PT.

Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Changing Cab

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Parking of equipment Operator Collision Fatality, Permanent 3 4 12 EL/SUB 1. Park at safe leve place 2 4 8 Planning task
Mechanic Interaction with people disability, Long term
Supervisor absence due to treatment ADM

ADM 2. Barricaded area off TAKE-5

EL/SUB 3. Sufficient space around

equipment
Lift the bowl and place pin into position to keep Mechanic Pinned by bowl Fatality, Permanent 3 4 12 EL/SUB 1. Always place both pin into 2 4 8
bowl in position and safe Supervisor disability, Long term position
absence due to treatment
ENG/SEG 2. Ensure that pins are locked and
cannot be removed (locked point)

ENG/SEG 3. When lifting bowl all worker must

be at safe distance if rock or
material fall from bowl
Lock Out and Tag Equipment Mechanic Unauthorized start Fatality, Permanent 2 4 8 ADM 1. Multiple lock out and tag 1 4 4 Strive for LIFE walk
Supervisor Rotating parts disability, Long term
absence due to treatment ADM

EL/SUB 2. Stop blocks behind wheels

EL/SUB 3. Equipment in neutral

EL/SUB 4. Park brakes applied

Stripping cab Mechanic Hand injury Permanent disability, Long 2 2 4 PPE 1. Use safety harness when 1 2 2 Monthly inspections/register
Supervisor term absence due to washing at heights and on the ADM
Auto electric treatment edges of walkways
EL/SUB 2. Identify all cables/wires/pipes SWL certificates
when removing ADM

Uncontrolled Document When Printed 1 of 8 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Changing Cab

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified 4 2
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

ENG/SEG 3. Disconnect battery terminals to

avoid electrical short

EL/SUB 4. Stack parts such as seat, panels,

steering at safe place out of working
area
EL/SUB 5. Cover all parts with PVC to
protect from rain and weather
conditions.
Lifting cab off with crane Crane operator Falling onto Permanent disability, Long 2 2 4 EL/SUB 1. Park crane at correct position 1 2 2 JSEA
Mechanic Load slipping term absence due to (out rigger) ADM
Supervisor treatment
ADM 2. Inspect lifting chain ADM TAKE-5

EL/SUB 3. Hook at correct position Monthly crane inspection

ADM

BHV 4. Good communication between SIMPER

worker - work as team ADM

BHV 5. All workers stand at safe position

when lifting cab

ADM 6. Use guide rope to control

cab/load to required position

EL/SUB 7. Place the cab into ground and

ensure it is stable, support if
required

Uncontrolled Document When Printed 2 of 8 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Changing Cab

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Replace cab with crane Crane operator Falling onto Permanent disability, Long 2 2 4 ADM 1. Lift with caution and guide cab 1 2 2
Mechanic Load slipping term absence due to with guide rope
Supervisor treatment
ADM 2. Good communiaction between
crane operator and spotter

EL/SUB 3. Lift slow and safe

ENG/SEG 4. Clear lifting area and do not lift

over worker

EL/SUB 5. Secure cab before removing

lifting chain

PPE 6. Use safety harness when working

at heights and an edges of walking
platform
Assembly cab Mechanic Pinned and Falling off Permanent disability, Long 2 2 4 ADM 1. Ensure all cable, pipes are 1 2 2
Supervisor term absence due to connected as OEM
Auto electric treatment
ADM 2. Tighten all bolt on cab as per
OEM

ADM 3. Test all function when work

completed

EL/SUB 4. Be aware of testing components

when battery is connected (flash)

Uncontrolled Document When Printed 3 of 8 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Changing Cab

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Remove Lock and Tag Mechanic Unauthorized start when Fatality, Permanent 3 4 12 EL/SUB 1. Clear all work from equipment 2 4 8
Supervisor open rotary disability, Long term
absence due to treatment
ADM 2. Walk around to inspect all
components are secure and no
work present
Start equipment and lower bowl Mechanic Pinned between Fatality, Permanent 3 4 12 ADM 1. Good communication between 2 4 8
Supervisor equipment disability, Long term operator and worker to remove pin
absence due to treatment
ENG/SEG 2. Ensure no worker are between
bowl and equipment

ADM 3. Test equipment and ensure all

function work properly and safely

ADM 4. Complete required paper work

and sign off

Uncontrolled Document When Printed 4 of 8 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

1. Lifting procedure
2. ID205-JSEA-P&E-104(03) - General Lifting

register

Uncontrolled Document When Printed 5 of 8 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

ction

Uncontrolled Document When Printed 6 of 8 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 7 of 8 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 8 of 8 LCI-HSE-FM-001A(02)

Feb 2010