Leighton International Limited
JOB SAFETY AND ENVIRONMENTAL ANALYSIS WORKSHEET
Country Office /
Indonesia/ ID 204 MHU Coal Mine Project
Project:
Job Location & Details: MHU, Penarikan unit WATER TRUCK
JSA Participants: Ngadikun, Mujiko, Gabriel
Responsible Supervisor: Gabriel
     
JOB STEP HAZARDS IDENTIFIED
(Eg. Electrocution from
(Eg. Set Up Crane)
11Kv Cables)
1. Pengecekan alat / Unit 1.1 Kerusakan peralatan
dan lokasi
Lokasi sempit dan lalulintas
padat
- Orang terluka / terjatuh /terjepit
- Tidak menggunakan APD
1.2 Lokasi sempit (diantara ruang
makan dan posisi genset dan
tanki air
1.3 Dumping body raise/ body
dump naik
1.4 Unit no Isolation/ Unit tidak di
isolasi
Mar 2008
Tools and or Equipment required:
JSA No: ID 204-JSA-WS-006
- Helmet, safety glasses, safety,
Sepatu Safety, Earplug, Gloves Date Prepared: 28 Jan 08
- Unit Grader/ unit Dozer
- Water Truck 773D, WT Renault Approved by PM:
- Radio Communication
Date: Bambang Nuryono
CONTROLS REQUIRED (Eg. Remove overhead cable or ACTION BY/RECORD
isolate/sheath overhead or monitor with spotter) Training PPE
(Eg. Supervisor)
Needs
1.1.1 Memastikan semua peralatan yang akan dipakai dalam 1.1.1.1 Supervisor, Mechanics
kondisi tidak rusak
1.1.2 Ensure unit in safe and workers knows the danger/ pastikan 1.1.2.1 Supervisor, Mechanics
unit dalam keadaan baik dan pekerja mengerti akan bahaya yang
terjadi
1.1.3 Ensure “ 3 point contacts” while raise to the unit and works 1.1.3.1 Supervisor, Mechanics
area must be clean/ tidy/Pastikan “ 3 titik tumpuan utama” ketika
naik ke unit dan kebersihan/kerapihan area kerja
1.2.1 Ensure the area must be level and clean/ Pastikan area 1.2.1.1 Supervisor, Mechanics
harus di ratakan dan bersih
1.3.1 Ensure dump body up install with lock pin dump in safe/ 1.3.1.1 Operators
Pastikan posisi dump naik terpasang lock pin ,pekerja bekerja
dengan aman
1.4.1 Ensure fit”Out of Service tag” and Personal danger tag” / 1.4.1.1 Mechanics, supervisor
Pastikan pasang Out of service tag” and Personal Danger tag”
Page 1 of 4 LIL-HSE-FM-001B(01)
 Leighton International Limited
JOB SAFETY AND ENVIRONMENTAL ANALYSIS WORKSHEET
1.5 Tools set/ support equipment
fault/ Alat-alat atau peralatan
pembantu rusak
2. Remove and Install 2.1 Crushing/ impacted/terlindas/
Engine Group/ Melepaskan terjepit
dan memasang Engine
group
2.2 Falling / Impacted/ Terjatuh/
Terjepit
2.3 Tools set/ Support equipment
broken/ Alat-alat /peralatan
pembantu rusak
2.4 Lifting load / pengangakatan
beban
2.5 Crane/ Manitou rolled over/
Crane/ Manitou terbalik
Mar 2008
1.5.1 Ensure check tools set/ support equipment in good condition/ 1.5.1.1 Supervisor, Mechanics
Pastikan pemeriksaan alat-alat/ peralatan pembantu dalam kondisi
baik
2.1.1 Ensure unit in safe and workers knows the danger/ pastikan 2.1.1.1 Supervisor and
unit dalam keadaan baik dan pekerja mengerti akan bahaya yang Mechanics
terjadi
2.1.2 Ensure do not put part of body on the pinch point / Pastikan 2.1.2.1 Mechanics
tidak menempatakan bagian tubuh pada titik jepit
2.2.1 The worker must be careful and concentration while working/ 2.2.1.1 Mechanics
Pekerja harus berhati-hati dan konsentrasi ketika bekerja
2.2.2 Ensure working at high more 1,8m use safety harness belt as 2.2.2.1 Supervisor and
standard./ Pastikan bekerja di ketinggian lebih dari 1,8m harus Mechanics
pakai safety harness belt
2.2.3 Ensure use ladder agreeable/ Pastikan menggunakan tangga 2.2.3.1 Mechanics
yang sesuai
2.3.1 Ensure use correct proper tools and lifting gear sets 2.3.1.1 Mechanics and Crane/
(chain/belt) / Pastikan menggunakan alat-alat dan peralatan bantu Manitou Operators
angkat-mengangkat (rantai/ sabuk) yang benar.
2.4.1 Ensure correct manual handling procedure/ Pastikan 2.4.1.1 Mechanics
melakukan mengangkat manual dengan benar / sesuai prosedur
2.4.2 Ensure use correct lifting equipment as load SWL / Pastikan 2.4.2.1 Supervisor,
menggunakan alat angk at sesuai dengan SWL beban Mechanics, operator
Crane/Manitou
2.4.3 Ensure use webbing sling to tie Engine unit/ Pastikan 2.4.3.1 Mechanics, Operator
menggunakan webbing sling untuk mengikat engine unit Crane/ Manitou
2.4.4 Ensure use agreeable lifting chain/ webbing belt with weigh 2.4.4.1 Operator Crane/
stick cylinder/ Pastikan menggunakan rantai/ webbing belt sesuai Mechanics
dengan berat stick cylinder
2.4.5 Ensure the workers not under load / radius lifting activity/ 2.4.5.1 Rigger, Supervisor
Pastikan pekerja tidak berada di bawah beban / radius
pengangkatan beban
2.4.6 Ensure the operator crane/ manitou have licence to operating 2.4.6.1 Supervisor
unit/ pastikan operator crane/ Manitou mempunyai ijin
mengoperasikan unit
2.5.1 Ensure Crane/Manitou in safe & level position/ Pastikan posisi 2.5.1.1 Operator, Supervisor
Crane/Manitou aman dan rata
Page 2 of 4 LIL-HSE-FM-001B(01)
 Leighton International Limited
JOB SAFETY AND ENVIRONMENTAL ANALYSIS WORKSHEET
2.6 Missed communication/ salah
pengertian saat berkomunikasi
3. Job Finish/ Pekerjaan 3.1 No remove isolation tags/
selesai Tidak melepaskan tanda isolasi
unit
3.2 Poor housekeeping at the
area/ area kurang bersih
Mar 2008
2.6.1 Ensure have rigger when lifting activities/ Pastikan ada rigger 2.6.1.1 Supervisor, Operator
pemandu untuk kegiatan pengangkatan Crane/ Manitou
2.6.2 Ensure the operator crane/ Manitou must concentration, only 2.6.2.1 Operator Crane/
following signal from rigger ./ Pastikan operator crane/Manitou Manitou
memperhatikan, mengikuti signal, aba-aba rigger
3.1.1 Ensure remove isolation tags from machine/ Pastikan 3.1.1 Mechanics
melepaskan tanda isolasi dari unit
3.2.1 Cleaning and tidy up work area/ bersihkan dan rapihkan area 3.2.1.1 Supervisor, Mechanics
kerja
Page 3 of 4 LIL-HSE-FM-001B(01)
 Leighton International Limited

JOB SAFETY AND ENVIRONMENTAL ANALYSIS WORKSHEET

I fully understand this Job Safety Analysis and will work according to it Job Description ,
Saya Sangat mengerti Analisa bekerja aman dan akan melakukan sebaik-baiknya. __________________________
__________________________
Date issued , _______________
JOB PARTICIPANT LIST

NO. Name Position Signature

01

02

03

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06

07

08
09
10

Mar 2008 Page 4 of 4 LIL-HSE-FM-001B(01)