Job Safety

Analysis
JSA Full Scale
Task Risk Assessment
(TRA)

INSTALLATION MINI PLATFORM

( CENTRAL PROCECING PLATFORM AREA )

Job title/task :
Job
Sequence
no:

1.
2.
3.
4.
5.
6.
7.

JSA No. :

Job Sequences
PJSM (Pre Job Safety Meeting) / (Penjabaran langkah / tahapan kerja sebelum memulai pekerjaan)
Tools and equipments preparation (Persiapan perlengkapan peralatan)
Install Scaffolding (Pemasangan Perancah)
Loading material to site (Pengangkatan material ke lokasi kerja)
Installs Mini Platform, Leg mini platform, Handrail, and ladder (Pemasangan mini platform, kolom, handrail, dan tangga)
Dismantling Scaffolding (Pembongkaran Perancah)
House keeping and demobilization all tools and equipment. (Kebersihan dan kerapihan, serta mengembalikan semua peralatan yang digunakan)

Job Risk Assessment Form

Job Safety
Analysis
JSA Full Scale
Task Risk Assessment
(TRA)

INSTALLATION MINI PLATFORM

( CENTRAL PROCECING PLATFORM AREA )

Job title/task:
No

JSA No. :

Assessment Team

Meeting
Date

Signature

Review Team

Review
Date

Signature

NOTE : Minimal Requirement Member to Conduct JSA is 3 (Three) Parties, ex : Maintenance, Production and EHS
Reference Documents required:
Risk Assessment Inputs and Reference Documents:

Job Risk Assessment Form

Job Safety
Analysis
JSA Full Scale
Task Risk Assessment
(TRA)
S:
L:
R:

Severity
Likelihood
Risk

JOB TITLE/TASK:

Date:

SECTION:
1. Engineering

ANALYSIS BY:
Production and EHS

PLANT/LOCATION:

DEPARTMENT:

REVIEWED BY:

CPP Area

Engineering

INSTALLATION MINI
PLATFORM
( Central Procecing Platform
Area )

SUPERVISOR:
Sukirman

NEW

REVISED

APPROVED BY
Note:
LOW Residual risk to be approved by Prod. Superintendent
HIGH or MEDIUM Residual risk to be approved by Prod. Manager / OIM

REQUIRED AND RECOMMENDED PERSONAL PROTECTIVE EQUIPMENT

(PPE)

N0

TASK STEP

HAZARD

HAZARD EFFECT

CONTROL

INITIAL RISK
S

1.

PJSM (Pre Job Safety

Meeting)
(Penjabaran langkah /
tahapan kerja sebelum
memulai pekerjaan)

Job Risk Assessment Form

NA

Permit To Work (PTW)

(Surat Ijin Kerja)

Job Safety Analysis

(JSA)
(Analisa Keselamatan
Kerja)

NA

ACTIONS

Risk

Make sure all Man Power have given safety

briefing about job and how to minimize risk
of accident at each step of work before start
to work.
(Pastikan bahwa smua pekerja telah
mendapatkan pengarahan tentang
pekerjaan dan bagaimana meminimalisir
resiko dari bahaya sebelum memulai
pekerjaan)

RESIDUAL RISK
S

Risk

N0

TASK STEP

HAZARD

HAZARD EFFECT

CONTROL

INITIAL RISK
S

Tools and Equipment

preparation
(Persiapan
perlengkapan &
peralatan )

Install Scaffolding
(memasang
Perancah)

Slip and Trip

(Terpeleset, dan
tersandung)
Pinch point and

impact injury
(Terjepit dan
megakibatkan luka)
Ergonomic issue
(Salah posisi
bekerja dan
pengangkatan
manual)
Slip, Trip, and
fall
(Terpeleset,
tersandung,
dan terjatuh)

Pinch point
(Terjepit)

Ergonomic
issue
(Salah
pengangkatan)

Scratch by
sharp object
(Tertusuk
benda tajam)

Job Risk Assessment Form

Personal injury
(Luka pada
orang/pekerja)
Back injury
(Luka dan sakit
tulang belakang)

Permit To Work (PTW)

(Surat ijin kerja)
Job Safety Analysis
(JSA)
(Analisa keselamatan
kerja)
Manual Handling
Procedure
(Tata cara
pengangkatan manual)

Personal
injury
(Luka pada
orang/peker
ja)
Equipment

damage
(Peralatan
rusak)

Permit To Work
(PTW)
(Surat Izin
Memulai
Pekerjaan)

Personal
injury
(Luka pada
orang/peker
ja)
Personal
injury
(Luka pada
orang/peker
ja)
Personal

ACTIONS

Risk

Personal
certification as a
scaffolder
(Personil
bersertifikat

Obtained PTW, JSA in place

(Permit, PTW & JSA tersedia
dilapangan)

Ensure the worksite is free

from trip hazard before the
jobs start.
(Pastikan area kerja aman
dari bahaya tersadung dan
terpeleset sebelum pekerjaan
dimualai)

Make sure personal in right

position during dismantling of
scaffolds
(Pastikan semua personel
dalam posisi yang benar
selama pembongkaran
perancah)

Proper manual handling

practice
(Melakukan dengan tata cara

Job Safety
Analysis (JSA)
(Analisa
Keselamatan
Kerja)
Manual Handling
Procedure
(Prosedur
Penanganan
Manual)

Obtained PTW in place

(Surat Ijin kerja tersedia dilapangan)
Proper manual handling practice
(Melakukan dengan tata cara
pengangkatan yang benar)
Proper PPE Mandatory is required
(Alat pelindung diri yang wajib
dipersyaratkan)

RESIDUAL RISK
S

Risk

N0

TASK STEP

HAZARD

HAZARD EFFECT

CONTROL

INITIAL RISK
S

4.

Loading material to site

(Pengangkatan material
ke lokasi kerja)

5.

Installs Mini Platform, Leg

mini platform, Handrail,
and ladder
(Pemasangan mini
platform, kolom, handrail,
dan tangga)

Job Risk Assessment Form

injury
(Luka pada
orang/peker
ja)

sebagai
scaffolder)

Slip and Trip

(Terpeleset, dan
tersandung)
Pinch point and

impact injury
(Terjepit dan
megakibatkan luka)
Ergonomic issue
(Salah posisi
bekerja dan
pengangkatan
manual)
Drop object
(kejatuhan
benda/material)

Personal injury
(Luka pada
orang/pekerja)
Back injury
(Luka dan sakit
tulang belakang)

Permit To Work (PTW)

(Surat ijin kerja)
Job Safety Analysis
(JSA)
(Analisa keselamatan
kerja)
Manual Handling
Procedure
(Tata cara
pengangkatan manual)
Secure Area
(Pengamanan Lokasi
Kerja)

Slip, trip, & fall

hazard
(Bahaya terpeleset,
tersandung &

terjatuh)
Pinch point
(Terjepit)
Personnal and other
equipment hit by pipe
material during rig
down and remove
(Personel dan
equipment lainnya

Personnal injury
(Personel
terluka)

Equipment
damage
(Peralatan
rusak)

ACTIONS

Risk

Risk

pengangkatab yang benar)

Permit To Work (PTW)

(Surat ijin kerja)
Job Safety Analysis
(JSA)
(Analisa keselamatan
kerja)
Manual Handling
Procedure
(Tata cara
pengangkatan manual)
Completness & PPE
awareness
(penggunaan APD dan

RESIDUAL RISK

Proper PPE Mandatory is

required
(Alat pelindung diri wajib
dipersyaratkan)
Obtained PTW in place
(Surat Ijin kerja tersedia dilapangan)
Proper manual handling practice
(Melakukan dengan tata cara
pengangkatan yang benar)
Proper PPE Mandatory is required
(Alat pelindung diri yang wajib
dipersyaratkan)
Baricade Area
(pemasangan pita pembatas)

Obtained PTW, JSA in place

(Permit, PTW & JSA tersedia dilapangan)
Ensure the worksite is free from hazard
before the work start.
(Yakinkan tempat kerja bebas dari bahaya
sebelum pekerjaan dimulai)
Proper tools and equipment and
inspected by SAKA team).
(Peralatan dan perlengkapan dalam
kondisi baik, layak pakai dan telah
diinspksi oleh team SAKA)
Proper manual handling practice
(Melakukan pengangkatan dengan benar)

N0

TASK STEP

HAZARD

HAZARD EFFECT

CONTROL

INITIAL RISK
S

terkena material pipa

selama membongkar
dan memindahkan)
Ergonomic issue
(Salah posisi badan
saat melakukan
pekerjaan)
Drop object
(kejatuhan
benda/material)

6.

Dismantling Scaffolding
(Pembongkaran
Perancah)

Job Risk Assessment Form

Slip, trip, & fall

hazard
(Bahaya terpeleset,
tersandung &

terjatuh)
Pinch point
(Terjepit)
Personnal and other
equipment hit by pipe
material during rig
down and remove
(Personel dan
equipment lainnya
terkena material pipa
selama membongkar
dan memindahkan)
Ergonomic issue

Personnal injury
(Personel
terluka)

Equipment
damage
(Peralatan
rusak)

ketepatan pemakaian)
Permanent
contact/communicate
with authorized
company personnel at
site/operator
(ijin dan komunikasi
dengan
personel/operator di
lapangan)
Approved Work
Methode
(Metode Kerja yang
sudah disetujui)
Secure Area
(Pengamanan Lokasi
Kerja)
Permit To Work (PTW)
(Surat ijin kerja)
Job Safety Analysis
(JSA)
(Analisa keselamatan
kerja)
Manual Handling
Procedure
(Tata cara
pengangkatan manual)
Completness & PPE
awareness
(penggunaan APD dan
ketepatan pemakaian)
Permanent
contact/communicate
with authorized

ACTIONS

Risk

RESIDUAL RISK
S

Risk

Proper PPE mandatory is required.

(Alat pelindung diri (APD) wajib
dipersyaratkan)
Follow the approved work methode
(Ikuti langkah-langkah yang ada di
metode kerja yang sudah disetujui)
Baricade Area
(pemasangan pita pembatas)

Obtained PTW, JSA in place

(Permit, PTW & JSA tersedia dilapangan)
Ensure the worksite is free from hazard
before the work start.
(Yakinkan tempat kerja bebas dari bahaya
sebelum pekerjaan dimulai)
Proper tools and equipment and
inspected by SAKA team).
(Peralatan dan perlengkapan dalam
kondisi baik, layak pakai dan telah
diinspksi oleh team SAKA)
Proper manual handling practice
(Melakukan pengangkatan dengan benar)
Proper PPE mandatory is required.
(Alat pelindung diri (APD) wajib
dipersyaratkan)
Follow the approved work methodology

N0

TASK STEP

HAZARD

HAZARD EFFECT

CONTROL

INITIAL RISK
S

7.

House keeping and

demobilization all tools

and equipment.
(Kebersihan dan
kerapihan, serta

mengembalikan semua
peralatan yang
digunakan)

(Salah posisi badan

saat melakukan
pekerjaan)
Drop Object
(kejatuhan
benda/material)

Slip, Trip, and fall

hazards (Bahaya
tersandung dan
terpeleset)
Pinch point and
impact injury.

(Terjepit dan
mengakibatkan luka)

Job Risk Assessment Form

Personal & back

pain injury
(Luka dan sakit
tulang
belakang /
keseleo)
Personal Injury
(Personal
cidera / terluka)
Equipment
damage
(Peralatan
rusak)

company personnel at
site/operator
(ijin dan komunikasi
dengan
personel/operator di
lapangan)
Approved Work
Methodology
(Work methodology
yang sudah disetujui)
Permit To Work (PTW)
(Surat ijin kerja)
Job Safety Analysis
(JSA)
(Analisa keselamatan
kerja)
Manual Handling
Procedure
(Tata cara
pengangkatan manual)

ACTIONS

Risk

RESIDUAL RISK
S

Risk

(Ikuti langkah-langkah yang ada di work

methodology yang sudah disetujui)

Obtained PTW, JSA in place

(Permit, JSA, tersedia dilapangan)
Ensure the worksite is free from trip
hazard before the jobs start.
(Pastikan area kerja aman dari bahaya
tersandung dan terpeleset sebelum
pekerjaan dimualai)
Proper PPE Mandatory is required
(Alat pelindung diri yang wajib
dipersyaratkan)

Assign a JSA Team Leader

Evaluate the Residual Risk (i.e. the risk assuming all controls and Action are in place and effective)

User invite the JSA Team

Identify the Step Required (Task Step)

Low

High
Is the Residual Risk High, Medium or Low?

Medium

Identify hazards for all

steps of the task

Identify hazards Effect

Describe the Existing control

Yes
Are additional control measures required?

No
Complete any actions before starting work

Evaluate the Initial Risk

Ensure the JSA results are communicated to those doing Note:
the workJSA Pictograms can be used in Safety Toolbox briefing

Determine the action for Risk Reduction measure :

Reduce likelihood of event occurring
Reduce severity of consequences

Job Risk Assessment Form

Proceed with work once actions have been closed-out

Job Risk Assessment Form