendiri-sendiri atau gabungan.
Impact of HS
Changes of environment in either harm or profitable caused by activities organizations,
products or services individually or in combination
3.4 Bahaya
Benda, bahan (zat), aktivitas atau kondisi yang potensial menyebabkan cedera, kerusakan
atau kerugian.
Danger
Things, materials (substances), activities or conditions that potentially cause injury, damage
or loss
3.5 Resiko
Kemungkinan satu atau lebih keadaan bahaya yang dapat terjadi dan mengakibatkan
kerugian di beberapa hal.
Risk
The possibility of one or more of a hazard that can occur and cause losses in some cases.
3.6 Kondisi Normal
Suatu keadaan dimana aktivitas atau komponen kerja (manusia/ peralatan) dioperasikan
dalam kondisi normal, misalnya kondisi kerja yang dilakukan setiap hari dan sudah
menjadi rutinitas.
Normal Condition
condition in which the activity or work components (human / equipment) is operated under
normal conditions, such as working conditions are carried out every
day and have become routine.
3.7 Kondisi Abnormal
Suatu keadaan dimana aktivitas atau komponen kerja (manusia/ peralatan) dioperasikan tidak
dalam kondisi normalnya, karena adanya penambahan/ pengurangan beban kerja,
misalnya saat startup/shut down, dan pada saat loading tinggi (over production).
Abnormal Condition
A condition in which the activity or work components (human / equipment) is not operated in
normal conditions, because addition / reduction in workload, for example at start up / shut
down, and at high loading (over production).
3.8 Kondisi Emergency
Suatu kondisi dimana aktivitas atau komponen kerja (manusia/ peralatan) terjadi pada saat
kondisi opersional tidak stabil, bisa diakibatkan karena pengaruh alam (bencana alam,
seperti banjir, tsunami dan gempa bumi), ataupun kondisi lainnya (seperti kebakaran,
meninggal dunia, dan lain sebagainya).
This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
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WILMAR GROUP INDUSTRY HR & Admin / Health and Safety Section Revision No :0

Emergency Condition
A condition in which activity or employment component (human / equipment) occurs when the
unstable operational conditions, can be caused due to the influence of nature (natural
disasters, like floods, tsunamis and earthquakes), or other conditions (such as fire, dies world,
and so forth).
Nilai Resiko
Hasil perkalian antara total nilai tingkat kemungkinan dengan total nilai tingkat
keparahan. Nilai ini digunakan sebagai dasar untuk menentukan nilai resiko.
Risk Value
Results of multiplication between the total value of probability level with a total value of
severity. This value is used as the basis for determining the value of risk.
3.9 Skala Prioritas
Besaran nilai tertinggi yang diutamakan sebagai dasar pembuatan program K3.
Priority Scale
Magnitude of the highest value is preferred as a basis for making HS program
3.10 K3
Keselamatan dan Kesehatan Kerja
HS
Health and Safety

4. Prosedur
PROCEDURE
4.1 Identifikasi aspek dampak K3 meliputi seluruh operasional dengan melihat/
mempertimbangkan:
Identification aspect impact of HS covers all of operational by looking/ consider at :
a. Aktifitas Produk dan Potensial
Potential activities and products
b. Aspek/ Bahaya Aktual/ Potensial
Aspects/Hazard Current/Potential
c. Sumber Aspek/ Bahaya
Source of Aspects/Hazard
d. Dampak/ Resiko Aktual/ Potensial
Impacts/Risk Actual/Potential

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
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e. Kondisi Normal/ Abnormal/ Emergency


Normal/Abnormal/Emergency Conditions
4.2 K3 Officer akan membuat/ menyiapkan jadwal dan formulir pendukung untuk
melakukan identifikasi aspek dampak K3 untuk masing-masing departemen/bagian.
HS Officer will make / prepare schedules and supporting forms to identify the aspects impacts
of HS for each department / section

4.3 K3 Officer memberikan briefing sebelum proses identifikasi aspek dampak K3


dilakukan oleh masing-masing Dept. Head sekaligus memberikan formulir pengisiannya.
HS Officer gave a briefing before the process identifying aspects impact of HS which made by
each Department Head / Section Head well as provide a form filling
4.4 Proses identifikasi aspek dampak K3 dilakukan oleh masing-masing Dept. Head dan
dibantu oleh K3 Officer.
Identification process aspects impact of HS made by each Department Head /Section and
assisted by HS Officer.
4.5 Semua potensi yang mungkin dapat ditimbulkan akibat aktivitas produk dan jasa wajib
didaftarkan dalam identifikasi aspek dampak. Hal ini bisa juga berlatar belakang dari jenis
kecelakaan yang mungkin pernah terjadi.
All potential that may be incurred due to product and service activities shall be registered in
the identification aspects impact of HS. This could also background of this type of accident
that may never happen.
4.6 Hasil identifikasi setiap bagian dikumpulkan kepada K3 Officer, yang selanjutnya akan
dilakukan pembobotan nilai tingkat kemungkinan dan keparahan dari masing-masing
dampak K3 bersama dengan Dept. Head terkait dan K3 Officer.
The identification of each section is collected to HS Officer, who will then be weighted value
of the level of probability and severity of each aspects impact of HS along with the Head
Department /Section Chef related and HS Officer
4.7 Apabila dari hasil identifikasi aspek dampak K3 pada tahun sebelumnya, terdapat
program perbaikan K3 yang belum efektif untuk mengurangi potensi dampak K3, maka
aktivitas aspek yang menjadi sumber penyebab wajib dimasukan ke dalam pelaksanaan
identifikasi aspek dampak K3 pada tahun berjalan.
If the results identification aspect impact of HS on the previous year, there are improvement
program of HS that has not been effective to reduce the potential impact of HS, then the
aspect of activity is the source of the cause shall be entered into the implementation of the
identification aspect HS impact on the current year.

4.8 Tingkat Kemungkinan terdiri dari beberapa penilaian, yaitu :


Probability Level of several assessment, are :
This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
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WILMAR GROUP INDUSTRY HR & Admin / Health and Safety Section Revision No :0

a. Frekuensi Proses (FP)


Frekuensi terjadinya proses dalam skala waktu tertentu (dinilai dari aktivitas aspek
yang dilakukan).
Process Frequency
Frequency occurrence of processes within a certain time scale (assessed from the
aspects of activities undertaken)
b. Frekuensi Kejadian (FK)
Frekuensi terjadinya dampak dalam skala waktu t e r t e n t u ( d i n i l a i d a r i
dampak yang terjadi).
Frequency of Occurrence
Frequency occurrence of impacts within a certain time scale (assessed from the impact
occurred)
c. Kemampuan Personil (KP)
Terkait kemampuan personil/operator dalam melaksana kan pekerjaannya.
Personnel Capability
Related capabilities of personnel/operator in performing his job.
 Tehnik
Bagaimana kompetensi personil/ operator secara teknis dalam melakukan
pekerjaannya.
Technical
How is the competence of personnel/operators are technically in doing their jobs
 K3 Knowledge
Bagaimana pengetahuannya mengenai potensi bahaya/ aspek K3 terkait dengan
pekerjaannya.
HS Knowledge
What knowledge about the potential hazard/aspects of HS related to their job
d. Sistem Perlindungan (SP)
Berupa perlindungan yang telah diberikan/dilakukan untuk meminimalkan potensi
terjadinya dampak, dapat berupa APD, sistem terkait, dan sebagainya.
Protection System (SP)
Represent the protection that has been given/taken to minimize potential impacts, can be
either PPE, related system, and etc.

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
PROSEDUR
IDENTIFIKASI PENILAIAN
RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
Effective Date : January 2, 2013
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WILMAR GROUP INDUSTRY HR & Admin / Health and Safety Section Revision No :0

 Standar
Apakah sistem perlindungan yang diberikan sudah memenuhi standar.
Standard
Is the system of protection provided have fulfill the standard
 Fungsi
Apakah penggunaan sistem perlindungan tersebut sudah sesuai dengan
fungsinya.
Function
Does the use of these protection systems are in accordance with its function.
 Prosedur
Apakah mekanisme persyaratan penggunaan sistem perlindungan sudah
terdapat dalam prosedur kerja terkait.
Procedure
Are the mechanisms of protection systems have terms of use contained in the
relevant work procedures
e. Pemeriksaan dan Pemeliharaan
Untuk melihat apakah prinsip preventive maintenance telah dijalankan.
Inspection and Maintenance
To see whether the principles of preventive maintenance has been running
 Jadwal
Apakah pemeriksaan dan pemeliharaan tersebut mempunyai jadwal tertentu.
Schedule
Does inspection and maintenance has a specific schedule
 Inspeksi (Preventive)
Apakah inspeksi pemeriksaan dan pemeliharaan tersebut dijalankan di
departemen/ bagian terkait.
Inspections (Preventive )
Does inspection and maintenance checks are carried out in the
department/departments concerned.
4.9 Tingkat Keparahan terdiri dari beberapa penilaian, yaitu :
Severity level of several assessment, are :
a. Aspek Hukum
Tingkatan hukum yang mendasari dari suatu aktivitas produk dan jasa.
This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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Legal Aspects
Level of the underlying law of a products and services
activities.
b. Dampak Lingkungan
Potensi besarnya tingkat pencemaran yang ditimbulkan akibat dari dampak yang
terjadi.
Environmental Impact
The potential size of the pollution level caused by the impact that occurred
c. Dampak Terhadap Manusia
Potensi besarnya keparahan kecelakaan yang terjadi pada personil/ operator akibat dari
dampak yang terjadi Bisnis dan Reputasi: Sisi bisnis dan reputasi yang diakibatkan
oleh dampak yang terjadi.
Impact on Human
The potential severity of the accidents that occurred in the personnel/operators resulting
from impacts occurring
 Effect ke Produksi
Apakah dari dampak yang ditimbulkan dapat mengakibatkan terhentinya kegiatan
produksi.
Effect to the production
Are the impacts can lead to cessation of productionactivities.
 Image Perusahaan
Apakah dari dampak yang ditimbulkan dapat berdampak terhadap image
perusahaan (image menjadi n egative).
Image Company
Does the impact could affect the company image (a negative image)
 Kerugian Finansial
Berapa kemungkinan nilai nominal kerugian yang ditimbulkan dari dampak yang
terjadi.
Financial Losses
How the possibility of a nominal value of losses incurred from the impact of what
happened.
4.10 Hasil pembobotan tersebut akan direview/analisa untuk menentukan skala prioritas dari
hasil identifikasi aspek dampak K3 tersebut. Proses ini dilakukan oleh seluruh Head
Dept/Ka. Bagian, K3 Officer dan Pimpinan Unit.

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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The weightings will be reviewed/analysis to determine the scale of priorities of the identified
aspects of the impact of these HS. This process is conducted by all Department Head/Section
Chief, HS Officer and Head of Unit.
4.11 Skala prioritas dapat dilakukan dengan skala tinggi, sedang dan rendah berdasarkan range
total nilai dari risk value.
The scale of priority can be done with high, medium and low range based on the total value
of the risk value.
4.12 Adapun skala prioritas yang dijadikan Program Perbaikan K3 adalah skala tinggi.
Sedangkan skala sedang dan rendah akan dijadikan Program Perbaikan Berkelanjutan
(Continued Improvement) berdasarkan tingkat kepentingan.
The scale of priority which made Improvement Program of HS is a high scale. While the
medium and low scale will be used as Continuous Improvement Program (Continued
Improvement) based on the level of interest.
4.13 Proses identifikasi aspek dampak K3 agar dapat dilakukan minimal 1 (satu) tahun sekali
dan atau jika ada perubahan proses/bahan baru/mesin atau peralatan baru yang
dipergunakan dalam kegiatan operasional.
Process of identification aspect impact HS to be performed at least once a year and or if
there is a change process or new materials/machines or new equipment used in operating
activities.

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
HEALTH AND SAFETY
PROCEDURE
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RESIKO
Document No : HSP-JMR-001
IDENTIFICATION RISK ASSESSMENT
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5. Pelaksanaan Identifikasi Aspek & Dampak K3


DIAGRAM KETERANGAN
1. K3 Officer menetapkan jadwal untuk pelaksanaan
MULAI
(START)
identifikasi aspek dampak K3 untuk masing-masing
departemen/bagian dan menyiapkan formulir
pengisiannya
Menetapkan jadwal HS Officer set a timetable for the implementation
(Setting schedule) identification aspect impact of HS for each
department/section and prepare the filling form
2. K3 Officer memberikan briefing pembuatan
Memberikan briefing identifikasi aspek dampak K3 dan pengisian
(Giving briefing) formulirnya sebelum melakukan proses identifikasi
aspek dampak K3
Identifikasi
Aspek HS Officer give a briefing making the identification
Dampak LK3
Melakukan identifikasi aspects impact of HS and filling the form before
pada tahun
sebelumnya (Doing identification) doing the process of identifying aspects impact of
(Identificatio HS.
n aspects
impacts of
3. Setiap Head Dept/Ka. Bagian melakukan identifikasi
LK3 in the aspek dampak K3 dibagian masing-masing dibantu
previous Mengumpulkan hasil identifikasi
year)
oleh HS Officer
(Collect result of identification)
(5) Each Head Department/Section Head identifies
aspects impact of HS for each section and assisted
by HS Officer
Melakukan pembobotan nilai 4. K3 Officer mengumpulkan hasil identifikasi aspek
(Doing weighting value) dampak K3 tersebut, Apabila dari hasil identifikasi
aspek dampak K3 pada tahun sebelumnya, terdapat
Tidak Sesuai
program perbaikan K3 yang belum efektif untuk
mengurangi potensi dampak K3 wajib dmasukan
Evaluasi
pada tahun berjalan
(Evaluation) HS Officer collects the results of the identification
aspects impact of HS, If the results of the
identification aspect impact of HS on the previous
Sesuai year, there are improvementEHS program that has
not been effective to reduce the potential impact of
Menentukan skala prioritas
HS, then shall be entered to the curent year.
(Determine scale of priority) 5. K3 Officer bersama dengan Head Dept/Ka. Bagian
terkait melakukan pembobotan nilai tingkat
kemungkinan dan tingkat keparahan dari masing-
masing dampak K3.
SELESAI HS Officer together with the Head
(FINISH) Department/Section Head related have weighting
the level of probability and severity of each HS
impact.
6. K3 Officer dan Head Dept/Ka. Bag akan

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mengevaluasi dari penilaian pembobotan tersebut.


HS Officer and Head Department/Section Had will
evaluate these weightings assessment.
7. Menentukan skala prioritas yang dilakukan oleh HS
Officer, Head Dept/Ka. Bagian dan Pimpinan Unit
untuk membahas pembuatan program K3.
Determining the priority scale conducted by HS
Officer, Head Department/Head Section and Unit
Leaders to disccuss about making program of HS.

Form Identifikasi Aspek Dampak K3


Aspects Identification Form Impact HS
Terdiri dari 2 KOLOM yaitu Kolom Identifikasi Aspek & Kolom Analisa Dampak/Resiko
Which consists of 2 COLUMN Column Column Identification Aspects & Impact Analysis / Risk
IDENTIFIKASI ASPEK DAMPAK ANALISA…

Aspek/Bahay Sumber Normal/


Dampak/Resiko
Kode Aktifitas,Produ a Aktual/ Aspek/ Pengendalian
No Aktual/Potensia Abnorma/
Area k & Potensial ….
Potensial Bahaya l
Emergency
1 2 3 4 5 6 7 8
Gangguan
Membuat
1 Terhirup Uap HCL Pernafasa/Kerac Normal
Adukan HCL
unan
Membuat Terkena
2 HCL Iritasi Kulit Normal
Adukan HCL larutan

Tata cara Pengisian Form:


Mechanism fillings form :
1. Kolom no.1 / Columns no. 1
 Diisi sesuai kode area yg disepakati oleh unit
Filled according to area code given by the unit
2. Kolom no.2 / Columns no. 2
 No urut identifikasi

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multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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 Number serial identification


3. Kolom no.3 / Columns no. 3
 Diisi sesuai aktifitas dari kegiatan operasional, aktifitas dari produk, aktifitas yang berpotensi
utk terjadi yang diidentifikasi,
 Filled according to the activities of operational activities, the activities of the products that have
the potential to occur were identified
4. Kolom no. 4 / Columns no. 4
 Diisi sesuai Aspek Bahaya yang actual terjadi ataupun yang berpotensi terjadi baik terhadap
manusia ataupun terhadap lingkungan
Filled according to the actual danger that have happen or potentially happen either on humans
or the environment

5. Kolom no.5 / Column no. 5


 Diisi sesuai sumber penyebab terjadinya yang diisi pada kolom 4
Filled according to the source of the cause which is filled in column 4
6. Kolom no.6 / Column no. 6
 Diisi sesuai dampak resiko yang actual terjadi ataupun yang berpotensi terjadi baik terhadap
manusia ataupun terhadap lingkungan
Filled according to the actual impact of the risks occur or potentially occur either on humans or
the environment
7. Kolom no.7 / Column no. 7
• Diisi dengan melihat isian pada kolom 3 apakah dalam kondisi :
Filled with view entries in column 3 whether the conditions :
 N : Normal
 A : Abnormal
 E : Emergency.

Selanjutnya petunjuk bagaimana mengisi kolom Analisa Dampak/ Resiko


Further instructions on how to fill a column of impact analysis / risk
ANALISA DAMPAK / RESIKO
Pengendalia Kemungkinan Keparahan Nilai Prioritas
n yang ada Resiko
saat ini FP FK KP SP PP JML A DL DTM RP JML
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multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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8 9 10 11 12 13 14 15 16 17 18 19 20 21

1.2 14.7 0.4


Belum Ada 5 2 4 2.5 1 3 4 8.42 124.279 1
6 6 2

8. Kolom no. 8 / Column no. 8


 Diisi sesuai pengendalian dari aktifitas yang diisi pada kolom 1
Filled according to the control of the activities that filled the first column
9. Kolom no. 9 s/d Kolom no. 14 / Column no. 9 until colomn No. 14
 Kolom 9 s/d kolom 14 adalah bagian dari Kolom Kemungkinan Terjadi. Cara pengisiannya
dengan melihat Tabel Kemungkinan ini
Column no. 9 until column no. 14 is a part of the Possibility Column. How to fill its by looking
at Possibitlity Table.
10. Kolom no. 15 s/d kolom 19 / Column no. 15 until colomn no. 19
 Kolom 15 s/d kolom 19 adalah bagian dari Kolom Keparahan Terjadi. Cara pengisiannya
dengan melihat Tabel Keparahan dibawah ini
 Column no. 15 until column no. 19 is a part of severity occurred. How to fill with see Severity
Table.
11. Kolom no. 20 / Column no. 20
 Isi Kolom 20 adalah hasil kolom 14 dikali dengn hasil kolom 19
Fill in Column no. 20 is the result of column no. 14 multiplied with columns no. 19
12. Kolom no. 21 / Column no. 21
 Diisi sesuai dari hasil kolom 20 yaitu menentukan prioritas dengan melihat hasil tertinggi dari
kolom 20
Filled according to the results of column no. 20 is determining the highest priority to see the
results of column no. 20
 Adapun rinciannya sebagai berikut :
The details are as follows :

Tabel Kemungkinan

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multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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Sistem Perlindungan Pemeriksaan & Kemampuan


SP Pemeliharaan PP Personil KP
Nila
FP FK Nilai Inspeksi Nilai EHS Nilai
i Stand Fungs Pros Jadwa
(Preventiv Teknis Knowl
ar i edur l
e) edge
>1
- Sesuai Baik Ada 0,63 Ada Dilakukan 1,25 Baik Baik 0,71
thn 1
Tdk
3 1x Sesuai Baik 1,26 Baik Cukup 1,42
Ada
bln-1 dlm 2
thn 1 thn Tdk Tidak Kuran
Sesuai Ada 1,89 Dilakukan 2,5 Baik 2,13
Baik ada g
Tdk Tdk
1 bln 2-3 x Sesuai 2,52
Baik Ada
-3 dlm 3 Cukup Baik 2,84
bln 1 thn Tdk
Baik Ada 3,15
Sesuai

4–5 Tdk Tdk Tidak


Baik 3,78 Ada 3,75
2 hr- x Sesuai Ada dilakukan
4 Cukup Cukup 3,55
1 bln dlm Tdk Tdk
1 thn Ada 4,41
Sesuai Baik
Kuran
> 5x Cukup 4,26
Haria Tdk Tdk Tdk Tidak Tidak g
dlm 5 5 5
n Sesuai Baik Ada ada dilakukan Kuran Kuran
1 thn 5,00
g g

Probability Table
Checking and Personnel
Protective System
Maintenance Capability
Val Valu Valu
FP FK Inspection EHS Nilai
ue Standar Funct Proce e Sched e Techn
(Preventiv Knowl
d ion dure ule ical
e) edge
>1 1 Appropi
- Good Have 0,63 Have Have done 1,25 Good Good 0,71
year ate
3 1 2 Appropi Haven Haven Have Done 2,5
Good 1,26 Good Good 1,42
mths- times ate ’t ’t
1 in 1
Appropi Not Have 1,89 Good Less 2,13
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multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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ate Good
year year
Appropi Not Haven
2-3 2,52
ate Good ’t
1- 3 times Enoug
3 Not Good 2,84
mths in 1 h
year Appropi Good Have 3,15
ate
Not
4–5 Haven Haven’t
2 Appropi Good 3,78 Have 3,75
time ’t Done
days- ate Enoug Enoug
ns in 4 3,55
1 Not h h
1 Not
mths Appropi Have 4,41
year Good
ate
>5 Enoug
Not Less 4,26
times Not Haven Haven Haven’t h
Daily 5 Appropi 5 5
in 1 Good ’t ’t Done
ate Less Less 5,00
year

Tabel Keparahan
Bisnis dan Reputasi

Dampak Dampak Efek


Nila Terhadap
Aspek Hukum Terhadap Terhadap Efek Terhadap Kerugia Nilai
i Image
Lingkungan Manusia Produksi n
Perusahaa
n
<.Rp 1
Tidak Tidak 0,42
Peraturan Sakit juta
Tidak ada atau
Umum Internal Ringan/Tidak Rp 1
hampir 1
Perusahaan Kehilangan hari juta s/d
mencemari Tidak Tidak 0,83
seperti PKB/PP kerja Rp 10
juta
>. Rp 10
Tidak Tidak 1,25
juta
Mencemari
Sakit <.Rp 1
lingkungan di Ya Tidak 1,67
Kebijakan LK3 ringan/kehilanga juta
area kerja 2
Perusahaan n hari kerja > 1
masing-masing
hari Rp 1
(< 50%)
Ya Tidak juta s/d 2,08
Rp 10
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juta
>.Rp 10
Ya Tidak 2,5
juta
<.Rp 1
Tidak Ya 2,92
juta
Mencemari
Peraturan
lingkungan di Rp 1juta
Daerah Rawat inap atau
area kerja 3 Tidak Ya s/d Rp 3,33
Kabupaten atau cidera berat
masing-masing 10 jt
Propinsi
(50%-100%)
>.Rp 10
Tidak Ya 3,75
juta
<.Rp
Ya Ya 4,17
1juta
Mencemari
Peraturan Akut/kronis atau Rp 1juta
Lingkungan di
Perundangan/Ke kehilangan fungsi 4 Ya Ya s/d Rp 4,58
Area Landscape
tentuan Nasional tubuh 10 juta
perusahaan
>.Rp 10
Ya Ya 5
juta
Mengakibatkan
banyak orang
meninggal
Assosiasi/Ketent
dunia dan/atau Meninggal dunia
uan/ Peraturan 5
berdampak (>1 orang)
Internasional
kepada
masyarakat
sekitar
Severity Table
Businness and Reputation
Environmen Valu Efec to Valu
Legal Aspects Humans Impact Efec to
t Impact e Company Loss Expense e
Production
Image

General Intern Haven’t Haven’t <Rp 1 million 0,42


Company
Regulations Never or
Sick/No Have
Like Company Almost Have 1
Lost Work Day Rp 1 s/d Rp
Regulations Pollution Haven’t Haven’t 0,83
10 million
/Work
Agreement

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multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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> Rp 10
Haven’t Haven’t 1,25
million

Have Have Haven’t <Rp 1 million 1,67


Pollution in
Sick/Lost Work
EHS Policy Each Work 2
Day > 1 day Rp 1 s/d Rp
Area (< Have Haven’t 2,08
10 million
50%)

>Rp 10
Have Haven’t 2,5
million

Haven’t Have <Rp 1 million 2,92


Have
Pollution in
Region Opname or Rp 1 s/d Rp 10
Each Work 3 Haven’t Have 3,33
Regulations Weight Defect million
Area (50%-
100%) >Rp 10
Haven’t Have 3,75
million
Have Have Have <Rp 1 million 4,17
Critical/Chronis
National Pollution in
or Lost Body 4 Rp 1 s/d Rp 10
Regulations All of Area Have Have 4,58
Function million
in Company
>Rp 10
Have Have 5
million

Have Caused
Provisions/ Many People
Die or Effect Have Died (>1
International 5  
to Society people)
Regulations Around the
Company

6. Dokumen Pendukung
Supporting Document
FORM Identifikasi Aspek Dampak K3 (FHSP-JMR-01-01)
Form Safety and Health Risk Assessment (FHSP-JMR-01-01)

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multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.
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7. Referensi
7.1 ISO 14001, OHSAS 18001
7.2 WSC Prosedur No. PROS-SD-03-01

1. LAMPIRAN
APENDDIX
DAFTAR MASTER DOKUMEN
MASTER LIST OF DOCUMENTS
NO DOCUMENT DESCRIPTION APPROVED BY DATE OF REV
NUMBER

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JMR QP-04, Form 4.1, Rev : 01, July 21, 2008

DAFTAR DISTRIBUSI DOKUMEN


DISTRIBUTION LIST OF DOCUMENTS
ISSUE RETURN
DOCUMENT NO : ISSUE TO : REV. REV. REMARK
DATE SIGN DATE SIGN
NO NO
                 
                 

                 

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JMR QP-04, Form 4.2, Rev : 01

“CONTROLLED DOCUMENT” STAMP

CONTROLLED DOCUMENT

FIG. 1

“UNCONTROLLED DOCUMENT” STAMP


UNCONTROLLED DOCUMENT
FOR REFERENCE ONLY

FIG. 2

“ABSOLETE DOCUMENT” STAMP


ABSOLETE DOCUMENT

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
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FOR REFERENCE ONLY

FIG. 3

This Health and Safety Procedure only applied to Unit PT Jawamanis Rafinasi, Wilmar Group. Prohibited to
multiply or copy this Health and Safety Procedure without written permit from Management of Wilmar Group.

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