Risk Assessment Work Sheet

Project Title: Lotte Indonesia New Ethylene (LINE) Complex

FIT UP AND PULLING USING CHAINBLOCK & LEVEL Risk Assessment No. Permit No.
Job Title
BLOCK JEL/SMP2/RA/0011 Revision Date 4/20/2024 No.

Work Location LINE WP - 01 Subcontractor PT. JEL SMP 2 Discipline SMP

Prepared by (RA Team) Name Position Date Signature

Subcontractor Discipline Manager / Engineer Bonang F.K Engineer 4/29/2023

Subcontractor HSE Engineer / Supervisor Andry Kusuma HSE 4/29/2023

Subcontractor Discipline Supervisor Effendi Supervisor 4/29/2023

Checked by (Preliminary Review) Name Position Date Signature

Discipline Manager / Engineer J E Bae Construction Manager 4/29/2023

Discipline Supervisor / Engineer J H Choi Senior Engineer 4/29/2023

HSE Manager / Engineer H S Lee HSE Manager 4/29/2023

HSE Supervisor / Engineer Hendra G HSE 4/29/2023

 Risk Assessment Work Sheet
Job Tittle : FIT UP AND PULLING USING CHAINBLOCK & LEVEL BLOCK
HSE Equipment / Facilities
Equipment & Tools to be used Materials to be used Inspection required Training / Competency required
required
1 Levelblock 1 Steel structure 1 Lifting gear 1 Induction 1 Hard Baricade
2 Webbing Sling 2 Pipe 2 Levelblock 2 Permit To Work 2 Safety net
3 Shackle 3 3 Chainblock 3 Working at Height 3 Connector safety cone
4 Chainblock 4 4 Shackle 4 4 Radio Communication
5 Pulley 5 5 Anchorage Points 5 5 Body Harness
6 Handtools 6 6 6 6
7 7 7 7 7
8 8 8 8 8
9 9 9 9 9
10 10 10 10 10
Number of Worker 7 Discipline Supervisor 1 Safety Supervisor 1
personnel required Other Discipline Foreman Safety Officer / Inspector

Risk Assessment Matrix (RAM) and Hierarchy of Control

PROBABILITY [1 - 3] Can proceed with the task
HSE Risk Assessment of Incident Rare (1) Possible (2) Likely (3) Of ten (4) Frequent (5)
Encountered Has occurred Has occurred Occurs Occurs [4 - 10] Can proceed with the task. Consider more controls.
in industry in HEC in HEC sev eral times sev eral times
SEVERITY People Assets Environment Reputation
but not in project within project within a y ear in a y ear at this
HEC projects last 5 y ears last 3 y ears HEC projects project
[12 - 25] Stop work. Change work method or put more controls
Slight injury Slight ef f ect Slight ef f ect
or health (less than 500 (less than 50
1-Insignificant
ef f ects USD liter oil/
Slight impact 1 2 3 4 5
(FAC) Damage) Chemical)
Minor ef f ect Minor ef f ect
Minor injury or
(500 ~ 10,000 (less than 100
2-Minor health ef f ects
USD liter oil/
Minor impact 2 4 6 8 10
(MTC)
Damage) Chemical)

Major injury or Local damage Localized

health ef f ects (10,000 ~ ef f ect (100 ~ Considerable
3-Moderate (RWC; LTI <7 100,000 USD 200 liters of impact 3 6 9 12 15
day s) Damage) oil/Chemical)

Single f atality Major damage Major ef f ect

or permanent (100,000 ~ (200 ~ 1000 National
4 -Major disability or 500,000 USD liters of impact 4 8 12 16 20
LTI > 7 day s Damage) oil/Chemical)

Extensiv e Massiv e
damage ef f ect (more
Multiple International
5-Catastrophic
f atalities
(more than than 1000
impact 5 10 15 20 25
500,000 USD liters oil/
Damage) Chemical)
 Risk Assessment Work Sheet
Job Tittle : Fit Up and Pulling using Chain Block & Level Block
Initial Risk Action Residual Risk
No. Description of Work Step Potential Hazards & Consequences Control and / or Recovery Measures Responsible
S P R Person S P R
Every work activity as per site condition should be discussed at TBM prior to start and when
deemed necessary (Setiap aktivitas kerja sesuai kondisi lapangan harus didiskusikan di TBM
sebelum dimulai dan bila dianggap perlu)

Clear information regarding the work must be explained in details (Informasi yang jelas mengenai
pekerjaan harus dijelaskan secara rinci)

All work force must be well informed regarding the RISK existed all the site (semua tenaga kerja
harus mendapat informasi yang baik tentang RISIKO yang ada di semua lokasi)
SPV, Rigger,
Supervisor must be aware and understand of the permitting system implementation of "No
Lack of information and awareness Banksman,
2 3 6 Permit, No Work" system (Supervisor harus mengetahui dan memahami penerapan sistem 2 1 2
(Kurangnya informasi dan kesadaran) Flagsman,
perijinan sistem “No Permit, No Work”)
Worker, HSE

Acquired permit to work (Memperoleh izin untuk bekerja)

Permit to work must be available on site, with attachments required (izin untuk bekerja harus
Work Preparation tersedia di lokasi, dengan lampiran yang diperlukan)
1
(Persiapan pekerjaan)
Supervisor must be more attentive and responsible (Pengawas harus lebih perhatian dan
bertanggung jawab)

Ensure the potential hazard have been informed to the worker through TBM (Pastikan potensi
bahaya telah diinformasikan kepada pekerja melalui TBM)

Ensure all tools to be used passed internal inspection (Pastikan semua alat yang akan digunakan
lulus inspeksi internal)
Mobilization and Preparation SPV, Rigger,
Tools/equipment Ensure no material blocking work access (Pastikan tidak ada material yang menghalangi akses Banksman,
2 3 6 2 1 2
Mobilisasi dan persiapan alat kerja) Flagsman,
kerja /peralatan Worker, HSE

Install barricade and signage (Pasang barikade dan rambu rambu)

Wearing proper PPE (Mengenakan APD yang tepat)

Ensure the potential hazard have been informed to the worker through TBM (Pastikan potensi
bahaya telah diinformasikan kepada pekerja melalui TBM)

Avoid pinch points (Hindari titik jepit) SPV, Rigger,

Slipped, pinched feet or hands Banksman,
2 Pulling activity (Terbentur/terjepit kaki dan tangan)
3 3 9
Flagsman,
2 1 2
All workers involve shall have to wear body harness with two lanyards and tie off policy shall be Worker, HSE
adhered, and ensure 100% double hook tie off (semua pekerja yang terlibat harus memakai body
harness dengan dua lanyard dan ketentuan pengikatan harus dipatuhi, dan pastikan 100%
double hook dicantolkan)
 Take your time and pay attention to the area around. (Luangkan waktu Anda dan perhatikan area
sekitar) SPV, Rigger,
Slipped, pinched feet or hands Banksman,
3 3 9 2 1 2
(Terbentur/terjepit kaki dan tangan) Flagsman,
Worker, HSE
Wear appropriate PPE, and hand gloves (Kenakan APD yang sesuai, dan sarung tangan)

Good coordination and communication during pulling the material (Koordinasi dan komunikasi
yang baik selama penarikan material)

Barricade the work area so that unauthorized persons do not cross the work area (Barikade area
kerja agar orang yang tidak berkepentingan tidak melintas di area kerja) SPV, Rigger,
Banksman,
Drop object (Benda jatuh) 3 3 9
Flagsman,
2 1 2

No one shall be allowed to stay under the suspended load (Tidak seorang pun akan diizinkan Worker, HSE
untuk berada di bawah beban yang ditangguhkan)

Work Platform must be equipped with toeboard (Platform kerja harus dilengkapi dengan
toeboard)

Tools/equipment should be inspected and checked before use (Tools/equipment yang akan
digunakan diinspeksi dan dicek terlebih dahulu sebelum memulai pekerjaan)

Material which pulled in accordance with the load capacity of the chainblock (Barang yang ditarik
2 Pulling activity SPV, Rigger,
sesuai dengan kapasitas beban chainblock)
Banksman,
Gears broke (Rantai rusak/putus) 3 3 9
Flagsman,
3 1 3
Make sure the work done is in accordance with the lifting plan (Pastikan pekerjaan yang Worker, HSE
dilakukan sesuai dengan lifting plan)

Ensure the tied of material before pulled (Pastikan kembali ikatan barang sebelum ditarik)

Put stable body position in platform (Menempatkan posisi tubuh yang stabil di platform )

SPV, Rigger,
Make the load smaller or lighter and easier to grasp. (Buat beban lebih kecil atau lebih ringan Banksman,
Back Injuries (Cidera punggung) 3 3 9 atau lebih mudah digenggam) Flagsman,
2 1 2
Worker, HSE
Avoid excessive work rates and tight deadlines. (Hindari waktu kerja yang berlebihan dan tenggat
waktu yang ketat)

Choose a sling of adequate capacity and determine the best means of attachment (pilih sling
dengan kapasitas yang memadai dan tentukan cara pemasangan terbaik)

Swing material and hit worker or other SPV, Rigger,

building/equipment (Material mengayun Install tag line (Min 2EA and 10m minimum) (Pasang tagline (Min 2EA dan minimum 10m)) Banksman,
3 3 9 3 1 3
dan mengenai pekerja, bangunan lain, Flagsman,
atau peralatan) Worker, HSE

Set a safe distance when pulling takes place (Tetapkan jarak aman saat penarikan berlangsung)
 Ensure that workers to perform the task are well trained, competent and knowledgeable (Pastikan
bahwa pekerja untuk melakukan tugas terlatih dengan baik, kompeten dan berpengetahuan)
SPV, Rigger,
Banksman,
Unskill Person (Pekerja tidak terlatih) 3 3 9
Flagsman,
2 1 2
Proper and clear instructions must be given to workers on what tools and equipment are going to Worker, HSE
be used, RA, must be informed during pulling process (Instruksi yang tepat dan jelas harus
diberikan kepada pekerja tentang alat dan perlengkapan apa yang akan digunakan, RA, harus
diinformasikan saat penarikan)

Do training and socialization about how to use the equipment (Diberi training atau sosialisasi
terkait tatacara penggunaan alat)
Using not follow fabrication standards SPV, Rigger,
Banksman,
2 Pulling activity (Penggunaan alat tidak mengikuti 3 3 9
Flagsman,
2 1 2
standard pabrik)
Asking supervisor an expert if there is something trouble with the equipment during pulling activity Worker, HSE
(Menanyakan kepada SPV atau ahlinya jika terjadi suatu masalah saat proses penarikan)

Remove obstacles from your path and always keep the area clear from any hazards. (Singkirkan
rintangan dari jalur Anda dan selalu jaga agar area tersebut bersih dari bahaya apa pun)
SPV, Rigger,
Banksman,
Block access (Akses terhalang) 2 3 6
Do housekeeping before and after work (Melaksanakan bersih-bersih sebelum dan sesudah Flagsman,
2 1 2
melakukan pekerjaan) Worker, HSE

Do not put material which possible block an access (Tidak menempatkan material yang
memungkinkan menghalangi akses)

Ensure the potential hazard have been informed to the worker through TBM (Pastikan potensi
bahaya telah diinformasikan kepada pekerja melalui TBM)

Avoid pinch points (Hindari titik jepit) SPV, Rigger,

Slipped, pinched feet or hands Banksman,
3 3 9 3 1 3
(Terbentur/terjepit kaki dan tangan) Flagsman,
Good coordination and communication during fitting up the material between worker and SPV Worker, HSE
(Koordinasi dan komunikasi yang baik selama fit up material antara pekerja dan SPV)

Wear appropriate PPE , and hand gloves (Kenakan APD yang sesuai dan sarung tangan)
3 Fit up activity

Tools/equipment should be inspected and checked before use (Tools/equipment yang akan
digunakan diinspeksi dan dicek terlebih dahulu sebelum memulai pekerjaan)
SPV, Rigger,
Do not force the equipment if it has reached the maximum capacity (Only 1 person) (Tidak Banksman,
Gears broke (Rantai rusak/putus) 3 3 9
memaksakan alat ketika sudah mencapai kapasitas maksimum, (hanya 1 orang)) Flagsman,
3 1 3
Worker, HSE
Barricade the work area so that unauthorized persons do not cross the work area (Barikade area
kerja agar orang yang tidak berkepentingan tidak melintas di area kerja)
 Cool drinking water should be available near site at all times (Air minum dingin harus tersedia di
dekat lokasi setiap saat)

SPV, Rigger,
Rest shelter should be available near the work area (Tempat peristirahatan harus tersedia di Banksman,
Severe heat (Panas yang parah) 2 3 6 dekat area kerja) Flagsman,
2 1 2
Worker, HSE
If symptoms occur due to heat stress immediately seek first aid / medical assistance (jika timbul
gejala akibat stress panas segera cari pertolongan pertama / pertolongan medis)

Water shall be sprayed to minimize the dusts (Air harus disemprotkan untuk meminimalkan debu)

4 Adverse/unsafe condition Necessary protection for crew shall be provided to control inhalation of dust : like dust mask SPV, Rigger,
(Perlindungan yang diperlukan untuk awak kapal harus disediakan untuk mengendalikan Banksman,
Dust concentration (Debu) 2 3 6 2 1 2
penghirupan debu: seperti masker debu) Flagsman,
Worker, HSE
Poor visibility administrative control should be apply if the situation getting worse, work shall be
stopped (Pengawasan administratif visibilitas yang buruk harus diterapkan jika situasi semakin
buruk, pekerjaan harus dihentikan)

Provide shelter (Menyediakan tempat berlindung)

SPV, Rigger,
Banksman,
Rain (Hujan) 2 3 6 2 1 2
Flagsman,
If the situation getting worse, work shall be stopped (jika keadaan semakin parah, pekerjaan Worker, HSE
akan dihentikan)

Proper instruction giving at TBM (Pemberian instruksi yang tepat di TBM)

Everyday housekeeping on site (Bersih-bersih setiap hari)

SPV, Rigger,
Sharp materials at working site, hand tools
Banksman,
5 Housekeeping is not in proper place, and lost items in 2 3 6 2 1 2
Flagsman,
ground
Properly maintain hand tools (Rawat handtools dengan baik) Worker, HSE

Providing waste bin at site (Menyediakan tempat sampah di lokasi)