P T .

P E LAY A RA N T AM AR I N S A M U D RA , T bk

QHSE PLAN
Guidelines Performing QHSE Activities in PHE Offshore Fields
"Time Charter Party For Accommodation Work Barge"

PT. PELAYARAN TAMARIN SAMUDRA, Tbk

Jl. Alaydrus No. 78C Jakarta Pusat 10130 Indonesia
Phone : (62-21) 6334489, (62-21) 6342275
Facsimile : (62-21) 6335557 E-mail : service@tamarin.co.id Website : www.tamarin.co.id

PT. Pelayaran Tamarin Samudra, Tbk PHE Management Representatives

Jabatan Nama TTD Jabatan Nama TTD

Disusun Diperiksa
QHSE Manager
Oleh Oleh

Diperiksa Deputy Director Diverifikasi

Oleh and Comercial Oleh

Disetujui President Disetujui

Oleh Director Oleh

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I. Table Of Content

I Contents 2

II Definition of Terms 4

III Scope 6

1. Leadership and Commitment 6

1.1 Leadership 6

1.2 Commitment 7

2 Policy and Strategic Objective 7

2.1 QHSE Policy Statement 7

2.2 Strategic Objectives 9

3 Organization, Responsibilities, and Documentation 10

3.1 QHSE Organization 10

3.2 Subcontractor 14

3.3 QHSE Communication and Meeting Program 14

3.4 QHSE Promotion and Awareness Program 16

3.5 QHSE Training, Competency, and Minimum Requirement 16

3.6 QHSE Legislation and Standard 17

4. Evaluation and Risk Management 17

4.1 Hazard Management 17

4.2 PPE Requirement 18

5 Planning and Procedure 21

5.1 QHSE Procedure 21

5.2 Emergency Response Procedure 22

5.3 Equipment Control and maintenance 23

5.4 Occupational Health, Medical Facilities 26

5.5 Environmental Program 26

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5.6 Transportation 28

6 Implementation and Performance Monitoring 28

6.1 QHSE Performance Monitoring 28

6.2 Incident and Investigation Report 29

7 Management Of Change 30

8 Audit and Review 31

8.1 Audit Procedure 31

8.2 Management Review 32

9 Appendix 34

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II. DEFINITION OF TERMS

Accident
Accidents are unexpected event or an unintended outcome that results in harm to people and/or damage to or
loss of property or process.

Confined Space
A space that is large enough and so configured that an employee can enter bodily, has limited or restricted means
for entry or exit (for example, tanks, vessels, vaults, pits), and is not designed for continuous occupancy.

Construction
A combination of engineering, purchasing, erection, installation, assembly, demolition, or fabrication used to
create a new facility, or to alter, add to, rehabilitate, dismantle, or remove an existing facility. It also includes any
construction and excavation activities conducted as part of environmental remediation efforts.

Contaminant
An unwanted material (for example, radioactive, biological or chemical) that is likely to harm the quality of the
working environment. The most common workplace contaminants are chemicals that may be present in the form
of dusts, fumes, gases or vapors.

Controls
The word can refer to:
 The steps taken to eliminate or reduce hazards or exposure to them. Hazards can be controlled at the
source, along the path and at the personal level
 Measures designed to eliminate or reduce hazards or hazardous exposures.
 Examples include: engineering controls, administrative controls, personal protective equipment. Hazards
can be controlled at the source, along the path to the worker, or at the worker.

Corrosive
This is a chemical that causes visible destruction of, or irreversible alterations in, living tissue by chemical action
at the site of contact.

Danger Zone
An area or location where the probability of injury is high (for example, in the vicinity of saw blades) and can also
refer to any place in or about a machine or piece of equipment where an employee may be struck by or caught
between moving parts, caught between moving and stationary objects or parts of the machine, caught between
the material and a moving part of the machine, burned by hot surfaces or exposed to electric shock.

Elimination
The most effective risk control measure. It involves the removal of the risk, eg. changing work practices.

Emergency
An event that will produce or exacerbate injury to people and / or damage to property unless immediate
intervention occurs. An emergency plan then means a set of detailed procedures for responding to an emergency,
such as a fire or explosion, a chemical spill, or an uncontrolled release of energy. An emergency plan is necessary
to keep order, and minimize the effects of the disaster.

Ergonomic
Design of equipment, machinery and workstations to suit people, occupational ergonomics is the design of the
workplace and its processes to best match the anatomical, physiological and psychological capabilities of people.

Exposure
The measurement of time during which the subject is at risk from a hazard.

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Fatality
Death due to a work related incident or illness regardless of the time between injury or illness and death.

Harm
Includes death, injury, physical or mental ill health, damage to property, loss of production, or any combination of
these.

Hazard
A source or a situation with a potential to cause harm, including human injury or ill health, damage to property,
damage to the environment, or a combination of these.

Health
A state of complete physical, mental and social well-being, not merely an absence of disease or injury.

Housekeeping
Maintaining the working environment in a tidy manner.

QHSE
Quality, Health, Safety and Environment.

Incident
An event that:
- Results in death or injury to person where the injury requires medical attention (including first aid);
- Results in injury/damage to persons, property or process;
- Is not in compliance with statutory requirements, safe work procedures or in-house guidelines.

Interface Document
A document that clearly identifies how the Owner’s QHSE expectations and the Contractors or Client QHSE
management systems will be interlinked during the work programmed.

Lost Time Injury (LTI)

Work related injury or illness that renders the injured person unable to perform any of their duties or return to
work on a scheduled work shift, on any day immediately following the day of the accident.

Medical Treatment Case (MTC)

Work related injury or illness requiring more than first aid treatment by a physician, dentist, surgeon or
registered medical personnel.

Near Miss
A near miss is an unplanned event that had the potential to result in personal injury, illness, asset loss or damage –
but fortunately it did not.

Personal Protective Equipment (PPE)

All equipment and clothing intended to be utilized, which affords protection against one or more risks to health
and safety. This includes protection against adverse weather conditions.

Restricted Work Case

Work related injury or illness that renders the injured person unable to perform all normally assigned work
functions during a scheduled work shift or being assigned to another job on a temporary or permanent basis on
the day following the injury.

Risk
A measure of the likelihood that the harm from a particular hazard will occur, taking into account the possible
severity of the harm.

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Risk Assessment
The process of analyzing the level of risk considering those in danger, and evaluating whether hazards are
adequately controlled, taking into account any measures already in place.

Risk Management
The process of identifying hazards, assessing risk, taking action to eliminate or reduce risk, and monitoring and
reviewing results.

Training
The process of imparting specific skills and understanding to undertake defined tasks.

Unsafe act or condition

Any act or condition that deviates from a generally recognized safe way or specified method of doing a job and
increases the potential for an accident.

Work Programmed
The work being undertaken by a site on behalf of the Company.

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III. SCOPE
This plan covers the requirements of the accident prevention rules and safety program to be applied to the
projects that will be performed by the Shipboard personnel (AWB and, or AHTS) under the operation of PT.
Pelayaran Tamarin Samudra, Tbk.

The primary purpose of this plan is to provide a guideline for preventing any accidents which may injure
Employees or damage property of the Contractor and his Subcontractors (hereinafter called Subcon) at the
onshore and offshore site and to minimize the potential loss of or damage to the environment and property.

Subcon shall abide by all safety rules and other regulations imposed at the site by the Laws of the country and the
provisions of applicable laws, rules and regulations, including rules and procedures as applicable from the Owner.

The successful QHSE Management system model comprises eight interrelated components:
 Management Leadership and Commitment
 Policy and Strategic Objectives
 Organization, Responsibilities, Resources,
 Standards and Documentation
 Hazards and Effects Management
 Planning and Procedures
 Implementation and Performance Monitoring
 Audit
 Review

1. Management Leadership and Commitment

1.1. Leadership
Managers shall provide strong, visible leadership and actively participate in the continuing drive toward a
corporate culture that place QHSE equal in importance to the other critical business objectives. Visible
leadership includes setting a personal example in everyday work and actively contributing to QHSE
actives such as audits, site visits, etc. Managers are responsible for maintaining a culture of QHSE
awareness so that prevention of accidental risk and loss to process is a recognized and integral part of our
daily activities. Managers shall also encourage the involvement of all employees and empower them to
develop and implement solutions pertinent QHSE issues at their site.

1.2. Commitment
PT. Pelayaran Tamarin Samudra, Tbk acknowledges that QHSE matters is very important and shall be
providing full cooperation and assistance with the clients or customers. The company is committed to
ensuring QHSE for all workers or employees at workplace. With understanding of QHSE to all workers or
employees, the company believes that work related injuries, disease and property loses are preventable.

Each employee for the company is accountable for his/her own action and must observe all provision and
instruction pertaining to QHSE measures and precautions applicable at the workplace.

2. Policy and Strategic Objectives

2.1. QHSE Policy Statement
In doing the operation activity PT. Pelayaran Tamarin Samudra, Tbk realizes the important of
commitment for Safety, Health and Environment, which will be formed as a term of Quality, Health, Safety
& Environment (QHSE). QHSE Policies has been established to comply with government & international

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rules & regulation. Everyone, including subcontractor and vendor, whom commence work & activities in
company job site shall fully comply with company’s QHSE procedures.

Management of PT. Pelayaran Tamarin Samudra, Tbk believes that this policy can only be achieved, if all
employees involve and support directly to finish this policy well. Besides, maintaining discipline and
QHSE are a challenge to be faced.

Organization which is organized by PT. Pelayaran Tamarin Samudra, Tbk depends on this commitment
and leadership of management that has been a company policy, to always give priority to QHSE aspects in
term of employees, contractors and other supervisors. Maintain a workplace that is safe, healthy,
environmentally friendly and secure from unexpected conditions.

Signed & approved QHSE Policy Statement are posted in designated area of the barges, AHTS, offices, and
other job site of PT. Pelayaran Tamarin Samudra, Tbk (refer to Appendix – 1). QHSE Pocket Book is given
to each personnel after pass through HSE induction in shore office Jakarta by HSE Coordinator.

2.1.1. SAFETY AND ENVIRONMENT POLICY

The welfare of all personnel working on PT. Pelayaran Tamarin Samudra,Tbk premises, including our
employees as well as employees of our contractors and their subcontractors, is of strong interest to us.
Accordingly, it is important that each individual recognize certain rules when doing his job. These rules
are basic and general in nature and cannot cover every possible working condition. Therefore, the
cooperation of each person is a necessity so that operating procedures and work methods do not expose
you or your co-workers to injury.

Remember, SAFETY is a team effort in which each person must share to eliminate or reduce the risk of
loss or damage to personnel or property. Good judgment and common sense are required to supplement
any rules. If you have any doubt at any time, consult your supervisor. Report all accidents, injuries and
near misses as soon as possible to your supervisor, because the little anomaly can be a big difference to
our safety & health and it CAN NOT be tolerate by any means.

2.1.2. DRUG AND ALCOHOL POLICY

Management of PT. Pelayaran Tamarin Samudra, Tbk realizes the importance of consistent approach
associated with management of health and security related abuse of drugs and alcohol at workplace. To
support the achievement of above statement, PT. Pelayaran Tamarin Samudra,Tbk Management, is
committed that:
1. All employees shall report for duty at workplace in a condition a capable of Health, Safety and
Environment (QHSE) carrying out their allocated task.
2. All employees are strictly prohibited under influence of drugs and alcohol to start or continue
working.
3. If any employees who commit grief violation, such as: getting drunk, consuming intoxicating drinks,
narcotic, misusing prohibit drugs or other stimulant medicine at the workplace or any other place
which bring adverse to the work will get disciplinary action which lead to termination without
severance pay.

2.1.3. QUALITY MANAGEMENT SYSTEM POLICY

By Operating the quality and safety management system, the Quality Management Standard will be
achieved which meets the requirements of the International Quality Management Assurance Standard.
This must be involved all personnel between on board vessel and on shore. This is mandatory for all
employees.

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The Company strives to:

• Seek continuous improvement in its occupational health and safety performance, taking into account
evolving community expectations and the continual management of change and practice.
• Comply with all applicable laws, regulations and standards and where adequate laws do not exist,
adopt and apply a company standard that reflects our commitment to Health, Safety and the
Environment preservation.
• Involve employees and contractors in the continual company improvement of occupational health
and safety performance.
• Train, compensate and hold individual managers accountable for their area of responsibility.
• Manage risk by implementing a management system to identify, monitor and control hazards and by
continually reviewing systems performance.
• Communicate openly with our employees, government and community on occupational health and
safety issues.

2.1.4. OCCUPATIONAL SAFETY HEALTH & ENVIRONMENT POLICY

PT. Pelayaran Tamarin Samudra,Tbk as a marine operator in offshore facilities and other area, will carry
out all safety, health and environment requirements include for the occupational SHE. All personnel on
board and in office shall implement and develop the standard required in terms of occupational QHSE.

2.1.5. STOP WORK AUTHORITY

PT. Pelayaran Tamarin Samudra, Tbk has a Stop Work rules that against all anomalies in fleet that will
come out at working area. It shall use, not restricted to personnel on shore to prevent all incident or
accident happened. Using this policy as a basic reason to stop all activities when it’s not proper or when a
perceived unsafe condition or behavior may result in an unwanted event.

2.2. Strategic Objectives

We will strive for a zero defect culture:
 No accidents
 No loss to process
 No harmful emissions
 No health-related incidents.
 No lapses in security.

This zero defect culture shall be attained through:

 Provide for safe practice in ship operation and a safe working environment
 Continuously improve safety management of personnel ashore and abroad ship including
preparing for emergencies related both to safety and environmental protection.
 Provide for the identification of hazards and establish safeguards against hazards.
 Creating a culture that HSE is an integral part of the line of operations and production in all layers
of the organization within the company.

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3. Organization, Responsibilities, & Resources

3.1. QHSE Organization
PT. Pelayaran Tamarin Samudra Tbk full organization chart can be seen in Appendix – 2 &
Vessel/Barge organization chart can be seen in Appendix – 3.

3.1.1. This section provides an overview of the project organization structure that shall exist
throughout the project implementation.

Deputy Director of Operation with QHSE Manager will work in close liaison with, and will be
advised by the PHE OSES QHSE Dept. In charge for all Safety related aspects of the project
activity.

3.1.2. Primary Contact Names and Telephone Numbers

Position Name Contact Details

Deputy Director of Operation Edi Purwanto +62 811 860 771
QHSE Manager R. Damar Bagus P +62 812 8112 3259

3.1.3. Director of Operation

The Director of Operation is responsible for the safety of the workforce throughout the duration
of the project.

He will be responsible for the implementation of the Project QHSE Plan at all worksites. He will
report to the BOD for all matters of safety.

It is his responsibility to ensure that all site representatives are familiar with the contents of this
Safety Plan and actively engage in implementing it all times. To facilitate the above the Project
Manager will ensure that all site representatives are issued with a personal copy of the Safety
Plan and that the QHSE Manager has been briefed on its contents and implementation

3.1.4. Deputy Director of Operation

The Deputy Director of Operation is responsible for ensuring all offshore activities are
performed in a safe manner and that all matters regarding safety at work are continually under
review for improvement, taking any corrective action where necessary to improve safety at
work.

3.1.5. QHSE Manager

The QHSE Manager is responsible to the Deputy of Director Operation for safety matters for
daily fleet operation & activities. When emergency situation arise, HSE Manager will be work
closely with DPA/CSO and report directly to President Director. He will be responsible for
providing specialist advice on all health and safety matters necessary to comply with this QHSE
Plan and statutory requirements.

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Other responsibilities include:

 Administration of and, where possible, participation in safety inspections and audits at
applicable offshore and onshore worksites.
 Coordination of all Accident/Incident Reporting and follow up investigations
 Provision of statistical information to project and senior management, in order to monitor
the effectiveness of this Safety Plan.
 Issue of Internal Safety Notices where reports of accidents, incidents or near misses at any
worksite have indicated a potential for a similar hazard at another worksite.
 Where applicable, provide additional safety procedures, which may be required for a
particular task or process, identified the project works.

3.1.6. QHSE Assistant Manager and QHSE Coordinator shall:

1. Ensure that the operation complies with all legal requirements.
2. Ensure that the company health & safety policy is understood and implemented by all
employees at their site.
3. Ensure that all new employees at site receive an adequate briefing on the work program.
4. Report incidents and other information to the safety department, either directly or through
the Director.
5. Ensure that all QHSE Program that already designated in worksite is implement

3.1.7. Port Engineer (PE) shall:

1. To monitor, inspect and implement ship maintenance system part of the engine room
according to the plan that has been made.
2. Ensure that the machine and ship technical equipment is functioning properly and ready for
operation.
3. Providing support to the ship's personnel in the repair and maintenance.
4. Assist deputy director of operation duties.
5. Prepare every vessel needs and complaints including when docking both the deck and
engine room section.
6. Knowing how to use the monitoring and measurement equipment properly.
7. Conduct inspections of ships according to the schedule determined by the Company.

3.1.8. Port Captain (PC) shall:

1. Port Captain report to Head of Operation Division and responsible to ensure smooth
operations especially on vessels, crew matters and safety on board.
2. PC is responsible to monitor crew discipline and constantly educate all crew to improve
their skills and knowledge in carrying out their duties.
3. PC is responsible for monitoring the vessel and crew performance to ensure that customers
contract requirements are compiled and act as the prominent link to the customers.

3.1.9. Crewing Staff shall:

1. To assist in the search HRD Staff, acceptance and crew selection.
2. Ensure all crew candidates meet the criteria listed in the criteria form the crew

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3. Ensure that all candidates meet the requirements of the crew and have a certificate required
by the flag state.
4. Storing data and if necessary amend the crew.
5. Preparing payroll data, meal allowance and other allowances no later than the 24th of each
month.
6. Prepare correspondence crew including mutation, sign-on and sign-off.
7. Save the Sea Labor Agreement (Perjanjian Kerja Laut) crews and renew it when it expires.
8. To keep and update a list of "Blacklisted" crew.
9. Manage and monitor the equipment PPE held by each crew to ensure its maintenance
during the specified time.
10. Saving crew medical report.
11. Calculate, monitor and manage compensation leave all fishers.
12. To monitor progress and resolve any issues that may arise crew.
13. Be responsible for the management of crew insurance.

3.2. Subcontractor Management Plan

Refer to ISO “Pedoman Manajemen Sistem Terintegrasi”, Prosedur Pengadaan Barang Dan Jasa
K3, Prosedur - 11. The criteria shall be used for the evaluation of Sub-contractors in relation to
QHSE:

1. Sub-Contractors past performance.

2. Accident / Incident reports and follow-up.
3. QHSE Inspection reports that will report to main contractor
4. Lost Day Accident Frequency Rating.
5. QHSE follow-up program and other non-conformity report
6. Environmental protection and pollution control.
7. Management system and QHSE responsibility.

This standard is for all sub-contractors providing services to PTS whether on a long term or
short term basis.

Note: Failure to comply with the requirements of this standard by the subcontractor may result in
termination of the contract.

PTS is committed to the management of health and safety for both PTS employees and all sub-
contractors engaged by PTS, or those working on PTS sites or in the public domain. This
standard provides the health and safety guidelines that all parties must follow to ensure OHS
are managed during the course of business. PTS’s Sub-Contractor Management system is a
process of pre work assessment of contractor’s OHS management, approval to undertake work
for PTS and the ongoing checking, auditing and monitoring of contractors OHS management
performance. PTS’s Sbu-Contractor management system is designed to enable sharing of
information and continuous improvement.

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Through the application of the Contract Management System, PTS aims;

 Provide a safe and healthy workplace and systems of work that prevent reduce risk of
illness and injury equally for employees and sub-contractors

 to provide a practical, consistent and relevant system for PTS staff managing and overseeing
the work of contractors and/or their sub-contractors

 to integrate OHS requirements into contractor management

 fulfill PTS’s OHS legal requirements to ourselves and to sub-contactors

The following procedures must be followed when engaging a contractor or sub-contractor.

a) Sub-Contractor OHS Management. Sub-Contractors must provide details of their OHS

management structure, OHS record and their technical and commercial ability, for
consideration when their suitability for the work is assessed.

b) Documented OHS Requirements. The written contract, or in short term cases, in a letter of
engagement to carry out the specific task, both must include commitment to meet
contactor’s own OHS management standards and a reference to meeting PTS’s OHS
standards. In the case of a contractor not having their own OHS standards, a commitment to
apply and meet PTS’s OHS standards is satisfactory.

c) Insurances, Licences, Registrations & Certificates. The PTS manager or supervisor must
ensure that contractor’s or subcontractor’s employees possess the insurances, licences,
registrations and certificates required by local law or legislation.

d) Pre-Work OHS Induction. Before work is commenced, the PTS manager or supervisor will
organize for the PTS OHS induction training to be completed. Sub-contractors are not
permitted to start work until the PTS OHS Induction is successfully completed.

e) Safe Work Procedures. Where applicable, copies of PTS’s written safe work procedures
must be given to the sub-contractors. Particular attention must be paid to lockout or tag-out
procedures. Copies of the sub-contractor’s written safe work procedures must be provided
prior to any work being undertaken. If sub-contractors are undertaking PTS’s standard
work tasks, PTS’s procedures can be utilized by the sub-contractor.

f) Supervision. The PTS manager must arrange for the work of the sub-contractor to be
monitored to ensure their compliance with sub-contractor’s documentations, safe work
procedures, PTS standards and procedures, maintenance and correct use of tools or
equipment and observance of good housekeeping.

g) Feedback. If the subcontractor is not working to expected OHS standards, the manager or
supervisor must discuss the deficiencies with the persons concerned and work with the sub-
contractor to resolve the problems. At the completion of works or contract, where

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appropriate feedback is to be provided to the contractor on their OHS performance.

h) Reporting Incidents, Injuries and Property Damage. Contractors, subcontractors, or any

other persons must be advised during PTS’s OHS Induction that all incidents, injuries or
damage to property must be reported to the relevant PTS person on site, e.g. manager or
supervisor. Sub-Contractors who fail to meet the reporting standard will be subjected to
PTS’s disciplinary processes.

i) Emergency Procedures. Emergency procedures must be explained to contractors and

subcontractors during PTS’s OHS Induction. Contractors and subcontractors will be
required to take part in practice drills should they occur when the contractor or
subcontractor is on site. If the contractor is undertaking any tasks, or brings onto site any
tools/equipment or product that may affect the site’s emergency management, PTS is to be
notified prior to works to allow for a risk management strategy to be developed.

j) Environmental Protection. PTS’s environmental standards must be clearly outlined prior to

contractor engagement with the contractor or subcontractor having an understanding that
strict adherence to these standards is required. This applies to, but not limited to: noise,
dust, gas or fume emissions, water management, spillages and preservation of the local
ecology.

k) Property Security. Contractors, subcontractors or other persons must be made aware that
they will be responsible for the security of their own property while on site.

l) Drug and Alcohol Policy. Contractors and subcontractors will be made aware of the details
and the requirement to meet PTS’s Drug and Alcohol Standard during PTS’s OHS Induction.
Any person found to be not conforming with the Drug and Alcohol Standard will be
immediately removed for the workplace and will be subjected to the PTS disciplinary
processes.

In addition to the points detailed above, consideration must be given to the following standard
work procedures that may be relevant to the contractor and their employees:

 required permits, e.g. hot work, entry into confined spaces

 electrical isolation
 lockout and tag-out
 chemical handling
 manual handling
 housekeeping
 use of personal protective equipment
 use of tools
 use of scaffolds and elevated platforms
 working at elevated levels
 industrial gases
 disposal of waste and spills

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 compliance with PTS’s emergency procedures and Site Emergency Management Plans.

Copies of these, if deemed relevant, can be given to the contractor or subcontractor

Long term contractors are an integral part of PTS’s business. Long term contractors are to have
their own OHS Management System and standards that are equal to or greater than PTS’s
standards, or in the case of a long term contactor not having such standards, the agreement and
application of PTS’s OHS Standards is satisfactory.

As well as the general OHS requirements outlined above, the following procedures are to be
observed.
a) Written Contract. A long term contractor’s contract must include more than a directive to
‘work safely’. The contract must detail all the requirements of OHS compliance, methodology
of work (subject to changes) and include the points (b) to (j) detailed below.

b) OHS Induction. A long term contractor must be given a full site specific OHS Induction
training program as would be provided for a PTS employee.

c) Routine Health Surveillance. If a specific hazard is identified where risk of illness or injury
to a person may be a consequence due to exposure, a risk assessment must be undertaken.
The risk assessment is to determine the requirements to schedule health surveillance. If
there is any doubt, PTS Management are to be consulted to reach solution.

d) OHS Committee. It is essential that contractor’s input and involvement with health and
safety issues is sought and are invited were appropriate to be represented on State OHS
committees.

e) Safe Working Procedures. As well as ensuring that long term contractors are conversant
with all relevant safe work procedures. It is essential that contractor’s input is sought when
procedures that relate to their work are to be changed or developed. Particular emphasis
must be given to lockout and tag-out procedures or workplaces of high.

f) Emergency Procedures. Long term contractors must be fully conversant with PTS’s
emergency procedures and take part in any practice drills. If the contractor is undertaking
any tasks, or brings onto site any tools/equipment or product that may affect the site’s
emergency management, PTS is to be notified prior to works to allow for a risk management
strategy to be developed.

g) Personal Protective Equipment. All contractors are required to wear the mandatory
personal protective equipment. Contractors are to further wear any PPE as detailed in their
own safe work practices or risk assessments.

h) Incidents, Injuries and Property Damage. As well as the requirement to report incidents,
injuries and property damage as outlined in the General Requirements above, such incidents
involving contractors must be the subject of a full investigation. PTS’s Incident Investigation

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Standard is to be applied.

The investigation team may involve a PTS representative, this is to be decided on case by case
basis, and otherwise it is the responsibility of the contractor to complete the investigation (it is
assumed that a PTS representative will be involved in most incident investigations). The root
cause of the incident is to the aim of the investigation. On identification of the incident root
cause and any other gaps, risk controls are to be determined and implemented to prevent a
recurrence.

Any reported incident must be included in OHS committee agenda for review.
a) Injury Management. Despite the fact contractors have their own workplace injury
insurances, PTS can assist with the management of injuries and return to work. Support and
counseling can be provided by PTS following serious incidents, and assistance to managers
if impaired performance becomes a problem.

b) OHS Training and Instruction. When undertaking a training needs analysis, contractors are
considered and will be included were assessed as necessary. Contractors will be included in
any training that is required to meet PTS or legislative requirements. Records of contractors
training provided by PTS will be maintained by PTS. If a contractor has completed the
required training external to PTS, training records will be requested by PTS.

Company to decide whether to use contractor again, If there have been problems in the
contractor’s H&S performance, then ensure that improvements are implemented before further
work is conducted.

If the contractor has demonstrated unsatisfactory and/or shown lack of improvement, do not
engage contractor.

3.3. QHSE Communication and Meeting Program

In order to promote throughout the project, the following communication aids will be enforced
for the contract period.

3.3.1. QHSE KPI Record

All programs for QHSE activities during contract is based on program that already designed and
signed by Management of PT. Pelayaran Tamarin Samudra, Tbk regarding the QHSE Program
from PHE OSES will be follow in line during contract. KPI record shall maintained and report to
PHE OSES also to QHSE Dept. PT. Pelayaran Tamarin Samudra, Tbk.

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3.3.2. Accident Reports

3.3.2.1. All accidents are to be immediately reported orally to the supervisor in the cases
described below and will be followed by a written report.
 All fatal injuries.
 All injuries requiring first aid treatment.
 All damages, to the Owner’s or Contractor’s properties.
 All fires.
 All releases or spills of hazardous materials.

3.3.2.2. A written accident report shall describe in detail the circumstance, and include the
results of the accident investigation and analysis.

This report describes the accident classification, cause, time, date, location, etc. Written
incident reports shall be submitted to Safety Officer and Owner’s representative through
Contractor within 1 day.

3.3.2.3. A daily first aid record must be kept on all employees requiring first aid treatment.

3.3.3. Safety Meeting

3.3.3.1. A safety committee meeting shall be held on a weekly and/or monthly basis and chaired
by the vessel Barge Master and attended by all personnel, including vessel crew,
subcontractors, and client personnel.

3.3.3.2. Safety meeting is to be held immediately prior to work commencement for the entire
crew. Planned activities to be done at that point of time are to be discussed and the crew
given the opportunity to put forward opinions safety consideration.

3.3.3.3. Each safety meeting shall be minutes by the Supervisor or his nominee and copy issued
to the Contractor Safety officer, Client representative, Vessel Barge Master.

3.3.4. Toolbox (Safety) Talk

Toolbox Safety talks will be given by supervisors to the general members of the workforce
under their control at the beginning of each shift, or before any new or extraordinary operation
or task which may occur during the work.

These Toolbox talks will be in addition to any other safety meetings or required will also record
the names of attendance, the party giving talk and the duration of the talks.

3.3.5. Safety Violation Notice

Any infringement of safety practices or procedures will result in the offender receiving a “Safety
Violation Notice”. This notice will detail the infringement and serve as warning to the recipient

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that the receipt of two violation notice may make that person liable to being dismissed from the
PTS’s employment following review by management.

3.4. QHSE Promotion and Awareness

PT. Pelayaran Tamarin Samudra, Tbk conduct QHSE promotion and awareness effectively
needed for this work and workers. (E.g. performance board, newsletter, bulletin, poster,
recognition program, observation program, intervention program, etc). It is QHSE Coordinator
duty to make HSE bulletin, and observation program to improve the awareness of PT. Pelayaran
Tamarin Samudra,Tbk personal at office and working site.

3.5. QHSE Training and Personnel Competency

PT. Pelayaran Tamarin Samudra,Tbk provide training program to improve the knowledge and
QHSE behavior to implement the QHSE plan on job activity to all off employee and management.

QHSE Department encourages & support each section or department to promote their
personnel which need specific training for the job based on approved Training Matrix (refer to
Appendix – 4). It is responsibility of each section or department leader to ensure all personnel
working under his/her supervision has suitable minimum standard competency required by the
job standard.

Type of QHSE training to Crews, which are programmed to be conducted during future
implementation are as follow:

1. QHSE Induction
2. Basic First Aid
3. Environmental Awareness
4. Waste Handling
5. Basic Safety Training
6. Emergency Response
7. HIRA (Hazards Identification Risk Assessment)
8. Accident/ Incident Reporting and Investigation.
9. Internal Audit Training
10. T-BOSIET Training (if needed in contract by client)

3.6. QHSE Legislation and Standard

PT. Pelayaran Tamarin Samudra, Tbk conduct all business operations under Republic of Indonesia law
& regulations and comply to International Standard for Marine Organization (IMO) rules i.e SOLAS,
MARPOL, STCW, and also Oil & Gas Industry standard.

Refer to Integration Management System of ISO 9001, ISO 14001, OHSAS 18001 and ISM Code.
Prosedur Identifikasi Persyaratan Perundangan K3 (refer to Appendix – 5).

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4. Evaluation and Risk Management

4.1. Hazard Management

PT. Pelayaran Tamarin Samudra, Tbk apply certain principles including the evaluation of
unavoidable risk and taking of action to reduce them. The PTS has suitable and sufficient
assessment of the risks to health, safety of workers arising in the normal course of their
activities or duties for the purpose of identifying:

a) Group of workers at particular risk in the performance of their duties.

b) The measures to be taken to comply with PT. Pelayaran TamarinSamudra, Tbk

Risks Assessment or Job Safety Analysis is a tool which provides a list planned work activities
and identifies QHSE activities required for hazards control and allocates responsibilities for
implementing controls. JSA shall be used through the project shall be conducted on all activities
details in the project procedures and on non-routine or potentially hazardous activities
identified on the job and before the contract signed (refer to Appendix – 6).

4.2 PPE Standard

Each employee will be issued with personnel protective equipment. The employee is
responsible for wearing, maintaining in a serviceable condition and reporting to his supervisor.
Any damage or faults with the PPE shall be reported & investigated, thus replaced with new
spare on site.

Barge Master alongside with Safety Officer is responsible for ensuring that personal protective
equipment is used where required, demonstrating its correct fit, and enforcing the wearing such
equipment.

The QHSE Manager is responsible for advising subcontractors and vendor representative
personnel on complying with this PPE policy. The policy will be strictly enforced without
exception.

When outside the accommodation, Hard Hat & Safety Boots MUST be worn at all times. The only
exclusion will be the helideck when used for recreational purposes.

PT. Pelayaran Tamarin Samudra, Tbk has enrolled PPE Matrix for the guidance of each
personnel working on site (refer to Appendix – 7).

4.2.1. Safety Helmet / Hard Hat

Safety helmets of a lightweight plastic material shall be approved to ANSI Z89.1-1986 or the
local equivalent. Metal helmets, which are proven to be electrically unsafe, are not worn on any
PT. Pelayaran Tamarin Samudra,Tbk work site. Helmets must be kept clean and inspected
regularly for possible cracks in the shell or UV deterioration that leaves them brittle and
intrinsically unsafe.

Helmets must not have stickers, paint, marker pen, etc. as not only will these obscure hairline

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cracks, but also the solvents used in their manufacture will break down the structure of the
plastic to a small degree and hence downgrade the safety parameters of the helmet.
Note that any person with long hair shall have it secured inside a hair net before wearing a
helmet. This is to avoid hair being caught in machinery or obscuring peripheral vision.

All personnel shall wear a hard hat at all times on PTS and Project work sites. The only
exceptions being when in vehicles, offices, and any defined PPE exemption zones.

4.2.2. Safety Footwear

Safety foot wear shall approved by ANSI Z41.1-1991. Safety footwear shall be stout, robust, low
heeled and with metal toe caps. In hazardous areas, the metal toe caps shall not be exposed and
metal strips shall not be attached to the soles because of the possibility of causing sparks. Soles
that slip on wet surfaces shall be avoided.
When handling hazardous or toxic substances, calf length, non-porous, chemically safe rubber
steel capped boots must be worn.
Lace up boots or shoes must be worn with laces adequately tied to ensure the footwear is held
in position.

4.2.3. Coveralls
Coveralls shall be worn on all work sites, both offshore and onshore. The only alternative shall
be long cotton heavy weight drill trousers and tong sleeved shirts specifically constructed for
working conditions. Coveralls are to be cotton or a 60/40 cotton synthetic mix to provide some
measure of protection against welding burns, sparks, etc. Pure synthetics are to be avoided. For
all welding or burning operations and any activity that requires exposure to potentially harmful
substances, coveralls must be long sleeved.

Coveralls shall be kept clean and in good condition. Avoid wearing coveralls that have become
saturated with oils, grease and the like as not only do they represent a fire hazard, but will cause
unnecessary skin complaints. This requirement is not intended to cover the handling of
dangerous or toxic substances. Any such substances shall require the use of specialized
protective clothing.

4.2.4. Eye & Face Protection

Eye protection that conforms to ANSI Z87.1-2003 or the local equivalent should be worn in all
appropriate circumstances. When working in the vicinity of structures, safety glasses must be
worn in all areas outside the accommodation. Safety glasses must be completed with side
shields and inspected regularly for heavy scratching or damage. They shall be worn for all
activities that include grinding, chipping, painting and any activity that may result in debris
entering the eye.

For the handling of chemicals, full face safety visors must be worn. Welding and cutting
operations require the use of specialized face protection.

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4.2.5. Hand Protection

Gloves are to be used for all operations that present risk of injury or skin conditions; it shall
approved ANSI 105-2011. For normal deck operations, cotton gloves are sufficient; however for
all rigging operations and handling of wires, leather gloves must be worn.

Gauntlet type leather gloves are to be used for all burning and welding operations. Rubber
heavy duty gauntlets must always be utilized for the handling of chemicals or toxic substances.
Hand gloves must be worn when handling wire rope with the exception being in instance where
gloves may be caught in a running-in situation.

4.2.6. Hearing Protection

Hearing protection must be approved by ANSI 512.6-2010. Noise induced hearing loss can
result from regular exposure to high levels of noise. Areas with high noise levels are to be
clearly marked by notices at access points and personnel should, wherever possible, avoid those
areas.

Where this cannot be avoided, personnel must wear ear defenders and/or ear plugs. Hearing
protection must be worn by all personnel exposed to 85dB (A) or more for a full 8 hours.
Ear plugs (disposal or re-usable) should be used:

a) When operating grinders, buffers, sledge hammers, noisy tools or equipment.

b) Inside noisy workshops.
c) Where signs indicate to do so and when instructed by supervisors. Reusable ear plugs must
be cleaned daily.

4.2.7. Dust Masks

Dust mask must be approved by ANSI Z88.10. These masks are constructed to provide safe
filtering protection in a normal atmosphere where dust is present. They are not safe for, nor
must be used at any time in the presence of noxious gases or in an oxygen deficient atmosphere.
Approved respiratory protection must be worn in all areas where airborne health hazards exist.
in accordance with manufacturer’s requirements and the paint or other products being used.

4.2.8. Fall Protection

Safety belts shall be approved by ANSI Z359. Safety belts or harnesses must be worn and
secured when working on any elevation over two meters when it is not enclosed with handrail.
Safety belts or harnesses shall be worn by all personnel working on elevated Jackets. Safety belt
must fit snugly around the waist and be fitted with a lanyard no longer than 1.2 meters in
length.

The lanyard should be secured to a substantial member of the structure, no lower than the waist
of the wearer. Fall protection equipment shall be inspected for defects prior to being worn.
Defective equipment shall not be used. Safety belts, harnesses and lanyards shall be stored and
maintained free from oil, grease or other contaminants. Any fall protection device that has been
subject to severe shock leading shall be immediately destroyed.

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4.2.9. Buoyancy Vests

All work vest and any flotation device shall complied with SOLAS Reg. 31-32 standard or
common USCG Standard. Buoyancy vests (work vests) shall be worn when working over the
side of a ship, crossing over from ship to ship or ship to other offshore installation using
gangway, or crossing over from such structure over water. Buoyancy vests shall be worn when
standing or working beyond the handrails of material vessel or where no handrails exist on a
vessel. When launching the bell or working in the moon pool area, work vests MUST be worn at
all time.

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5. Planning and Procedure

5.1. QHSE Procedure

PT. Pelayaran Tamarin Samudra, Tbk provide procedures to cover hazardous operations in this
job. These procedures include all precaution needed to eliminate or minimize hazard and risk.

Written procedures shall be available, understood and implemented by all workers including
subcontractors. Refer to ISM Manual and QHSE Manual.

5.2. Emergency Response Procedure

Contractor maintains a standard set of formats to handle accidents and / or emergencies.
Further, the company is very specific on how investigations following incidents will be carried
out. It is crucial that every job site follows these procedures; not only to ensure that damage to
facilities or equipment and project downtime is minimized.

Contractor, specifically the deputy director and QHSE manager carry ultimate responsibility for
any accident. Therefore, it is vital that they be kept informed of all developments. This will
normally be done through the DPA or QHSE Manager. DPA or QHSE Manager must be available
24 hours a day either by office phone, home phone or hand phone.

In case of any type of emergency involving our personnel offshore, client formally requests that
our DPA be granted immediate access to the PT. Pelayaran Tamarin Samudra, Tbk Emergency
Team through radio telecommunication / telephone. (refer to Appendix – 8).

The role of the key Contractor person on site is as follows:

 Assess and stabilize the immediate situation as outlined in the Emergency Response Manual
in which you MUST be familiar with
 If you have a Client Representative on board, quickly explain the situation, the steps you
have taken, and future action. Assign him to the communications center (Normally the radio
room) and get him to open a line of communication with the Duty Manager on your behalf.
Unless the situation is such that it immediately affects the integrity of client property, it
must be insisted that he do this before any call to his own Duty Officer. He should be asked
to remain on site and act as your communications controller.
 Remember – Report All Accident / Incidents No Matter How Small the estimated outside
assistance required (i.e) medical Advice, Medevac, Standby Vessel for Man Overboard
Assistance, Abandon Ship Assistance, fire Fighting Assistance, etc.
 In case of an injury or decompression illness, ensure that the Contractor Transmittal
Documents is completed by a responsible member of your team as soon as possible and
make arrangements to send it ashore immediately.
 DO NOT delay treatment of any causality
 Stabilize the patient(s) condition until expert advice can be given.

Type of Emergency Situation:

a) Serious accident or Illness

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b) Fatality
c) Man Overboard
d) Man Missing
e) Fire or Explosion
f) Abandon Ship

Emergency Contact Number

No. CONTACT PERSON POSITION PHONE / MOBILE
PT. PELAYARAN TAMARIN SAMUDRA, TBK
Jl. Alaydrus No. 78-C Jakarta 10130 Indonesia
1
Telp. (62-21) 6342275; 6334489
Email : service@tamarin.co.id ; ops@tamarin.co.id

Deputy Operation &

2 Edi Purwanto 0811 860 771
Commercial Director

3 R. Damar Bagus P QHSE Manager 0812 8112 3259

4 Nugroho F.P.P QHSE Assistant Manager 0822 9956 6324

5 Achmad Arga QHSE Coordinator 0812 8054 0175

5 Capt. Surja Aditjahja Port Captain 0813 4736 7262

6 Erwanto Hadi Port Engineer 0812 9837 3476

7 Andreas Darma Crewing Coordinator 0813 1005 8002

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5.3. EQUIPMENT CONTROL AND MAINTENANCE

5.3.1. Objective
To ensure that the shipboard maintenance for the hull, machinery and equipment of the ships
under the Company’s management satisfy the requirements of the Safety management Policy,
relevant regulations and the Rules of the Classification Society by the establishing procedures
for the same.

5.3.2. Maintenance Equipment

The equipment covered by the requirements of this section includes but are not limited to the
following:

 Life-saving equipment and Fire-fighting equipment;

 Equipment for the prevention of environmental pollution such as oil discharge monitoring
and control systems, tank cleaning equipment, incinerators, sewage tanks etc.;
 Navigational equipment incl. Gyro compass, Radar, ARPA, GPS, etc ;
 Steering gear;
 Mooring equipment
 Main Engines and maneuvering equipment;
 Auxiliary Diesel Generator Engines;
 Main Switchboards and electrical equipment;
 Anchor handling equipment;
 Radio equipment.

5.3.4. Preparation of Shipboard Maintenance Plan

It is important to prepare a Shipboard Maintenance Plan, specifying all maintenance items and
timings for the satisfactory implementation of ship maintenance, and to perform maintenance
services in accordance with this plan (refer to Appendix – 9).

A Shipboard Maintenance Plan shall be prepared in accordance with the following standards:
a) it shall be prepared in accordance with the Shipboard maintenance standards. (Items for
sub-contracted work shall be included);
b) items for which no maintenance standards have been established shall be dealt with
referring to manufacturers’ recommendations;
c) Consideration may be given to those items supported by open-up and maintenance records;
d) Due dates of classification surveys and statutory surveys shall be taken into account;
e) Dates for implementing maintenance services for CMS items shall be determined taking the
valid terms into account;
f) Items associated with many sub-items shall be planned so that they are taken care of during
the ship’s dry-docking period;
g) The period for a Shipboard Maintenance Plan shall be 2.5 years (30 months), and the next
plan shall be drawn up at least six months in advance.

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5.3.5. QHSE Inspection Program

A. Barge Master
Barge Master is responsible for seeing that this procedure is adhered to on board
B. Safety Officer
Safety Officer is responsible for managing the inspection program. The responsibilities
include establishing the QHSE Inspection schedule, maintaining inspection checklist,
collecting the complete inspections, evaluating and reporting of the inspection finding. He
will work together with the Barge Master to identify target areas for inspection. He is
responsible for communicating the inspection program result to the site team and to
client’s representative. He will also maintain a register of items requiring follow up.
C. ON Board Members
All PT. Pelayaran Tamarin Samudra, Tbk team members are responsible for
implementation of the QHSE Inspection Program. Each team members of site management
will conduct at least one QHSE Inspections monthly.
QHSE Annual Program can be seen in Appendix – 10.
Inspection procedure:
a) QHSE Inspection Program
The Safety Officer will prepare the schedule, subject and locations for inspection with input
from the site project team. This will be done on a monthly basis and should align with
current operation activities.
b) QHSE Inspection Schedule
The schedule of QHSE Inspection Program will be reviewed each month at the site progress
meeting. Safety Officer will consult in advance on board in order to ensure good
communication and to prevent conflict.
c) Inspection Checklist
The inspection will conducted using the checklist of QHSE Inspection. Person will conduct
the inspection will review the area, work process and person performing work as
appropriate. They will then complete the checklist indicating items as acceptable (yes),
deficient (no) or and not applicable (NA). Deficiencies should be described on the checklist
form in sufficient detail to allow follow up to be prepared.
d) Inspection Location
The QHSE Inspection will conduct at locations specified on board area and or other areas of
working in relation with.
e) Evaluation and Reporting
Upon completing of QHSE Inspection the checklist will be returned to Safety Officer for
further summarizing, evaluation and reporting. Any deficiency noted on the checklist will
capture and determination made regarding to need for follow up.

When there are serious potential hazards identified during inspection immediate steps will be
taken to communicate this information to appropriate person without delay. The Barge Master
and Safety Officer should also be informed of any items needing immediate corrective action.

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5.4. Occupational Health and Medical Facilities

All crew/personnel working on site shall have a valid health certificate. All Subcontractor
Personnel working under PT. Pelayaran Tamarin Samudra,Tbk shall have a medical certificate
of a standard equal to Charterer requirements.

The ship’s hospital should be supplied with the medicines and medical tools required for
topside medical conditions.

PT. Pelayaran Tamarin Samudra,Tbk maintains a complete kit of hyperbaric medical treatment
supplies and medical tools as required by the regulation and the Company Policy. A full first aid
kit shall be maintained in a stocked condition in all operation area. Medics must ensure that
only the quantities of medical supplies/drugs necessary are delivered to the patients.'

5.5. Environmental Program

PT. Pelayaran Tamarin Samudra,Tbk is committed to the protection of the environment at all
times within the scope and control of PHE OSES projects.

PT. Pelayaran Tamarin Samudra,Tbk has been established procedure to dispose of waste and
scrap materials in order to protect the environmental from harm and to avoid pollution. Vessel
Barge Master is directly responsible for ensuring the Waste Management Plan procedure is
enforced. Purpose is to establish set procedures to dispose of waste and scrap materials in order
to protect the environment from harm and to avoid pollution.

The following shall be adhered to:

a) All scrap and surplus materials steel sward, off-cuts, of steel, wood, etc. is to be returned to
shore in designated rubbish skips for disposal with a company approved contractor.
b) Dirty oil is to be pumped into empty drums, clearly marked (Dirty Oil) and returned to shore
for re-cycling or proper disposal.
c) Oily water and bilge waste is to be disposed of according to the latest IMO regulations
utilizing the oily water separator and is to be logged into the “oily water separator log book”
and “waste management log book”.
d) Minor oil / grease spills on the desk etc. are to be treated with oil dispersion and diluted
with water, prior to wash down.
e) Note: The Chief Engineer shall keep accurate records.
f) All galley / kitchen waste is to be separated into food scraps, paper/plastics and tins. Food
scraps are to be immediately macerated in the waste disposal unit (not bagged for
incineration). All paper / plastics are to be burnt in incinerator (if available). Tins will be
sent ashore for proper disposal.
g) Note: Never hose directly over the side without first treating with dispersion.
h) Good housekeeping is essential at all times throughout the Vessel to avoid any unnecessary
built-up of waste materials. Housekeeping is not only good safety practice, but it is an
integral part of everybody’s work duties.
i) (3)P of environmental management:
 Protect the Environment
 Prevent Pollution
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 Promote Good Housekeeping

5.5.1. Preventing Of Marine Pollution

Bilge Contents, Oily bilge water produced in the engine room is to be pumped from the bilge or
bilge holding tanks to a bilge separator. The oil content of any water processed by the separator
shall be measured for its oil content with an Oil Discharge Monitoring and Control System and
discharged overboard only when the oil content in the bilge is 15 ppm or less. It is essential to
restrict the oil content in the bilge discharged overboard to as low a level as possible. It is
important to maintain individual bilge discharge system component parts in good working
order.

5.5.2. Pollution Prevention Equipment

Shipboard Oil Pollution Emergency Plans, MARPOL 73/78 requires that all vessels must be
provided with a Shipboard Oil Pollution Emergency Plan (SOPEP). This is a controlled
document.

5.6. Transportation
It is the policy of PT. Pelayaran Tamarin Samudra,Tbk to comply with the client applicable
regulations concerning transportation of personnel to offshore locations.

Transportation to offshore locations includes:

 By Helicopter
 By Speed Boat
 By Direct Transfer

For land transportation, PT. Pelayaran Tamarin Samudra, Tbk commits to :

 Maintaining all company vehicles in a safe, clean and roadworthy condition to ensure the
maximum safety of the driver, occupants and other road users at all the time. All the
personal license shall be collect by company and maintain the record
 Ensuring that staff company vehicles:
a) Demonstrate safe driving and other good road safety habits
b) Make a pre-use checklist every time the vehicle will be used
c) Report vehicles incident at all times when driving.

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6. IMPLEMENTATION AND PERFORMANCE MONITORING

6.1. QHSE Performance Monitoring

PT. Pelayaran Tamarin Samudra, Tbk apply certain principles including the evaluation of
unavoidable risk and taking of action to reduce them. Also the implementation and monitoring
program that based on specific procedure. The Company has suitable and sufficient assessment
of the risks to health, safety of workers arising in the normal course of their activities or duties
for the purpose of identifying. All program that already been acknowledge by marine crew will
be monitored from head office which is QHSE Dept. taking the responsibility to maintain and
make sure that all program will be implemented in minimum ways that client require, have
organize some stage to observe the implementation of QHSE activity on site this can descript as:

1. Action Point Tracking List.

List of immediately action is to take and create by sources of :
- Lagging Indicator, that established in QHSE Program such as :
1. Man hour recorded from and Year to date
2. Fatality
3. Lost Time Incident
4. Non Recordable Incident
5. Oil Spill
6. Total Land Vehicle Kilometer
- Leading Indicator, that established in QHSE Program such as :
1. Toolbox talks
2. HSE Induction
3. HSE Meetings
4. Management Visit
5. STOP Card/BBS Card (not limited to other client requirement)

2. Inspection Program
A systematic fire patrol is to be carried out on a weekly basis by the Safety Officer on site
helped by 2nd officer and Chief Engineer, helped by 2nd engineer
Inspection is to be carried out routine and scheduled:
 All facility onboard.
 Hygiene & Sanitation.
 Office Inspection.
 Heavy Equipment Inspection.
 Management Inspection.

6.2. Incident and Investigation Report

QHSE Dept. taking the responsibility to maintain and make sure that all program will be
implemented in minimum ways that client require, have organize some stage to observe the
implementation of QHSE activity on site include the incident and investigation report. The
incident investigation are include but not limited to: Health incident (hazardous substance
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exposure), environmental incident (spill or pollutant intruder), Other safety incident such as
safety device failure or property loss. Taking the investigation PT. Pelayaran Tamarin Samudra,
Tbk is using a SCAT Analyze System and for NearMiss using a 5W method.

6.2.1. Incidents
PT. Pelayaran Tamarin Samudra,Tbk ensures that any incident involving loss or damage to plant
and/or materials are investigated and a full report is prepared within the time frame that
already mentioned in Investigation Procedure. For the first 24 hour the preliminary report has
been carried out by safety officer and signed by the Barge Master or OIM, for the 48 hour un-
official report has been carried out and signed by the OIM, 72 hour after incident/accident the
full report about the incident/accident has been carried out and copy of report already
distribute to all department that involved and take a responsible to ensure the same
incident/accident will not happened in the future.

6.2.2. Near Misses

Full investigation will be conducted into all near miss incidents and a written report will be
prepared detailing the events leading to the near miss, highlighting the possible consequences
had the near miss become an actual incident. Reporting off all accidents and incidents and near
misses will in the first instance be carried out by the Offshore Installation Manager (OIM) within
12 hours of the occurrences on an Accident Report form, a copy of which appears in Appendix.

A copy of this form will be given to the onboard Client’s representative on each and every
occasion.

6.2.3. Reporting of Notable Accident and Incidents

It is the responsibility of the owner of vessel to inform the enforcing authority of specific
Notable accidents and emergencies. PT. Pelayaran Tamarin Samudra,Tbk recognize the duty of
the client in this matter and will make all information known to the Client’s representative
onboard to allow him to fulfill his obligation.

It will be the duty of the Offshore Installation Manager (OIM) to ensure the Clients
representative has sufficient information to allow him or his superiors to complete the
information to allow him to make this initial notification and thereafter provide sufficient
information to allow him or his superiors to complete the information required when making
out and forwarding details to the authorities.

The Client’s representative is to be informed immediately of all accidents and incidents. All
accidents and incidents shall be detailed in the Daily Progress Report.

Near Misses Reporting Form & Accident/Incident Investigation & Report please refer to
Appendix – 11.

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7. MANAGEMENT OF CHANGE

Experience has shown that the incidence of such injuries or damage that is often caused by not
following appropriate training due to some form of unexpected changes. Change Management seeks to
monitor the actions of the occupation. This means that we must re-assess the risks associated with
change. We do this through Change of Management is defined. Its main features are:
 Changes in planned procedures apply hazard identification, risk assessment and
 Control analysis;
 The change is based on the consent of Management / Supervisory according to
 the MOC process before the job is done;
 People involved in the work should be informed about the procedure or equipment and risk
before a new job;
 Work cannot continue until the changes have been re- evaluated, approved and revised
procedures explained to those involved in the task;

Division heads should identify changes that will take place in his division before execution. Information
on the changes could come from the following sources (but not limited to):
a) Management Top
b) Client
c) Sub-Contractors / Suppliers
d) Internal operations

Internal changes:
a) a reduction in the number of positions, or the number of personnel in positions in operations,
including engineers, foremen and supervisors with direct responsibility in the operation;
position with emergency response duties; and positions with security responsibilities
b) a substantial increase in duties in the operation, including engineers, foremen and supervisors
with direct responsibility in the operation; position with emergency response duties; and
positions with security responsibilities (for example, the addition of equipment or
instrumentation that significantly adds to the complexity of the system)
c) the organizational structure as changes in the positions of responsibility in the operation,
including engineers, foremen and supervisors with direct responsibility in the operation;
position with emergency response duties; and positions with security responsibilities
d) the new process
e) work procedure

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8. Audit and Review

8.1. Audit Procedure
HSE audits will be conducted systematically within the time frame of PT. Pelayaran Tamarin
Samudra,Tbk. The purpose of safety Audit is to verify compliance with Health & Safety Policy
statement and to ensure that supplementary local requirements are being fulfilled. The audits
are directed towards the identification of defects and short comings in policy and procedure,
and where such short comings exist, to identify a course of action remedy the defect. Summary
of audit will be distributed to all head department or supervisor and will taking an action to
complete all the finding. Annual Audit & Review please refer to Appendix – 12.

PT. Pelayaran Tamarin Samudra, Tbk establishes, documents and maintains a program and
procedures, and ensure the internal and external audit are carried out in order to determine
whether or not :
a) Activities conform to the planned arrangements of the Management System.
b) The Management System is being actively implemented, maintained and is effective.
c) The Management System which is being validated or implemented is complied.

Planning and Development Department is responsible for planning and ensuring that internal
and external audits are conducted as required.
Internal audit is carried out to verify the effectiveness of the company’s Management System
both at the office and onboard the vessel.
External audit is carried out to obtain verification and certification from the Certified
Organization, as an evidence that the implemented Management System both at the office and
onboard the vessel is in accordance with the code requirements.

Process and implementation of audit are divided as follow :

 Management System Audit at the office – to evaluate the Effectiveness of management
system implementation at the office according to the prevailing standard element and
procedure.
 Management System Audit onboard the vessel – to evaluate the Effectiveness of
management system implementation onboard the vessel according to the prevailing
standard element and procedure.

8.2 Management Review

The objective of Management Review is to ensure that the Safety Management system will
determine periodically whether an effective management structure and system are in place, and
whether they are being implemented in PT. Pelayaran Tamarin Samudra,Tbk office and vessels.
Management review will conduct according to plan that already sign and acknowledge by
company top management

Management Review shall be carried out:

a) Quarterly, where each quarterly will consist of data measurement of the three months and
Management Review will be carried out at the latest one month after the period of quarter
end and the data will be compared against the data of the last four quarters.

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b) Annually, where the Management Review will be carried out together with the 4th Quarter
review of running year and is the accumulation measurement data throughout the year. This
data will be compared against the last four years.

The Quarter Period Management Review will consists of:

a) Measurement reviews of the running quarter and compared with the previous four quarters
(as available).
b) Review of internal and external audits result on the reviewed quarter (if any).
c) Summary of all approved revised procedure (PIN) of the reviewed quarter as well as any
changes that may need to be highlighted.
d) Review the achievement of previous quarter target.
e) Conclusion and corrective action to be taken to ensure targets are achieved.

Annual Management Review shall consist of:

a) Measurement reviews for the whole year and compared against the data of the four
previous years (as available).
b) Review of Existence and Effectiveness of Management System
c) Review of stated Policies and Objectives

The output from Management Review will include any decisions and action points related to:
a) Improvement of the effectiveness of the management system and its processes.
b) Improvement of product related to customer requirements.
c) Improvement of existing resources or needs.
d) All departments will update on the progress of all targets given as well as propose new
targets for the coming period as required.
e) All records of Management Review shall be documented and maintained for a period of 10
(ten) years by Planning and Development Department.

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9. APPENDICES

APPENDIX 1 : QHSE COMPANY POLICY STATEMENT

APPENDIX 2 : ORGANIZATION CHART OF PT. PELAYARAN TAMARIN SAMUDRA TBK

ORGANIZATION CHART OF P2K3

APPENDIX 3 : BARGE ORGANIZATION CHART

AHTS ORGANIZATION CHART

APPENDIX 4 : TRAINING MATRIX (APPROVED)

TOOL BOX SAFETY MEETING FORM
MINUTES OF MEETING FORM
EMERGENCY DRILLS FORM

APPENDIX 5 : RULES & REGULATION COMPLIANCES

APPENDIX 6 : HIRA-DC LIST

JOB SAFETY ANALYSIS RECORD
PERMIT TO WORK FORM
BEHAVIOURAL BASED SAFETY FORM
STOP WORK AUTHORITY FORM

APPENDIX 7 : PPE MATRIX

APPENDIX 8 : EMERGENCY RESPONSE FLOW CHART

APPENDIX 9 : PLANNED MAINTENANCE SCHEDULE

APPENDIX 10 : COMPANY ANNUAL QHSE PROGRAM

APPENDIX 11 : NEAR MISSES REPORTING FORM

ACCIDENT & INCIDENCT INVESTIGATION & REPORTING FORM

APPENDIX 12 : COMPANY ANNUAL AUDIT & REVIEW SCHEDULE

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