HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON

(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Tertabrak Trailer dan Crane

pada saat proses mobilisasi.
( Got hit by a trailer and a crane Fatality 4 3 12 HIGH A
during the mobilization
process )

MOBILISASI CRANE DAN

MOBIL FUSO KE AREA
Telescopic Crane and
1. PROYEK ( MOBILIZATION Entrance Acces Road Corteva NR N
Trailer
CRANE AND FUSO CAR TO
PROJECT AREA )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Material merosot menimpa

orang atau material yang ada
MOBILISASI CRANE DAN disekitarnya , akibat tali
Medical Treatment,
MOBIL FUSO KE AREA pengikat putus 3 3 9 MODERATE A
Telescopic Crane and ( Declining material afflicts Property Damage
1. PROYEK ( MOBILIZATION Entrance Acces Road Corteva NR N
Trailer people or material around
CRANE AND FUSO CAR TO
PROJECT AREA ) them, due to broken straps )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

MOBILISASI CRANE DAN
Unit of work
MOBIL FUSO KE AREA
: PEB Building Next reviewed : TBA
Telescopic Crane and
1. PROYEK
Sub Unit ( MOBILIZATION Entrance AccesSteel
: Unloading Road Corteva
StructureNR N Trailer
CRANE AND FUSO CAR TO
PROJECT AREA ) Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Cover Sewer Pecah saat Crane

masuk ke area saat melintasi
drainase ( Crane or Fuso car
Kerusakan properti
Mired drainage when it heavy 3 2 6 MODERATE A
( Properi Damage )
rain suddenly . And boom crane
crashing into an existing
building )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Crane atau mobil Traiiler

menyenggol pagar seng
karena area kerja yang sempit
Property Damage 3 2 6 MODERATE A
( The crane or Trailer nudge the
zinc fence because of of the
narrow road )

PENGATURAN POSISI
CRANE DAN MOBIL FUSO
AGAR PRESISI DAN
PENGATURAN OUTRIGGER
BILA SUDAH STOP
2. Crane And Fuso Car NR N
( SETTINGS POSITION
CRANE AND FUSO CAR
FOR PRECISION WHEN
OUTRIGGER ALREADY
STOP )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
PENGATURAN POSISI NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
CRANE DAN MOBIL FUSO (Bahaya pekerjaan)
bahaya)
AGAR PRESISI DAN
PENGATURAN OUTRIGGER
1 BILA SUDAH STOP
2 3 4 5 6 7 8 9 10 11 12 13 14
2. Crane And Fuso Car NR N
( SETTINGS POSITION
CRANE AND FUSO CAR
FOR PRECISION WHEN
OUTRIGGER ALREADY
STOP )

Jari Tangan terjepit saat

pengaturan / memposisikan
First Aidn ( Wounds on
outriggers ( fingers pinched 2 2 4 LOW A
the fingers )
when setting / positioning
outriggers )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

orang tertimpa tumpukan

rangka baja saat melepaskan
Fatality atau patah
tali pengikat material ( a
tulang ( Fatlity or 4 3 12 HIGH
person is crushed by a broken
Fracture )
steel structure when releasing a
strap )

PERSIAPAN UNLOADING
RANGKA BAJA SERTA
PEMASANGAN SELING DAN
SHACKLE ( UNLOADING
3. Area IF formulation project NR N Telescopic Crane
PREPARATION OF STEEL
STRUCTURE AND
INTERMITTEN SHACKLE
INSTALLATION )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
PERSIAPAN UNLOADING (Dampak resiko (S X L)
(Bahaya pekerjaan)
RANGKA BAJA SERTA bahaya)
PEMASANGAN SELING DAN
SHACKLE ( UNLOADING
3.
1 2 Area IF formulation
3 project NR
4 N5 6 Telescopic 7Crane 8 9 10 11 12 13 14
PREPARATION OF STEEL
STRUCTURE AND
INTERMITTEN SHACKLE
INSTALLATION )

Existing Floor rusak karena

tekanan Crane ( Existing Floor
Properti damage 2 3 6 MODERATE A
damaged due to Crane
pressure )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Kepala terbentur ayunan

rangka baja pada saat lifting Fatality or seriously
4 2 8 MODERATE A
( Head hit by swing Steel Injury
structure when lifting )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Crane terguling / Tumbang saat

loading. (Crane collapse /
Fatality and property
fallen down when loading 4 3 12 HIGH A
damage
because radius boom crane
violating the load chart )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Material jatuh menimpa orang

atau material karena webing
seling putus atau shackle patah
Fatality and property
( material falls on people or 4 2 8 MODERATE A
damage
material because webing is
broken is broken or shackle
broken )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

salah posisi , orang

Komunikasi yang tidak sampai
karena kerusakan alat
komunikasi radio
(Communication that did not
arrive due to damage to radio
communication equipment )
terjepit , terangkat ,
Atau membentur
sesuatu yang ada di
4 3 12 HIGH A
sekitarnya ( wrong
position , pinched
people , lifted up , or hit
something around it )

ULOADING STEEL
4. STRUCTURE ( STEEL IF Formulation project NR N Telescopic crane
STRUCTURE UNLOADING)
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

ULOADING STEEL
4. STRUCTURE ( STEEL IF Formulation project NR N Telescopic crane
STRUCTURE UNLOADING)

terpleset karena licin

.Kerusakan
Terjadi kebocoran oli atau atau lingkungan . Atau
minyak solar (Any Kebakaran ( Sippery 3 3 9 MODERATE A
leakage lube oil and gasoline ) because slip .
Environmental
damage , and fire )
 STRUCTURE UNLOADING)

HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON

(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Kaki terjepit karena material

merosot disebabkan salah
patah tulang atau luka
pengambilan material ( foot
lecet ( Fracture or 4 3 12 HIGH A
Pinched because material
Abrassion )
degenerate due to wrong
material uotake )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Jalan aspal atau lantai kerja

rusak karena tidak mampu
menahan beban crane ( the Kerusakan properti
1 4 4 LOW A
asphalt road or work floor is ( Properi Damage )
damaged because it is unable
to withstand the crane's load )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

kaki terpleset injak struktur

baja saat pengikatan karena
Luka memar atau luka
posisi tumpukan baja yang labil
robek ( Bruises or torn 2 4 8 MODERATE
(Foot slipped stampede steel
wounds )
structure when binding because
position unstable pile of steel )
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/ Impact Risk value
NR AN
E Equipment used Aspect Severity Likelihood Risk level A/A
(Dampak resiko (S X L)
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14

HOUSKEEPING SETELAH Tersandung material baja yang

AKTIVITAS UNLOADING di letakan sembarangan di jalan
Tersandung nearmiss
5. SELESAI (HOUSEKEEPING Around Site Office NR N Manual ( tripped over steel material that 2 2 4 LOW A
( Stumble near miss )
AFTER UNLOADING was laid carelessy on the road
ACTIVITIES COMPLETED ) )

Kondisi RN (Risk Number) = LxS

- R = Routine < 5 : Low
- NR = Non-Routine 5 - 9 : Moderate
- N = Normal 10 - 16 : High
- AN = Abnormal > 16 : Extreme Risk
- E = Emergency

Severity Likelihood
If Risk Rack RN > 9 (Over High) the control measures must be stated in the
1 - Insignificant 1 - Unlikely
GOP (Goals, Objectives and Programs HSE), and if necessary made JSEA.
2 - Minor 2 - Rarely
3 - Moderate 3 - Possible
4 - Major 4 - Probable
 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINING CON
(HIRAD

Field : MEDAN PLANT CORTEVA AGRISCIENCE Date reviewed : 28 Desember 2019

Unit of work : PEB Building Next reviewed : TBA
Sub Unit : Unloading Steel Structure
Risk and Impact Assessment
Condition Hazard identification
Initial Risk Status

Activities Location Risk / Environmental

No Hazard sources/ Environment
(Tahapan pekerjaan) (Lokasi pekerjaan) R/ N/
E Equipment used Aspect If RiskImpact
Rack RN > 9 (Over Severity
High) the control measuresRisk
Likelihood mustvalue
be stated
Riskinlevel
the A/A
NR AN (Dampak
GOP resiko
(Goals, (S X L) made JSEA.
Objectives and Programs HSE), and if necessary
(Bahaya pekerjaan)
bahaya)

1 2 3 4 5 6 7 8 9 10 11 12 13 14
5 - Catastropic 5 - Almost certain

Risk and Impact Assessment :

A = Acceptable =non - significant
NA = Not Acceptable = significant
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Briefing operator crane dan

Pastikan orang untuk
berjalan pada
UU No. 22 Tahun 2009 &
pedestrian
UU No. 1Tahun 1997
( Make sure people to
walk on pedestrian )
Sediakan flagman untuk supir sebelum memasuki
memandu crane dan Trailer Area project pastikan
masuk ke lokasi proyek . Operator memiliki SIM dan
Sediakan APD.
pastikan safety cone terpasang SIO dan ikuti Traffic
Sesuai aturan HSE
sebagai pembatas pedestrian Management Plan (Briefing Monitoring by
Corteva .( to provide 2 1 2 LOW
( Provide a flagman to guide the crane operators and drivers SPV,Flagman & HSE
PPE accord rule of
crane and trailer into the project before entering the Project
HSE. Corteva.)
site. make sure the safety cone area, make sure the
is installed as a pedestrian Operators have a SIM and
barrier ) SIO and follow the Traffic
Management Plan )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan safety briefing

UU No. 22 Tahun 2009 &
UU No. 1Tahun 1997
dengan sopir Trailer dan
operator Crane sebelum
masuk area project tentang
keselamatan berkendara
Pastikan jalur yang akan dan sopir harus mengikuti
di lalui Crane dan Trailer batas maksimum
Sopir harus selalu memeriksa Sediakan APD.
bersih dan tidak ada kecepatan berkendara di
lashing dan memastikan aman. Sesuai aturan HSE
hambatan area proyek (10 km/.jam). ( Monitoring by
( The driver Corteva .( to provide 2 1 2 LOW
( Make sure the path to Carry out a safety briefing SPV,Flagman & HSE
must always check lashing and PPE accord rule of
be traveled by cranes with the Trailer driver and
ensure it is safe.) HSE. Corteva.)
and trailers is clean and Crane operator before
there are no obstacles) entering the project area
about driving safety and the
driver must follow the
maximum speed of driving
in the project area (10 km /
hour))
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan safety briefing

Sediakan stell plate sebagai
alas dan akses untuk melintasi
UU No. 22 Tahun 2009 &
darinase. ( Provide a steel plate
UU No. 1 Tahun 1997
as a base and access to cross
the drainage )
dengan operator crane
sebelum masuk ke area
proyek . Pastikan operator
crane memahami isyarat
gerakan bendera dari
flagman untuk memandu
operator crane . Dan
operator crane pastikan
mematuhinya serta
Sediakan APD.
pastikan mengikuti traffic
Sesuai aturan HSE
management plan ( Carry Monitoring by
Corteva .( to provide 2 1 2 LOW
out a safety briefing with SPV,Flagman & HSE(
PPE accord rule of
the crane operator before
HSE. Corteva.)
entering the project area.
Make sure the crane
operator understands the
flag movement gesture
from the flagman to guide
the crane operator. And
crane operators make sure
to obey them and make
sure to follow the traffic
management plan.)
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Stand bye kan flagman untuk

Pastikan radius kerja Laksanakan Toolbox Sediakan APD.
UU No. 22 Tahun 2009 & memandu crane atau Fuso
aman dari halangan meeting sebelum masuk Sesuai aturan HSE
UU No. 1 Tahun 1997 saat parkir pengaturan posisi ( Monitoring by
( Make sure the working area kerja . ( conduct a Corteva .( to provide 1 1 1 LOW
Permenaker No. Stand by flagman to guide the SPV,Flagman & HSE
radius is safe from Toolbox meeting before PPE accord rule of
Per.05/MEN/1985 crane or Fuso when parking
obstructions ) entering the work area ) HSE. Corteva.)
position settings )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan toolbox meeting

sebelum aktivitas tentang Sediakan APD.
Gunakan alat bantu seperti
kerja aman pengaturan Sesuai aturan HSE
UU No. 22 Tahun 2009 & kayu untuk memutus line of fire Monitoring by SPV,Rigger
outrigger crane ( Conduct a Corteva .( to provide 1 2 2 LOW
UU No. 1 Tahun 1997 ( Use tools like wood to cut the & HSE
toolbox meeting before the PPE accord rule of
line of fire )
activity about safe work HSE. Corteva.)
setting outrigger cranes )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Pastikan stoper material

pada trailer masih
terpasang dan gunakan
Pastikan hanya orang yang Lakukan tool box meeting
alat bantu pada saat
berkepintangan saja yang boleh sebelum melakukan
mengikat material
berada di area tersebut saat unloading rangka baja dan Sediakan APD.
UU No. 22 Tahun 2009 & dengan webbing
proses persiapan pasang baricade agar yang Sesuai aturan HSE
UU No. 1 Tahun 1997 menggunakan ganjal Monitoring by SPV,Rigger
pengangkatan material. tidak berkepentingan tidak Corteva .( to provide 1 1 1 LOW
Permenaker No. kayu. ( Make & HSE
( Make sure that only people memasuki area kerja PPE accord rule of
Per.05/MEN/1985 sure the material stoper
with stints can be in the area ( Conduct of tool box HSE. Corteva.)
on the trailer is still
during the preparation process meeting before unloading
attached and use tools
for material removal ) the steel structure )
when binding the
material with webbing
using wooden shims )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan tool box meeting

Pasang steel matras out rigger
sebelum memulai aktifitas Sediakan APD.
UU No. 22 Tahun 2009 & bantalan plat untuk mengurangi
unloading Struktur baja Sesuai aturan HSE
UU No. 1 Tahun 1997 nilai tekanan crane (Install the Monitoring by SPV,Rigger
( Conduct a tool box Corteva .( to provide 1 2 2 LOW
Permenaker No. steel mat out rigger plate & HSE
meeting before starting the PPE accord rule of
Per.05/MEN/1985 bearings to reduce the value of
unloading steel structure HSE. Corteva.)
the crane pressure)
activity )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan tool box meeting

Pasang tag line untuk
mengendalikan swing selama
UU No. 22 Tahun 2009 &
proses pengangkatan dan
UU No. 1 Tahun 1997
hindari area bahaya ( use the
Permenaker No.
tagline to control the swing
Per.05/MEN/1985
during the lifting process and
avoid the line of fire area ) structure before the activity
tentang cara kerja aman
unloading struktur baja Sediakan APD.
sebelum meulai aktivitas Sesuai aturan HSE
Monitoring by SPV,Rigger
( Conduct a tool box Corteva .( to provide 1 1 1 LOW
& HSE
meeting about to work PPE accord rule of
safely unloading steel HSE. Corteva.)
starts)
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Memberikan
Pastikan crane memiliki
penjelasan sistem Ijin
sertifikat yang tepat dan
Kerja Untuk
diperiksa secara visual
mengangkat (PTW),
sebelum dioperasikan,
Untuk memastikan
dasar crane pada platform
pengaturan
solid, dukungan cadik
pengangkatan tidak
sepenuhnya digunakan,
melebihi derek Beban
dan lisensi pengoperasian Sediakan APD. Monitoring by SPV,Rigger
UU No. 22 Tahun 2009 & Kerja Aman (SWL),
crane (SIO untuk operator Sesuai aturan HSE & HSE ( HSE asking to
UU No. 1 Tahun 1997 dan Melakukan Boks Corteva .( to provide
dan SIA untuk 2 2 4 LOW operator crane so that
Permenaker No. Alat Bicara sebelum PPE accord rule of follow safe way working by
Per.05/MEN/1985 peralatan(Ensure crane
mengangkat HSE. Corteva.) load chart )
has proper certificate and
(To introduce lifting
visually inspected before
Permit To Work (PTW)
being operated, crane
system, To ensure
base at solid platform,
lifting arrangement not
outrigger support is fully
exceeding crane Safe
used, and crane operating
Working Load (SWL),
license (SIO for operator
and Conduct Tool Box
and SIA for equipment)
Talk prior on lifting)
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan tool box meeting

Pastikan SWL webing seling tentang unloading material
webing seling atau shackle Sediakan APD.
UU No. 22 Tahun 2009 & lebih besar daripada material struktur baja yang aman
yang tidak layak diganti Sesuai aturan HSE
UU No. 1 Tahun 1997 yang diangkat sebelum memualai aktivitas Monitoring by SPV,Rigger
( Webing seling or shackle Corteva .( to provide 4 2 8 MODERATE
Permenaker No. ( Make sure the SWL webing is ( Conduct tool box meeting & HSE
is not feasible to be PPE accord rule of
Per.05/MEN/1985 larger than the material being about unloading material
replaced) HSE. Corteva.)
removed ) steel structure a safe before
to starts activity )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Stop Aktivitas unloading

ganti alat komunikasi radio
test alat komunikasi radio steel struktur untuk Sediakan APD.
UU No. 22 Tahun 2009 & dengan yang berfungsi
sebelum aktivitas unloading di sementara sampai radio Sesuai aturan HSE
UU No. 1 Tahun 1997 atau normal ( replace the
mulai ( test radio selesai di perbaiki ( Stop Corteva .( to provide 2 2 4 LOW Monitoring by SPV & HSE
Permenaker No. radio communication
communication tool . Before the activity unloading steel PPE accord rule of
Per.05/MEN/1985 device with a working or
unloading activity starts ) structure for a while until HSE. Corteva.)
normal one )
the radio finish repaired )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Bersihkan bocoran oli

atau solar dengan lap
kering masukan kedalam
ember dan dan dibuang
UU No. 22 Tahun 2009 &
ke tempat khusus limbah
UU No. 1 Tahun 1997
B3 ( Clean oil or diesel
Permenaker No.
leaks with a dry cloth
Per.05/MEN/1985
.Put into a bucket to be
disposed of in aspecial
place Hazardous and
toxic material waste)
Lakukan tool box meeting
tentang unloading material
Sediakan APD.
limbah B3 masukan ke dalam struktur baja yang aman
Sesuai aturan HSE
drum khusus ( Waste sebelum memualai aktivitas
Corteva .( to provide 1 2 2 LOW Monitoring by SPV & HSE
Hazardous and toxic materials ( Conduct tool box meeting
PPE accord rule of
put into special drum ) about unloading material
HSE. Corteva.)
steel structure a safe before
to starts activity )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan tool box meeting

Pengambilan Material
pengikatan harus dilakukan tentang unloading material
harus dari bagian atas Sediakan APD.
UU No. 22 Tahun 2009 & seorang rigger yang besertifikat struktur baja yang aman
agar tidak ada material Sesuai aturan HSE
UU No. 1 Tahun 1997 yang memahami cara - cara sebelum memualai aktivitas Monitoring by SPV,Rigger
yang merosot ( material Corteva .( to provide 2 2 4 LOW
Permenaker No. yang aman (binding must be ( Conduct tool box meeting & HSE
must be taken from the PPE accord rule of
Per.05/MEN/1985 done by a certified rigger who about unloading material
top so that nothing HSE. Corteva.)
understands safe methods) steel structure a safe before
slumps)
to starts activity )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan tool box meeting

tentang cara kerja aman
pemasangan bantalan
Outrigger crane di
pasang bantalan balok kayu outrigger yang benar agar
pasang bantalan balok
pastikan rata agar beban tidak merusak asphalt ikuti Sediakan APD.
UU No. 22 Tahun 2009 & agar mengurangi
tekanan crane terbagi atau petunjuk dari lifting Sesuai aturan HSE
UU No. 1 Tahun 1997 tekanan berat crane Monitoring by SPV,Rigger
dapat dikurangi ( Install wooden study( Conduct a tool box Corteva .( to provide 1 2 2 LOW
Permenaker No. ( outrigger crane & HSE
beam bearings make sure flat meeting about safe way of PPE accord rule of
Per.05/MEN/1985 installed wooden beam
so that load pressure the crane working to install bearings HSE. Corteva.)
bearings to reduce
divided or can be reduced ) outrigger correct so as not
pressure the crane )
to damage the asphalt,
Follow instruction lifting
study )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Lakukan tool box meeting

tentang cara kerja aman
unloading struktur baja
Tumpukan baja yang
pasang pengaman stoper kayu sebelum memulai aktifitas Sediakan APD.
UU No. 22 Tahun 2009 & labil jangan di injak. pilih
pada tumpukan struktur baja ikuti petunjuk dari lifting Sesuai aturan HSE
UU No. 1 Tahun 1997 posisi injak yang aman Monitoring by SPV,Rigger
yang labil ( Install safety study( Conduct a tool box Corteva .( to provide 2 4 8 MODERATE
Permenaker No. ( unstable pile of steel & HSE
wooden stopper at pile steel meeting about safe away of PPE accord rule of
Per.05/MEN/1985 don't step on it.choose a
structure unstable ) working unloading steel HSE. Corteva.)
safe stampede position )
structure before activity to
starts Follow instruction
lifting study )
ND DETERMINING CONTROL OF SAFETY & HEALTH RISK AND ENVIRONMENT ASPECT IMPACT
(HIRADC & EAIS)

Document Number : 001-GWK -19

Revision : 05
Effective Date : 10 Desember 2019
Risk and Impact Assessment
DETERMINATION OF RISK and IMPACT CONTROL
Residual Risk

MONITORING & REVIEW

Elimination RISK CONTROL
Reduksi (LOTO, Signage, Administration and Risk value
HSE Legal and requirements (Engineering control Substitution PPE Severity Likelihood Risk level
barricade, etc) Others Control (SXL)
etc)

15 16 17 18 19 20 21 22 23 24 27

Mengadakan tool box

meeting sebelum memulai
Pindahkan material baja Letakan material di tempat houskeeping topiknya
Sediakan APD.
yang di letakkan dijalan yang aman tidak menghalangi sesuaikan dengan
Sesuai aturan HSE
ke tempat yang aman jalan lalu lintas pekerja (Put the pekerjaan yang akan
UU No. 1 Tahun 1997 Corteva .( to provide 1 1 1 LOW Monitoring by SPV & HSE
( move the steel material material in a safe place. Which dilakukan ( conduct tool
PPE accord rule of
placed on the road to a does not obstruct workers box meeting before starting
HSE. Corteva.)
safe place ) traffic) the topic houskeeping
according to the work to be
down )

Prepared By, Checked By, Approved By,

Safety Officer Subcontractor HSE Officer / Ahli K3 PM / HSE Manager

 RISK MATRIX

LIKELIHOOD (L)/ INCREASING PROBABILITY

Ranking 1 2 3 4 5
Unlikely/ Almost certain/
People Rarely/ Remote Possible/ Rare Probable
Improbable Frequent
Rare event of Small like hood of An incident/defect work It tends to be an Incident/defect work
incident/defect work at incident/defect work at may occur at the incident/defect work at always occurred at the
Risk
Environment the workplace of the the workplace of the workplace of the the workplace of the workplace of the
Ranking construction activities construction activities construction activities construction activities construction activities
Safety Health (Eg incident occurred at (Eg; incident to (Eg, 1 case per 3 years (Eg, >1 case per a (Eg, >1 case per a
most 1 case in 10years) occurred 1 case in 5 until 1 case per a year) year) year in the same
years) project)

Contained on site gas

1 Slight First Aid 1/Low 2/Low 3/Low 4/Low 5/Moderate
emission below threshold
SEVERITY (S):

Spills < 50 Liters or gas

Medical
emission below threshold
2 Minor Treatment 2/Low 4/Low 6/Moderate 8/Moderate 10/High
and Impact can be
Case
remediated < 2 Days
Spills 50 liters to 100 Liters
Loss Time or gas emission above
3 Localised 3/Low 6/Moderate 9/Moderate 12/High 15/High
Injury threshold and impact can
be remediated in 3 days
Spills 100 Liters to 200
Liters or gas emission
above threshold and
4 Major Single Fatality 4/Low 8/Moderate 12/High 16/High 20/Extreme
impact can be remediated
within 1 week (significant
impact)
Spills > 200 Liters or gas
emission above threshold
Multiple
5 Catastopic and impact can be 5/Moderate 10/High 15/High 20/Extreme 25/Extreme
Fatalities
remediated > 1 week
(significant impact)
 Risk
Risk Level Corrective Action
Level
CAN NOT BE ACCEPTED. (STOP) Work should not be done until the level of risk reduced. If the risk is
Extreme > 16
probably reduced even with unlimited resources, work stopped and don'ts
Control measures can be done the work to be done to reduce the level of risk. Leadership involvement is
High Risk 10 - 16
needed to control it.
Medium Risk, Acceptrable if ALARP, Additional controls should be done to reduce the level of risk. Additional
Moderate
5-9 controls should be applied within a specific time period. ALARP should be evaluated, as Risk is Acceptable if
Risk
ALARP Demonstrated trought the use of cost effective risk reduction measures
Low risk acceptable, No additional control is needed. Required monitoring to ensure controls are maintained
Low Risk <5
and executed there. Manage to continous improvement