HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM

Location Project: Infineon Batam 3- Tunnel Assessment No. HIRAC – CDP – 52 - I - 2024
Main Activity MEP Tunnel Work
Conducted: Ngadimo (SV) . Purnawarman (HSE) Date: 09-01-2024 Risk Assessment Rev. R0
Prepared by: Agung Pradana (Doc.Controller) Date: 09-01-2024 Next Review Date: 09-02-2024
Check PPE & Safety Shoes  Safety Glasses  Ear Plug  Hand Gloves  Respirator  Safety Harness  ESD Smock - Other – List : Lighting
Controls Required : Safety Yellow Boots - Face Shield  Safety Helm  Coveralls  Mask  APAR  ESD Shoes -  = Mandatory  = As required - = Not required

Job Step Risk Residual Follow up By

Potential Hazard Risk Control Hazards Required Additional Control Measures
(Langkah Evaluation Risk (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

1. Preparation - Stumble then - Personnel 3 2 6 - Implement the 5Rs in the work area 2 2 4 - Conduct a Pre job safety meeting before Ngadimo
tools and fall Injury Lakukan penerapan 5R diarea kerja the implementation of work. (SV)
material Tersandung lalu Personil Melakukan Pre job safety meeting
Persiapan jatuh cidera - Ensure the condition of the tool is in good sebelum pelaksanaan pekrjaan Purnawarma
peralatan dan condition according to spect n (HSE)
material - Use - Minor Pastikan kondisi alat dalam keadaan baik - Read procedures before work execution
uninspected injuries sesuai spesipikasi and carry them out according to
equipment luka ringan procedures
Menggunakan make sure equipment used has passed Membaca prosedur sebelum
peralatan yang - inspection by HSE team by looking at color pelaksanaan pekerjaan dan
tidak di inspeksi code sticker printed on work tool. melaksanakannya sesuai prosedur
pastikan peralatan yang digunakan sudah lolos
Edge sharp inspeksi oleh tim HSE dengan melihat stiker - Ensure the work area and load are
- Terkena sisi kode warna yang tertera pada alat secure from unauthorized persons and
tajam install barricades to prevent entry.
- Isolate if there are sharp parts Pastikan area kerja dan muatan aman
- Pinch point Jauhkan atau isolasi jika terdapat bagian dari orang tidak berkepentingan dan
Titik jepit bagian tajam pasang barikade untuk mencegah
memasuki area tersebut.
materials - wear long-sleeved work clothes
- blocking traffic gunakkan baju kerja lengan panjang
access
material Put safety signs in pinch point area
menghalangi - Beri rambu rambu keselamatan di area titik
akses lalu lintas jepit

- make sure there is no material blocking traffic

access.
pastikan tidak terdapat matrial yang
menghalangi akses lalu lintas

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Control Hazards Required Additional Control Measures
(Langkah Evaluation Risk (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)
- provide safety signs in around work area and
2. Material - Employee traffic - IFBT 3 3 9 barricade area 2 3 6 - Specific internal briefing may be need Ngadimo
mobilization around working employee Menyediakan rambu keselamatan di area given to involved workers (SV)
using Pickup / area injured sekitar pekerjaan dan barricade area kerja Pengarahan internal yang spesifik
Mobilisasi Lalu lintas karyawan mungkin perlu diberikan kepada pekerja Purnawarma
material karyawan di IFBT cidera - Stop mobilizing materials if there are IFBT yang terlibat n (HSE)
menggunakan sekitar area shipping vehicles entering, make sure to
Pickup kerja - Serious coordinate well. - Safety officer and supervisor standby at
injury stop melakukan mobilisasi material jika work area
- Contractor Cidera terdapat kendaraan shipping IFBT masuk , Petugas keselamatan dan pengawas
Vehicle traffic parah pastikan melakukan koordinasi dengan baik. siaga di area kerja
Lalu lintas
kendaraan - Property - Standby 1 person at entry material traffic gate - Vehicle inspection before use
kontraktor Damage Stand by 1 orang untuk di pintu lalu lintas Inspeksi kendaraan sebelum digunakan
Kerusakan material masuk
- Overloaded properti - Use a mat to prevent oil dripping onto
vehicle - Driver must have a Driver License that the asphalt
Kendaraan - Environment matches the vehicle used Gunakan alas pencegah tetesan oli ke
kelebihan pollution Pengemudi harus memiliki sim sesuai dengan aspal
muatan Pencemarn kendaraannya
lingkungan - use a mat when transferring materials
- Long / width - Make sure the load does not exceed the and standby 1 person to clean the
materials - Lowback maximum limit stated on the transport vehicle. mobilization area.
Material lebar / pain Pastikan muatan tidak melebihi batas gunakan alas pada saat transfer
panjang nyeri maksimum yang tertera pada kendaraan material dan standby 1 orang untuk
punggung angkut melakukan aktifitas pembersihan area
- Blind spot bawah mobilisasi
Titik buta - Materials that generate dust or grit when
transported must be wrapped
- Vehicle is not Material yang menghasilkan debu atau pasir
suitable for its pada saat dibawa harus dibungkus plastik /
designation karung
Kendaraan
tidak sesuai - Carrying material must be more than 1 person
peruntukan Membawa material harus lebih dari 1 orang

- Material falling - Before transportation, do inspect vehicle

from the vehicle Sebelum melakukan pengangkutan pastikan
material jatuh dilakukan inspeksi terhadap kendaraan
dari kendaraan
- Before transporting materials make sure there
- Vehicle oil spills are no materials that could potentially fall off
Tetesan oli the vehicle.
kendaraan sebelum pengangkutan material pastikan tidak
ada terdapat material yang berpotensi jatuh
dari kendaraan

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Control Hazards Required Additional Control Measures
(Langkah Evaluation Risk (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

- Driving a 3 3 9 - Maximum speed below 10km/h when entering 2 3 6 Ngadimo

vehicle at high the IFBT area (SV)
speed maksimum kecepatan dibawah 10km/jam pada
membawa saat memasuki area IFBT Purnawarma
kendaraan n (HSE)
dengan - make sure the driver is not under the influence
kecepatan of alcohol, sleepy or tired.
tinggi pastikan supir tidak dalam pengaruh alkohol,
- ngantuk atau kelelahan
Pinchpoint
between - Bind the material on the vehicle
material lakukan pengikatan pada material diatas
Bagian tubuh kendaraan
terjepit antara
material - Away from the pinch point
- Menjauh dari titik jepit
Manual
Handling - Perform the lift with the technique of using
Pengangkatan thigh power, not back power (if you can't,
manual contact SV / HSE to be trained)
Lakukan pengangkatan dengan teknik memakai
tenaga paha, bukan tenaga punggung (kalau
belum bisa, hubungi SV / HSE untuk dilatih)

- Lift with a minimum of 2 people, one of the giver

command/signal
Angkat dengan minimal 2 orang, salah satu
pemberi komando/aba-aba

- Lifting items close to the body. Not turning the

body abruptly when carrying heavy items.
Mengangkat barang rapat ke tubuh. Tidak
memutar tubuh secara mendadak saat
membawa barang berat.

- Ensure that the placement of materials does not

block access
pastikan peletakan material tidak menghalangi
akses,

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Evaluation Control Hazards Risk Required Additional Control Measures
(Langkah (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

3. Checking gas - Gas detector is - Invalid 4 3 12 - gas detector is still in the calibrated period, do 2 3 6 - Safety officer and supervisor standby at Ngadimo
and oxygen not calibrated checking not use expired gasdetector work area (SV)
levels use gas gas detector pengeceka gas detector masih dalam masa sudah Petugas keselamatan dan pengawas
tidak dikalibrasi n tidak valid dikalibrasi , tidak menggunakan gasdetector siaga di area kerja Purnawarma
detector
yang kadaluarsa n (HSE)
before work Carried out by - lack of - Specific internal briefing may be need
pengecekan incompetent oxygen or - there is a calibration date on the gas detector given to involved workers
gas dan - people excess terdapat tanggal kalibrasi pada alat gas Pengarahan internal yang spesifik
kadar oksigen dilakukan oleh oxygen detector mungkin perlu di berikan kepada pekerja
menggunaka orang yang keurangan yang terlibat
n deteksi gas tidak oksigen make sure the gasdetector is physically good
berkompeten atau - by doing a physical check. - Implement the 5Rs in the work area
sebelum
kelebihan pastikan gasdetector baik secara fisik dengan Lakukan penerapan 5R diarea kerja
bekerja Incorrect oksigen melakukan cek secara fisik
checking - If there are excessive levels of PPM,
- procedure - Gas checks are carried out by competent and Co2 and LEL or oxygen levels are too
prosedur poisoning - trained people low or too high, a work permit is not
pengecekan keracunan pengecekan dilakukan oleh orang yang issued or it is not recommended to do
yang salah gas berkompeten dan terlatih activities in confined spaces, before
control is carried out and checked again
not checking - Exploded check the procedure and suitability of the area until the results match the classification.
- gas or oxygen Meledak - that will be used for work. jika terdapat kadar berlebih dari
levels regularly lakukan pengecekan sesuai prosedur dan PPM,Co2 dan LEL atau kadar okigen
tidak - Personnel kesesuaian pada area yang akan digunakan telalu rendah atau terlalu tinggi makan
melakukan Injury untuk berkerja izin kerja tidak di terbitkan atau tidak
pengecekan Personil dianjurkan untuk berkatifitas di ruang
kadar gas atau cidera - record the results of the initial check terbatas, sebelum control dilakukan dan
oksigen secara lakukan pencatatan hasil pengecekan awal dilakukan cek kembali sampai hasil
berkala sesuai klasifikasi
- PPM, LEL, CO2 on indicators below the
Fell into a threshold with values <10 for PPm, 0 for Co2, - check periodically, namely, before
manhole - <0.5 for LEL entering the confined space, during
jatuh ke dalam PPM, LEL, CO2 pada indikator harus dibawah activities and at the end of activities.
lubang got ambang batas dengan nilai <10 untuk PPm, 0 lakukan pengecekan secara berkala
untuk Co2, <0,5 untuk LEL yaitu, sebelum masuk ruang terbatas,
saat aktifitas dan diahir akifitas
- for safe oxygen levels between 19.5% - 23.5%
untuk tingkat oksigen yang aman antara - Stop activities and report any new
19,5% - 23,5% hazards in the work area.
stop aktifitas dan laporkan jika terdapat
at the time of checking not too on the edge of bahaya baru di area kerja
- the manhole
pada saat pengecekan tidak terlalu di tepi
pada manhole

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Evaluation Control Hazards Risk Required Additional Control Measures
(Langkah (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)
ensure work permits are approved before
4. Enter the - there is no work - lack of 4 3 9 - entering the confined space area. 2 3 6 - Safety officer and supervisor standby at Ngadimo
tunnel and permit oxygen or pastikan izin kerja sudah di setujui sebelum work area (SV)
make belum terdapat excess masuk ke area ruang terbatas Petugas keselamatan dan pengawas
izin kerja oxygen siaga di area kerja Purnawarma
preparations keurangan work permit granted based on gas detector n (HSE)
masuk ke workers are not oksigen - measurement results - Implement the 5Rs in the work area
trowongan trained to work atau izin kerja yang diberikan berdasarkan hasil Lakukan penerapan 5R diarea kerja
dan - in confined kelebihan pengukuran gas detector
melakukan spaces oksigen - Stop activities and report any new
pekerja tidak di Ensure that workers receive a briefing or hazards in the work area.
persiapan
beri pelatihan Gas - training on working in confined spaces. stop aktifitas dan laporkan jika terdapat
bekerja diruang - poisoning pastikan pekerja mendapat pembekalan atau bahaya baru di area kerja
terbatas keracunan training mengenai bekerja pada ruang
gas terbatas
no control of
incoming - Exploded Control workers who enter the confined space,
- workers Meledak - by filling in the entry and exit register form.
tidak dilakukan lakukan kontrol terhadap pekerja yang masuk
kontrol pekerja - Personnel diruang terbatas, dengan mengisi form
yang masuk Injury register masuk dan keluar
Personil
carrying toxic cidera workers who are not trained and do not have
and flammable - permission to enter, are not allowed to enter
materials the confined space work area.
- membawa pekerja yang tidak di training dan tidak ada
bahan beracun izin masuk, tidak di perkenan kan masuk ke
dan mudah area kerja ruang terbatas
terbakar
- standby 1 in the manhole area as supervisor
- lack of lighting standby 1 diarea manhole sebagai pengawas
kurang
pencahayaan do not use flammable search materials in
- confined space work areas
- absence of air tidak menggunakan bahan cari yang mudah
system terbakar di area kerja ruang terbatas
tidak adanya
sistem udara provide sufficient lighting before starting
- activities
- Use sediakan pencahayaan yang cukup sebelum
uninspected memulai aktifitas
equipment
Menggunakan - using a blower continuously as a clean air
peralatan yang circulator
tidak di inspeksi menggunakan blower secara kontinyu
sebagai sirkulai udara yang bersih

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Evaluation Control Hazards Risk Required Additional Control Measures
(Langkah (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

- Edge sharp - Personnel 3 3 9 - Carry and use work equipment that has 2 3 6 Ngadimo
Terkena sisi Injury passed inspection by the HSE team. (SV)
tajam Personil membawa dan menggunakan peralatan kerja
cidera yang sudah lolos inspeksi oleh tim HSE Purnawarma
Did not check n (HSE)
the tool - Minor - Isolate if there are sharp parts
- tidak injuries Jauhkan atau isolasi jika terdapat bagian
melakukan luka ringan bagian tajam
pengecekan
alat - Wear long-sleeved work clothes
- gunakkan baju kerja lengan panjang
Materials or
equipment - Put safety signs in pinch point area
blocking access Beri rambu rambu keselamatan di area titik
material atau jepit
peralatan
menutupi akses - Check the equipment before use
- melakukan cek kembali terhadap peralatan
Not installing sebelum digunakan
barricades or
signs - Materials and work equipment do not block
tidak traffic access
memasang material dan perlalatan kerja tidak menutupi
baricade atau akses lalu lintas
rambu
- Communicate with security regarding the
activities that will be carried out
lakukan komunikasi kepada scurity terkait
aktifitas yang akan dilakukan

- Install signs indicating that work is in progress,

and barricade the area
memasang rambu menandakan sedang ada
pekerjaan, dan baricade area

Always have fire extinguishers available in the

- work area
selalu sedia APAR diarea kerja

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Evaluation Control Hazards Risk Required Additional Control Measures
(Langkah (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

5. Install - Poor lighting - Serious 4 3 12 - Provide sufficient lighting at work area 2 3 6 - Safety officer and supervisor standby at Ngadimo
support pencahayaan kurang injury Menyediakan penerangan yang cukup work area (SV)
bracket Cidera parah di area kerjadan Petugas keselamatan dan pengawas
pemasangan lack of oxygen siaga di area kerja Purnawarman
suport braket - Kekurangan oksigen - Personnel using a blower continuously as a clean (HSE)
Injury air circulator - Implement the 5Rs in the work area
Personil - menggunakan blower secara kontinyu Lakukan penerapan 5R diarea kerja
Personnel injury cidera sebagai sirkulai udara yang bersih
- (scratched/cut hands) - check PPE Bodyharnes before use.
Personil cidera - fainting Perform by trained and competent lakukan pengecekan PPE Bodyharnes
(tangan pingsan person and proper PPE to be worn sebelum digunakan
tergores/terpotong - (Gloves all the time)
Dilakukan oleh orang yang
Bad cable berkompeten dan gunakan APD yang
- management, and sesuai (sarung tangan setiap saat )
damage cable
Management kabel - Electrical equipment in use must be
dan penggunaan connected with ELCB/RCCB
kabel yg rusak Peralatan listrik yang di pergunakan
harus terhubung dengan ELCB/RCCB
- Dust
Debu - Implement cable management
Terapkan management cable
- Dehidrasi
Dehidrasi organize working hours for workers,
- every 1 hour of work must be out of the
confined space area for 15 minutes.
lakukan pengaturan jam kerja pada
pekerja , tiap 1 jam kerja harus keluar
dari area ruang terbatas selama 15
menit

- provide proper and clean drinking water

for drinking
sediakan air minum yang layak dan
bersih untuk diminum

- Do not perform fabrication in confined

space areas, perform fabrication
outside of confined space areas
tidak melakukan fabrikasi di area ruang
terbatas, lakukan fabrikasi diluar area
ruang terbatas

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Control Hazards Required Additional Control Measures
(Langkah Evaluation Risk (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)
Provide sufficient lighting at work area
6. Install - Poor lighting - Serious 4 3 12 - Menyediakan penerangan yang cukup di area 2 3 6 - Safety officer and supervisor standby at Ngadimo
sprinkler pencahayaan injury kerjadan work area (SV)
pipe, Fire kurang Cidera Petugas keselamatan dan pengawas
Alrm and parah using a blower continuously as a clean air siaga di area kerja Purnawarma
pvc pipe - lack of oxygen circulator n (HSE)
Pemasang Kekurangan - Personnel menggunakan blower secara kontinyu sebagai - Implement the 5Rs in the work area
an pipa oksigen Injury - sirkulai udara yang bersih Lakukan penerapan 5R diarea kerja
springkler ,f Personil
ire alarm - cidera Perform by trained and competent person and - check PPE Bodyharnes before use.
dan pipa Personnel injury proper PPE to be worn (Gloves all the time) lakukan pengecekan PPE Bodyharnes
pvc (scratched/cut - fainting Dilakukan oleh orang yang berkompeten dan sebelum digunakan
hands) pingsan - gunakan APD yang sesuai (sarung
Personil cidera tangan setiap saat )
(tangan
- tergores/terpoto Electrical equipment in use must be connected
ng with ELCB/RCCB
- Peralatan listrik yang di pergunakan harus
Bad cable terhubung dengan ELCB/RCCB
management,
and damage Implement cable management
- cable Terapkan management cable
Management -
kabel dan organize working hours for workers, every 1
penggunaan hour of work must be out of the confined space
kabel yg rusak area for 15 minutes.
- lakukan pengaturan jam kerja pada pekerja ,
- Dust tiap 1 jam kerja harus keluar dari area ruang
Debu terbatas selama 15 menit

- Dehidrasi provide proper and clean drinking water for

Dehidrasi drinking
sediakan air minum yang layak dan bersih
- Painting pipe - untuk diminum
Pengecatan pipa
Do not perform fabrication in confined space
areas, perform fabrication outside of confined
space areas
- tidak melakukan fabrikasi di area ruang
terbatas, lakukan fabrikasi diluar area ruang
terbatas

paint outside the confined space area, not

inside the confined space area.
lakukan pengecatan diluar area ruang terbatas,
tidak didalam area ruang terbatas

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Job Step Risk Residual Follow up By
Potential Hazard Risk Evaluation Control Hazards Risk Required Additional Control Measures
(Langkah (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

7. Wiring cable - Termination is - Electric 4 3 9 - Make sure handtools used are suitable for thei 2 3 6 - Safety officer and supervisor standby at Ngadimo
Penarikan done by an shock / intended use work area (SV)
kabel incompetent Short Pastikan handtools yg digunakan sesuai untuk Petugas keselamatan dan pengawas
person electric Tersengat peruntukan nya siaga di area kerja Purnawarma
Terminasi listrik / arus n (HSE)
dilakukan oleh pendek - Not using modified handtools - Implement the 5Rs in the work area
orang yg tidak Tidak menggunakan alat kerja yang jenis nya Lakukan penerapan 5R diarea kerja
brkompeten - Personnel modifikasi
kelistrikan Injury / tanda berhati hati - Conduct a test before the cable is used
Personil Melakukan test sebelum kabel
- Using handtools cidera - Make sure the cable termination work is done digunakan
sharp /cuttuer by a competent electrical person.
Menggunakan - Minor Pastikan pekerjaan terminasi kabel dilakukan - Implement good cable management
alat kerja injuries oleh orang yang berkompeten kelistrikan Terapkan management cable yang baik
tajam / luka ringan
pemotong Make sure the material used is in accordance
- Property - with the specifications that have been
Using cables or - Damage determined
electrical Kerusakan Pastikan material yang digunakan sudah
materials that properti sesuai spesifikasi yang sudah di tentukan
do not comply
with If working near power lines/cables, pay
specifications attention to a safe distance so that they are not
menggunakan - affected by electric currents.
kabel atau Jika bekerja di dekat aliran listrik / kabel,
material listrik perhatikan jarak yang aman sehingga tidak
yang tidak terimbas oleh arus listrik.
sesuai
spesifikasi Make sure LOTO system is installed if
- necessary
Using - Memastikan system LOTO terpasang jika
inappropriate diperluka
tools
Menggunakan make sure the electric tools used are in a
alat yang tidak proper condition for use and have been inspec
layak - Pastikan alat alat listrik yang digunakan dalam
- keadaan layak digunakan dan sudah di
Bad cable inspeksi
management,
and damage Electrical equipment in use must be connected
cable - with ELCB/RCCB
Management Peralatan listrik yang di pergunakan harus
kabel dan terhubung dengan ELCB/RCCB
penggunaan
kabel yg rusak

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM

Job Step Risk Residual Follow up By

Potential Hazard Risk Evaluation Control Hazards Risk Required Additional Control Measures
(Langkah (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)

8. Install wall - Poor lighting - Serious 4 3 12 - Provide sufficient lighting at work area 2 3 6 - Safety officer and supervisor standby at Ngadimo
partition and pencahayaan kurang injury Menyediakan penerangan yang cukup work area (SV)
door Cidera parah di area kerjadan Petugas keselamatan dan pengawas
lack of oxygen siaga di area kerja Purnawarman
pemasangan
- Kekurangan oksigen - Personnel using a blower continuously as a clean (HSE)
dinding partisi Injury air circulator - Implement the 5Rs in the work area
dan pintu Personil - menggunakan blower secara kontinyu Lakukan penerapan 5R diarea kerja
Personnel injury cidera sebagai sirkulai udara yang bersih
- (scratched/cut hands) - check PPE Bodyharnes before use.
Personil cidera - fainting Perform by trained and competent lakukan pengecekan PPE Bodyharnes
(tangan pingsan person and proper PPE to be worn sebelum digunakan
tergores/terpotong - (Gloves all the time)
Dilakukan oleh orang yang
Bad cable berkompeten dan gunakan APD yang
- management, and sesuai (sarung tangan setiap saat )
damage cable
Management kabel - Electrical equipment in use must be
dan penggunaan connected with ELCB/RCCB
kabel yg rusak Peralatan listrik yang di pergunakan
harus terhubung dengan ELCB/RCCB
- Dust
Debu - Implement cable management
Terapkan management cable
- Dehidrasi
Dehidrasi organize working hours for workers,
- every 1 hour of work must be out of the
confined space area for 15 minutes.
lakukan pengaturan jam kerja pada
pekerja , tiap 1 jam kerja harus keluar
dari area ruang terbatas selama 15
menit

- provide proper and clean drinking water

for drinking
sediakan air minum yang layak dan
bersih untuk diminum

- Do not perform fabrication in confined

space areas, perform fabrication
outside of confined space areas
tidak melakukan fabrikasi di area ruang
terbatas, lakukan fabrikasi diluar area
ruang terbatas

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM

Job Step Risk Residual Follow up By

Potential Hazard Risk Control Hazards Required Additional Control Measures
(Langkah Evaluation Risk (Tindak Lanjut
(Potensi Bahaya) (Resiko) (Kontrol Bahaya) (Kontrol Tambahan yang Diperlukan)
Pekerjaan) L S R L S R Oleh)
- Away from the pinch point
9. Housekeeping - Pinch point - Personnel 3 2 6 Menjauh dari titik jepit 2 2 4 - Implement the 5Rs in the work area Simon
work area Titik jepit Injury Lakukan penerapan 5R diarea kerja (SV)
Pembersihan Personil - Wear long sleeves
lokasi kerja - Personnel injury cidera Gunakan baju lengan panjang Ariful Sari
(HSE)
(scratched/cut - Environment - Attention to the path to/from the
hands) al pollution equipment compartment
Personil cidera Pencemaran Perhatikan jalan menuju ke/dari tempat
- (tangan lingkungan peralatan
tergores/terpotong
- Maximum load allowed to lift by each
- Stumble then fall person is 20 kg
Tersandung lalu Beban maksimun yang boleh diangkat
jatuh oleh satu orang adalah 20 kg.

- Manual Handling - Perform the lift with the technique of

Pengangkatan using thigh power, not back power (if
manual you can't, contact SV / HSE to be
trained)
Employee traffic & Lakukan pengangkatan dengan teknik
- vehicle memakai tenaga paha, bukan tenaga
Lalu lintas karyawan punggung (kalau belum bisa, hubungi
dan kendarann SV / HSE untuk dilatih)

- Lift with a minimum of 2 people, one of

the giver command/signal
Angkat dengan minimal 2 orang, salah
satu pemberi komando/aba-aba

- Lifting items close to the body. Not turning

the body abruptly when carrying heavy
items.
Mengangkat barang rapat ke tubuh.
Tidak memutar tubuh secara
mendadak saat membawa barang
berat.
-
Be careful in mobilization of material
Berhati –hati dalam mobilisasi material
-
Put up signs
Memasang rambu / tanda berhati hati
-
Leftover materials are stored and

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
informed to the IFBT facility.
sisa material disimpan dan di
informasikan ke pihak facility IFBT

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM

RISK MATRIX
Severity
(Tingkat
Keparahan) Negligible Marginal Significant Critical
S Catastrophic
(Tidak (Kecil (Penting/ (Parah/
(Bencana)
L Berarti) Kemungkinan) Berarti) Kritikal)
5
Likelihood 1 2 3 4
(Rasio Wajar/
Kemungkinan)
Highly Likely
(Sangat Mungkin) 5 10 15 20 25
5
Likely
(Wajar) 4 8 12 16 20
4
Possible
(Mungkin) 3 6 9 12 15
3
Unlikely
(Tidak Mungkin) 2 4 6 8 10
2
Very Unlikely
(Sangat Tdk Mungkin) 1 2 3 4 5
1

Risk Level Level of Additional Controls or Protection:

SIF Range = Extensive and/or multiple additional controls

High
required
Medium Unacceptable Range = Additional controls required
As Low as Reasonably Possible (ALARP) Range = Continual
Low
review and improvement of existing controls required
Very low Acceptable Range = No mitigation action required

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 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL FORM
Supervisor HSE IN DUTY Project Manajer Acknowledge by
HSE Infineon
Date (PengawasKerja) (HSE yang bertugas di area kerja) (Manajer project)
(Tanggal) Name Signature Name Signature Name Signature Name Signature
(Nama) (TandaTangan) (Nama) (TandaTangan) (Nama) (TandaTangan) (Nama) (TandaTangan)
09/01/2024 Ngadimo Purnawarman Soni Irmen Pradana

Work Personnel Members

(Anggota Kelompok Kerja)

Name Position Signature

(Nama) (Posisi) (TandaTangan)

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