Faktor-Faktor yang Memengaruhi Pencapaian Nihil Kecelakaan Kerja Pada PT. Expro Indonesia di Kota Batam

Universitas Sumatera Utara

Universitas Sumatera Utara

Lampiran 3: Pedoman Wawancara

PEDOMAN WAWANCARA
FAKTOR-FAKTOR YANG MEMENGARUHI PENCAPAIAN NIHIL
KECELAKAAN KERJA PADA PT. EXPRO INDONESIA
DI KOTA BATAM
Pendahuluan
1. Melakukan perkenalan dua arah, baik peneliti atau informan.
2. Menjelaskan terlebih dahulu maksud dan tujuan wawancara disertai manfaat
penelitian dan menjelaskan bahwa kerahasiaan informan terjamin.
3. Meminta kesediaan calon informan untuk menandatangani lembar persetujuan
menjadi informan.
4. Melakukan kontrak wawancara, menawarkan waktu wawancara 1 jam sampai 1,5
jam.
IDENTITAS INFORMAN
Nama

:

Umur

:

Jenis Kelamin

:

Pendidikan Terakhir :
Jabatan

:

Masa Kerja

:

Universitas Sumatera Utara

A. Komitmen Perusahaan
1. Komitmen pimpinan
2. Anggaran khusus K3
3. Fasilitas K3 dan pemeliharaannya
4. Personel K3
B. Kebijakan K3
1. Penyusunan kebijakan K3
2. Keterlibatan pegawai dalam pembuatan kebijakan K3
3. Didokumentasi, diimplementasikan, dipelihara dan dikomunikasikan kepada
pekerja
C. Komunikasi dan Pelatihan K3
1. Sosialisasi program K3
2. Rambu-rambu K3
3. Pertemuan petugas K3
4. Pelatihan K3 yang berkualitas bagi pekerja
D. Inspeksi K3 dan penyelidikan kecelakaan kerja
1. Sosialisasi hasil inspeksi K3
2. Prosedur penyelidikan kecelakaan kerja
E. Evaluasi K3

1. Dikomunikasikan dan dikonsultasikan dengan semua pihak yang terlibat
2. Aspek yang dibahas dalam evaluasi K3
3. Tindakan perbaikan dan peningkatan kinerja K3

Universitas Sumatera Utara

m

Universitas Sumatera Utara

Batam, 7 Maret 2016
No.
Lampiran
Perihal

: 12/EPTI-BTM/III/2016
:: Surat Keterangan Penelitian

Kepada Yth.
Dekan Fakultas Kesehatan Masyarakat

Universitas Sumatera Utara
Di
Tempat
Dengan hormat,
Sehubungan dengan surat permohonan dari Universitas Sumatera Utara Nomor
1739/UNS.2.1.10/KRK/2016 tanggal 26 Februari 2016 mengenai Permohonan Izin Penelitian,
untuk dan atas nama mahasiswa dengan data sebagai berikut:
No.
1

Nama
Joanita Debi C S

NIM
121000211

Jenis Kelamin
Perempuan

Tpt/ Tgl Lahir

Peminatan
Batam, 8 Juli Keselamatan dan
1994
Kesehatan Kerja

Bersama dengan surat pernyataan ini, PT. Expro Indonesia menyatakan bahwa atas nama
tersebut di atas telah melaksanakan penelitiannya dengan judul FAKTOR-FAKTOR YANG
MEMENGARUHI PENCAPAIAN NIHIL KECELAKAAN KERJA PADA PT. EXPRO INDONESIA DI
KOTA BATAM , pada tanggal 27 Februari 5 Maret 2016.
Demikian surat ini kami sampaikan, atas perhatiannya kami ucapkan terimakasih.

Hormat kami

Universitas Sumatera Utara

Universitas Sumatera Utara

1.0

2.0

3.0

4.0

5.0

6.0

Deliverable

ber
De
cem

ber
vem
No

Oc

to

ber

t
Q2
Tar
ge

Q2
Sta
tu

ber
Sep
tem

gus
t
Au

y
Jul

s

arg
e
Q1
T

Q1
Sta
tu
e
Jun

Ap

KEY PERFORMANCE INDICATORS

Ma
y

EXPRO-PTI
ril

EPTI Indonesia HSEQ Plan 2015/16

t

Asia Region Area EIO 2009-10

s

Revision 0 - For Release

Rolling Quarterly Targets & Actual Status

Leadership & Commitment

1.1 Management Lead Safety Engagement Sessions

1 / Quarter

1.2 Management Review Meeting

1 / 6 Months

1.3 HSEQ Plan Review Meeting

1 / 6 Months

Risk Assessment & Evaluation

Number completed

2.1 Risk Assessment / JSA Reviews

1 / 6 Months

2.2 PIP / Client Observation Cards Raised

1 / Quarter

2.3 Hazop / Hazip / Safety Case done / review

1 / 12 Months

Personnel, Training & Competency
3.1 Training Plan Develop & Review

1 / 6 Monhts

3.2 Number of external Training

As per 2015 Training Plan

3.2 HSE Training Completion

Quarterly

3.4 MoveSmart Training Completion

Quarterly

Operation & Maintenance
4.1 Worksite Inspection Done

1 / month / location

4.2 Pre-job Site Inspection/PASR Done

Quarterly

4.3 Preventive Maintenance Completion

Monthly

4.4 PPE Distribution Record In-Place

Quarterly

Equipment, Facilities Design & Construction
5.1 Process Safety Information (PSI) In-place and updated

Quarterly

5.2 New equipment purchased to comply with QA specification

6 months

5.3 Building Integrity to comply with legal requirement

Yearly

Interfacing with Client, Contractors & Third Party
6.1 Vendor/Supplier Performance Assessment/Audit

2 / Quarter

6.2 Client Contractor HSEQ Meeting/Event

Monthly

File Ref:C:\Users\florianus.florianus\Documents\BATAM BASE\HSEQ Plan\HSEQ Plan 2015\New HSEQ Plan - EPTI Indonesia 2015 Sample.xls

Asia South

Universitas Sumatera
Utara
Issued by Region
Director - Asia

7.0

ber
De
cem

ber
vem
No

Oc
to

ber

t
Q2
Tar
ge

Q2
Sta
tu

ber
Sep
tem

gus
t
Au

y
Jul

s

arg
e
Q1
T

Q1
Sta
tu
e
Jun

Ap

6.3 Regulatory/Industry/O&G HSEQ Conference and Exhibition

Ma
y

EXPRO-PTI
ril

EPTI Indonesia HSEQ Plan 2015/16

t

Asia Region Area EIO 2009-10

s

Revision 0 - For Release

6 months

Incident Investigation
7.1 Incident Reporting to E-Trak

Monthly

File Ref:C:\Users\florianus.florianus\Documents\BATAM BASE\HSEQ Plan\HSEQ Plan 2015\New HSEQ Plan - EPTI Indonesia 2015 Sample.xls

Asia South

Universitas Sumatera
Utara
Issued by Region
Director - Asia

Quarterly

7.3 Incident Review Panel Meeting

6 Months

ber
De
cem

ber
vem
No

Oc
to

ber

t
Q2
Tar
ge

Q2
Sta
tu

ber
Sep
tem

gus
t
Au

y
Jul

s

arg
e
Q1
T

Q1
Sta
tu
e
Jun

Ap

8.0

7.2 Incident Investigation and Close-out

Ma
y

EXPRO-PTI
ril

EPTI Indonesia HSEQ Plan 2015/16

t

Asia Region Area EIO 2009-10

s

Revision 0 - For Release

Emergency Response

9.0

8.1 ER Organisation and Plan In-place and updated

6 months

8.2 ER Drill at work location

1 / Quarter

8.3 Malaysia Travel Management Plan Review

6 months

Information Management

10.0

9.1 HSEQ Alerts and Monthly HSEQ Topic Distribution

Monthly

9.2 HSEQ Performance Distribution

Monthly

9.3 HSEQ Information (SDS, Procedures etc.) In-place and updated

Quarterly

Continous Improvement

10.1 HSEQ Performance Reporting

Monthly

10.2 HSEQ Performance Management Review

6 months

10.3 HSEQ Recognition Award on Best Observation Card

Monthly

10.4 HSEQ Recognition Award on HSEQ Performance

Yearly

Review by:
EPTI Operation Manager

Approved by:
EPTI President

File Ref:C:\Users\florianus.florianus\Documents\BATAM BASE\HSEQ Plan\HSEQ Plan 2015\New HSEQ Plan - EPTI Indonesia 2015 Sample.xls

Asia South

Universitas Sumatera
Utara
Issued by Region
Director - Asia

PLANNED INSPECTION CHECKLIST
PTIMS-QAP-4.01N
CLIENT

RIG/ PLATFORM/
PROJECT/JOB LOCATION

1

2

3
4
5
6

Is Emergency response procedure available and known by
all personnel on base
* Flowchart on what to do
Floor is level, non-slip and free from trip hazards

Access doors are unlocked and unobstructed
Adequate clear exits are available for emergency escape
* Are exit signs in place and clearly visible
Access points in relation to the worksite are adequate
Movement between levels is by means of properly

PTIMS-QAP-4.01N
Page 1 of 3

INSPECTION CONDUCTED
BY

DATE OF INSPECTION

COMMENTS
RATING

Describe clearly what needs to be inspected. Inspection
requirements should address all areas used by EXPRO-PTI
personnel.

LOW - 0

INSPECTION REQUIREMENT
HIGH - 2

No

Yard Fabrication,
Generator, Chemical
Storage & Waste
materials

MEDIUM - 1

DEPARTMENT/AREA

No Client

1.Syamsir
2. Jufri Sani
3. Jon Hendri
4. Sebastian
5. Florianus
6. Ilham
3 February
2016

ACTION BY

TARGET
DATE

Welder &
Fitter

ASAP &
Conduct
daily basis

Describe why you have allocated the
rating to the description. This gives
EXPRO-PTI the opportunity to take
corrective action or communicate good
practices.

0
Flowchart displayed at Main Workshop
1

Poor cable management during working
hours
0
0
0
0

st

1 April 2011
REV 3.0
Universitas Sumatera Utara

PLANNED INSPECTION CHECKLIST
PTIMS-QAP-4.01N

7
8
9
10
11
12
13

14

15

16
18
19
20
21
22

constructed steps and ladders
Lighting for shaded/ indoors areas and during nightfall
provides safe illumination free of shade hazards
Is ventilation of the worksite adequate
Are there adequate trained First Aiders in the workplace.
* Two available at all times
Is the first aid box easily accessible and properly equipped
* Checklist of contents
Are any high levels of noise present at the worksite
* Above 80db (measured by?)
Storage areas are secure, fit for purpose, tidy, shelving not
overloaded
Storage racks are secured, not overloaded, with clear
access to equipment/tools/ spares.
* All storage at height properly secured and on pallet
Eye wash station present, accessible in an emergency, and
checked weekly
* in shaded area
Fire fighting equipment is present, accessible in an
emergency, full and in date
* right type of extinguisher
Are all Hazardous Substances correctly stored, with MSDS
sheets and correct PPE available.
Are adequate means of communication available
* Emergency response siren/horn/PA System
Is the forward work program known
Are toolbox talks conducted before each work shift
Have all EXPRO-PTI personnel had site/Installation
induction training
Are manning levels and competence/ mix of crew
PTIMS-QAP-4.01N
Page 2 of 3

0
0
0
0
1
1

First aid Box available at main
workshop
All workers equipped them self with ear
plug to protect hearing damage
Temporary storage behind main
workshop need to displayed rack SWL

Supervisor,
Foreman, HSE
Rismal

ASAP &
Daily basis

Eye wash station on going built up

HS. Marbun,
Jon Hendri

February
10, 2016

15 cylinder’s fire extinguisher under
refill by 3rd party

HSE

5 February
2016

0

1

0

0
0
0
0
0
0
st

1 April 2011
REV 3.0
Universitas Sumatera Utara

PLANNED INSPECTION CHECKLIST
PTIMS-QAP-4.01N

23

24
25

26

27

28

adequate
Are all PowerPoint’s protected by RCD devices and are
portable RCD’s available

0

Are barriers/ warning light/ signs correctly deployed in
hazardous areas
Are all visitors to the worksite instructed to report to the site
office
* Clear signage in place
* Register of personnel on site
Have all electrical leads been inspected and tagged within
the last twelve months
* Electric tools register

0
0

1

Are there adequately trained personnel in the use fire
extinguishers.
* Are extinguishers within certification period.
* Fire extinguisher register
General Tidiness of Work-Shop

TOTAL INSPECTION RATINGS PER CATEGORY

PTIMS-QAP-4.01N
Page 3 of 3

- Some electrical leads had not been
inspected and tagged within the last
twelve months
- Ongoing registered & Need to be
tested. By electrical lead tester

Edwin & Rudi

Ongoing

-

All Team must
maintain
HOUSE
KEEPING in
daily basis

ASAP

0

1

0

6

Found the improper method during
hot work operation e.g. failure to
provide fire blanket
- Poor cable management at hot work
location
- Cables laid obstruction the access way
0

st

1 April 2011
REV 3.0
Universitas Sumatera Utara

PLANNED INSPECTION CHECKLIST
PTIMS-QAP-4.01N

Actions Outstanding on Completion of Inspection
Outstanding will be follow up by each department to
improvement.

Action Party:
Maintenance, Mechanical, HSE, Electrical & Base
Supervisor

Deadline:
End February 2016

Above Actions Verified Complete by:
Syamsir LB

Sign:

Date:

Jufri Sani
Sebastian
Jon Hendri

Florianus Stu & Ilaham

PTIMS-QAP-4.01N
Page 4 of 3

st

1 April 2011
REV 3.0
Universitas Sumatera Utara

EXPRO-PTI
For PT EXPRO INDONESIA
Job Description
Position:

QA/QC COORDINATOR

Job Holder:

MIRWAN JAYA

Reports To:

BATAM BASE MANAGER

Location:

Batam

QA/QC

Description

Engku Nasir / Ronald Molando for

Prepared by & Date:

Nigel Ashton/ Dec 2012

(Position)
Department:

Overall Purpose of the Job:
(State briefly why the job exists)

To oversee all the QAQC issues for the base and delegate as necessary

Principal Accountabilities:
(Describe the important end results of the job, i.e., what has to be achieved and why. Start with the most important and number each one separately))

1.

Responsible for monitoring all Well Test equipment in Indonesia and issuing the correct job card to the correct person for the work
to be carried out in a timely manner

2.

Updating the master lists accordingly

3.

Ensure all aspects of equipment certification and control systems of the equipment maintenance as per Expro’s policies and AIMS

4.

In the process of QA and QC ensure thorough direct monitoring that the correct maintenance processes are used

5.

Liaise with Base manager to ensure that repairs and maintenance are performed safely, timely and to company required
standards

6.

Maintain contact with the relevant operations during all tasks to ensure no shortfalls or lack of procedure

7.

Promote, implement and maintain all Expro’s QA, QHSE systems, ensure all 3 party services to Expro do comply with Expro’s
equipment

8.

Prepare, maintain, store and control all maintenance documentation in a timely and professional manner

9.

Keep clear records of equipments status, available and fit for use at all times, effective reporting through to base manager

rd

Organisation:
(Show job titles and under c), indicate briefly the purpose of each job))

a)

Immediate Supervisor(s)

Line:

Base Manager

Function:

Area HSE QA/QC Manager

b)

Other jobs reporting to the same supervisor:

Base supervisor

c)

Immediate Subordinates:

None

Dimensions:
(Record any significant quantities on which job has some effect, e.g. budget or turnover, records processed, employees superv ised. Where appropriate, express annual
figures and indicate the year to which they relate.

Responsible and to ensure all equipment is in a fit for purpose condition as per Expro’s policies and AIMS.
Responsible for all equipments in Batam operations support base

Job Context and Main Activities:
(Outline the context in which the job operates and record the types of activity involved in achieving principal accountabilities:

1. Responsible and follow all company policies and work procedures in the process of work
2. Ensure that the customer’s requirements are fulfilled by liaison with Operations Coordinator
3. Ensure all the maintenance and certification process for all the equipment is as per Expro standard procedure and compiled in a good
manner
Page 1 of 4

Document: SFA 002
Revision: 2
Rev. Date: January 2010

Universitas Sumatera Utara

EXPRO-PTI
For PT EXPRO INDONESIA
Job Description
4. Actively support the base personnel during execution of all maintenance operation
5. Liaise with Base manager on equipment problems or queries arising during the work
6. Monitor all the certification expired date and create schedule to renew certification and make sure all equipment have valid certification
prior send to the job
7. Actively participate in departmental safety meetings and promoting company QHSE and business ethics
8. Performing authority under the PTW system
9. Represent Expro in a professional manner at all times and play a full and active role in promoting Expro’s services

Decision making Authority/Level of Supervision Required:
1. Decision to be made in conjunction with Base manager
2. Supervision is required for most of activities

Relationships:

(Who are the job holder’s most important contacts and for what purpose? Consider both external and internal contacts, excluding immediate supervisor and subordinates,
but including personnel at other locations , if appropriate)

In order of priority : 1. Base Manager Batam- Indonesia– Ronald Malonda
2. Country Manager – TBA
3. HSEQ Coordinator – Florianus Stu
Other
4. Document Controller – Ida Puspitasari
5. Region Operations Coordinators

Job Challenges:
(Identify the most complex or demanding aspects of the job)

1. Ensuring the companies equipment and certificate achieve and surpass the client’s expected level of performance
2. Effective reporting and monitoring of equipment status, record daily activities and changes relating to maintenance operations
3. Ensure that equipment is available and fit for use at all times by effective reporting through Expro system

Job Knowledge and Qualifications:
(Indicate minimum knowledge and essential background qualifications necessary to perform the job competently)

1.
2.
3.
4.
5.

Sound mechanical knowledge with previous proven experience at a similar level
Computer literacy
Good communication & leadership skills, able to be part of a team working environment
Excellent understanding of English language, verbal and written.
Must have extensive certification process and maintenance process and management

Competencies
(Technical skills, behavioural competencies, specialized training or Defined Competencies as outlined in Expro Competence & Training System)

Compliance:
Expro has delivered a Code of Conduct (‘the Code’) which will help guide you in your job and ensure that employees and the Company
comply with the law. The incumbent must read, understand and comply with the Code as well as the more detailed rules contain ed in
supporting directives and policies. Please refer to the Expro Intranet to access details of the full Code of Conduct. If you do not have
intranet access please refer to your Supervisor who will assist you with access.
Page 2 of 4

Document: SFA 002
Revision: 2
Rev. Date: January 2010

Universitas Sumatera Utara

EXPRO-PTI
For PT EXPRO INDONESIA
Job Description
The incumbent must be aware that failure to comply with the Code, or indeed any of the Company Policies, Standards, Procedures or
Processes may lead to Disciplinary action.

Compliance Control Position – Yes / No (must be completed - please delete as appropriate)
A position will automatically be considered as a Compliance Control position if it is the following:

Director, Manager or Officer Grade 1-3.

Senior positions within Legal / Contracts, Finance, HR, Asset Management, Sales or Business Development.

Country Managers, Senior Sales and Marketing personnel.

High Exposure Position – Yes / No (must be completed - please delete as appropriate)
A position may be considered High Exposure if it involves the following duties and responsibilities:

Work in the Legal / Contracts department, Finance, HR, Asset Management, Sales or Business Development.

Review of contracts, negotiation of contracts or agreements with third parties.

Responsibility or shared responsibility for Internal Controls.

Regular interaction or management or interaction of relationships with government officials, agents or government service
providers.

Supervisory functions, in particular, supervision of other employees who work in or frequently travel to high risk* countries .

Anyone with responsibility over the sale and disposition of assets.

Anyone with approval authority over Company expenditures in a high risk* country.
* refer to Expro Intranet for list of high risk countries.

Health and Safety:
Please highlight if the role is a Safety Critical Position as per the following definition:
A role is defined as Safety Critical where Employees, through any improper use of substances (as defined by the Substance Abuse Policy) may affect the health and safety of
themselves and/or their colleagues in their work area.

Safety Critical Role – Yes/No (Please delete as appropriate)
All Employees
As a minimum the incumbent must:
a)
b)
c)
d)
e)
f)

take reasonable care to prevent harm to themselves
consider the potential for harm to others or the environment that may be caused by their acts or omissions
work in accordance with information and training provided
refrain from intentionally misusing or recklessly interfering with anything that has been provided for Health, Safety and
Environment reasons
report any hazardous defects in plant, equipment and workplace, or shortcomings in the existing controls, to a responsible
person without delay
not undertake any task for which authorisation and/or training has not been given.

Responsibilities of Managers and Supervisors
The incumbent is responsible for ensuring that the QHSE Management System is implemented within the operations under their
control. The incumbent must actively monitor the workplace to ensure that acceptable standards are maintained. Where risks are
identified the incumbent must ensure that these risks are controlled, so far as is reasonably practicable.
The incumbent's duties include:
a)
b)
c)
d)
e)
f)
g)

ensuring that employees, contractors and visitors are aware of relevant QHSE procedures
establishing that all equipment, plant and substances used are suitable for the task and are kept in good working condition: this
includes the regular maintenance and servicing of equipment
providing adequate training, information, instruction and supervision to ensure that work is conducted without harm to people or
the environment
taking immediate and appropriate steps to investigate and rectify any risks to people environment/equipment and quality arising
from the work activity
bringing to the prompt attention of project management any QHSE issue that requires their attention
ensuring that all incidents are properly recorded and reported and that an investigation is carried out to establish and rectify root
causes
actively participating in the QHSE management system.

Page 3 of 4

Document: SFA 002
Revision: 2
Rev. Date: January 2010

Universitas Sumatera Utara

EXPRO-PTI
For PT EXPRO INDONESIA
Job Description
Job Description Agreed By:
Job Holder

MIRWAN JAYA

Date:

Supervisor

RONALD MALONDA

Date:

Reviewed By:
Job Holder:

Date:

Supervisor:

Date:

Page 4 of 4

Document: SFA 002
Revision: 2
Rev. Date: January 2010

Universitas Sumatera Utara

EPTI BATAM
HSE PROCEDURES
ITEM
NO

DOC. NO
(PTIMSQAP)

1

1.01

Safety and Environmental Policies and Organisation

4

23-Nov-2010

Engku Nasir

Florianus

HSE

2

1.0

HSE Manual Table of Contents

8

29-Nov-2010

Engku Nasir

Florianus

HSE

3

1.02

Safety Audit Procedures

3

25-Nov-2010

Engku Nasir

Florianus

HSE

4

1.02A

Internal Safety Audit Checklist

1

1-Dec-2010

Engku Nasir

Florianus

HSE

5

1.02B

Safety Audit Corrective Action

1

1-Dec-2010

Engku Nasir

Florianus

HSE

6

1.03

Risk Assessment and Job Safety Analysis Procedure

4

24-Nov-2010

Engku Nasir

Florianus

HSE

7

1.03A

Risk Assessment

2

1-Dec-2010

Engku Nasir

Florianus

HSE

8

1.03B

Risk Assessment Form Matrix

3

Engku Nasir

Florianus

HSE

9

1.03C

Job Safety Analysis

2

1-Dec-2010

Engku Nasir

Florianus

HSE

10

1.04

Manual Handling Procedure

3

24-Nov-2010

Engku Nasir

Florianus

HSE

11

1.04A

Manual Handling Assessment Summary

2

1-Dec-2010

Engku Nasir

Florianus

HSE

12

1.05

Substance Abuse Policy

3

24-Nov-2010

Engku Nasir

Florianus

HSE

13

1.06

Health, Hygiene and Environment

3

24-Nov-2010

Engku Nasir

Florianus

HSE

14

1.07

15

1.07A

16

DESCRIPTION

Current
REV

DATE LAST
MODIFIED

PRESENT
OWNER

Date: 24 February 2016

NEW
OWNER

NEW OWNER
DEPT

HSE Meetings

3

24-Nov-2010

Engku Nasir

Florianus

HSE

Monthly HSE Meeting Report

2

1-Dec-2010

Engku Nasir

Florianus

HSE

1.08

Medical Fitness Review

3

24-Nov-2010

Engku Nasir

Merindu

HR

17

1.09

Employee Induction

4

24-Nov-2010

Engku Nasir

Florianus

HSE

18

1.09A

Sattahip Facility Induction

2

9-Nov-2010

Engku Nasir

19

1.10

Short Service Employee Scheme

2

24-Nov-2010

Engku Nasir

Florianus

HSE

20

10.01

Electrical Safety

2

28-Nov-2010

Engku Nasir

Edwin

E&I

21

10.02

Battery Safety

3

28-Nov-2010

Engku Nasir

Edwin

E&I

22

10.03

Electrical Apparatus for Use in Potentially Explosive
Atmospheres

3

28-Nov-2010

Engku Nasir

23

10.04

Electrical Safety in Workshops

3

28-Nov-2010

Engku Nasir

Edwin

E&I

24

11.01

Hearing Conversation

3

28-Nov-2010

Engku Nasir

Florianus

HSE

25

12.01

Hand Tools and Portable Power Tools

3

28-Nov-2010

Engku Nasir

Edwin

E&I

29-Nov-2010

26

13.01

Permit to Work Entry Into Confined Spaces

3

27

13.01A

Confined Space Entry Permit

2
29-Nov-2010

Duration
Date
Planned to Required
New REV
To
be
UPDATED Update
Doc

Comments

Not Required

Not Required

Not Required

Engku Nasir

Florianus

HSE

Engku Nasir

Florianus

HSE

28

13.02

Permit to Work Hot Working

3

29

13.02A

Work Permit

2

Engku Nasir

Florianus

HSE

Engku Nasir

Florianus

HSE

30

14.01

Working with Pressure

3

31

15.01

Vehicle Operations

3

29-Nov-2010

Engku Nasir

Florianus

HSE

29-Nov-2010

Engku Nasir

Florianus

32

15.02

Journey Management

2

HSE

29-Nov-2010

Engku Nasir

Florianus

HSE

33

15.02A

Production Testers International, Daily Vehicle Checklist

34

16.01

Environmental Protection

2

15-Dec-2010

Engku Nasir

Florianus

HSE

3

29-Nov-2010

Engku Nasir

Florianus

35

17.01

HSE

HSE Manual Controlled Documents

2

29-Nov-2010

Engku Nasir

Florianus

HSE

36

2.02A

37

2.01

Production Testers International Incident Reporting Form

4

28-Nov-2010

Engku Nasir

Florianus

HSE

Provision for First Aid Arrangements

3

28-Nov-2010

Engku Nasir

Florianus

HSE

38

2.02

Accident and Incident Reporting and Investigation

4

28-Nov-2010

Engku Nasir

Florianus

HSE

39

2.03

Safety Alerts

3

28-Nov-2010

Engku Nasir

Florianus

HSE

40

3.01

Fire Safety

3

28-Nov-2010

Engku Nasir

Florianus

HSE

41

4.01

Safety Training

4

28-Nov-2010

Engku Nasir

Florianus

HSE

42

5.01

Office Safety

3

28-Nov-2010

Engku Nasir

Mark Hayes

Management

43

5.02

General Workshop Safety

3

28-Nov-2010

Engku Nasir

Florianus

HSE

44

5.03

Regulation for Contractors Working at Expro-PTI Premises

3

28-Nov-2010

Engku Nasir

Merindu

HR

45

5.04

Safety Assessment of Sub Contractors

3

28-Nov-2010

Engku Nasir

Florianus

HSE

46

6.01

Safety for Operational Personal

3

28-Nov-2010

47

6.02

Operational Audit Procedure

48

6.03

Well Test Safety

3

28-Nov-2010

Engku Nasir

Not Required

49

6.04

Emergency Response Procedure

3

28-Nov-2010

Engku Nasir

Not Required

50

6.04A

Emergency Response Procedure-Thailand

4

9-Nov-2010

Engku Nasir

51

6.04B

Emergency Response Procedure-Jakarta Office

1

1-Dec-2010

Engku Nasir

Florianus

HSE

52

6.04C

Emergency Response Procedure-Batam Base

3

30-Nov-2010

Engku Nasir

Florianus

HSE

53

6.04D

Emergency Response Procedure-Malaysian Office

3

11-Nov-2010

Engku Nasir

54

6.05

HSE Manual Emergency Response Drills and Exercise
Schedules

3

28-Nov-2010

Engku Nasir

Florianus

HSE

55

6.05A

HSE Manual Emergency Response Drills and Exercise
Schedules

2

1-Dec-2010

Engku Nasir

Florianus

HSE

Engku Nasir

Florianus

HSE

Engku Nasir

Florianus

HSE

25-Feb-16

1 Day

4

Completed

Not Required

Not Required

Universitas Sumatera Utara

EPTI BATAM
HSE PROCEDURES
ITEM
NO

DOC. NO
(PTIMSQAP)

56

7.01

57

7.02

58

8.01

59

8.01A

60
61
62

NEW OWNER
DEPT

Engku Nasir

Florianus

HSE

Engku Nasir

Florianus

HSE

28-Nov-2010

Engku Nasir

Florianus

HSE

2

3-Dec-2010

Engku Nasir

Florianus

HSE

Hydrogen Sulphide

3

28-Nov-2010

Engku Nasir

Methanol

3

28-Nov-2010

Engku Nasir

9.01

Manual Handling

3

28-Nov-2010

Engku Nasir

Florianus

HSE

63

9.02

Lifting Equipment

3

28-Nov-2010

Engku Nasir

Collin Fyfe

Base

64

9.4.11

Stop Work Intervention

0

26-May-2015

Engku Nasir

Florianus

HSE

3

1-Mar-2012

Engku Nasir

Florianus

HSE

66

DATE LAST
MODIFIED

Personal Protective Clothing and Equipment

3

28-Nov-2010

Use of Breathing Apparatus and Respirators

3

28-Nov-2010

Control of Exposure Hazardous Substances

3

COSHH Assessment Record

8.02
8.03

PRESENT
OWNER

NEW
OWNER

65

Current
REV

Date: 24 February 2016

DESCRIPTION

Batam-TMPBatam Travel Management Plan
03-09

Duration
Date
Planned to Required
New REV
To
be
UPDATED Update
Doc

Comments

Not Required
Not Required

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Blasting)

1

February-11

Engku Nasir

Florianus

HSE

67

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Confined Space
Entry)

1

January-07

Engku Nasir

Florianus

HSE

68

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Crane Operations)

1

January-07

Engku Nasir

Florianus

HSE

69

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(General Electrical
Installation and Repair)

1

February-11

Engku Nasir

Florianus

HSE

70

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Forklift Operation)

1

February-11

Engku Nasir

Florianus

HSE

71

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form( General Carpenter
Work)

1

February-11

Engku Nasir

Florianus

HSE

72

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Heat Tracing
Works)

1

February-11

Engku Nasir

Florianus

HSE

73

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Hot Works)

1

January-07

Engku Nasir

Florianus

HSE

74

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Instrumentation
Works)

1

January-07

Engku Nasir

Florianus

HSE

75

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Machine Service)

1

February-11

Engku Nasir

Florianus

HSE

76

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(MPI )

1

February-11

Engku Nasir

Florianus

HSE

77

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Painting Works )

1

February-11

Engku Nasir

Florianus

HSE

78

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Pressure Test)

1

January-07

Engku Nasir

Florianus

HSE

79

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(Work at Height)

1

January-07

Engku Nasir

Florianus

HSE

80

OPS-002

Job Safety (Hazard) Analysis JSA/JHA Form(X-Ray )

1

February-11

Engku Nasir

Florianus

HSE

81
82
83
84
85

Universitas Sumatera Utara

TOOL BOX TALK TOPIC LIST
February 2016
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29

DATE
01.02.2016
02.02.2016
03.02.2016
04.02.20016
05.02.2016
06.02.2016
07.02.2016
08.02.2016
09.02.2016
10.02.2016
11.02.2016
12.02.2016
13.02.2016
14.02.2016
15.02.2016
16.02.2016
17.02.2016
18.02.2016
19.02.2016
20.02.2016
21.02.2016
22.02.2016
23.02.2016
24.02.2016
25.02.2016
26.02.2016
27.022016
28.022016
29.02.2016

TOPIC
Only authorized electrician are allowed to repair electrical equipment (Hanya electrician yang boleh memperbaiki peralatan listik)
Fire occur due to electric shock (Kebakaran akibat hubungan arus pendek)
Fever due to welding fumes (Demam akibat asap welding)
Slip, trip, fall risk (Resiko terpeleset, tersandung)
Use of cable hanger to arrange the hose/electrical cable (Gunakan kabel hanger untuk penataan selang dan kabel listrik)
Gas hose and cable inspection (Inspeksi selang gas dan kabel)
Cutting job (Pekerjaan memotong)
Be aware and maintenance of hose (Kepedulian dan perawatan selang)
Types of gas hose unused (Ciri-ciri sealng gas yang sudah tidak layak pakai)
Gas hose inspection during break time and end of the shift (Pemeriksaan selang gas saat jam istirahat dan setelah selesai bekerja)
Handling of gas cylinder (Penaganan tabung-tabung gas)
Storage of compressed gas cylinder (Penyimpanan tabung gas)
Maintenance of gas cylinder (Perawatan tabung-tabung gas)
Disconnect the hose from manifold when break time (Melepas sealng dari manifold waktu istirahat)
Lifting of compressed gas cylinder (Pengangkutan tabung-tabung gas cylinder)
Working at height safely (Bekerja diketinggian yang aman)
Hazard of carbon monoxide resulting from welding job (Bahaya karbon monoksida sebagai hasil pekerjaan welding)
Welding job (Pekerjaan welding)
Grinding job (Pekerjaan gerinda)
Grit blasting job (Pekerjaan grit blasting)
Housekeeping copper slag after completion of blasting job (Pembersihan copper slag setelah pekerjaan blasting)
Spray painting job (Pekerjaan spray painting)
Color coding of compressed gas cylinder (System pewarnaan tabung gas bertekanan)
Safe pressure of compressed gas cylinder system (Tekanan gas yang aman pada regulator tabung)
Working in confined space (Bekerja diruangan tertutup)
Confined space lighting (Penerangan diruangan tertutup)
Hazard of leaking compressed hose in confined space (Bahaya kebocoran selang gas didalam ruangan tertutup)
Hazard of compressed oxygen when react with hydrocarbon (Bahaya oksigen bertekanan bila bereaksi dengan hidrokarbon
Ventilation system in confined space (Sistem ventilasi yang baik diruangan tertutup)

REMARKS

Universitas Sumatera Utara

Training Matrix - HSEQ

Training Matrix 2014/2015
Updated : 14-07- 2015

X
X
X
X

X
X
X

X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
XX
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X

X
X

Boiler Training

X
X
X
X

X
x
X
X
X
X
x
X
X
X

Confined Space Entry

X

X
X
X
X
X
X
X
X
X
X

Ergonomics

X

X
X
X
X
X
X
X
X
X
X

Respiratory Protection

X
X
X
X
X
x
X
X
X
X
x

X

Hearing Conservation

X
X

X
X
X

Expro House Rules

X
X

X
X
X

PTW System

X
x

Dangereous Good
Awareness Training

X

Lithium Batteries,
Handling & Packaging

X

Manual Handling

X
X
X

Rigging & Slinging
Training

QA Awareness / MS rollout

X
X
X

Forklift Training

X

Positive Intervention

X
x

Risk Assessment / JSA

x

Basic First Aid

HUET / Sea Survival /
Combine Offshore
Training

X
X
X

Job Specific
Fire Fighting Training

Base HSE Induction

x
x

Working At Height

Non Mandatory

EXPRO-PTI Region Induction

Champion Safety

Position

Grade / Maintenance

Name

MoveSmart

Mandatory

Training Status

x

x

BATAM BASED
PERSONNEL

Jufri Sani
Merindu Siregar
Mirwan Jaya
Rome Hernandez
Razmayanti
Repi Kestok
Rusdiyatno
Sri Elfifi
Suharyanto
Tri Indah Lestari
Fina Fadiana
Abdul Majid
Afrizal
Afdaludin
Dedi Sipakkar
Derek Seleky
Fajar Surya Dani
Golan Hamonangan
Mukhlisin
Kristian Marpaung
Muliadi
Muhadi
Musyadi
Pondang Sipangkar
Raja Saul Sinaga
Rismal
Rusmawan
Sayadi
Suryadi
Yudha Syarif
Yuliadi

Base Manager
Base Supervisor
Draftsman
Base Engineering
Base Engineering
Finance Assistant
QA/QC Technician
HSEQ Coordinator
Purchasing Assistant
Yard Supervisor
Doc. Controller
Purchasing Coordinator
Instrument
Well Test Operator
HR & GA Admin
QA/QC Coordinator
Project Engineer
Logistic Coordinator
Draftsman
Engineer
Purchasing Supervisor
Draftsman
Secretary
Cost Controller
Well Test Operator
Electrician
Well Test Operator
Well Test Operator
Mechanic
Well Test Operator
Electric / Instrument
Well Test Operator
Well Test Operator
Well Test Operator
Well Test Operator
Well Test Operator
Well Test Operator
Well Test Operator
Storeman
Well Test Operator
Well Test Operator
Well Test Operator
Mechanic
Well Test Operator

Achmad Mujianto
Andika

Assistant QA/QC
Maintenance

Bayu Dwi Atmoko
Edwin Fabe
Elfiane Vivi
Firman Buchari
Florianus Stu
Herna Nuraeni
H.S. Marbun
Ida Puspitasari
Jennar Silitonga

Juster Purba

X

x
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X

X
X
X
X
X
X
X
X

x
x
x
x
x
X
X
x
x
x
x
X
x
x
x

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X

X
X
X
x
X
X

X
X

X

X
X

x
X
X
X
X
X
X

x
x
x
x
x

X
X
X
X
x
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X

X
X
X
x
X

X

X
X
X
x
X
X
X
X

x

Mark Hayes
Collin Fyfe
Anggun Kusno Riadi

X
X

X

X
X
X
X
X
X

X
X
X

X
X
X

x
X
X

x

X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X

X
X

X
X

X

X

X

X
X
X
X
X
X
X
X
X

X
X

X
X
X
X
X
X
X
X
X
X
X
X
X

X

X

X
X
X

X
X

X
X
X

X
X

X
X
X
X
X
X
X
X
X

X
X
X

X
X

X
X

X
X
X
X
X
X
X
X

X

X
X
X

X
X

X
X

X

x
X

X
x

X

X
X

X
X
X
X
X
X

X
X
X

x

x

x

X
X

X
X
X
X

X
X
x
x
x
X
X
x
x
x
x

X
X

X

x
x

X

Universitas Sumatera Utara

X

Ansyarullah
Junaidi Abdullah
Asbon
A. Syaikhu
Bonefasius Purna
Binatang Dani
Bunawi
Benediktus Manurung
Budiman Bancin
Efrizal
Eka Sanjaya
Gusril
Yola Meininda
Heru Rusli
Hikmah Jaya
Isra
Jesrel
Jhon D. Sawen
Jon Hendri
Junaidi
Karel Melaira
Kembang Matius Marbun
Mangoloi Manurung
Marsunggul
M. Arief
Mangabdi
M. Soleh
Nixon Pardede
Nurmansyah
Nugraha Eko Pratama
Porman Marbun
Roni Candra
Rudy Melaira
Rudi Hartono
Samsudin
Sarles Pakpahan
Sebastianus
Solikin
S. Nordiansyah
Syamsir Lumban Batu
Suprianto
Tarpin
Thomsen Lasder
Wagiman
Warsita
Wasnadi

Welder
Welder
Welder
Security
HSEQ OFFICER
Maintenance
Sandblaster / Painter
Fitter
Fitter
Fitter
Maintenance
Fitter
Receptionist
Fitter
Fitter
Sandblaster / Painter
Fitter
Maintenance
Mechanic
Fitter
Helper Electrician
Instrument
Security
Instrument
Maintenance
Instrument
Sandblaster / Painter
Fitter
Driver
Fitter
Sandblaster / Painter
Forklift Oparator
Electrician
Fitter
Storeman
Instrument
HSE Officer
Maintenance
Welder
Foreman

X
x

Maintenance
Welder
Maintenance
Fitter
Fitter

X
X
X

Cost Accountant
Account Clerk
Well Test Operator
Finance Supervisor

X

X

X
X
X
X

X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X

X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

x

x

X

X

X
x

X

x
x

X

x
x

X

x
X

x
X

x
x

X
X
X

X
x

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X

X
X
X
X
X

X

X

X

X
X

X
X
X
X
X
X

X
X
X
X

X
X

X
X
X
X

X
X
X
X

X
X
X
X

X

X
X
X
X
X

X
X
X

X
X
X
X
X
X

X
X
X

X
X

X
X
X
X

X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X
X

X

X
X
X
X

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

X

X

X

Boiler Training

Confined Space Entry

Ergonomics

Respiratory Protection

Hearing Conservation

Expro House Rules

PTW System

Dangereous Good
Awareness Training

Lithium Batteries,
Handling & Packaging

Manual Handling

Rigging & Slinging
Training

QA Awareness / MS rollout

Forklift Training

Positive Intervention

Risk Assessment / JSA

Basic First Aid

Fire Fighting Training

Working At Height

HUET / Sea Survival /
Combine Offshore
Training

Base HSE Induction

EXPRO-PTI Region Induction

MoveSmart

Champion Safety

Position

Grade / Maintenance

Name

x
X
X
x
x
x
x
x
x
x
x
x
x
x
x
X
X
X
x
x
X
x
x
x
x
x
x
x
x
x
x
X
x
x
X
x
x
x
x
x
x
x
X
X
x

X

X
X

X

JAKARTA BASED
PERSONNEL
Adam Paramesywara
Anis Purwanti
Budi Setiyono
Buditalira

X

X
X
X
X

X

X

X
X
X
X

Universitas Sumatera Utara

X

X

X
X
X
X
X
X
X
X
X
X
X
X
X

Internal Internal Internal

Provider

X

X

X

X

X

X

X

X

X

External

TRAINING PLAN FOR 2015 (BATAM BASE)

IOSH
AK3 Umum
MoveSmart Training
Boiler Operator
Fire Fighting
Permit to Work
Risk Assessment
Work At Height
Dangerous Goods Awareness
IATA
T.BOSIET

INTENDED PARTICIPANT
Manager and Supervisor Level
Safety Personnel
All Office & field team
All Well Test Operators
Yard Personnel
Yard Personnel, Field Operator
Yard Personnel, Field Operator
Yard Personnel, Field Operator
Logistic
Logistic
Well Test Operator

PROVIDER
Internal
Third Party
Internal
Third Party
Third Party
Internal
Internal
Internal
Internal
Third Party
Third Party

X
X

External External Internal Internal External Internal External Internal Internal Internal Internal Internal External External Internal External Extern

Training Date

DESCRIPTION

Boiler Training

Confined Space Entry

Ergonomics

Respiratory Protection

Hearing Conservation

Expro House Rules

PTW System

X
X
X
X
X
X
X
X
X
X
X
X
X

X

External

Dangereous Good
Awareness Training

Lithium Batteries,
Handling & Packaging

Manual Handling

Rigging & Slinging
Training

QA Awareness / MS rollout

Forklift Training

Positive Intervention

Risk Assessment / JSA

Basic First Aid

Fire Fighting Training

Working At Height

HUET / Sea Survival /
Combine Offshore
Training

Well Test Operator
Admin Assistant
Trainee Well Test Operator

X
X
X

Base HSE Induction

Sugeng Raharjo
Suwardi Sajangi
Victor Silaban

X
X

EXPRO-PTI Region Induction

Senior Plant Operator
Mechanic
Admin Coordinator
Receptionist
Operations Secretary
Well Test Operator
Senior Well Test Operator
Account Payable
Business Development Manager
Office Manager

MoveSmart

Dede Iskandar
Dedek Afrizal
Donny Soemarwoto
Intan Widuri
Lili Herlina
Lili Suyatno
M. Farid Fauzan
Muhammas Arief Kurniawan
Nur Witjaksono
Rosalinda Fitriyani

Champion Safety

Position

Grade / Maintenance

Name

MONTH

REMARK

Refreshing Training for HSE Personal
Office Team Batam Base 2015
Done for field crew on may 2014
Done for all Base personnel
On August 2015
Done .
Refreshing Training for Maintenance Personnel
Plan to refresh in 2015
Refresh in 2015

Universitas Sumatera Utara

Universitas Sumatera Utara

Universitas Sumatera Utara

RISK ASSESSMENT FORM

PTIMS-HSE-1.03A
Assessment No: EPTI-BTM-RA-003
Date: 30 - 09 - 2015
Rev: 1
Assessment Team:, Collin Fyfe, Florianus Stu, Edwin
Fabe, Sebastianus A.

Activity Description: Pressure Testing
Other assessments referred to:
RA-IND-01 Manual Handling
RA-IND-07 General Forklift Operations
RA-IND-09 Electrical Inspections & Maintenance
EXPRO/RA/BTM/011 Lifting and Hoisting of Equipments / Materials

Company/ Department: Expro Batam
Frequency of Activity: Daily

Operation/
Event
Pre-job
Planning

Identified
Hazard
Failure to
address
hazards

Persons Affected: Personnel performing the
operation
Probable Harm

P

S

R

- Personnel Injury.
- Damage to equipment
- In-experience of personnel to
perform the job

3

4

12

Location: Batam Base
Required Controls

-

A PTW is required and a risk assessment carried out.
A toolbox talk is to be conducted before starting
work.
Area to be inspected by Base QC & Base Manager
before PTW signed.
Clear understanding of task.
Clear levels of communication.

P

S

R

1

4

4

ALL pressure testing job at the base must be lead
and witness by Supervisor.

P = Probability of harm occurring, S = Severity of harm caused, R = Risk Rating, prefix with asterisk denotes ‘after controls taken into account’.

ALARP = ‘As Low As Reasonably
Practicable’
Universitas
Sumatera

Utara

RISK ASSESSMENT FORM
Equipment
preparation

- Unsuitable
- Broken
hand-tool

- Equipment failure
- Injury to personnel
- Wrong or endanger of
equipment position
- Pinch Points
- Manual Handling

4

3

12

-

Operation/
Event
Check
condition of test
pump & hose
connection.

Identified
Hazard
Equipment
/connection
failure

Probable Harm

-

Equipment damage
Hand injury

P

S

R

4

2

8

Trap
pressure to
release

-

Pressure release could cause
fatality and injury to personnel.

3

3

9

Pressure test activity must be done in pressure test
bay or secured area away from other operations
ongoing depending on the situation.
Ensure door is closed and light of pressure test sign
is ON.
If pressure test activity must be done in workshop or
yard, make sure to give safety barrier board in order
to secure area where other jobs are running.
Never let equipment inlet and outlet to face any
public area or to endanger to personnel. If unsure or
doubt contact or communicate with supervisor.

1

3

3

P

S

R

Ensure all low pressure hose connections are to
be R-clip and secured.
Ensure all testing connection to have 2
pressures monitoring like pressure gauge and
chart recorder during operation.
Ensure all hoses are fitted with ID tag.

2

2

4

Ensure all possible trap pressure cavities to have
relief valve & pressure gauge
Ensure all valves to be bled-off on arrival at yard
and prior to and after every pressure test job.

1

3

3

Required Controls

-

Check any
possible of trap
pressure
existence

PTIMS-HSE-1.03A

-

P = Probability of harm occurring, S = Severity of harm caused, R = Risk Rating, prefix with asterisk denotes ‘after controls taken into account’.

ALARP = ‘As Low As Reasonably
Practicable’
Universitas
Sumatera

Utara

RISK ASSESSMENT FORM
Start 1st
pressure testing
job

-

Pressure
release
Trap
pressure
Electrical
supply
down

-

Fatality
Personnel Injury
Equipment damage
Flying equipment and
material
- STOP all electrical
appliances

4

3

12

-

Operation/
Event

Identified
Hazard

Probable Harm

P

S

R

PTIMS-HSE-1.03A

Inspections carried out in compliance with company
maintenance Guidelines or equipment manual.
Regular maintenance carried out, Clear line of
communication, (Accepted and understood).
Ensure equipment must be depressurized and test
caps remove prior to any repair or tighten of unions.
Written approved pressure test procedure in place,
i.e.”Pressure test procedures” in the Design of
Service.
Restriction in work area of non-essential personnel.
Ensure circuit breaker of electrical was NOT
weak and wires have been inspected regularly.

Required Controls

P = Probability of harm occurring, S = Severity of harm caused, R = Risk Rating, prefix with asterisk denotes ‘after controls taken into account’.

2

2

4

P

S

R

ALARP = ‘As Low As Reasonably
Practicable’
Universitas
Sumatera

Utara

RISK ASSESSMENT FORM
Pressure
testing
Equipment

of
-

Pressure
release
Trap
pressure

- Over pressure caused
equipment damage
- Personnel Injury

5

3

15

-

-

Over
pressure

-

Over pressure damage relief
valve.
Over pressure release can kill
& injury personnel

PTIMS-HSE-1.03A

Use of calibrated gauges.
Use of isolation valves.
Use of proper rated and tested relief valves.
Permit to work in place before job commences.
Restriction in work area of non-essential personnel.
Ensure pressure gauge gave similar reading with
chart recorder. Ensure correctly ranged (33 –
75%) pressure been applied.
Clear line of communication,(Accepted and
understood).
Use of sign’s and barriers.
Use of PA announcements.
Toolbox talk before work commences.
Permit to work in place before job commences.
Lines and equipment secured.
Line up security cameras on equipment being tested.
(zoom in)
Refer to Work Instruction guideline.

2

3

6

5

4

20

-

Use proper rated & tested relief valve.
Relief valve maintain as per maintenance procedure.
Test pressure not more than 90% of relief valve set
pressure.

1

4

4

-

Wear adequate hearing protection (ear plugs).
Conduct hygiene monitoring of noise level
periodically (once a year)

1

3

3

P

S

R

Pump operation

Noise Hazard

Excessive noise level endanger
personnel hearing

3

3

9

Operation/
Event

Identified
Hazard

Probable Harm

P

S

R

Required Controls

P = Probability of harm occurring, S = Severity of harm caused, R = Risk Rating, prefix with asterisk denotes ‘after controls taken into account’.

ALARP = ‘As Low As Reasonably
Practicable’
Universitas
Sumatera

Utara

RISK ASSESSMENT FORM
Over
Pressure

-

Equipment :
Operation of
Valves

Over
exertion.

Over pressure may release
pressure at connection &
tubing.
Injury to personnel

- Manual handling injury to
personnel.
- Strains & sprains to back,
hand & arms

4

3

12

-

Use of calibrated gauges.
Use of isolation valves.
Use of proper rated and tested relief valves.
Permit to work in place before job commences.
Restriction in work area of non-essential personnel.
Lines and equipment secured.
Clear line of communication. (Accepted and
understood).

1

3

3

4

1

4

-

Ensure equipment is bled off unless otherwise stated
in Work Instruction.
Ensure equipment is properly bled off and test caps
to be removed.
Ensure adequate manning present to complete
operations.
Use mechanical handling devices if possible.
Apply proper manual handling techniques.

2

1

2

Identify hammer unions before making up.
Do not make up unions that cannot be identified.
Technology Bulletin TB-GL-STE-006
Use GO / NO GO indicators.
Use of Colour Coding to identify hammer union type.
Ensure clear line of communication. If unsure or
doubt contact supervisor.

1

3

3

P

S

R

-

Mismatch
Hammer
Unions

Operation/
Event

of

Trap
pressure

Identified
Hazard

- Damage to equipment.
- Personnel Injury.
- Release of Uncontrolled
Pressure.
- Release of uncontrolled
Hydrocarbons.

Probable Harm

PTIMS-HSE-1.03A

3

3

9

P

S

R

-

Required Controls

P = Probability of harm occurring, S = Severity of harm caused, R = Risk Rating, prefix with asterisk denotes ‘after controls taken into account’.

ALARP = ‘As Low As Reasonably
Practicable’
Universitas
Sumatera

Utara

RISK ASSESSMENT FORM
Hammering up
Unions

Manual
Handling
Hazard

-

Splinters
Flying objects,
Manual Handling.
Pinch points
Personal Injury

4

Working in hot
weather
Working in
rainy Day

Personnel
tired

-

Personnel fatigue
Personnel slip

4

Stop the job
House keeping

Concurrence
activity
hazard

1

4

-

2

8

-

-

Trap pressure release.
Slip & trip

3

5

15

-

PTIMS-HSE-1.03A

Ensure to bled off pressure completely and remove
the test caps before hammering the unions.
Correct positioning of personnel and body posture.
Apply proper manual handling techniques.
Ensure to inspect tools / hammers for damage /
defect prior to use. Change to new tools if damage. If
unsure contact base supervisor. Ensure to inspect
unions prior to hammering. Ensure to wear full
P.P.E. (Hard Hats, Goggles, Face Mask, Ear Plugs)

2

1

2

Rotation of personnel
Correct position of personnel facing any in-let outlet
which may have pressure release.
Drink a lot of water.
STOP work if necessary
Must work with rain-coat.
STOP work if lighting & thunderstorm

2

2

4

Ensure communication by team member on
personnel duty.
Never start house keeping when equipment not
finish pressure testing job.
Check any possible pressure trap in any cavity or
vessel.
Keep any pellet or tool-box away from pressurize
equipment.

1

3

3

P = Probability of harm occurring, S = Severity of harm caused, R = Risk Rating, prefix with asterisk denotes ‘after controls taken into account’.

ALARP = ‘As Low As Reasonably
Practicable’
Universitas
Sumatera

Utara

SEVERITY OF HARM

RISK ASSESSMENT FORM
RISK

ENVIRONMENTAL
IMPACT

1

Minimal pollution effect,
contained locally

2

3

4

5

6

Minor pollution, slight or
negligible impact,
negligible remedial/
recovery work.
Pollution with some
onsite impact &
recovery work. Some
local media interest
Significant pollution
with offsite impact &
recovery work. Some
local and regional
media interest.
Massive pollution with
significant site impact &
recovery work.
Regional / National
media interest.
Massive pollution with
significant recovery
work. Global media
interest.

LOW RISK
MEDIUM
RISK
HIGH RISK

FINANCIAL
IMPACT

< £1,000

> �