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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION

Page: 1 of 32 Version: 3.4 DEPARTMENT


Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

PENDAHULUAN INTRODUCTION
Dokumen ini terdiri dari 2 bagian; Bagian 1 menjelaskan This document is comprised of two sub-sections; Section
tujuan dan gambaran dari Sitem Otoritas untuk Bekerja 1 explains the purpose and an overview of the Authority
(ATW), sementara pada bagian 2-5, 7 yang menjelaskan to Work (ATW) System, while sections 2-5,7 explain the
rincian prosedur penggunaan izin ATW. detailed procedure for use of the ATW permit.

LINGKUP SCOPE
Prosedur ini berlaku untuk karyawan PTAMNT dan mitra This procedure applies to employees and business
bisnis yang bekerja di area Proyek Batu Hijau PTAMNT. partners who are required to perform work at PTAMNT
Batu Hijau Operations.

Apa yang dimaksud dengan Sistem ATW? What is the ATW System?
Sistem ATW adalah: The ATW system is:
 Proses otorisasi kerja yang memuat tanggung jawab  A work authorization process that assigns
dan memastikan komunikasi yang efektif dan responsibilities and ensures effective communication
persetujuan untuk memulai bekerja antara pemilik and approval for work to commence between work
pekerjaan, pemilik area, dan supervisor kru kerja. owners, area owners and supervisors of work groups.
 Tujuan penerapan sistem ATW adalah untuk  The ATW system objective is ensuring that every
memastikan setiap orang yang melakukan tugas person conducting any task in any area is authorized
apapun di area kerja manapun mendapatkan otorisasi to work.
untuk bekerja.
 Otoritas untuk bekerja berlaku bagi setiap personel  The authority to work is required by every
atau tim kerja yang melakukan setiap person/team conducting every task in any location!
tugas/pekerjaan di setiap area kerja.

TUJUAN- Sistem Otorisasi untuk Bekerja (ATW) PURPOSE - Authority to Work (ATW) System
Sistem Otorisasi untuk Bekerja atau Authority to Work The purpose of the Authority to Work (ATW) System
(ATW) bertujuan untuk memastikan semua is to ensure that all work tasks at PTAMNT are
tugas/pekerjaan yang dilakukan di PTAMNT authorized by the area owner Superintendent prior to
mendapatkan persetujuan/otoritas dari Superintendent commencing.
area kerja sebelum memulai bekerja.

Sistem Otorisasi untuk Bekerja memadukan sistem The ATW System integrates existing systems that are
yang selama ini sudah diterapkan untuk used to identify hazards and ensure controls are in
mengidentifikasi potensi bahaya dan memastikan place to reduce harm to employees such as Safe Check,
upaya pengendalian untuk meminimalkan bahaya Job Hazard Analysis (JHA), work permits and ATW
terhadap karyawan seperti Safe Check, Job Hazard permit.
Analysis (JHA), izin kerja dan izin ATW.

Di PTAMNT, dilarang memulai pekerjaan jika tidak No task will commence at PTAMNT without first
dilengkapi dengan otorisasi untuk memulai bekerja. having the authorization to start work.
 Sistem ATW BUKAN sistem yang berdiri sendiri  The ATW system is NOT a stand-alone system,
tapi memadukan keempat perangkat lain yaitu but integrates four existing tools including; Safe
Safe Check, izin Kerja, JHA dan Izin ATW. Check, Work Permits, JHA and ATW Permits.

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 2 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Kapan Izin untuk Bekerja (ATW) diperlukan? When is the Authority to Work required?
Note: - Ini berarti bahwa Otorisasi untuk mulai Note: - this means the authority to start work (may
bekerja (bisa dimulai dengan izin ATW atau Safe be an ATW permit or a Safe Check)
Check)
ATW diperlukan untuk setiap pekerjaan: ATW is required for every task:
 Termasuk tugas yang berisiko rendah, sedang,  This includes low, medium, high and extreme
tinggi, dan ekstrim dan tugas-tugas yang risk tasks and those requiring other associated
membutuhkan perizinan kerja terkait lainnya. work permits.
 Tingkat risiko suatu pekerjaan menentukan  The risk level of the task will determine what
tingkat otorisasi yang dibutuhkan. authorization level is required.
 Setiap tugas akan diberi otorisasi untuk  Every task will be authorized to start through a
memulai bekerja melalui sistem Safe Check Safe Check or ATW permit. (Refer to the
atau izin ATW. (lihat diagram alir pada bagian flowchart in section Page 2, section 1.1at the
8 pada akhir dokumen untuk mengklarifikasi) end of this document for clarification)
 Tugas berisiko rendah dapat dilanjutkan dengan  A Low Risk Task can proceed with an
proses penilaian Safe-Check. authorized Safe-Check assessment.
 Izin ATW diperlukan untuk semua  An ATW permit will be required for all
tugas/pekerjaan berisiko tinggi yang telah Designated High-Risk tasks and all other tasks
ditentukan dan semua tugas yang berisiko which are medium, high or extreme risk.
sedang, tinggi atau ekstrim.

Siapa yang harus melengkapi apa? Who Completes what?


 Safe-Check dapat dibuat oleh siapapun yang  The Safe-Check is completed by any person
terlibat dalam pekerjaan, tetapi diprioritaskan involved in the task, but as priority will be the
dibuat oleh supervisor, team leader atau orang supervisor, team leader or delegated person
yang ditunjuk jika bekerja sendiri. when working alone.
 JHA dibuat oleh supervisor bersama kru yang  The JHA is completed by the supervisor and the
melakukan pekerjaan team doing the work.
 Izin Kerja dibuat oleh penerima izin (Pengawas  The Work Permit is completed by the permit
Pekerjaan). receiver (Supervising the work).
 Izin ATW dibuat oleh penerima izin (Pengawas  The ATW Permit is completed by the permit
Pekerjaan). receiver (Supervising the work).

Siapa mengotorisasi apa? Who Authorizes What?


 Safe-Check diotorisasi oleh Superintendent  The Safe-Check is authorized by the area owner
pemilik area. (dapat dilakukan secara verbal). Superintendent (May be verbal approval).
 Izin ATW diotorisasi oleh Superintendent  The ATW Permit is authorized by the area
pemilik area. (harus izin tertulis di lokasi kerja). owner Superintendent (Must be written
approval at the job location).
DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_
THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 3 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Note: Dokumen ini hanya membahas tentang Note: The remainder of this document only
prosedur ATW. Untuk informasi prosedur discusses the procedure for the ATW Permit. For
Safe_Check, JHA, dan Izin Kerja, dapat merujuk further information on the individual procedures
pada masing-masing prosedur terkait di Prospector. for Safe-Check, JHA and Work Permits, please
refer to the dedicated and individual procedures and
forms located on Prospector.

TUJUAN - Izin Otoritas Untuk Bekerja (ATW) PURPOSE-Authority to Work (ATW) Permit
Tujuan dari izin Otoritas untuk Bekerja (ATW) adalah The purpose of the Authority to Work (ATW) permit
untuk memastikan proses formal di lokasi kerja dengan is to ensure there is a formal process in place that
memberikan tanggungjawab untuk bekerja dan assigns responsibilities for the work and ensures
memastikan komunikasi efektif dan izin untuk effective communication and approval for work to
memulai bekerja antara pemilik kerja, pemilik area, commence between work owners, area owners and
dan supervisor tim kerja. supervisors of work groups.

DEFINISI DEFINITIONS
Istilah Deskripsi Term Description
Semua tugas Tugas apapun yang mungkin All other Any task where there is reasonable
lain berpotensi menimbulkan cedera yang tasks potential for a recordable injury such
memerlukan perawatan medis (MTI) as Medical Treatment Injury (MTI) or
atau lebih parah. greater.
Izin Otorisasi Izin ATW adalah form yang Authority to An ATW permit is a form which is
untuk digunakan untuk memastikan Work (ATW) used to ensure formal communication
bekerja komunikasi formal telah dilakukan Permit is conducted between Work Owner
(ATW) antara Supervisor Pemilik Kerja dan Supervisors and Permit Receivers
Penerima Pekerjaan (Pengawas (Supervising the Work) and that no
Pekerjaan) dan pekerjaan belum task is started until the Permit
dapat dimulai sampai izin diberikan Receiver has written authorization by
secara tertulis oleh Superintendent. the area owner Superintendent.
Pemilik Area.
Izin ATW harus ditandatangani di The ATW permit must be signed off
lokasi kerja. in the field at the job location.

Validitas izin Izin ATW berlaku sepanjang durasi ATW permit An ATW permit is valid for the total
ATW penyelesaian tugas, mulai awal Validity duration of the task, start wok to
pekerjaan sampai selesai. Jika finish. If the work is more than 7
pekerjaan lebih dari 7 hari maka days, the work owner must report
pemilik pekerjaan wajib melaporkan back to the giver of permission (the
kembali kepada Pemberi izin area owner)
(Pemilik area)
Izin ATW selalu digunakan The ATW permit is always used with
bersamaan dengan JHA, semua a JHA, all work team members shall
anggota kru harus menanda tangani sign onto the JHA. The JHA shall be
JHA. JHA harus dikaji, diperbarui, reviewed, updated, discussed and re-
didiskusikan, dan ditandatangani signed by supervisor and work teams
ulang oleh supervisor dan kru di awal at the start of each shift and the
shift dan nomor referensi ATW harus respective ATW reference number
dicantumkan dalam salinan lembar must be copied to the attached JHA
JHA asli dan tambahan form JHA original and additional Multi-Shift
Multi-Shift yang ditandatangani. sign off forms.
Aturan Untuk semua fungsi dalam izin kerja ATW Permit For all roles included on the ATW

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 4 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Pendelegasian ATW sebagai prioritas adalah pekerja Role permit; as a priority, employees in
izin ATW yang menjalankan tugas secara penuh Delegation these full-time supervisory positions
di posisinya. Bagaimanapun juga hal Rules shall fulfill the roles. However,
ini tergantung dari kebutuhan depending on business requirements
sehingga di mungkinkan untuk di others may be nominated to act in the
jalankan sementara petugas respective roles providing the
sementara yang telah di tunjuk nominees meet the following
dengan memiliki persayaratan minimum requirements.
minimum.
Pra-syarat Wajib; Mandatory pre-requisites;
 Berpengalaman dan memiliki  Previous experience and
kompetensi sebagai supervisor competence in working in the
 Terlatih dan kompeten dalam capacity of a Supervisor
prosedur penyusunan JHA, Izin  Trained and competent in JHA’s,

Kerja, dan ATW. Work Permits and ATW permit


 Telah menyelesaikan semua modul procedures.
pelatihan K3 bagi supervisor.  Completed all mandatory
supervisor safety training modules.
 Orang yang diberikan Otorisasi  The person who was given the

telah mendapat training ATW dan authorization had received ATW


teregister. training and was registered.

Pra-syarat Tambahan; Preferable pre-requisite;


 Memegang kartu POP dan/atau  POP and/or POM qualified.

POM.
In addition; respective to the
Sebagai tambahan, dalam tugas kusus following specific roles, these rules
berikut di aplikasikan. apply.

Superintendent Pemilik Work Owner Superintendent;


Pekerjaan;
Catatan; tanggung jawab ini hanya This responsibility can only be
bisa dilimpahkan jika Supt normal delegated if the normal Supt is offsite
sedang tidak berada di site seperti on approved leave etc. and can then
dalam posisi cuti dan lainnya maka only be formally delegated to the
bisa secara formal didelegasikan single person acting in their capacity.
kepada satu orang yang bertugas
acting dalam kapasitas sebagai Supt.

Superintendent Pemilik Area; Area Owner Superintendent;


Orang yang diberi wewenang; The persons delegated;
 Harus mendapatkan persetujuan  Must be approved by the
dari manajer departemen. department manager. Use
Gunakan lembar permohonan “AMNT-TRN-005-F003
“AMNT-TRN-005-F003 Delegation Authorize to Work”
Delegation Authorize to Work” form for request and approval
untuk persetujuan.
 Kewenangan harus di catat dalam  Authorization shall be recorded
ATW permit list di training on the ATW permit training
departemen. register.

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 5 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

ATW – Departemen atau mitra bisnis yang ATW - Area The department or business partner
Departemen bertanggung jawab pada area atau Owner responsible for a given area or
Pemilik Area bangunan infrastruktur di area/lokasi Department infrastructure in an area/location.
(Referensi Izin yang tercantum dalam ATW. (ATW permit
ATW permit) reference)
Pemilik Area Superintendent yang bertanggung Area Owner A Supt. responsible for the area
(Supt) (ATW jawab pada suatu area kerja tempat (Supt) (ATW where the work is taking place. They
permit pekerjaan tersebut akan berlangsung. permit will authorize work to commence by
reference) Supt. akan memberikan otorisasi reference) signing the ATW permit.
untuk memulai bekerja dengan
menandatangani izin ATW.
Tugas Tugas yang memerlukan izin kerja Designated A task that requires a work permit
Berisiko khusus seperti izin kerja panas, izin high risk task such as Hot work, Confined space
Tinggi memasuki ruang terbatas, izin entry, excavation etc.
Tertentu penggalian, dll.
Superintende Orang yang menjabat sebagai Superintende A person in the role of a
nt Superintendent atau jabatan setara nt Superintendent or an equivalent
dengan tanggung jawab yang sama position with similar role
(atau orang yang ditunjuk secara responsibilities (or their authorized
resmi untuk mewakili) nominee).

Bahaya Segala sesuatu yang berpotensi Hazard Anything with the potential to cause
menimbulkan cidera atau kerugian. harm or loss.
Job Hazard Suatu proses yang diterapkan untuk Job Hazard A process used to identify and control
Analysis mengidentifikasi dan mengontrol Analysis hazards during task planning,
(JHA) bahaya pada tahap perencanaan, (JHA) execution and review. The
pelaksanaan, dan pemeriksaan kerja. workgroup doing the work, breaks the
Kru yang bertugas melaksanakan job down into basic steps, identifies
pekerjaan, membagi beberapa the hazards associated with each step,
tahapan tugas, mengidentifikasi and decides what actions are
potensi bahaya di setiap tahapan necessary to control each hazard. The
kerja, dan menentukan tindakan yang details are recorded on a form for
perlu diambil untuk mengontrol reference and after completion of the
setiap bahaya yang teridentifikasi. work the details are reviewed and
Rincian tahapan dituangkan dalam filed. JHA’s must be reviewed and
formulir sebagai referensi dan setelah signed by
pekerjaan selesai dilakukan, rincian Supervisor/Superintendent/Superinte
tersebut akan diperiksa dan ndent or Manager based on the risk
diarsipkan. JHA harus diperiksa dan levels prior to starting work.
ditandatangani oleh
Supervisor/Superintendent/Superinte
ndent atau Manajer sesuai tingkat
risiko yang dihadapi sebelum
memulai bekerja.
Tugas Risiko Pekerjaan yang memiliki risiko Low Risk Any task where the maximum
Rendah cidera maksimal yang teridentifikasi Task foreseeable injury considered to be no
dimana tidak lebih dari pertolongan more than a first aid injury.
pertama (first aid).

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 6 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Area Meliputi area tambang, proses, Operational Typically, the mining, processing,
Operasional eksplorasi, pembangkit listrik dan Areas exploration, power station and port
pelabuhan. Selain itu area areas are considered operational
infrastruktur operasional juga areas. Operational areas may also
meliputi jaringan kabel listrik, include infrastructure such as power
jaringan pipa, jalan umum atau area lines, pipelines and roads that are in
sharing. Setiap manajer departemen common or shared areas. Each
harus menetapkan wilayah area department Manager shall formally
operasional dan non-operasional establish their operational and non-
masing-masing. operational areas.

Area Non- Area non-opersional meliputi area Non- Non-operational areas are considered
Operasional dimana hanya terdapat pelaksanaan Operational to be those where administration
yang berhubungan dengan kegiatan Areas functions only are conducted.
administrasi.
Penerima Pengawas yang didelegasikan oleh Permit A supervisor delegated by the
Izin departemen yang melakukan Receiver Department who is doing the work.
(pengawas) pekerjaan. (Supervising He/she will be the direct supervisor of
(ATW permit Pengawas akan secara langsung the Work) the team conducting the task covered
reference) mengawasi tim yang melakukan (ATW permit under the ATW permit.
pekerjaan sesuai izin ATW yang reference)
dibuat.

Aturan Izin ATW Multi-Shift; ATW Permit Multi-Shift Rules; An


Sebuah izin ATW valid hingga durasi ATW permit is valid for the total
pekerjaan diselesaikan. Jika duration of the task. Where a task
pekerjaan dilakukan lebih dari 1 shift, continues for more than one shift, the
penerima Izin sebelumnya (nama original Permit Receiver whose name
yang tertulis yang di ATW) harus is written on the ATW permit is
memastikan semua JHA, izin kerja, responsible to ensure all JHA’s, work
dan kontrol bahaya ada di lokasi kerja permits, and controls are in place for
pada shift sebelumnya. Untuk shift the first shift. For subsequent shifts,
selanjutnya, Penerima Izin the oncoming (next shift) Permit
bertanggungjawab untuk pekerjaan Receiver will assume responsibilities
dan secara formal diketahui dari for the task and this will be formally
proses JHA Multi-Shift yang telah acknowledged through the JHA
ditandatangani. Multi-Shift process and sign off form.

Departemen Departemen yang membutuhkan Requesting Department that needs work to be


Pemohon pengajuan permohonan pekerjaan di Department done in their area of responsibility or
(ATW permit area tanggung jawabnya, atau di (ATW permit on equipment and or infrastructure
reference) peralatan dan /atau infrastruktur yang reference) that they are responsible for.
menjadi tanggung jawabnya.
Risiko Peluang terjadinya sesuatu yang Risk The chance of something happening
berdampak terhadap pencapaian that will have an impact upon
tujuan, diukur berdasarkan objectives. It is measured in terms of
konsekuensi dan kemungkinan. consequences and likelihood.

Risiko Peluang terjadinya sesuatu yang Residual The chance of something happening
Residual berdampak terhadap pencapaian Risk that will have an impact upon
tujuan, setelah diterapkan upaya objective after controls are put in
pengendalian guna meminimalkan place to reduce consequences and or
konsekuensi dan/atau kemungkinan. likelihood.
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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 7 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Penilaian Proses mengidentifikasi dan Risk The process of identifying and rating
Risiko menentukan tingkat risiko Assessment risks based on consequence and
berdasarkan konsekuensi dan likelihood and putting controls in
kemungkinan, menerapkan upaya place which will lower the final risk
pengendalian guna meminimalkan rating.
tingkat risiko akhir.
Safe-Check Suatu penilaian risiko yang dilakukan Safe-Check A risk assessment that is conducted
oleh pihak pelaksana pekerjaan by the work party prior to
sebelum memulai bekerja. Hal-hal commencing work. Point of Work
yang diperhatikan dalam penilaian Risk Assessments are considered to
risiko adalah kapan personel terakhir be the last time that personnel may
harus mengidentifikasi risiko dan have to identify and control hazards
mengendalikan potensi bahaya before they start work.
sebelum mereka memulai bekerja.

Tugas Tugas merupakan salah satu item Task A task is an item of work that requires
dalam suatu pekerjaan yang a number of different actions, steps,
memerlukan beragam langkah, or activities to be performed for its
tindakan atau kegiatan untuk completion.
menyelesaikan pekerjaan tersebut.
Departemen Departemen/unit kerja/mitra bisnis Owner The department/section/business
Penanggung yang bertanggung jawab unutk Department partner who is responsible for the safe
jawab menyelesaikan pekerjaan dengan Responsible completion of the work. Responsible
Pemilik aman. Bertanggung jawab untuk (ATW permit for arranging and managing who will
Kerja (ATW mengatur dan menentukan siapa yang reference) do the work.
permit akan mengerjakan pekerjaan.
reference)
Untuk identifikasi penanggung jawab For area identification work owner
Pemilik Area di PTAMNT dapat department responsible in PTAMNT
melihat lampiran bagian 6; Matriks Site Refer to section 6; Area Owner
Superintendent Pemilik Area (Site- Superintendent Matrix (Site-Wide)
Wide)
Superintende Seseorang yang mewakili Work Owner Represents the work owner
nt Pemilik Departemen Pemilik pekerjaan yang Superintende department responsible.
Kerja diberi tanggung jawab. nt (ATW
(ATW permit permit
reference) Aturan Izin ATW Permit Multi- reference) ATW Permit Multi-Shift Rules; An
Shift; Sebuah izin ATW valid hingga ATW permit is valid for the total
pekerjaan berakhir. Jika pekerjaan duration of the task. Where a task
dilanjutkan lebih dari 1 shift maka continues for more than one shift or
Superintendent Pemilik Pekerjaan the original Work Owner
yang namanya ditulis pada ATW Superintendent whose name is
permit tidak berlaku, dia harus written on the ATW permit is not
mendelegasikan pekerjaan dan izin available, he/she shall hand over the
ATW yang telah disetujui kepada details and location of all active ATW
Superintendent Pemilik Pekerjaan permitted tasks to an alternative
pada shift berikutnya. Work Owner Superintendent.

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 8 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Supervisor Supervisor yang bertugas dan Work Owner A supervisor who works for and is
Pemilik diberikan delegasi oleh Supt. Pemilik Assigned delegated by the Work Owner Supt.
Kerja Yang pekerjaan yang mengkoordinir dan Supervisor Coordinates and oversees the work to
ditunjuk mengawasi pekerjaan sesuai izin (ATW permit be conducted under the ATW permit.
(ATW permit ATW yang diterima. reference)
reference)
ATW Permit Multi-Shift Rules; ATW Permit Multi-Shift Rules; An
Sebuah izin ATW valid hingga ATW permit is valid for the total
pekerjaan berakhir. Jika pekerjaan duration of the task. Where a task
dilanjutkan lebih dari 1 shift maka continues for more than one shift, the
Supervisor Pemilik Pekerjaan yang original Work Owner Assigned
namanya ditulis pada ATW permit Supervisor whose name is written on
bertanggungjawab the ATW permit is responsible to
mengkoordinasikan dan memastikan coordinate and oversee the work
pekerjaan pada shift awal. Untuk shift covered under the permit for the first
selanjutnya, Supervisor Pemilik shift. For subsequent shifts, the
Kerja shift selanjutnya oncoming (next shift) Work Owner
bertanggungjawab untuk Assigned Supervisor will assume
melanjutkan dan mengkoordinasikan responsibilities to continue
pekerjaan. coordination for the task.

Izin Kerja Formulir izin resmi yang diperlukan Work Permit A formal permit form used for
untuk melaksanakan pekerjaan designated high-risk work such as
berisiko tinggi seperti pekerjaan Hot Work, Confined space entry,
pemotongan/ pengelasan, memasuki excavation, Working at height, etc.
ruang terbatas, bekerja di ketinggian,
dsb.

TANGGUNG JAWAB RESPONSIBILITIES

Jabatan Tanggung Jawab Utama Role Major Responsibilities


General Bertanggung jawab menyiapkan General Responsibility for resources available
Manager sumberdaya yang diperlukan untuk Manager to implement the ATW system and
Operation menerapkan prosedur system ATW Operations permitting procedure.
dan prosedur izin kerja.
Memastikan seluruh area di site Ensure that every area across site is
tercakup di dalam matrik spesifik covered in the specific area ownership
kepemilikan area, dan tidak ada yang matrices, no black holes.
terlewatkan.

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 9 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

SHLP Mengkaji dan memperbarui dokumen SHLP Review and update this document
Manajer prosedur ini, memastikan kepatuhan Manager ensuring legal and site compliance.
terhadap persyaratan hukum dan
ketentuan di site. Ensure that communication strategies
Memastikan strategi komunikasi dan and training is in place to meet the
pelatihan dilaksanakan dengan baik requirements of this procedure.
untuk memenuhi persyaratan
prosedur ini Conduct random ATW system and
Melakukan pemeriksaan acak izin permit field compliance audits to
ATW di lapangan guna memastikan ensure the site standard/procedure is
standar/prosedur site dipatuhi dengan followed (meet the expectation).
baik (sesuai harapan)
Departemen Memahami dan menerapkan proses Department Understand and implement the ATW
Manajer perizinan ATW di area tanggung Managers processes in their areas of
jawab masing-masing. responsibility.
Memastikan semua karyawan dan Ensure all employees and business
mitra bisnis telah mengikuti pelatihan partners have undertaken ATW
dan penilaian kompetensi mengenai training and competency assessments.
ATW
Menetapkan matriks area ownership Establish area ownership matrix for
di area tanggung jawab masing- their areas of responsibility and or
masing dan/atau infrastruktur dan infrastructure and facilities they are
fasilitas yang berada di bawah responsible for.
tanggung jawabnya.
Superintend Memastikan implementasi proses dan Superintend Ensure implementation of the process
ent aplikasi yang konsisten atas prosedur ent and consistent application to the
AMNT/AMI ini. AMNT/AMI procedures.
G/Aliansi Melakukan inspeksi dan audit G/Alliance Conducts field inspections and audits
lapangan untuk memastikan to check compliance with this
kepatuhan terhadap prosedur ini. procedure.
Memastikan karyawan mengikuti Ensures employees are made available
pelatihan prosedur ATW. for training of the ATW procedures.

Superintend Semua Superintendent; memastikan Superintend All Superintendent; ensure all


ent semua karyawan yang ditentukan ent required employees have undertaken
mengikuti pelatihan dan penilaian ATW training and competency
kompetensi ATW. assessments.
Superintendent Pemilik pekerjaan; Work Owner Superintendent;
 Memastikan penerima izin  Ensure the Permit Receiver
menyelesaikan izin ATW dan completes the ATW permit and
menerima otorisasi sebelum receives authorization prior to
memulai pekerjaan, commencing work.
 Menugaskan pemilk pekerjaan  Assigns a Competent work owner
yang kompeten sebagai Supervisor assigned Supervisor.
 Memeriksa kepatuhan izin ATW  Checks compliance to the ATW
selama pekerjaan berlangsung. permit during progress of the work.

Aturan Izin ATW Multi-Shift; ATW Permit Multi-Shift Rules;


Dimana pekerjaan dilanjutkan lebih Where a task continues for more than
dari 1 shift; pendelegasian tugas pada one shift; assigns another Work Owner
Supervisor Pemilik Pekerjaan shift Assigned Supervisor.
selanjutnya.
DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_
THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 10 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

Superintendent Pemilik Area; Area Owner Superintendent;


Memeriksa dan memberikan otorisasi Review and authorise all work before
semua pekerjaan sebelum pekerjaan it can commence as follows;
dimulai;
 Melakukan pemeriksaan fisik  Physically check the work area
area kerja bersama penerima izin. with the Permit Receiver.
 Memastikan semua kontrol  Confirms all controls noted on the
dituliskan pada JHA di lokasi initial JHA are in place and where
kerja dan resiko bahaya lainnya additional hazards have been
telah diidentifikasi, dikontrol di identified, controls for these are
lokasi kerja. also in place.
 Memastikan JHA benar, lengkap,  Confirms the JHA has been
dan telah ditandatangani completed and approved at the
sebagaimana mestinya sesuai appropriate level based on level of
tingkat risiko. risk.
 Memastikan izin ATW lengkap  Ensure the ATW permit is
dan semua dokumen yang completed and all required forms
diperlukan (seperti STP, JHA, (i.e., STP, JHA, work permits) are
izin kerja) dilampirkan. attached and inspect the work area
Menginspeksi area kerja covered by the ATW permit before
sebagaimana tercantum di izin authorizing and signing the ATW
ATW sebelum memberi otorisasi open.
dan menandatangani ATW –
membuka izin.
 Memberikan otoritas untuk  Gives authority for the work to
memulai pekerjaan sebagaimana commence as described in this
diuraikan dalam izin yang permit.
diberikan.
 Setelah pekerjaan selesai,  After the work is completed;
menginspeksi area kerja inspect the work area covered by
sebagaimana tercantum di izin the ATW permit and sign the
ATW dan menandatangani ATW ATW closed
- menutup izin.
 Memastikan salinan izin ATW  Ensure white and yellow copies of
berwarna putih dan kuning yang all closed ATW permits are
sudah selesai, disimpan dan retained and managed.
dikelola dengan baik.

Supervisor Supervisor Pemilik Kerja yang Supervisors Work Owner Assigned Supervisor;
AMNT/AMI ditunjuk; AMNT/AMI  Together with the Permit Receiver
G/Aliansi  Bersama dengan penerima izin, G/Alliance physically reviews the work to be
memeriksa secara fisik pekerjaan done and all items on the JHA are
yang akan dilakukan dan semua complete, and all required controls
item yang tercantum di JHA telah are implemented prior to starting
lengkap dan semua upaya kontrol work.
yang dibutuhkan telah diterapkan
sebelum memulai bekerja.
 Mengkoordinasikan dan  Coordinate and oversees the work
mengawasi pelaksanaan authorized under the ATW permit
pekerjaan sesuai izin JHA dan and check compliance to the JHA
memeriksa kepatuhan izin kerja and other work permits before and
during progress of the work;

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 11 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

sebelum dan selama proses


pekerjaan;

Aturan Izin ATW Multi-Shifts; ATW Permit Multi-Shift Rules;


Dimana pekerjaan dilanjutkan lebih Where a task continues for more than
dari 1 shift; pekerjaan dipastikan one shift; the oncoming (next shift)
Supervisor Pemilik Pekerjaan shift Work Owner Assigned Supervisor will
selanjutnya bertanggungjawab assume responsibilities as noted above
terhadap pekerjaan yang diberikan. for the task.

Penerima Izin: Permit Receiver:


 Melengkapi izin ATW.  Completes the ATW permit.
 Memastikan STP, JHA dan  Ensures STP, JHA and affiliated
perizinan work terkait lainnya work permits are correct and are at
benar dan ada di lokasi kerja. the work location.
 Memastikan semua upaya  Ensures all hazard controls are in
pengendalain bahaya telah place prior to starting work and
diterapkan sebelum memulai during the task.
bekerja dan selama pekerjaan
berlangsung.
 Bersama-sama dengan  Together with the Work Owner
Supervisor Pemilik Pekerjaan Assigned Supervisor, physically
mereview pekerjaan yang akan reviews the work to be done and
dilakukan secara fisik dan semua all items on the JHA are complete,
item di JHA lengkap, dan semua and all required controls are
yang dibutuhkan untuk implemented prior to starting
mengontrol bahaya sudah work.
diimplementasikan sebelum
memulai kerja.
 Sebelum pekerjaan dimulai,  Before the task begins, contact the
menghubungi Superintendent Area Owner Superintendent for
pemilik area untuk mendapatkan authorization to start work.
izin memulai pekerjaan.
 Mensupervisi pekerjaan sesuai  Supervise the work authorized
izin ATW. under the ATW permit.
 Setelah pekerjaan selesai,  When work is complete, contact
menghubungi Superintendent the Area Owner Superintendent to
pemilik area untuk menutup izin close the ATW permit.
ATW.
 Memastikan lembaran izin ATW  Ensure pink copies of all closed
yang berwarna Pink/Merah Muda ATW permits are returned to the
dikembalikan ke pemilik kerja planning or other delegated
atau departemen yang department for filing.
didelegasikan untuk disimpan.

Aturan Izin ATW Permit Multi- ATW Permit Multi-Shift Rules;


Shift; Dimana pekerjaan dilanjutkan Where a task continues for more than
lebih dari 1 shift; Penerima izin shift one shift; the oncoming Permit
selanjutnya akan bertanggungjawab Receiver will assume responsibilities
untuk pekerjaan sesuai dengan proses for the task through the JHA Multi-
JHA Multi-Shift dan form yang Shift process and sign off form.
ditandatangani.

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 12 of 32 Version: 3.4 DEPARTMENT
Approval Date: 4/24/2022
Review Cycle: 2 Years
Author: Manager SHLP Sistem Otorisasi Untuk Bekerja & Prosedur Izin
AuthorPosID: 50000973 ATW_Authority To Work (ATW) System Overview &
Approval: Site Director
ApprovalPosID: 50000009 ATW Permit Procedure

SHLP  Melakukan inspeksi dan audit SHLP  Conducts field inspections and
Departemen lapangan untuk memastikan Department audits to check compliance with
kepatuhan terhadap prosedur ini. this procedure.
 Mengkaji ulang prosedur setiap  Conduct a review of this procedure
dua tahun sekali. every two years.
 Mendukung dan memberikan  Provide the Departments with
arahan kepada departemen dalam support and guidance when using
menerapkan prosedur ini. this procedure.
Training  Mengkaji modul training setiap Training  Conduct a review of training
Departemen dua tahun sekali. Department module every two years.
 Mengadakan Training Sistem dan  Perform ATW System and permit
Izin ATW pada 3 days mandatory training by 3 days mandatory
supervisory HSLP training. supervisory HSLP training.
 Memantau training register untuk  Maintain a training register for all
semua karyawan yang persons authorized as nominated
dinominasikan oleh Area Owner Superintendents.
Superintendent Pemilik Area.

PROSEDUR PROCEDURE
Apa yang dimaksud dengan Sistem ATW? How is a ATW Permit completed?
Lihat Bagian 7; Sistem Authority to Work (ATW) Refer to Section 7; Authority to Work (ATW)
System - Flow Chart. System - Flow Chart.

Manajemen dan Pengarsipan Izin ATW ATW Permit Management and Filing
Formulir Izin ATW akan memiliki 3 rangkap; Requirements
bagian berwarna putih (asli), kuning, dan merah Printed ATW Permit booklets will have three
muda yang memiliki nomor urut pada bagian atas carbon copies; a white (original), yellow and pink
formulir izin. copy and will also have sequential numbering at
the top of the permits.
Kapan sebuah izin ATW aktif atau terbuka; While an ATW permit is active or open, the;
 Kopian berwarna putih dan merah muda harus  White and pink copies must remain at the job
diletakkan di lokasi kerja penerima izin. location with the permit receiver.
 Kopian berwarna kuning dikembalikan kepada  Yellow copy must be retained by the area owner
Superintendent pemilik Area sebagai tanda bahwa Superintendent in a dedicated active ATW Permit
izin ATW. file location.

Kapan izin ATW ditutup; When an ATW permit is closed, the;


 Izin ATW ditutup ketika pekerjaan dinyatakan  ATW permit is closed when the job is declared
selesai oleh Supervisor/Superintenden pemilik finished by the Supervisor/Superintendent of the
pekerjaan. work owner.
 Kopian berwarna Merah Muda harus disimpan oleh  Pink copy must be filed by the permit receiver’s
Departemen Pemilik Pekerjaan untuk keperluan department for auditing purposes.
audit.
 Kopian berwarna putih dan kuning harus disatukan  White and Yellow copies must be stapled together
dan disimpan oleh Superintendent Pemilik Area di and retained by the area owner Superintendent in
penyimpanan ATW permit untuk keperluan audit. a dedicated ATW Permit storage location for
auditing purposes.

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 13 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

AREA OWNER SUPERINTENDENT MATRIX (Site-Wide)


Note:- If there are any work areas/Area Owners Superintendents not identified in the able below, call the area manager for guidance on who is the
appropriate Area Owners Superintendent!

These Superintendents/delegate personels are responsible to approve work to start (for Safe-Checks and ATW permits) in their respective areas
Site Main Areas Work Area Area Owner Superintendent

EXPLORATION Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Supt. Exploration 50000034 Rinaldi 10306686 +62 81139 49995
Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
IUPK – Batu Hijau Block
Sr. Geologist 50000056 Alfian 10306705 +62 81139 41229
Sr. Geologist 50000049 Enos Pebrian 10307225 +62 81139
Sr. Geologist 50000024 Wahyudi 10306691 +62 81139 41211
Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
Supt. Exploration 50000034 Rinaldi 10306686 +62 81139 49995
IUPK Area IUPK– Elang Block, Elang Sr. Geologist 50000024 Wahyudi 10306691 +62 81139 41211
Camp and Lamurung Camp
Supt. - Development 50000035 Ulul Albab 10306016 +62 81139 41672
Sr. Geologist 50000049 Enos Pebrian 10307225 +62 81139
Supt. - Exploration
50000062 Omar Syarief 10306626 +62 81139 49211
Indonesia
Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
IUPK – Lampui Block Supt. Exploration 50000034 Rinaldi 10306686 +62 81139 49995
Sr. Geologist 50000024 Wahyudi 10306691 +62 81139 41211
Supt. - Development 50000035 Ulul Albab 10306016 +62 81139 41672

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 14 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

EXPLORATION Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Sr. Geologist 50000049 Enos Pebrian 10307225 +62 81139
IUPK – Lampui Block Supt. - Exploration
50000062 Omar Syarief 10306626 +62 81139 49211
Indonesia
Supt. Exploration 50000034 Rinaldi 10306686 +62 81139 49995
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
IUPK – Rinti Block Sr. Geologist 50000056 Alfian 10306705 +62 81139 41229
Sr. Geologist 50000049 Enos Pebrian 10307225 +62 81139
Sr. Geologist 50000024 Wahyudi 10306691 +62 81139 41211
Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Exploration Office –
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
IUPK Area Townsite, Exploration and
Exploration Core Shed#2 – Sr. Geologist Resource 50000058 Andi Kadir Jailani 10305975 +62 81138 41518
Benete area Achmad Syahid
Sr. Geologist Resource 50000044 10306627 +62 81138 49772
Ramdhani
IUPK – Teluk Puna Blok Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Supt. Exploration 50000034 Rinaldi 10306686 +62 81139 49995
Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
Other Remote Flying Camps
Sr. Geologist 50000056 Alfian 10306705 +62 81139 41229
Sr. Geologist 50000049 Enos Pebrian 10307225 +62 81139
Sr. Geologist 50000024 Wahyudi 10306691 +62 81139 41211
Manager Exploration 50000031 Hery Sulistyo 10106071 +62 81139 49135
Port Area Core Shed - Benete
Supt. Exploration Support 50000038 Dadan Ramdani 10105843 +62 81138 41148
Supt. - Exploration
50000038 Dadan Ramdani 10105843 +62 81138 41148
Concentrator Support
SS Laydown (ex Sawmill)
Area Supt. - Exploration
50000062 Omar Syarief 10306626 +62 81139 49211
Indonesia

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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 15 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

MINING Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Supt. - Road Maintenance 50002857 Muhammad Hatta 23000027 +62 81139 49813
Supt. - Road Maintenance 50002858 Anas 23000147 +62 81139 41572
Dwinanang Jati
50002077 23000166 +62 81139 41089
Kurniawan
Superintendent Mining
Andarias
50002081 23000042 +62 81139 49401
Hermanto Saranga
Waste Dumps Perdamen Karo
50002076 23000072 +62 81139 41235
Superintendent Mining Karo
50002078
Sarilan Zaputra 23000025 +62 81139 49073
50002079 Muhajir 23000067 +62 81139 49819
Superintendent Mining
50002080 Mustamir 23000021 +62 81139 49760
Lorensius
Land Clearing and Contact Superintendent Earthwork 50001773 23000076 +62 81139 49822
Muhang
Channel
Superintendent Earthwork 50001774 Lasma Ary 23000112 +62 81139 41396
Lorensius
Waste Dump Reclamation Superintendent Earthwork 50001773 23000076 +62 81139 49822
Muhang
Area *
Superintendent Earthwork 50001774 Lasma Ary 23000112 +62 81139 41396
Lorensius
Superintendent Earthwork 50001773 23000076 +62 81139 49822
Dry Season Project Muhang
Superintendent Earthwork 50001774 Lasma Ary 23000112 +62 81139 41396
*Untuk penebangan pohon atau penggunaan lain di area reklamasi memerlukan
*For tree cutting or re-disturbance on reclamation area requires writing
persetujuan tertulis dari Superintendent ENV Planning & Project/Manager
approval from Supt Env Planning & Project/Manager Environmental
Enviromental
Superintendent Road
50002782 Ridun Pawa 23000120 +62 81139 49133
Maintenance
All roads in mining area Supt. - Road Maintenance 50002857 Muhammad Hatta 23000027 +62 81139 49813
Supt. - Road Maintenance 50002858 Anas 23000147 +62 81139 41572

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 16 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Andarias
Supt. - Mining 50002081 23000042 +62 81139 49326
Hermanto Saranga
Supt. - Mining 50002079 Muhajir 23000067 +62 81139 41089
Perdamen Karo
Mining (Hendra Corpriadi & Supt. - Mining 50002076 23000072 +62 81139 49073
Karo
Saiful Nilopo) Supt. - Mining Dwinanang Jati
50002077 23000166 +62 81139 41235
Kurniawan
Supt. - Mining 50002080 Mustamir 23000021 +62 81139 49819
Supt. - Mining 50002078 Sarilan Zaputra 23000025 +6282341911113
Superintendent Drill and
50001430 Denny S Permana 23000158 +62 81139 49823
Mine Area Blast
Drill & Blasting
Superintendent Drill and
50001431 Faisal Sebayang 23000121 +62 81139 41289
Blast
Superintendent Road
50002782 Ridun Pawa 23000120 +62 81139 49133
Maintenance
Mine - Land fill facilities Supt. - Road Maintenance 50002857 Muhammad Hatta 23000027 +62 81139 49813
Supt. - Road Maintenance 50002858 Anas 23000147 +62 81139 41572
Concentrator - Landfill Supt. - Site Support Ops 50000118 Jontar Sibarani 10302560 +62 81139 49939
facilities Supt. - F&S Maintenance 50000239 Edy Purwanto 10302917 +62 81139 49534
Superintendent Drill and
Air Merah Crusher 50001430 Denny S Permana 23000158 +62 81139 49823
Blast
Santong Dam (Santong Toe
Dike, Santong#1, Santong#2, Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Santong#3, Santong Booster)
Santong Diversion (Cut 21,
Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Jalit, Kokar Mas, Nangka)
Tongoloka Dam (Tongloka
Pond, Ujat Pond, Effluent
Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Pond, Reclamation
Diversion)

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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 17 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Katala Dam (New Katala


Pond, Katala Emergency Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Pond)
Kanloka Dam (Kanloka
Pond, Reclamation Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Diversion)
Pump Cluster Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Mine Area
Pit Sump Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Deep Well (DW 14, DW 15) Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Break Tank
(11TK01, 64TK101,
Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
64TK202, 64TK203,
64TK204)
Mining MMA
Superintendent Electrical 50001567 Junaedi 23000372 +62 81139 49622
Substation/Switch Gear
All electrical substation in
mine area include shovel
Superintendent Electrical 50001567 Junaedi 23000372 +62 81139 49622
Subs, and Mine water
pumping subs
Olat Ballat Facilities Superintendent Electrical 50001567 Junaedi 23000372 +62 81139 49622
Laydown operation MWM Superintendent MWM 50003378 M. Subhan 23000024 +62 81139 49826
Superintendent Drill and
50001430 Denny S Permana 23000158 +62 81139 49823
Blast
Laydown Drill Operation
Superintendent Drill and
50001431 Faisal Sebayang 23000121 +62 81139 41289
Blast
Supt. - Road Maintenance 50002782 Ridun Pawa 23000120 +62 81139 49133
Laydown URL 510 Supt. - Road Maintenance 50002857 Muhammad Hatta 23000027 +62 81139 49813
Supt. - Road Maintenance 50002858 Anas 23000147 +62 81139 41572
MMA, Mine and Trakindo 50003172 Askari 23000183 +62 81139 41975
HEWS Supt. Truck
Warehouse 50003174 Nurmala Tjahyadi 23000227 +62 81139 41019

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 18 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

50004761 Hidayat 23000010 +62 81139 49406


50003173 Heri Prasetyo 23000202 +62 8113949925
MOB Superintendent Welding 50003876 Tuara Saragih 23000089 +62 81139 49963
50003172 Askari 23000183 +62 81139 41975
50003174 Nurmala Tjahyadi 23000227 +62 81139 41019
Supt. Truck
MMA Yard and Wash pad 50004761 Hidayat 23000010 +62 81139 49406
50003173 Heri Prasetyo 23000202 +62 8113949925
Superintendent Welding 50003876 Tuara Saragih 23000089 +62 81139 49963
Tyreshop Supt. Tyre 50004976 Iwan Setiawan 23000037 +62 81139 41183
50003172 Askari 23000183 +62 81139 41975
Katala Shop and Trakindo 50003174 Nurmala Tjahyadi 23000227 +62 81139 41019
Rental, United Tractor Supt. Truck 50004761 Hidayat 23000010 +62 81139 49406
Workshop at shovel yard 50004761 Hidayat 23000010 +62 81139 49406
Supt. Truck 50003172 Askari 23000183 +62 81139 41975
MRC, COC, TUE (Major Supt. Truck 50003174 Nurmala Tjahyadi 23000227 +62 81139 41019
Component) at concentrator
Supt. Truck 50004761 Hidayat 23000010 +62 81139 49406
Supt. Truck 50003173 Heri Prasetyo 23000202 +62 8113949925
Supt. Truck 50003172 Askari 23000183 +62 81139 41975
MMA Fuel
Station,Lube MMA Fuel Station, Lube Supt. Truck 50003174 Nurmala Tjahyadi 23000227 +62 81139 41019
Module (Primary Module Supt. Truck 50004761 Hidayat 23000010 +62 81139 49406
Crusher Area) Supt. Truck 50003173 Heri Prasetyo 23000202 +62 8113949925
Superintendent Drill and
50001430 Denny S Permana 23000158 +62 81139 49823
Air Merah Workshop area Blast
Dewatering
and Crusher Air merah Superintendent Drill and
50001431 Faisal Sebayang 23000121 +62 81139 41289
Blast
Shovel and Drill 50003028 Kurniawan 23000075 +62 81139 49673

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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 19 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Shovel and Drill Workshop, Superintendent Shovel & Hanung Budi


50003027 23000065 +62 81139 41018
Laydown and Rebuild Yard Drills Hartono
50003028 Kurniawan 23000075 +62 81139 49673
Superintendent Shovel &
Epiroc, Hexindo, Liebherr Hanung Budi
Drills 50003027 23000065 +62 81139 41018
Hartono
Superintendent Drill and 50001430 Denny S Permana 23000158 +62 81139 49823
Front building, Detonator
Blast
storage, AN plant and Orica
Plant and workshop 50001431 Faisal Sebayang 23000121 +62 81139 41289
Mine Magazine
Superintendent Drill and 50001430 Denny S Permana 23000158 +62 81139 49823
AN yard
Blast 50001431 Faisal Sebayang 23000121 +62 81139 41289
Temporary
Temporary Magazine AN Superintendent Drill and 50001430 Denny S Permana 23000158 +62 81139 49823
Magazine
Benete Blast
50001431 Faisal Sebayang 23000121 +62 81139 41289
Core Shed#1 – Concentrator
Core shed Superintendent Geology 50000368 Wahyudi Malik 10105794 +62 81139 49377
area
Geology Geology core drilling project Superintendent Geology 50000368 Wahyudi Malik 10105794 +62 81139 49377
Geotech Horizontal Drill Superintendent
Geotech 50000369 Ariadin Sinuraya 10107035 +62 81139 41021
Project Geotechnical
PROCESSING Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Supt. - Shift Metallurgy &
50000766 Gufran Khomaeni 10105932 +62 81139 41533
Primary Crusher & Control Room
OLC/Tripper Supt. - Upstream
50000682 Jermias Singkoh 10102121 +62 81139 41514
Operations
Primary Crusher- All MCC’s within primary Supt. - Process
OLC 50000674 Erfan Zulkarnaen 10104201 +62 81139 49278
crushing/OLC areas Maintenance Electrical
OLC Satelite Workshop & Supt. - Maint. Projects & Mohammad
50000789 10105600 +62 81139 49325
Supra Workshop Reliability Engineering Ramadhani
Maintenance Workshops @
Supt. - Shift Maintenance 50004158 Muhammad Ashar 10302360 +62 81139 49944
Crushing & Conveying Area
Supt. - Upstream
Grinding Mill Stockpile 50000682 Jermias Singkoh 10102121 +62 81139 41514
Operations

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 20 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Grinding, Pebble Crushing, Supt. - Upstream


50000682 Jermias Singkoh 10102121 +62 81139 41514
Ball Sorting Operations
130 Bench Road and empty Supt. - Upstream
50000682 Jermias Singkoh 10102121 +62 81139 41514
space Operations
130 Bench Reagent mixing Supt. - Upstream
50000682 Jermias Singkoh 10102121 +62 81139 41514
and handling facilitates Operations
All MCC’s within grinding Supt. - Process
50000674 Erfan Zulkarnaen 10104201 +62 81139 49278
area Maintenance Electrical
Maintenance Workshops @
Supt. - Shift Maintenance 50004158 Muhammad Ashar 10302360 +62 81139 49944
Milling Area
Supt. - Power Planning &
150 KV Substation 50000588 Sumadi 10303145 +62 81139 49968
Technical Services
Supt. - Power Planning &
33 KV Substation 50000588 Sumadi 10303145 +62 81139 49968
Technical Services
Supt. - Process
11 KV Substation 50000674 Erfan Zulkarnaen 10104201 +62 81139 49278
Maintenance Electrical
130 Bench Supt. - Upstream
50000682 Jermias Singkoh 10102121 +62 81139 41514
Rougher/Scavenger Flotation Operations
Supt. - Upstream
130 Bench Reagent Plant 50000682 Jermias Singkoh 10102121 +62 81139 41514
Operations
Supt. - Upstream
106 Bench Cleaner flotation 50000682 Jermias Singkoh 10102121 +62 81139 41514
Flotation Operations
All MCC’s within flotation Supt. - Upstream
50000682 Jermias Singkoh 10102121 +62 81139 41514
area Operations
Maintenance Workshops @
Supt. - Process Mech.
130 Flotation & 106 Cleaner 50000677 Zainul Wahidin 10101706 +62 81139 41108
Maint. Downstream
Area
156 Bench Process Water Supt. - Downstream
50000684 Horas Sitorus 10101978 +62 81139 49392
and Fire Water System Area Operations
CCD/Utilities 106 Bench CCD, Tail Box,
Supt. - Downstream
Lime Plant, NaHS Plant, 50000684 Horas Sitorus 10101978 +62 81139 49392
Operations
GEHO

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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 21 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Santong Water Treatment Supt. - Downstream


50000684 Horas Sitorus 10101978 +62 81139 49392
Plant (SWTP) Operations
Supt. - Downstream
Storm Pond 50000684 Horas Sitorus 10101978 +62 81139 49392
Operations
All MCC’s within
Supt. - Process
CCD/Utilities, SWIS, 50000674 Erfan Zulkarnaen 10104201 +62 81139 49278
Maintenance Electrical
GEHO, SWTP, Sejorong
Maintenance Workshops @ Supt. - Process Mech.
50000677 Zainul Wahidin 10101706 +62 81139 41108
CCD/Utilities/SWTP/SWIS Maint. Downstream
IT Data Center Concentrator Supt. - IT Infrastructure 50000309 Rusli 10101429 +62 81139 49566
Tailing Corridor Supt. - Downstream
50000684 Horas Sitorus 10101978 +62 81139 49392
Operations
Supt. - Downstream
50000684 Horas Sitorus 10101978 +62 81139 49392
Operations
All Well Water Area Supt. - Downstream
50000684 Horas Sitorus 10101978 +62 81139 49392
Operations
Supt. - Operations Project 50000685 Muhammad
10101968 +62 81139 41498
& Utility Sahrir
3,3 KV Overhead line for Supt. - Power Planning &
50000588 Sumadi 10303145 +62 81139 49968
sejorong well pump Technical Services
130 Bench Metallurgical Supt. - Metallurgical &
Metallurgy 50000815 Darius Varianemil 10106752 +62 81139 49294
Laboratory Tech. Services
130 Bench Assay / Lab Sr.Chemist-Quality &
Fachrul
Assay Laboratory Sucofindo Benete / QC&QA Statistical Control 50000432 10106792 +62 81139 49291
Mucharam
Laboratory Proc\Qa-Qc
130 Bench Fabrication Supt. - Process Maint.
50000678 Harry Wibowo 10106944 +62 81139 41110
workshop Support
Process Supt. - Process Maint.
Maintenance 130 Bench Rebuild workshop 50000678 Harry Wibowo 10106944 +62 81139 41110
Support
130 Bench Electrical GMD Supt. - Process
50000674 Erfan Zulkarnaen 10104201 +62 81139 49278
workshop Maintenance Electrical

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 22 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Sr. Process Control &


130 Bench Instrument
Instrumentation 50000580 Billy Lesnussa 10101745 +62 81139 49101
Workshop
Engineering

Laydown Ex Macindo 130 Supt. - Maint. Projects & Mohammad


50000789 10105600 +62 81139 49325
Concentrator Reliability Engineering Ramadhani

Laydown Sunowo 156 bench Supt. - Maint. Projects & Mohammad


50000789 10105600 +62 81139 49325
Concentrator Reliability Engineering Ramadhani

Superintendent Fleet
MEWS laydown, yard 50000129 Amiruddin Ishak 10306760 +62 81139 41302
Maintenance
MEWS
Superintendent Fleet
Cranserco Area 50000109 Irwansyah 10303472 +62 81139 49422
Crane Operation
PAR from Benete to Mine,
includes work on side of road Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
like pipework and grass Support Operation
cutting
All access roads from PAR to Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
OLC Support Operation
Access road PAR to 130 Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
Bench Support Operation
Access road from PAR to Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
Roads Santong 3 Support Operation
Access road PAR to Santong Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
Water Treatment Plant Support Operation
Access road PAR to
Superintendent Site
Emergency storm water pond 50000118 Jontar Sibarani 10302560 +62 81139 49939
Support Operation
and pond area
Access road PAR to SWIS, Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
tails corridor Support Operation
Access roads Sejorong fresh Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
water bore field Support Operation

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 23 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Access road to Tower


Superintendent Site
Communication at Port, 50000118 Jontar Sibarani 10302560 +62 81139 49939
Support Operation
Town and Mine area
Access road PAR to High
Superintendent Site
Voltage (HV) Tower from 50000118 Jontar Sibarani 10302560 +62 81139 49939
Support Operation
Benete to Concentrator
Access road PAR to 106 Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
Bench Support Operation
Access road PAR to Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
Townsite Support Operation
Superintendent Site
Roads within Townsite 50000118 Jontar Sibarani 10302560 +62 81139 49939
Support Operation
Roads around port site Superintendent Site
50000118 Jontar Sibarani 10302560 +62 81139 49939
(Benete) Support Operation
Santong Fabrication & Supt. - Maint. Projects & Mohammad
50000789 10105600 +62 81139 49325
sandblasting shop Reliability Engineering Ramadhani
PDP Corrosion Remediation Supt. - Maint. Projects & Mohammad
50000789 10105600 +62 81139 49325
Workshop Reliability Engineering Ramadhani
Supt. - Maint. Projects & Mohammad
Business Partners Supra Workshop 50000789 10105600 +62 81139 49325
Reliability Engineering Ramadhani
Superintendent Project & Agus Ivan
50000794 10105365 +62 81139 49114
Construction Verdian
SWIS Tailing Project
Supt. - Maint. Projects & Mohammad
50000789 10105600 +62 81139 49325
Reliability Engineering Ramadhani
Superintendent Project & Agus Ivan
50000794 10105365 +62 81139 49114
Construction Verdian
Laydown Kepli Laydown Sejorong
Supt. - Maint. Projects & Mohammad
50000789 10105600 +62 81139 49325
Reliability Engineering Ramadhani
PORT SITE Work Area Position Title Pos ID Personal Name ID Badge Phone Number

Filter plant, Concentrate Supt. - Process Mech.


Filter Plant 50000677 Zainul Wahidin 10101706 +62 81139 41108
Barn, shiploader Maint. Downstream

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 24 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Supt. - Process Mech.


Water pond Benete 50000677 Zainul Wahidin 10101706 +62 81139 41108
Maint. Downstream

Coal unloading area Supt. - Process Mech.


50000677 Zainul Wahidin 10101706 +62 81139 41108
Conveyor only Maint. Downstream

Pebble lime unloading Supt. - Marine &


50000885 Abdul Aziz 10306941 +62 81139 49118
facility Laydown
Superintendent Power Agustinus Jonny
Power sea water pump area 50000587 10103150 +62 81139 49107
Plant Maintenance Rukka
All MCC’s within Filter Supt. - Process
50000674 Erfan Zulkarnaen 10104201 +62 81139 49278
Plant area Maintenance Electrical
Maintenance workshop Supt. - Process Mech.
50000677 Zainul Wahidin 10101706 +62 81139 41108
within Filter area Maint. Downstream
SUPPLY CHAIN
Work Area Position Title Pos ID Personal Name ID Badge Phone Number
MANAGEMENT
Jetty Concentrate
Jetty Jamuna/bulk
Jetty cargo
Jetty Galagher
Supt. - Marine &
Port Benete laydown 1, 2, 3 and 9 50000885 Abdul Aziz 10306941 +62 81139 49118
Laydown
Laydown 3 wash pad
Laydown 3 ringing and
lifting barn
ROV and Diving facilities
Superintendent Project & Agus Ivan
Benete Smelter Project 50000794 10105365 +62 81139 49114
Construction Verdian
Warehouse and con-yard Superintendent
Con 1 50000833 Ahmad 10302535 +62 81139 49285
Bone yard Warehouse

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 25 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Concentrator fuel station


Central receiving and
distribution
Power warehouse
Benete fuel station
Gasoline tank Benete
Mine fuel station
Benete chemical storage
Superintendent
Warehouse Remote Permanent tank farm 50000833 Ahmad 10302535 +62 81139 49285
Warehouse
Laydown 6 and 10
Kepli Laydown
Fuel PipeLine KM#1 -
KM#8, Port site area
(Jamuna, Passenger, Cargo)
POWER
Work Area Position Title Pos ID Personal Name ID Badge Phone Number
STATION
Superintendent Power
Coal Plant and diesel stations 50000589 Ketut Tunggalika 10101644 +62 81139 49827
Plant Operations
Supt. - Power Planning &
Demin Plant 50000588 Sumadi 10303145 +62 81139 49968
Technical Services
All MCC’s within Power Superintendent Power
Power Plant 50000589 Ketut Tunggalika 10101644 +62 81139 49827
Plant area Plant Operations
Maintenance workshops Superintendent Power Agustinus Jonny
50000587 10103150 +62 81139 49107
within Power plant area Plant Maintenance Rukka
RF #5 Diesel Generator GE- Superintendent Power
50000589 Ketut Tunggalika 10101644 +62 81139 49827
138 Plant Operations
Transmission 150KV transmission line and Superintendent Power Agustinus Jonny
50000587 10103150 +62 81139 49107
Facilities corridor Plant Maintenance Rukka

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 26 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

All 33KV and 11 KV power


lines, Substations and Superintendent Power Agustinus Jonny
50000587 10103150 +62 81139 49107
corridors excluding Mine Plant Maintenance Rukka
area
150KV Concentrator Superintendent Power Agustinus Jonny
50000587 10103150 +62 81139 49107
Substation Plant Maintenance Rukka
FACILITIES &
Work Area Position Title Pos ID Personal Name ID Badge Phone Number
SERVICES
Townsite: All housing and Superintendent F&S
50000239 Edy Purwanto 10302917 +62 81139 49534
Camps Maintenance Town site
Townsite: All admin Superintendent F&S
50000239 Edy Purwanto 10302917 +62 81139 49534
buildings Maintenance Town site
Townsite: All Public
facilities (School,
Superintendent F&S
Community hall, 50000239 Edy Purwanto 10302917 +62 81139 49534
Maintenance Town site
Commissary, Swimming
pool, etc.)
Superintendent F&S
Townsite: All generator set 50000239 Edy Purwanto 10302917 +62 81139 49534
Maintenance Town site
Townsite Townsite: WTP, STP and Superintendent F&S
50000239 Edy Purwanto 10302917 +62 81139 49534
Water well 41 Alfa facilities Maintenance Town site
Townsite: Water tank area Superintendent F&S
50000239 Edy Purwanto 10302917 +62 81139 49534
1100 Maintenance Town site
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Port Area: All office Maintenance PCM
buildings at port Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Port Area: Jetty passenger Maintenance PCM
and Hangar buildings Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 27 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Port Area: STP Plant and Maintenance PCM
WTP Plant Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Port Area: Public buildings Maintenance PCM
(Mosque, Mess hall, etc.) Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
Concentrator Area: All office 50000238 Ratno 10306910 +62 81139 41414
Maintenance PCM
buildings except Trakindo
main office. Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Concentrator Area: Training Maintenance PCM
center building Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Concentrator Area: All Maintenance PCM
warehouse buildings Supv. - Hvac
Concentrator 50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
Concentrator Area: WTP 50000238 Ratno 10306910 +62 81139 41414
Maintenance PCM
Plant 130 & WTP Plant
Trakindo Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Concentrator Area: STP plant Maintenance PCM
and incinerator Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Maintenance PCM

DOKUMEN INI TIDAK DIKONTROL DALAM FORMAT HARDCOPY_


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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 28 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Concentrator Area: - Public


Supv. - Hvac
buildings (Mosque, Mess hall 50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
etc.)
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Mine Area: All office Maintenance PCM
buildings at MMA area Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
Mine Area: Public buildings 50000238 Ratno 10306910 +62 81139 41414
Maintenance PCM
Mine at MMA area (Mosque, Mess
hall) Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
Superintendent F&S
50000238 Ratno 10306910 +62 81139 41414
Mine Area: STP Plant MMA Maintenance PCM
& WTP Plant, MMA Supv. - Hvac
50000248 Kusnadi 10305478 +62 81139 49856
Maintenance
TRAINING Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Concentrator Area: -
Training center equipment Superintendent Fixed
50003765 Haryadi 23000182 +62 81139 49435
and machinery inside training Plant Training
Concentrator center trades building.
Concentrator Area: -
Supt. - Onboarding
Training center main office 50003764 Ishak 23000191 +62 81139 49831
Training
and administration
ENVIRONMENT
Work Area Position Title Pos ID Personal Name ID Badge Phone Number
AL
Supt. - Env. Compliance,
Environmental office Muhammad
Reporting & 50000989 10301680 +62 81139 49741
(Concentrator) Amrul Husni
Improvement
Concentrator Environmental Lab area Superintendent Env
50000987 Windy Prayogo 10305315 +62 81139 49787
(Concentrator) Monitoring
Reclamation Nursery (near Superintendent Env.
50000988 Mara Maswahenu 10304340 +62 81139 49742
MEWS) Planning & Project

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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 29 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Environmental office & Superintendent Env


50000987 Windy Prayogo 10305315 +62 81139 49787
Marine Lab area (Benete) Monitoring
Benete Superintendent Env.
B3 Waste Storage area Muhammad
Permitting, Reporting & 50000989 10301680 +62 81139 49741
(Benete) Amrul Husni
Compliance
TRANSPORT Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Townsite bus station Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
Townsite
Townsite wash pad Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
Benete Benete – bus station Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
Benete Avtur tank Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
PAR Sekongkang Bus station Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
Concentrator Concentrator Bus Station Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
Kayangan Jetty passenger Kayangan Supt Land Transportation 50001079 Deky Engel B. 10303242 +62 81139 49175
TOWER Work Area Position Title Pos ID Personal Name ID Badge Phone Number
Superintendent F&S
50000239 Edy Purwanto 10302917 +62 81139 49534
Maintenance Town site
Tower Telkomsel, Tower XL Supt. - Planning Cost &
Townsite 50000240 Rudi Setiawan 10307087 +62 81139 49490
and Tower Admin 3 Town Facilities
Supt. - F&S Maintenance 50000238 Ratno 10306910 +62 81139 41414
Supt. - Power Planning &
50000588 Sumadi 10303145 +62 81139 49968
Technical Services
RF5
Superintendent Power
Benete 50000589 Ketut Tunggalika 10101644 +62 81139 49827
Plant Operations
Supt. - Marine &
Logistic 50000885 Abdul Aziz 10306941 +62 81139 49118
Laydown
Supt. - Upstream
50000682 Jermias Singkoh 10102121 +62 81139 41514
Operations
Concentrator Tower Telkomsel
Supt. - Operations Project 50000685 Muhammad
10101968 +62 81139 41498
& Utility Sahrir

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Page: 30 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Supt. - Downstream
50000684 Horas Sitorus 10101978 +62 81139 49392
Operations
Supt. - Shift Metallurgy &
50000766 Gufran Khomaeni 10105932 +62 81139 41533
Control Room
Tower XL, Olat Balat and
Air Merah
Mining Superintendent Electrical 50001567 Junaedi 23000372 +62 81139 49622
Tower XL, Olat Balat and
Air Merah

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Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 31 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Authority to Work (ATW) System - Flow Chart / Sitem Izin untuk Bekerja (ATW) – Diagram Alir

Perizinan untuk Memulai Bekerja


Perizinan untuk Memulai Bekerja via IZIN ATW
melalui Safe-Check
Langkah 1. Langkah 2a. Langkah2b. Langkah 3 Langkah 4. Langkah5.
‘Supervisor/Ketu Pekerjaan Resiko rendah Resiko Sedang, Tinggi dan Pekerjaan Lainnya Penerima Izin Supervisor Pemilik ‘Supt. Pemilik Area
a Tim yang ‘Supervisor/Ketua Tim (tingkat resiko dari SafeCheck atau identifikasi Kerja dan Penerima - Menginspeksi lokasi
didelegasikan yang didelegasikan sebelumnya. Lengkapi : Izin kerja
(pengawas (pengawas pekerjaan -Permohonan Izin -Memastikan semua - Memastikan resiko pada
Memastikan persertujuan ATW; dokumen disiapkan JHA disetujui secara
pekerjaan)
untuk memulai bekerja dari Superintendent. Pemilik Pekerjaan
-Menyelesaikan -JHA - Memastikan semua benar
Supt.. Pemilik (Boleh -Mendelegasikan pekerjaan kepada “Dept./Section
SafeCheck, dilakukan secara lisan) -STP’s. bahaya dikontrol di - Memastikan Izin Kerja
yang akan mengerjakan
memastikan tingkat - Izin lainnya lokasi kerja didalam JHA diletakkan
-Catat nama yang - Menetapkan” “Supervisor Pemilik Pekerjaan’.
resiko? menyetujui pada SafeCheck - Pastikan kontrol di lokasi kerja
- Catat kontrol bahaya pada bahaya di lokasi Penerima Izin - Memastikan kontrol
SafeCheck Department/ Sectionyang mengerjakan pekerjaan. - Hubungi supervisor - Briefing dengan tim bahaya di lokasi kerja
- Memberi arahkan kru - Menetapkan Supervisor yang mengelola pekerjaan pemilik pekerjaan kerja sesuai dengan JHA
MULAI PEKERJAAN (Penerima Izin) dan Supt. Pemilik - Penerima izin dan tim - Jika aman, tandatangani
Area kerja menandatangani izin ATW untuk
JHA membuka izin untuk
MEMULAI
PEKERJAAN.

NO Jika multi-shift Kontrol Pekerjaan Multi-Shift via JHA


pekerjaan
Langkah 6 TUTUP IZIN ATW (pekerjaan tidak Langkah 7a. (JHA) Langkah 7b. (JHA)
Penerima Izin selesai dalam satu Penerima Izin Penerima Izin
shift) -Pada awal shift selanjutnya
gunakan form “Additional JHA - Ulangi proses 7a hingga
Apakah pekerjaan selesai atau
Pekerjaan - Hubungi Supt.. Area, minta Izin Multi-Shift’ dan tulis nomor
Pekerjaan ATW ditutup. maksimum 7 hari. Jika .7
Selesai referensi izin ATW pada JHA
Terselesaika hari, buat JHA baru.
ATAU SHIFT -Perbaharui izin kerja lainnya-
n? - Supt. Pemilik Area menginspeksi - Jika <7 hari, TUTUP dan
review dan revisi JHA (kontrol dan
lokasi kerja. tandatangani penutupan izin
bahaya) Diskusikan dengan
crew/tim ATW (Langkah 6)
- Jika selesai dan aman, tandatangani
-Penerima Izin dan Crew/Tim PEKERJAAN SELESAI
PENUTUPAN Izin ATW
menandatangani form JHA Arsipkan Semua Dokumen
YES PEKERJAAN SELESAI ATW
Arsipkan Semua Dokumen ATW

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THIS DOCUMENT IS UNCONTROLLED IN HARDCOPY FORMAT
Doc No: CDC-SLP-040-P067 SAFETY, HEALTH AND LOSS PREVENTION
Page: 32 of 32 Version: 3.4
Approval Date: 4/25/2022 12:00:00 AM
DEPARTMENT
Review Cycle: 2 Years
Author: Manager SHLP
AuthorPosID: 50000973 Sistem Otorisasi Untuk Bekerja & Prosedur Izin ATW
Approval: Site Director
ApprovalPosID: 50000009

Authorization to Start Work Granted


Authorization to Start Work Granted via an ATW Permit
via a Safe-Check
Step 1. Step 2a. Step 2b. Step 3. Step 4. Step 5.
‘Supervisor/Deleg LOW Risk Task Medium, high risk and all other tasks Permit Receiver Work Owner Area Owner Supt.
ated Team ‘Supervisor/Delegate (risk rating from Safe-Check or previously Assigned Sup and -Inspects job location
Leader d Team Leader identified) Completes; Permit Receiver - Confirms JHA risk
(supervising the (supervising the work) -ATW Permit -Confirm all documents rating is approved
work) Work Owner Supt. Request information; prepared. correctly
Seeks approval to start -Delegates work to ‘Department/Section doing the -JHA -Confirm all hazard - - Confirms Work Permits
-Completes a Safe work from Area Owner work’. -STP’s. controls in place.
stated on JHA in place
Check, confirms Supt. (may be verbal) -Assigns a ‘Work Owner Assigned Supervisor’. -All other work
risk rating? permits - Confirms controls in
-Writes approvers Department / Section doing the work’. -Puts hazard controls Permit Receiver place for hazards
name on Safe Check -Assigns a ‘Supervisor to Manage the Work (Permit in place. -Briefs work team noted on JHA
Receiver)’ -Contacts Work -Permit Receiver and - - If safe, signs ATW
-Puts hazards controls Owner assigned Work Team sign on permit to authorize
in place Supervisor & Area JHA Permit OPEN.
-Briefs crew Superintendent. START WORK
START WORK

NO If multi-shift job
Multi-Shift Tasks Controlled via JHA
(job not finished on
Step 6 CLOSE ATW Permit. one shift) Step 7a. (JHA) Step 7b. (JHA)
Permit Receiver Permit Receiver Permit Receiver

-Contacts Area Owner Supt. , requests -At start of next shift use the Repeat this process until
END OF TASK ATW permit closure. ‘Additional JHA Multi-Shift’ form either completion of the job
OR Is the task and write ATW reference Number or a maximum of 7 days.
END OF complete? - Area Owner Supt. inspects job on JHA
SHIFT location. If >7 days, start a new JHA.
-Update other work permits If <7 days, CLOSE and sign
- If complete and safe, signs ATW -Review and revise JHA hazards off ATW (Step 6)
permit CLOSED. and controls-Discuss hazards and
controls with crew. WORK COMPLETE
WORK COMPLETE File all ATW copies
File all ATW copies -Permit Receiver and Crew sign
YES
JHA Multi-Shift’ form

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