HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING CONTROL
Assessor : Department / Process Location / Area : Date of Assessment
1
2
3
RISK
NEXT / ADDITIONAL CONTROL
ACCIDENT POTENTIAL EXISTING CONTROL
RISK
NO TASK / PROCESS LOCATION HAZARD (CONSEQUENCY / RISK / (PENGENDALIAN
EVENT) SEVERITY LIKELIHOOD SAAT INI)
RANK EL SUB EC ADM PPE EXPLANATION OF CONTROL
1.Training teknik dongkrak
Tidak APD sudah 2.Mengganjal mobil
Bengkel menggunakan Badan/kepala tertindih 3 3 H tersedia, toolbox
telah dilakkukan
v x x x v menggunakan jack stand
3.SOP dongkrak
jack stand 4.Mengganti dongkrak botol
dengan dongkrak buaya
1
Kondisi tanah
tidak rata
4
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING CONTROL
Assessor : Department / Process Location / Area : Date of Assessment
1
2
3
RISK
NEXT / ADDITIONAL CONTROL
ACCIDENT POTENTIAL EXISTING CONTROL
RISK
NO TASK / PROCESS LOCATION HAZARD (CONSEQUENCY / RISK / (PENGENDALIAN
EVENT) SEVERITY LIKELIHOOD SAAT INI)
RANK EL SUB EC ADM PPE EXPLANATION OF CONTROL
10
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING
Assessor : Department / Process Location / Area : Location / Area : Date of Assessment
1
2 PRODUKSI
3
INITIAL RISK EXISTING RISK
NEXT / ADDITIONAL C
ACCIDENT POTENTIAL /
NO TASK / PROCESS LOCATION HAZARD RISK EXISTING CONTROL RISK
CONSEQUENCY / RISK
SEVERITY LIKELIHOOD SEVERITY LIKELIHOOD
RANK RANK EL SUB EC ADM PPE
1 LISTRIK TERSETRUM
4 1 M Safety sign x v v v x
KABEL - KABEL YG
KEGIATAN TERSANDUNG
BERSERAKAN
MENGOPERASIKAN KELAS
LCD PROJECTOR
PANAS YG
BERASAL DARI DEHIDRASI
PROJECTOR
2 v v v v v
BUTIRAN GRAM
HASIL GERINDA
KABEL - KABEL YG
TERKELUPAS 0 3 H 0 3 H
POSISI KERJA YG
2 26
BERDIRI LAMA
3 6.5
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING
Assessor : Department / Process Location / Area : Location / Area : Date of Assessment
1
2 PRODUKSI
3
INITIAL RISK EXISTING RISK
NEXT / ADDITIONAL C
ACCIDENT POTENTIAL /
NO TASK / PROCESS LOCATION HAZARD RISK EXISTING CONTROL RISK
CONSEQUENCY / RISK
SEVERITY LIKELIHOOD SEVERITY LIKELIHOOD
RANK RANK EL SUB EC ADM PPE
4
NTIFICATION, RISK ASSESSMENT & DETERMINING CONTROL
NEXT / ADDITIONAL CONTROL
EXPLANATION OF CONTROL
1. Kebijakan tinggi maks 1
M
2. Pakai Palet
3. Pasang Tiang
4. Pakai Sign, Meeting,
Pelatihan
5. APD
NTIFICATION, RISK ASSESSMENT & DETERMINING CONTROL
NEXT / ADDITIONAL CONTROL
EXPLANATION OF CONTROL
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING CONT
Assessor : Department / Process Location / Area : Date of Assessment
1
2 PRODUKSI ALARP
3
INITIAL RISK
NEXT / ADDITIONAL CONTROL
ACCIDENT POTENTIAL /
NO TASK / PROCESS LOCATION HAZARD RISK EXISTING CONTROL
CONSEQUENCY / RISK
SEVERITY LIKELIHOOD
RANK EL SUB EC ADM PPE EXPLANATION OF CONTROL
1. SOP cangkul 2. Training teknik
Kaki / badan
3 3 H
mencetak dok APD sdh tersedia,
cangkul 3. Warning sign 4.
1 site Mata Cangkul tajam inspeksi dilaksanakan, v x x v V
Mengganti dgn backhoe 5. Safety
menggnakan printer tercangkul toolbox di laksanakan
Shoes standard osha
Mata cangkul lepas
mencetak dok Gagang cangkul AS LOW AS REASONABLE
menggnakan printer rapuh dan goyang dan mengenai PRACTICABLE
anggota tubuh
aliran listrik
mencetak dok
menggnakan printer
2
mencetak dok
menggnakan printer
Percikan api kebakaran H
Mengangkat barang Barang yang
Warehous
3 manual ke atas truk / bertumpuk di atas
e / Yard
kendaraan lemari
Lantai tidak tidak Pekerja Terjatuh
rata
Barang terjat
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING CONT
Assessor : Department / Process Location / Area : Date of Assessment
1
2 PRODUKSI ALARP
3
INITIAL RISK
NEXT / ADDITIONAL CONTROL
ACCIDENT POTENTIAL /
NO TASK / PROCESS LOCATION HAZARD RISK EXISTING CONTROL
CONSEQUENCY / RISK
SEVERITY LIKELIHOOD
RANK EL SUB EC ADM PPE EXPLANATION OF CONTROL
Mobil / kendaraan
yg lalu lalang di Mobil menabrak pekerja
area loading
4
PELUANG
Rare Unlikely Possible Likely
Consequency may
Consequency will
only occur in Consequency could Consequency should
probably occur in
exceptional occur in sometimes occur in sometimes
most circumstances
circumstances
Terpapar beberapa jam Terpapar beberapa jam Terpapar hanya
Terpapar beberapa jam
AS/NZS 4360:2004 (10 Jam) dalam
(10 Jam) dalam sebulan
(10 Jam) dalam maksimal 2 jam dalam
setahun seminggu hari kerja
Incident has Incident has
Never heard in the Has occurred in the
occurred in occurred several
World world but unlikely
company times in company
KEPARAHAN
Less than once Once every 3 - 5 Once every 1 > 5 times every
in 10 years years year years
People Assets Reputation 1 2 3 4
International Impact - Attention International
Multiple Fatalities - from Extensive Damage - Substansial or Total Loss of media, Impact to International
Operation, Costs > Rp. 100.000.000,- Licence;Beberpa kematian dari kecelakaan 5 High High Extreme Extreme
Accident or Occupational health atau kesehatan kerja
Single Fatalities - from Accident Major Damage - Partial Operation Lost (>1
National Impact - Attention national media,
Week), Costs > Rp. 50.000.000,-
Impact to National Licence;Dari kecalakaan 4 Moderate High High Extreme
or Occupational health atau kesehatan kerja
Major Injury or health effect Considerable Impact - Attention Local
Local Damage - Partial Operation Loss (1 day),
(Including Permanent Disability / Costs > Rp. 25.000.000,-
media, Impact to National Licence;Luka 3 Low Moderate High Extreme
berat
LWDC)
Minor Injury or Health Effect Limited Impact - Attention Some Local
Minor Damage - Costs > Rp. 10.000.000,-
media 2 Low Low Moderate High
(RWDC)
Slight Injury or Health Effect Slight Impact - Attention to local company
Slight Damage - Costs > Rp. 1.000.000,-
attention;Ditangani P3K 1 Low Low Moderate High
(FAC & MTC)
PELUANG
Almost Certain
consequency is
expected to occur in
most circumstances
Terpapar Sepanjang
hari (>6 Jam) kerja
Incident has
occurred several
times in branch /
business unit
> 10 times every
years
5
Extreme
Extreme
Extreme
Extreme
High
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING CONTROL
Assessor : Department / Process Location / Area : Date of Assessment
1
2 purchasing
3
RISK
NEXT / ADDITIONAL CONTROL
ACCIDENT POTENTIAL
NO TASK / PROCESS LOCATION HAZARD RISK EXISTING CONTROL
(CONSEQUENCY)
SEVERITY LIKELIHOOD
RANK EL SUB EC ADM PPE EXPLANATION OF CONTROL
- Sosialisasi bahaya di jalanan,
Training SR
- Membuat Safety Practice,
3 3 a3 9 xx xx xx vv xx
Pengawasan Kerja APD
3
HAZARD IDENTIFICATION, RISK ASSESSMENT & DETERMINING
CONTROL
Assessor : Department / Process Location / Area : Location / Area : Date of Assessment
1 Sri Supriatin
2 Helen purchasing
3
INITIAL RISK EXISTING RISK
NEXT / ADDITIONAL CONTROL
RISK EXISTING RISK
ACCIDENT POTENTIAL
LIKELIHOOD
LIKELIHOOD
CONTROL
SEVERITY
SEVERITY
NO TASK / PROCESS LOCATION HAZARD / BAHAYA (CONSEQUENCY / RISK /
(PENGENDALIAN
EVENT)
SAAT INI)
RANK RANK EL SUB EC ADM PPE EXPLANATION OF CONTROL
Trafo Isolator, rambu
1 komputer kelas Aliran listrik Luka bakar krn tersetrum 4 3 H 4 3 H X X V V v
k3, sop, inspeksi listrik
tersetrum
