2 Ptfi-Hira Forms 1 To 26

PT Pamapersada Nusantara
NUMBER / NOMOR
FREEPORT ROAD CONTRACT
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
HIRA Summary
LIST OF PROCESSES AND OPERATIONAL HAZARDS
EXACT LOCATION
TIME OF DAY
DAFTAR PROSES DAN BAHAYA SAAT OPERASI
TEMPAT YANG TEPAT
WAKTU
RISK
ASSESSMENT
RISK
FOR SITUATION
ASSESSMENT
WITH NO
FOR SITUATION
CONTROLS IN WITH CONTROLS
RISK
RISK REDUCTION
PENILAIAN
PLACE
IN PLACE
REDUCTION
REMARKS
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI
SITUASI TANPA
DENGAN
PENURUNAN
PENURUNAN
KONTROL
KONTROL
RESIKO
KOMENTAR RESIKO
Describe the Hazard in Detail:- Item / Substance / Activity / Condition

Provide a detailed description of the
Indicate at what time
Deskripsi Bahaya Dengan Rinci:- Benda / Bahan / Kegiatan / Kondisi
Exact Position (Location) of the Hazard. of the day or on which
Menyiapkan Deskripsi Rinci tentang Tempat shift the Hazard exists.
Risk
Risk
kejadian Bahaya.
Tentukan waktu atau P S F Resiko P S F Resiko
shift Bahaya yang ada.
Planning, Mobilisation & Site Establishment
Operations, Surveying & Pedestrians
Loading (Shovels, Excavators & Wheel Loaders)
Crushing, Hauling, Tipping & Dumping
Road Maintenance & Road Construction
Servicing & Maintenance of Equipment (Breakdown / Overhaul)
Occupational Hygiene (Noise / Lighting / Cleanliness)
Injury & Property Damage Incidents
Chemicals (storage / use / etc)
Electrical Installations & Appliances
Lifting Gear, Lifting Appliances & Cranes
Compressors & Air Receivers
Oxy / Acetylene Bottles & Torch Cutting
Electrical Arc Welding
Ladders, Stairs, Walkways, Scaffolding & Working at Heights
Machine Guarding (moving parts)
Use of Hand-tools
Tyre (maintenance / repair)
Environmental Contamination (Waste Disposal)
Emergency Preparedness
Vehicle Management & Control
Various Task Risks (CTI / TSP / PTO)
Quality Control
Working at High Altitudes
On-Site & Off Site Travelling
Management & Control of Other Hazards that may arise
All Areas
All Areas
Grassberg Mine Surface (Pit)
Grassberg Mine Surface (Pit) / Workshop
All Areas
All Areas
Warehouse & Workshop
All Areas
Workshop
All Areas
Compressors and Heavy Equipment
Grasberg Mine & Tyre Shop
All Areas
All Areas
All Areas
All Areas
All Areas
All Areas
All Areas
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
All Shifts
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
4
4
4
4
4
4
5
4
3
4
4
5
4
4
4
3
3
4
3
3
5
5
5
4
5
4
3
3
3
3
5
3
3
2
3
2
3
3
3
3
5
5
5
2
5
5
5
5
5
5
5
5
60
60
60
60
100
60
75
40
45
40
60
75
60
60
100
75
75
40
75
75
125
125
125
100
125
100
2
2
2
2
3
2
3
2
3
2
3
2
2
2
3
2
2
3
2
2
2
2
2
2
3
2
4
4
4
4
4
4
3
4
3
4
4
5
4
4
4
3
3
4
3
3
5
5
5
4
5
4
3
3
3
3
5
3
5
2
3
2
3
3
3
3
5
5
5
2
5
5
5
5
3
3
5
3
24
24
24
24
60
24
45
16
27
16
36
30
24
24
60
30
30
24
30
30
50
50
30
24
75
24
Amount
Jumlah
36
36
36
36
40
36
30
24
18
24
24
45
36
36
40
45
45
16
45
45
75
75
95
76
50
76
Sufficient Reduction ?
Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
Yes
Yes
Yes
No
Yes
No
Yes
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
No
Yes

NUMBER / NOMOR
"Top 21" H

Risk
P S F Resiko
2
2b
4
RISK
ASSESSMENT
FOR SITUATION
WITH NO
CONTROLS IN
PLACE
PENILAIAN
RESIKO UNTUK
SITUASI TANPA
KONTROL
2c
4b
4c
5
5b
5c
5f
5h
7
7c
7e
15
15a
15b
20
20b
20f
21
21a
21b
22
22a
25
25b
25c
25d
25h

Initial Site clearance (* By Dozer)
Initial Site clearance (* rock / material felling)
Collision with other Vehicles / Equipment / Structures
Driver Fatigue (sleepy)
Constructing Safety Berm Walls
Blocking Road (Traffic Control at restricted areas)
Employee Fatigue / illness (due to extreme temperatures)
Environmental contamination (due to dust)
Unsafe Equipment - Fall Down (Injury & Damage)
Slippery Surfaces - Fall Down (Injury & Damage)
Flooding - Injury & Damage (Drowning Equipment)
Major Ground Movement - Injury, Damage & Loss
Unsafe Vehicles (Poor Condition) - Incidents (Injury & Damage)
Unsafe Driving of Vehicles - Incidents (Injury & Damage)
Unsafe Acts (Injury, illness, Damage & Loss)
Travelling In Tram (Injury)
Travelling On-Site In Bus (Injury)
Travelling On-Site Via Underground Access (Injury, Damage & Loss)
Travelling Off-Site By Bus / Taxi (Injury)
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
4
4
4
4
5
5
4
5
5
4
4
5
4
3
4
4
4
3
5
5
5
5
5
5
5
5
5
5
5
5
3
5
5
3
5
5
5
5
5
5
5
3
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
60
100
100
60
125
125
100
125
125
100
100
75
100
75
100
100
100
75
125
125
125
125
125
125
125
125
125
125
125
125
RISK
"TopASSESSMENT
21"
Hazards / Risks (>50)
FOR SITUATION
WITH CONTROLS
RISK
RISK REDUCTION
PENILAIAN
IN PLACE
REDUCTION
REMARKS
RESIKO UNTUK
SITUASI
DENGAN
PENURUNAN
PENURUNAN
KONTROL
RESIKO
KOMENTAR RESIKO
Risk
Amount
Jumlah
24
60
60
24
75
75
60
75
75
60
60
45
60
60
60
60
60
30
50
50
50
50
50
50
50
75
50
75
60
60
36
40
40
36
50
50
40
50
50
40
40
30
40
15
40
40
40
45
75
75
75
75
75
75
75
50
75
50
65
65
P S F Resiko
2
3
3
2
3
3
3
3
3
3
3
3
3
4
3
3
3
2
2
2
2
2
2
2
2
3
2
3
4
4
4
4
4
4
5
5
4
5
5
4
4
3
4
3
4
4
4
3
5
5
5
5
5
5
5
5
5
5
5
5
3
5
5
3
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
3
3
Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No

NUMBER / NOMOR

P S F
1d Transport from port to site

2
11
15
20
21
22
All Unt
RISK
ASSESSMENT FOR
SITUATION WITH
NO CONTROLS IN
PLACE
PENILAIAN
RESIKO UNTUK
SITUASI TANPA
KONTROL
2
2b

2c

4a Operating Dump Truck / Haul Truck
4b Collision with other Vehicles / Equipment / Structures
4c Driver Fatigue (sleepy)
5a Operating Bulldozer / Grader / Excavator / Wheel Loader
5b Collision with other Vehicles / Equipment / Structures
5c Driver Fatigue (sleepy)
5f Constructing Safety Berm Walls
5h Blocking Road (Traffic Control at restricted areas)
Servicing & Maintenance of Equipment (Breakdown / Overhaul)
6e Working on Scaffolds / Elevated Work Area / Platforms
6j Working / Testing Live Equipment
7c Employee Fatigue / illness (due to extreme temperatures)
7e Environmental contamination (due to dust)
7f Poor visibility results in incidents (due to dust / fog)
Lifting Gear, Lifting Appliances & Cranes
11d Unsafe Manual Handling (Injury)
11e Unsafe Operation of Overhead Crane (Dropped Loads - Injury / Damage)
11f Unsafe Operation of Overhead Crane (Crash into Vehicles / Structures Injury / Damage)
15a Unsafe Equipment - Fall Down (Injury & Damage)
15b Slippery Surfaces - Fall Down (Injury & Damage)
20b Flooding - Injury & Damage (Drowning Equipment)
20f Major Ground Movement - Injury, Damage & Loss
21a Unsafe Vehicles (Poor Condition) - Incidents (Injury & Damage)
21b Unsafe Driving of Vehicles - Incidents (Injury & Damage)
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
4
4
4
4
4
4
4
5
5
4
4
5
5
4
4
4
4
3
5
4
3
4
4
3
3
3
3
5
5
3
5
5
5
5
5
5
5
5
5
3
2
5
3
5
5
3
3
5
5
5
5
5
5
5
5
5
5
5
5
4
4
4
4
3
5
5
5
5
5
5
3
5
5
5
5
5
5
5
5
5
5
25
22a Unsafe Acts (Injury, illness, Damage & Loss)

25b Travelling In Tram (Injury)
25c Travelling On-Site In Bus (Injury)
25d Travelling On-Site Via Underground Access (Injury, Damage & Loss)
25e Travelling On-Site Via HEAT Road (Injury, Damage & Loss)
25f Travelling Off-Site In Bus (Injury) (To Timika)
25g Travelling By Airfast / Garuda / Merpati (Injury)
25h Travelling Off-Site By Bus / Taxi (Injury)
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
All Untolerable Hazards / Risks (>32)
RISK
RISK
ASSESSMENT FOR ASSESSMENT FOR
SITUATION WITH
SITUATION WITH
NO CONTROLS IN
CONTROLS IN
PLACE
PLACE
PENILAIAN
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI TANPA
SITUASI DENGAN
KONTROL
KONTROL
Risk
Resiko
P S F
Risk
Resiko
RISK
REDUCTION
RISK REDUCTION REMARKS
PENURUNAN
RESIKO
PENURUNAN KOMENTAR
RESIKO
Amount Jumlah
60
60
60
100
100
60
100
125
125
100
100
125
125
100
100
60
40
75
75
100
75
60
60
75
2
3
2
3
3
2
2
3
3
3
2
3
3
3
3
2
4
3
3
3
4
4
3
3
4
4
4
4
4
4
4
5
5
4
4
5
5
4
4
4
4
3
3
4
3
4
4
3
3
3
3
5
5
3
5
5
5
5
5
5
5
5
5
3
2
5
5
5
5
3
3
5
24
36
24
60
60
24
40
75
75
60
40
75
75
60
60
24
32
45
45
60
60
48
36
45
36
24
36
40
40
36
60
50
50
40
60
50
50
40
40
36
8
30
30
40
15
12
24
30
60
36
24
60
100
100
100
75
125
125
125
125
125
125
3
3
3
3
2
2
2
2
2
2
2
4
4
4
4
3
5
5
5
5
5
5
3
5
5
5
5
5
5
5
5
5
5
36
60
60
60
30
50
50
50
50
50
50
24
40
40
40
45
75
75
75
75
75
75
Sufficient Reduction ? Yes

or No Plus additional
Remarks. Penurunan
Cukup ? Ya atau Tidak Plus
Komentar Lain.
Yes
No
Yes
No
No
Yes
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
Yes
No
No
No
No
No
No
125
125
125
125
125
125
125
125
125
2
3
2
3
4
3
3
3
4
5
5
5
5
5
5
5
5
5
5
5
5
5
3
3
3
3
3
50
75
50
75
60
45
45
45
60
75
50
75
50
65
80
80
80
65
No
No
No
No
No
No
No
No
No
NUMBER / NOMOR
RISK
RISK
ASSESSMENT
ASSESSMENT
FOR SITUATION FOR SITUATION
WITH NO
WITH
CONTROLS IN
CONTROLS IN
RISK
RISK REDUCTION
PENILAIAN
PLACE
PLACE
REDUCTION
REMARKS
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI
SITUASI TANPA
DENGAN
PENURUNAN
PENURUNAN
KONTROL
KONTROL
RESIKO
KOMENTAR RESIKO

Risk
Risk
P S F Resiko P S F Resiko

1a
1b
1c
1d
1e
1f
1g
Mine Planning
Mobilisation (Off Site)
Off-loading LCT's / Ships
Transport from port to site
Re-assembly (On Site)
Construction ** (buildings)
Environmental Contamination
Operations, Surveying & Pedestians

2a
2b
2c
2d
2e
2f
2g
2h
2i
Mine Planning / Survey

Persons hit by falling objects from (highwall / vehicles ).
Pedestrains hit by vehicles
Falling from inclines or highwalls.
Environmental Damage
Persons working at toe of dump or highwall
Trip and fall (uneven ground)
Loading (Shovels / Excavators & Wheel Loaders)

3a
3b
3c
3d
3e
3f
3g
Operating Shovels / Excavators / Wheel Loaders

Collision with Shovels / Excavators / Wheel Loaders
Working too close to face / highwall
Operator to toilet
Maintenance / Servicing / Refuelling of Shovels / Excavators on Road
Fire on Shovels / Excavators / Wheel Loaders
Bump into Mechanics / Pedestrians

4a
4b
4c
4d
4e
4f
4g
4h
Operating Dump Truck / Haul Truck

Operator / Driver to toilet
Maintenance / Servicing / Refuelling of Trucks
Fire on Trucks
Rear-end Dump Truck overturns (not standing level)
Operating the Mobile Crusher
Amount
Jumlah
Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
5
5
5
5
5
5
5
5
4
4
4
4
4
4
4
3
3
2
3
3
3
3
5
3
60
40
60
60
60
60
100
45
2
3
2
2
3
2
1
3
4
4
4
4
4
4
4
3
3
2
3
3
3
3
5
3
24
24
24
24
36
24
20
27
36
16
36
36
24
36
80
18
Yes
5
5
5
5
5
5
5
5
5
5
4
3
4
4
4
4
4
3
4
3
3
3
5
5
3
3
3
3
3
3
60
45
100
100
60
60
60
45
60
45
2
2
3
3
2
2
2
3
2
3
4
3
4
4
4
4
4
3
4
3
3
3
5
5
3
3
3
3
3
3
24
18
60
60
24
24
24
27
24
27
36
27
40
40
36
36
36
18
36
18
Yes
5
5
5
5
5
5
5
5
4
3
4
4
4
4
5
4
3
5
5
3
3
3
5
3
60
75
100
60
60
60
125
60
2
2
2
1
2
2
3
2
4
3
3
4
4
4
5
4
3
5
5
3
3
3
2
3
24
30
30
12
24
24
30
24
36
45
70
48
36
36
95
36
Yes
5
5
5
5
5
5
5
5
5
4
4
5
5
4
4
5
4
3
3
5
5
5
3
3
5
5
3
60
100
125
125
60
60
125
100
45
2
2
3
3
2
2
3
2
3
4
4
5
5
4
4
5
3
3
3
5
5
5
3
3
2
5
3
24
40
75
75
24
24
30
30
27
36
60
50
50
36
36
95
70
18
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
4i Maintenance / Servicing of the Mobile Crusher

4j Bump into Mechanics / Pedestrians / Road Workers
4k Recovery / retrieval / towing of broken-down / Bogged-down trucks
Road Maintenance & Road Contruction

5a
5b
5c
5d
5e
5f
5g
5h
5i
Operating Bulldozer / Grader / Excavator / Wheel Loader

Maintenance / Servicing / Refuelling of Equipment
Bump into Pedestrians / Road Workers
Road & Safety Berm Design
5
5
5
4 3
4 3
3 3
5
5
5
5
5
5
5
5
5
5
4
4
5
5
4
4
4
4
4
3
5
5
5
5
3
3
5
3
5
2
60
60
45
2
2
3
4 3
4 3
3 3
24
24
27
36
36
18
100
100
125
125
60
60
100
60
100
30
3
2
3
3
2
2
3
2
3
3
4
4
5
5
4
4
4
4
4
3
60
40
75
75
24
24
60
24
60
18
40
60
50
50
36
36
40
36
40
12
5
5
5
5
3
3
5
3
5
2
Yes
Yes
Yes
No
No
No
No
Yes
Yes
No
Yes
No
Yes
NUMBER / NOMOR
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
1a
1b
1c
1d
1e
1f
1g
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT
OPERASI
TEMPAT YANG TEPAT
TIME OF DAY
OTHER INFLUENCES
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
WAKTU
PENGARUH LAIN
KONTROL YANG ADA
PENILAIAN RESIKO UNTUK

SITUASI TANPA KONTROL
Describe the Hazard in

Provide a detailed
Indicate at what
What If?:- What if the People,
List the Existing Controls like; Laws,
Detail:- Item /
description of the
time of the day or Activities or Physical Conditions
Regulations, Standards, Procedures,
Substance / Activity /
Exact Position
on which shift the
change? What if new People or
Rules & SOPs. Buat daftar Kontrol yang
Condition Deskripsi
(Location) of the
Hazard exists.
Equipment enters the area?
ada seperti; Hukum, Regulasi, Standar,
Bahaya Dengan Rinci:- Hazard. Menyiapkan
Tentukan waktu
Bagaimana Jika?:- Bagaimana jika
Prosedur, Peraturan & SOP.
Benda / Bahan /
Deskripsi Rinci tentang atau shift Bahaya
Orang, Kegiatan atau Kondisi Fisik
Kegiatan / Kondisi
Tempat kejadian
yang ada.
Berubah? Bagaimana jika Orang atau
Bahaya.
Alat baru memasuki area?
Planning,
Mobilisation & Site All Areas
Establishment
Mine Planning
Mobilisation (Off Site)
Off-loadingfrom
LCT's
Transport
port
to site
Re-assemble (On Site)
Construction ** (buildings)
Environmental Contamination
Semua Shift Kerja
Jika ada orang (karyawan) baru :-
Risk
Resiko
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Amount
Jumlah
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
60
24
# Safety Induction
# Specialised Training
Jika ada aktifitas baru :# Tidak mungkin
Kontrol Karyawan & Peralatan:# Follow PTFI Systems for permission to

come onto site.
# Safety Induction.
# Surat Izin Operasi.
# Work with PTFI Survey Dept. for
Jika kondisi fisik berubah :# Prosedur Bekerja yang Aman

# Safety Talk
# Perawatan Harian
Planning / Design / Layouts.

Kontrol Operator / Driver :# Pelatihan Operator
# Safety Induction.
5
5
5
5
5
4
4
4
4
4
2
3
3
3
3
40
60
60
60
60
3
2
2
3
2
4
4
4
4
4
2
3
3
3
3
24
24
24
36
24
16
36
36
24
36
Yes
Yes
Yes
No
Yes
#
#
#
#
#
5
5
4
3
5
3
100
45
1
3
4
3
5
3
20
27
80
18
Yes
Yes
Jika ada peralatan / unit baru :# Pemeriksaan kelayakan unit

# Pelatihan bagi operator
Safety Talk Harian & Mingguan

Pelatihan Identifikasi Bahaya ( HIRA )
Follow existing PAMA TSP's
Prosedur Tugas Training (TSP)
Observasi Tugas Terencana (PTO)
Kontrol Perencanaan Tambang / Mine

Planning
# Co-ordinated Mine Planning
# Co-ordinated Surveying
# Continuous Quality Control
Kontrol General :# Follow PTFI / Grasberg Procedures.
36 Yes
VERIFICATION OF PROBABILITY
RATING
VERIFICATION OF SEVERITY RATING
VERIFICATION OF FREQUENCY
RATING
RISK
RATING
ADDITIONAL CONTROLS REQUIRED
PERSON IN CHARGE
DATE
VERIFIKASI UNTUK RATING

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
KONTROL YANG LAIN YANG PERLU
OLEH TANGGUNG JAWAB
TANGGAL
Justify the Severity Rating by using

Geographical, Behavioral, Process,
Energy Sources, Environmental
Factors, Historical Performance, etc.
Pembuktian Rating Keparahan dengan
menggunakan Geografi, Perilaku,
Proses, Sumber Energi, Faktor
Lingkungan, Keadaan Sejarah, dll.
Justify the Frequency Rating by using

Pembuktian Rating Frekuensi dengan
menggunakan Geografi, Perilaku, Proses,
Sumber Energi, Faktor Lingkungan,
Keadaan Sejarah, dll.
(P x S x F)
List any Additional Controls that are

required to reduce the Risk to an
Acceptable level. Buat daftar Kontrol yang
lain yang diperlukan untuk mengurangi Resiko
pada tingkat yang dapat diterima.
Name of person who is

responsible for compiling
Additional Control
Measures. Nama yang
bertanggung jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai Tujuan
Justify the Probability Rating by using

P
Energy Sources, Environmental Factors,
Historical Performance, etc. Pembuktian
Rating Probabilitas dengan menggunakan
Geografi, Perilaku, Proses, Sumber Energi,
Faktor Lingkungan, Keadaan Sejarah, dll.
4
( Tanpa Kontrol )
Tanpa kontrol kemungkinan besar terjadi
cedera dan / atau kerusakan harta benda.
3
( Tanpa Kontrol )
Tanpa kontrol tingkat keparahan dapat
mencapai kerugian > US$ 10.000 atau
Fatal insiden.
24
( Tanpa Kontrol )
Tanpa kontrol tingkat keseringan insiden
adalah beberapa orang setiap bulan.
3
( Dengan Kontrol )
2 Dengan kontrol yang ada kerugian cedera
2 atau harta benda berkurang cukup signi3 fikan.
2
4
( Dengan Kontrol )
4 Adanya penurunan tingkat keparahan
4 antara US$ 5000 - 10000 dan Cedera
4 masih bisa fatal.
4
2
( Dengan Kontrol )
3 Aktifitas sama, tidak ada penurunan
3 dalam tingkat keseringan cedera.
3
3
24
24
24
36 Security Escorted Convoys
24
1
3
4
3
5
3
20
27
PTFI & Pama Log Dep Head
Ongoing / daily
SIGNATURE
TANDA-TANGAN
Signature and actual
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR
LIST OF PROCESSES AND

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN BAHAYA

SAAT OPERASI
TEMPAT YANG TEPAT
Describe the Hazard in Detail:Item / Substance / Activity /
Condition Deskripsi Bahaya
Dengan Rinci:- Benda / Bahan /
Kegiatan / Kondisi
Operations, Surveying &

Pedestrians
TIME OF DAY
OTHER INFLUENCES
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
WAKTU
PENGARUH LAIN
KONTROL YANG ADA

Provide a detailed Indicate at what time

description of the
of the day or on
Activities or Physical Conditions Regulations, Standards, Procedures, Rules &
Exact Position
which shift the
SOPs. Buat daftar Kontrol yang ada seperti;
(Location) of the
Hazard exists.
Hukum, Regulasi, Standar, Prosedur, Peraturan
Hazard. Menyiapkan Tentukan waktu atau
& SOP.
Deskripsi Rinci tentang
shift Bahaya yang
Tempat kejadian
ada.
Bahaya.
Pit - Tambang
All Areas
Semua Shift Kerja
Jika ada orang (karyawan) baru :# Safety Induction
Kontrol Karyawan & Peralatan:# Follow PTFI Systems for permission to come
onto site and access control.
# Specilised Training
# Safety Induction for all.
Jika ada aktifitas baru :-
# Surat Izin Operasi (licensing).

# Work with PTFI Survey Dept. for initial
Planning / Design / Layouts and field work.
# Joint Surveying.
Kontrol Operator / Driver / Pedestrian:# PPE (reflective vests / bright coloured clothing
/ lace-up boots / etc)
# Tidak mungkin
2a
2b
Mine Planning / Survey

2c
2d
2e
Persons hit by falling objects from (highwall / vehicles).

Pedestrains hit by vehicles
# Safety Talk
# Perawatan Harian
2f
2g
2h
2i
Falling from inclines or highwalls.

Environmental Damage
Persons working at toe of dump or highwall
Trip and fall (uneven ground)

# Safety Talks
# Env. Protection (use PTFI and Pama SOP's to
minimise Env. impact)
Identifikasi
Bahaya
( HIRA )
# Pelatihan
Follow existing
PTFI Rules
(Pedestrians)
and
Golden Rules (min 1.5m from highwalls).
# Follow existing PAMA TSP's
# Prosedur Tugas Training (TSP)
# Observasi Tugas Terencana (PTO)
# Pelatihan Semua Operator
# Safety Induction.
Kontrol Perencanaan Tambang / Mine
Planning
# Co-ordinated Mine Planning
# Surveying (joint survey)
# Quality Control (daily)
Kontrol General :# Follow PTFI Grasberg Procedures & Rules.
Risk
Resiko
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Amount
Jumlah
60
24
36
5
5
3
4
3
5
45
100
2
3
3
4
3
5
18
60
27
40
100
60
40
5
5
4
4
3
3
60
60
2
2
4
4
3
3
24
24
36
36
5
5
5
5
4
3
4
3
3
3
3
3
60
45
60
45
2
3
2
3
4
3
4
3
3
3
3
3
24
27
24
27
36
18
36
18
RISK REDUCTION
REMARKS
RATING
RATING
RISK
RATING
PENURUNAN
KOMENTAR
RESIKO

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO


Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes

P
2
4
( Tanpa Kontrol )
3
( Tanpa Kontrol )
mencapai kerugian > US$ 10.000 /
adalah sedikit orang sekali setiap hari.
Fatal insiden.
3
( Dengan Kontrol )
4 Adanya penurunan tingkat keparahan
(P x S x F)
( Tanpa Kontrol )
2
( Dengan Kontrol )
3 Dengan kontrol yang ada kerugian cedera

List any Additional Controls that are required to reduce the Risk to
an Acceptable level. Buat daftar Kontrol yang lain yang diperlukan
untuk mengurangi Resiko pada tingkat yang dapat diterima.
24
Yes
No
No
3 atau harta benda berkurang cukup signi-
4 antara US$ 5000 - 10000 dan masih
3
( Dengan Kontrol )
5 Aktifitas sama, tidak ada penurunan
dalam tingkat keseringan melakukan
5 pekerjaan terkait.
18
60 Because these tasks are not done on a regular basis there is a high risk of
incidents due to forgetfulness. Refresher training regarding TSP's and
60 SOP's must be provided before these tasks are conducted.
Yes
Yes
2 fikan.
2
4 ada kemungkinan terjadi insiden fatal.

4
3
3
24
24
Yes
Yes
Yes
Yes
2
3
2
3
4
3
4
3
3
3
3
3
24
27
24
27
PERSON IN CHARGE
DATE
SIGNATURE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN

responsible for
compiling Additional
Control Measures.
Nama yang bertanggung
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Prod Dept Head

SH&E dept Head
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai
Tanggal Selesai.
Tujuan
Ongoing
NUMBER / NOMOR
3a
3b
3c
3d
3e
3f
3g
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Provide a detailed
Indicate at what time of
Detail:- Item / Substance / description of the
the day or on which shift Activities or Physical Conditions
Regulations, Standards, Procedures, Rules
Activity / Condition
Exact Position
the Hazard exists.
& SOPs. Buat daftar Kontrol yang ada seperti;
Deskripsi Bahaya Dengan
(Location) of the
Tentukan waktu atau shift
Rinci:- Benda / Bahan /
Hazard. Menyiapkan
Bahaya yang ada.
& SOP.
Kegiatan / Kondisi
Deskripsi Rinci
tentang Tempat
kejadian Bahaya.
Loading (Shovels /
Excavators & wheel
Loaders)
Semua Shift Kerja

Grasberg Mine
Surface (Pit)
Operating Shovels / Excavators / Wheel Loaders

Collision with Shovels / Excavators / Wheel Loaders
Working too close to face / highwall
Operator to toilet
Maintenance / Servicing / Refuelling of Shovels / Excavators on Road
Fire on Shovels / Excavators / Wheel Loaders
Bump into Mechanics / Pedestrians
Kontrol Unit / Machine :-
# Safety Induction
# Specific Training
# Program Pemeriksaan Mesin (PPM)

# Program Pemeriksaan Undercarriage (PPU)
# Program Analisisa Pelumas (PAP)
# Program Perawatan Harian (P2H)
# Program Preventive Terencana (PPT)
# Safety Induction
# Surat Izin Operasi
# Safety Talk Harian & Mingguan
# Pelatihan Identifikasi Bahaya ( HIRA )
# All Units fitted with automatic fire suppression
or portable fire extinguishers

# Safety Talks
# Perawatan Harian
Kontrol General :# Standar Operation Procedures

# Follow PTFI Grasberg Procedures & Rules.
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
60
24
36
Yes
45
70
48
36
36
95
36
Yes
Yes
Yes
Yes
Yes
Yes
Yes
5
5
5
5
5
5
5
3
4
4
4
4
5
4
5
5
3
3
3
5
3
75
100
60
60
60
125
60
2
2
1
2
2
3
2
3
3
4
4
4
5
4
5
5
3
3
3
2
3
30
30
12
24
24
30
24
RATING
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

4
( Tanpa Kontrol )
2
2
1
2
2
3
2

( Dengan Kontrol )
Dengan kontrol yang ada kerugian cedera
atau harta benda berkurang cukup signifikan.
3
3
4
4
4
5
4

3
( Tanpa Kontrol )
Fatal insiden.
( Dengan Kontrol )
Adanya penurunan tingkat keparahan
antara US$ 5000 - 10000 dan masih
ada kemungkinan cedera fatal
(P x S x F)
24
( Tanpa Kontrol )
5
5
3
3
3
2
3
( Dengan Kontrol )
Aktifitas sama, tidak ada penurunan
dalam tingkat keseringan melakukannya.
30
30
12
24
24
30
24
List any Additional Controls that are Name of person who is

responsible for
Acceptable level. Buat daftar Kontrol
yang lain yang diperlukan untuk
Control Measures.
mengurangi Resiko pada tingkat yang Nama yang bertanggung
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG
TEPAT

Detail:- Item / Substance /
Kegiatan / Kondisi
Crushing, Hauling,
Tipping & Dumping)
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Provide a detailed Indicate at what time

description of the
of the day or on
Exact Position
which shift the
(Location) of the
Hazard exists.
& SOP.
Deskripsi Rinci
shift Bahaya yang ada. Orang, Kegiatan atau Kondisi Fisik
tentang Tempat
kejadian Bahaya.
Grasberg Mine
Surface (Pit)
Semua Shift Kerja

# Specific training
Kontrol Units / Equipment:# Program Pemeriksaan Mesin (PPM)


# Safety Induction
4a
Operating Dump Truck / Haul Truck
Jika kondisi fisik berubah :-
4b
4c
4d
4e

Maintenance / Servicing / Refuelling of Trucks
# Prosedur Bekerja yang Aman

# Safety Talk
# Perawatan Harian
4f
4g
4h
4i
4j
4k
Fire on Trucks
Rear-end Dump Truck overturns (not standing level)
Operating the Mobile Crusher
Maintenance / Servicing of the Mobile Crusher
Bump into Mechanics / Pedestrians / Road Workers
Recovery / retrieval / towing of broken-down / Bogged-down trucks


RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
60
24
36
100
40
60
5
5
5
5
5
5
4
4
5
5
3
3
125
125
60
60
3
3
2
2
5
5
4
4
5
5
3
3
75
75
24
24
50
50
36
36
5
5
5
5
5
5
5
4
3
4
4
3
5
5
3
3
3
3
125
100
45
60
60
45
3
2
3
2
2
3
5
3
3
4
4
3
2
5
3
3
3
3
30
30
27
24
24
27
95
70
18
36
36
18
RISK REDUCTION
REMARKS
VERIFICATION OF PROBABILITY RATING
VERIFICATION OF FREQUENCY RATING
RISK
RATING
PENURUNAN KOMENTAR
RESIKO

PROBABILITAS

KEPARAHAN
VERIFIKASI UNTUK RATING FREKUENSI
RESIKO
RATIO
Yes or No Plus additional
Remarks. Penurunan
Komentar Lain.
Yes

4
( Tanpa Kontrol )
No
No
Yes
Yes
3
3
2
2
Yes
Yes
Yes
Yes
Yes
Yes
3
2
3
2
2
3
5
3
3
4
4
3
(P x S x F)
24
( Dengan Kontrol )
5

bisa terjadi cedera fatal

( Tanpa Kontrol )
( Dengan Kontrol )
5
5
4
4

Rating Frekuensi dengan menggunakan
4
( Tanpa Kontrol )
Fatal insiden.
( Dengan Kontrol )
No

5
5
3
3
2
5
3
3
3
3
40
75
75
24
24
30
30
27
24
24
27
Because of the high level of interaction between Pama equipment and

other equipment this remains a high area of risk that must be continuously
monitored on a daily basis. Daily PTO's & Inspections must be carried out
by all Supervisors to ensure compliance to all rules. All operators must be
constantly reminded of the fatigue hazard due to lack of oxygen / regular
breathing exercises.
PERSON IN CHARGE
DATE
SIGNATURE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Prod Dept Head
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai
Tanggal Selesai.
Tujuan
Daily
Prod Dept Group Leaders Ongoing

Safety Officers
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG
TEPAT

Kegiatan / Kondisi
Road Maintenance &

Road Construction
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Provide a detailed
Indicate at what
description of the
time of the day or
Exact Position
on which shift the
(Location) of the
Hazard exists.
& SOP.
Deskripsi Rinci
shift Bahaya yang
tentang Tempat
ada.
kejadian Bahaya.
Grasberg Mine
Surface (Pit)
Semua Shift Kerja

# Specific training
Kontrol Units / Equipment:# Program Pemeriksaan Mesin (PPM)


# Safety Induction
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION
RISK REDUCTION
REMARKS

SITUASI DENGAN
PENURUNAN PENURUNAN KOMENTAR
KONTROL
RESIKO
RESIKO
Yes or No Plus additional
Remarks. Penurunan
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
100
60
40
No
5a
Operating Bulldozer / Grader / Excavator / Wheel Loader
100
40
60
No
5b
125
75
50
No
5c
5d
5e

# Safety Talk
# Perawatan Harian

5
5
5
5
4
4
5
3
3
125
60
60
3
2
2
5
4
4
5
3
3
75
24
24
50
36
36
No
Yes
Yes
5f
5g
5h
5i

Bump into Pedestrians / Road Workers
Road & Safety Berm Design

5
5
5
5
4
4
4
3
5
3
5
2
100
60
100
30
3
2
3
3
4
4
4
3
5
3
5
2
60
24
60
18
40
36
40
12
No
Yes
No
Yes

RATING
RISK
RATING

PROBABILITAS

KEPARAHAN
RESIKO
RATIO


4
( Tanpa Kontrol )

Historical Performance, etc.
(P x S x F)
5
( Tanpa Kontrol )
Fatal insiden.
( Dengan Kontrol )
2
60
( Dengan Kontrol )
5
40
75
3
2
2
5
4
4

bisa terjadi cedera fatal
5
3
3
75
24
24
3
2
3
3
4
4
4
3

List any Additional Controls that are required to reduce the Risk to an Acceptable level.
Buat daftar Kontrol yang lain yang diperlukan untuk mengurangi Resiko pada tingkat yang dapat
diterima.
( Tanpa Kontrol )
( Dengan Kontrol )
4
5
3
5
2
60
24
60
18
Because of the high level of interaction between Pama equipment and other equipment this
remains a high area of risk that must be continuously monitored on a daily basis. Daily PTO's &
Inspections must be carried out by all Supervisors to ensure compliance to all rules. All
operators must be constantly reminded of the fatigue hazard due to lack of oxygen / regular
breathing exercises.
Because ecavators are sometimes required to work on top of berms and therefor close to the
tops of highwalls, this remains a high risk activity that must be conducted under direct
supervision at all times.
Because of the high level of interaction between Pama equipment and other equipment this
remains a high area of risk that must be continuously monitored on a daily basis. Daily PTO's &
Inspections must be carried out by all Supervisors to ensure compliance to all rules.
A high level of co-operation and discipline must be applied to ensure that PTFI traffic adheres to
traffic control signage / instructions.
PERSON IN CHARGE
DATE
SIGNATURE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Prod Dept Head
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai Tujuan
Tanggal Selesai.
Daily
Prod Dept Group Leaders Ongoing

Safety Officers
Prod Dept Head & Group

Leaders
Daily / Ongoing
Prod Dept Head

Daily / Ongoing
Prod Dept Group Leaders Daily / Ongoing
PTFI Pit Supervisors &
Operators
Daily / Ongoing
NUMBER / NOMOR
RISK
RISK
ASSESSMENT
ASSESSMENT
WITH NO
WITH
CONTROLS IN
CONTROLS IN
RISK
RISK REDUCTION
PENILAIAN
PLACE
PLACE
REDUCTION
REMARKS
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI
SITUASI TANPA
DENGAN
PENURUNAN
PENURUNAN
KONTROL
KONTROL
RESIKO
KOMENTAR RESIKO

Risk
Risk
Servicing & Maintenance of Equipment

6a
6b
6c
6d
6e
6f
6g
6h
6i
6j
6k
6l
Changing Wheels / Tyres

Changing Engines / Gearboxes / Diffirentials
Tagging Out / Locking Out Energy Sources
Working on Scaffolds / Elevated Work Area / Platforms
Not Wearing appropriate PPE
Jacking-up / Supporting Vehicles / Equipment
Washing Equipment (Environmental Contamination)
Environmental Contamination from workshop area
Working / Testing Live Equipment
Oxy / Acetylene Torch Cutting

7a
7b
7c
7d
7e
7f
7g
7h
7i
Hearing Loss (due to Noise)

Incidents due to inadequate lighting levels
Employee Fatigue / illness (due to poor ergonomical conditions)
Environmental Contamination (due to dust)
Poor visibility results in incidents (due to dust / fog)
Unsafe / Unhygienic Physical Condition - (Injury, illness & Loss)
Unsafe Conditions - Slip, Trip & Fall Incidents (Injury & Damage)
Unsafe Stacking & Storage - Incidents (Injury, Damage & Loss)
Injury & Property Damage Incidents

8a Incidents are not reported and investigated
8b During re-enactment another incident happens
8c No follow-up is done to ensure that remedial actions are implemented
Chemicals (Storage / Use / Etc)

9a
9b
9c
9d
9e
9f
9g
Chemicals fall from transportation (injury / damage)

Environmental contamination (due to spillage / leakage)
Drivers exposed to chemicals (substances / fumes / etc)
Improper storage (exposure / spillage / fire / etc)
Improper usage / handling (injury / damage / loss)
Improper disposal (environmental contamination / loss)
Inadequate knowledge (no MSDS & no training)
Amount
Jumlah
Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
5
5
5
5
5
5
5
5
5
5
5
5
5
4
4
4
4
4
4
3
4
3
3
3
4
4
3
2
2
3
3
2
5
3
5
5
5
3
3
60
40
40
60
60
40
75
60
75
75
75
60
60
2
3
3
2
2
4
2
2
2
2
3
2
2
4
4
4
4
4
4
3
4
3
3
3
4
4
3
2
2
3
3
2
5
3
5
5
5
3
3
24
24
24
24
24
32
30
24
30
30
45
24
24
36
16
16
36
36
8
45
36
45
45
30
36
36
Yes
5
5
5
5
5
5
5
5
5
5
5
3
3
4
3
3
4
3
3
3
3
5
3
5
5
5
3
5
5
3
75
75
45
100
75
75
60
75
75
45
3
2
3
3
2
4
4
2
2
3
3
3
3
4
3
3
4
3
3
3
5
5
3
5
5
5
3
5
5
3
45
30
27
60
30
60
48
30
30
27
30
45
18
40
45
15
12
45
45
18
No
5
5
5
5
4
3
4
4
2
2
2
2
40
30
40
40
2
2
3
2
4
3
4
4
2
2
2
2
16
12
24
16
24
18
16
24
Yes
5
5
5
5
5
5
5
5
3
3
3
3
4
3
3
3
3
3
3
3
3
3
3
3
45
45
45
45
60
45
45
45
3
2
3
3
2
3
3
2
3
3
3
3
4
3
3
3
3
3
3
3
3
3
3
3
27
18
27
27
24
27
27
18
18
27
18
18
36
18
18
27
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
10
Electrical Installations / Appliances

10a Electrical Shock (electrocution)
10b Electrical Fires (short circuits)
10c Work Delay (due to power failure)
5
5
5
5
4
4
4
4
2
2
2
2
40
40
40
40
2
1
2
2
4
4
4
4
2
2
2
2
16
8
16
16
24
32
24
24
Yes
Yes
Yes
Yes
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION

SAAT OPERASI
TEMPAT YANG TEPAT
Kegiatan / Kondisi
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Provide a detailed
Indicate at what
description of the
time of the day or
Activities or Physical Conditions
Exact Position
on which shift the
& SOPs. Buat daftar Kontrol yang ada
(Location) of the
Hazard exists.
seperti; Hukum, Regulasi, Standar, Prosedur,
Hazard. Menyiapkan Tentukan waktu atau Bagaimana Jika?:- Bagaimana jika
Peraturan & SOP.
Deskripsi Rinci tentang shift Bahaya yang
Tempat kejadian
ada.
Bahaya.
Servicing & Maintenance of Grasberg Mine Surface All Shifts

(Pit)
Equipment
6a
6b
6c
6d
Changing Wheels / Tyres

Changing Engines / Gearboxes / Diffirentials
Tagging Out / Locking Out Energy Sources
6e
6f
6g
6h
6i
Working on Scaffolds / Elevated Work Area / Platforms

Not Wearing appropriate PPE
Jacking-up / Supporting Vehicles / Equipment
Washing Equipment (Environmental Contamination)
Environmental Contamination from workshop area
6j
6k
6l
Working / Testing Live Equipment

Oxy / acetylene torch cutting

# Specilised Training
# Safety Talks
# Perawatan Harian
Kontrol Semua Unit & Peralatan :# Program Pemeriksaan Mesin (PPM)

Kontrol Mekanik / Helper :# Pelatihan Mekanik / Helper (BMS)
# Safety Induction
# Follow Danger Tag & Lock out SOP
# Safety Talk

Kontrol Plant Departement :# MIMS
# Checklist Periodical Service

# Quality Control
Kontrol General :# Instruksi Kerja Internal Plant
# Follow PTFI Grasberg Procedures & Rules
# Follow "Refuelling' Procedure
# Daily & Monthly Inspections
# Follow PTFI Locking-out Rule
# Follow Pama TSP's
# Washbay must have sediment trap!
# Separate Heavy Equipment & Light Vehicles.
# Restricted access & security checkpoints
# Drains and Oil trap for workshop facility
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
60
24
36
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
5
5
5
5
4
4
4
4
2
2
3
3
40
40
60
60
3
3
2
2
4
4
4
4
2
2
3
3
24
24
24
24
16
16
36
36
Yes
Yes
Yes
Yes
5
5
5
5
5
4
3
4
3
3
2
5
3
5
5
40
75
60
75
75
4
2
2
2
2
4
3
4
3
3
2
5
3
5
5
32
30
24
30
30
8
45
36
45
45
No
Yes
Yes
Yes
Yes
5
5
5
3
4
4
5
3
3
75
60
60
3
2
2
3
4
4
5
3
3
45
24
24
30
36
36
No
Yes
Yes
RATING
RISK
RATING
PERSON IN CHARGE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB

4
( Tanpa Kontrol )
4
2
2
2
2
3
2
2

4
4
4
4
4
3
4
3
3
3
4
4

(P x S x F)
3
( Tanpa Kontrol )
Fatal insiden.
( Dengan Kontrol )
( Dengan Kontrol )
3
3
2
2


ada kemungkinan terjadi cedera fatal.

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
24
( Tanpa Kontrol )
( Dengan Kontrol )
2
2
3
3
2
5
3
5
5
5
3
3

24
24
24
24
32
30
24
30
30
45
24
24
Because this type of work is not done on a regular basis there is still a
high risk of injury. Any work at heights must be strictly controlled by
means of the permit to work standard as well as direct supervision.
Dept Head Plant & Chief

Mechanics
Because equipment is not controlled by locking out during live tests, there Dept Head Plant & Chief
Mechanics
remains a risk of injury. All live tests must be directly supervised and
regular PTO's must be conducted to ensure compliance to procedures and
rules.
DATE
SIGNATURE
TANGGAL
TANDA-TANGAN
Targeted
Completion Date.
Tanggal Tercapai
Tujuan

Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
Daily / Ongoing
Daily / Ongoing
NUMBER / NOMOR
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT
OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Describe the Hazard in Provide a detailed Indicate at what time

Detail:- Item /
description of the
of the day or on
Exact Position
which shift the
Condition Deskripsi
(Location) of the
Hazard exists.
Bahaya Dengan Rinci:- Hazard. Menyiapkan Tentukan waktu atau
& SOP.
Benda / Bahan /
Deskripsi Rinci
shift Bahaya yang
Kegiatan / Kondisi
tentang Tempat
ada.
kejadian Bahaya.
Occupational
Hygiene
All Areas
All Shifts
(Noise / Lighting /
Cleanliness)
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
RISK REDUCTION
REDUCTION
REMARKS

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
75
45
30
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Kontrol Unit / Peralatan / Bangunan :-
# Safety Induction
# Program Pemeriksaan Mesin (PPM)

# Program Periodical Service ( PS )
# Inspeksi Terencana Bangunan / Daerah
# Inspeksi Critical / Part Items
# Pemantauan Kebisingan ; Pencahayaan ;
Tegangan Panas / Dingin.
5
5
3
3
5
3
75
45
2
3
3
3
5
3
30
27
45
18
Yes
Yes

# Safety Talk
# Perawatan Harian
No
7a
7b
Hearing Loss (due to Noise)

Incidents due to inadequate lighting levels
7c
7d

Employee Fatigue / illness (due to poor ergonomical conditions)
Kontrol Karyawan :-
5
5
4
3
5
5
100
75
3
2
4
3
5
5
60
30
40
45
No
Yes
7e
Environmental contamination (due to dust)
# Safety Induction
75
60
15
No
7f
7g
7h
7i
Poor visibility results in incidents (due to dust / fog)

Unsafe / Unhygienic Physical Condition - (Injury, illness & Loss)
Unsafe Conditions - Slip, Trip & Fall Incidents (Injury & Damage)
Unsafe Stacking & Storage - Incidents (Injury, Damage & Loss)
#
#
#
#
#
#
#
5
5
5
5
4
3
3
3
3
5
5
3
60
75
75
45
4
2
2
3
4
3
3
3
3
5
5
3
48
30
30
27
12
45
45
18
No
Yes
Yes
Yes
Pelatihan Identifikasi Bahaya dan Resiko

Pelatihan Kesehatan Kerja
Pelatihan Inspeksi Terencana
Pelatihan Observasi Tugas
Pelatihan Kesadaran Lingkungan
Safety Talk
Medical Examination
# Alat Pelindung Diri (Ear Plugs / Dust Masks/

jacket/etc)
Kontrol General :# Standar Faktor Fisik Lingkungan ditempat
Kerja ( Kebisingan ; Debu ; dsb )
# Follow safety rules of PTFI / Grasberg
Procedures and Rules
# Reduce Dust by watering down
# Dust Monitoring by PTFI
RATING
RISK
RATING
PERSON IN CHARGE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB

2
3
3
2


(P x S x F)
45
( Tanpa Kontrol )
( Tanpa Kontrol )
Fatal insiden.
( Tanpa Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )
ada kemungkinan terjadi cedera LTI
( Dengan Kontrol )
3
3
4
3
5
3
5
5
List any Additional Controls that are required to reduce the Name of person who is
Risk to an Acceptable level. Buat daftar Kontrol yang lain
responsible for
yang diperlukan untuk mengurangi Resiko pada tingkat yang
dapat diterima.
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
30
27
60
30
60
Pama has issued all employees with special cold weather

clothing, but because of the prevailing weather conditions this
remains a risk that will require continuous monitoring and
controlling by Front Line Supervisors. All employees will be
given additional vitamin C supplements.
Front Line Supervisors &

HRGA Dept Head &
Safety Officers
Due to the fact that PTFI only has 2 water trucks available and All Front Line Supervisors
limited water resources, this remains an area of high risk.
& Operators of Pama as
Continuous supervision and strict adherence to procedures and well as PTFI
rules will be required during dusty periods.
Due to the prevailing weather conditions and the comments
All Front Line Supervisors
regarding dust suppression above, this remains a risk that will & Operators of Pama as
require continuous monitoring and controlling by all concerned. well as PTFI
4
2
2
3
4
3
3
3
3
5
5
3
48
30
30
27
DATE
SIGNATURE
TANGGAL
TANDA-TANGAN
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai Tujuan
Tanggal Selesai.
Daily / Ongoing
Daily / Ongoing
Daily / Ongoing
NUMBER / NOMOR

OPERATIONAL HAZARDS
8a
8b
8c
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
EXACT LOCATION
TEMPAT YANG TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Provide a detailed
Indicate at what
description of the
Activity / Condition Deskripsi
Exact Position
on which shift the
Bahaya Dengan Rinci:- Benda
(Location) of the
Hazard exists.
/ Bahan / Kegiatan / Kondisi Hazard. Menyiapkan
Tentukan waktu
& SOP.
Tempat kejadian
yang ada.
Bahaya.
Injury & Property

Damage Incidents
All Areas
All Shifts
Incidents are not reported and investigated

During re-enactment another incident happens
No follow-up is done to ensure that remedial actions are implemented

Jika ada aktifitas baru :# HIRA Assesment & Approval
# Safety Talk
# Perawatan Harian
Kontrol Managemen :# Kebijakan Dasar K3&LH

# PAMA Safety Management System (PSMS)
Kontrol Karyawan :# Penandatanganan IKRAR K3&LH
# Safety Induction
# Pelatihan Identifikasi Bahaya & Resiko
# Pelatihan P3K Pada Kecelakaan
# Pelatihan Pemadam Kebakaran
# Pelatihan Observasi Tugas
# Pelatihan Operator Alat Berat / Skill - Up
# Pelatihan BMS untuk Mekanik
# Pelatihan Inspeksi Terencana
# Pelatihan Investigasi Insiden
# Safety Talk
Kontrol Unit / Peralatan / Bangunan :# Program Pemeriksaan Mesin (PPM)
# Program Periodical Service ( PS )
# Inspeksi Terencana Bangunan / Daerah
Kontrol General :# Pengadaan SOS / AEA
# Paramadic dan Dokter Full Time (SOS)
# Risk Financing / Insurance
# Penyelidikan Insiden dan Analisis
# Hazard Reporting System (Green Cards)
# Follow PTFI & Pama Incident reporting &
Investigation Standard.
# Quality Control
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
40
16
24
5
5
5
3
4
4
2
2
2
30
40
40
2
3
2
3
4
4
2
2
2
12
24
16
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
18
16
24
Yes
Yes
Yes
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

2
( Tanpa Kontrol )

( Tanpa Kontrol )
4
4
4

3
( Tanpa Kontrol )
Fatal insiden.
( Dengan Kontrol )
( Dengan Kontrol )
3
3
2


ada kemungkinan terjadi cedera LTI
ringan
( Tanpa Kontrol )
(P x S x F)
24
( Tanpa Kontrol )
( Dengan Kontrol )
1
2
2

( Tanpa Kontrol )
12
24
16

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI TEMPAT YANG TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Provide a detailed
Indicate at what
Detail:- Item /
description of the
Exact Position
on which shift the
Condition Deskripsi
(Location) of the
Hazard exists.
Bahaya Dengan Rinci:Hazard. Menyiapkan
Tentukan waktu
Peraturan & SOP.
Benda / Bahan / Kegiatan / Deskripsi Rinci tentang atau shift Bahaya
Kondisi
Tempat kejadian
yang ada.
Bahaya.
Chemicals
All Areas
All Shifts
(Transport, Storage,
Handling and Disposal)
9a
9b
9c
Chemicals fall from transportation (injury / damage)

Environmental contamination (due to spillage / leakage)
Drivers exposed to chemicals (substances / fumes / etc)
9d
9e
9f
9g
Improper storage (exposure / spillage / fire / etc)

Improper usage / handling (injury / damage / loss)
Improper disposal (environmental contamination / loss)
Inadequate knowledge (no MSDS & no training)

# Safety Talk
# Perawatan Harian
Jika ada peralatan / unit baru :# Pemeriksaan kelayakan alat / unit
# Pelatihan bagi petugas terkait.
Kontrol Unit / Peralatan / Bangunan :# Inspeksi Terencana Bangunan / Daerah

RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
45
27
18
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
Kontrol Karyawan :# Safety Induction

# Pelatihan Identifikasi Bahaya & Resiko
# Pelatihan Inspeksi Umum Terencana
# Pelatihan Kepedulian Lingkungan Dasar
# Pelatihan MSDS
# Pelatihan Prosedur Tugas
# Observasi Tugas (PTO's)
5
5
5
3
3
3
3
3
3
45
45
45
2
3
3
3
3
3
3
3
3
18
27
27
27
18
18
Yes
Yes
Yes
Kontrol Workshop :# Sistem Drainage Workshop (with oil trap)

# Planned Inspection
5
5
5
5
4
3
3
3
3
3
3
3
60
45
45
45
2
3
3
2
4
3
3
3
3
3
3
3
24
27
27
18
36
18
18
27
Yes
Yes
Yes
Yes
Kontrol Drum Storage:# Bunding with oil / spill trap

# Planned Inspections
Kontrol General :# SOP (Bahan Kemia Berbahaya)
# SOP Penanganan Limbah Bahan Kimia
# Obtain MSDS's for all substances on site
# Follow PTFI waste disposal system and
procedures
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

2
3
3
2
3
3
2


(P x S x F)
27
( Tanpa Kontrol )
( Tanpa Kontrol )
mencapai kerugian US$ 1000 -5000.
atau cedera LTI
( Tanpa Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )
Tingkat keparahan masih tetap
antara US$ 1000 - 5000 atau
cedera LTI
( Dengan Kontrol )
3
3
3
4
3
3
3
3
3
3
3
3
3
3
18
27
27
24
27
27
18

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Describe the Hazard in Detail:- Provide a detailed

Indicate at what
Item / Substance / Activity /
description of the time of the day or Activities or Physical Conditions
Exact Position
on which shift the
(Location) of the
Hazard exists.
Kegiatan / Kondisi
Hazard. Menyiapkan Tentukan waktu
& SOP.
Deskripsi Rinci
atau shift Bahaya
tentang Tempat
yang ada.
kejadian Bahaya.
Electrical Installations &

10 Appliances
All Areas
All Shifts

10a Electrical Shock (electrocution)

10b Electrical Fires (short circuits)
10c Work Delay (due to power failure)

# Safety Talk
# Perawatan Harian
Kontrol Unit / Peralatan / Bangunan :# Inspeksi Critical / Part Items

# Kartu Inspeksi Peralatan
# Pembumian / Grounding
# Follow PTFI ELCB Standard & Inspections
Jika ada peralatan / unit baru :-

# Pelatihan Identifikasi Bahaya dan Resiko
# Pelatihan Inspeksi Peralatan Listrik
# Pelatihan Kebakaran
# Pemeriksaan kelayakan alat / unit

# Observasi Tugas
# Alat Pelindung Diri
Kontrol General :# Standar Control of Electrical Installations
# Use only PTFI approved Electrical
Contractors
# Monthly Inspection of Portable Electrical
Appliances
# Follow electrical safety procedures / rules of
PTFI
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
40
16
24
5
5
5
4
4
4
2
2
2
40
40
40
1
2
2
4
4
4
2
2
2
8
16
16
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
32
24
24
Yes
Yes
Yes
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

1
2
2


16
( Tanpa Kontrol )
( Tanpa Kontrol )
mencapai kerugian US$ 5000 - 10000
atau cedera Fatal
( Tanpa Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )
Tingkat keparahan tetap
atau cedera Fatal
( Dengan Kontrol )
4
4
4
2
2
2
(P x S x F)
8
16
16

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR
11

Risk
Lifting Gear / Lifting Appliances & Cranes

Unsafe Lifting Practice (Dropped Loads - Injury / Damage)
Unsafe Lifting Equipment (Dropped Loads - Injury / Damage)
Unsafe Support / Tripods (Vehicles fall off stands - Injury / Damage)
Unsafe Manual Handling (Injury)
Unsafe Operation of Overhead Crane (Dropped Loads - Injury / Damage)
11f Unsafe Operation of Overhead Crane (Crash into Vehicles / Structures Injury / Damage)
Compressors & Air Receivers

12a Unsafe Compressors - Explosion (Injury / Damage)
12b Unsafe Air Receivers - Explosion (Injury / Damage)
12c Unguarded V-belts - Injury to persons
13
Oxy / Acetylene Bottles & Torch Cutting

13a Unsafe Oxy / Acetylene Sets - Flashback / Explosion (Injury / Damage)
13b Unsafe Cutting / Welding - Flashback / Explosion (Injury / Damage)
13c Unsafe Storage of Bottles - Fire / Explosion / Damage
14

14a Unsafe Welding Machines - Electrical Short (fire / damage)
14b Unsafe Welding Machines - Electrical Shock (Injury - electrocution)
14c Unsafe Welding Practices - (Injury - electrocution)
15
Risk
11a
11b
11c
11d
11e
12
RISK
RISK
ASSESSMENT
ASSESSMENT
WITH NO
WITH
CONTROLS IN
CONTROLS IN
RISK
PENILAIAN
PLACE
PLACE
REDUCTION
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI
SITUASI TANPA
DENGAN
PENURUNAN
KONTROL
KONTROL
RESIKO
Ladders, Stairs, Scaffolding & Working at Heights

15c Working at Heights - Fall Down (Injury & Damage)
Amount
Jumlah
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR RESIKO
Yes or No Plus
additional Remarks.
Penurunan Cukup ? Ya
atau Tidak Plus
Komentar Lain.
5
5
5
5
5
5
4
4
4
4
3
4
3
3
3
3
5
3
60
60
60
60
75
60
3
2
2
2
3
3
4
4
4
4
3
4
3
3
3
3
5
3
36
24
24
24
45
36
24
36
36
36
30
24
No
4 3
60
4 3
36
24
5
5
5
5
5
5
5
3
3
3
3
3
75
75
75
45
2
2
2
2
5
5
5
3
3
3
3
3
30
30
30
18
45
24
36
36
Yes
5
5
5
5
4
4
4
4
3
3
3
5
60
60
60
100
2
2
2
1
4
4
4
4
3
3
3
5
24
24
24
20
36
36
36
80
Yes
5
5
5
5
4
4
4
4
3
3
3
3
60
60
60
60
2
2
2
2
4
4
4
4
3
3
3
3
24
24
24
24
36
24
45
45
Yes
5
5
5
5
4
4
4
4
5
5
5
5
100
100
100
100
3
3
3
1
4
4
4
4
5
5
5
5
60
60
60
20
40
40
40
80
No
Yes
Yes
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG TEPAT

Kegiatan / Kondisi
Lifting Gear, Lifting

11 Appliances & Cranes
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Provide a detailed
description of the
of the day or on
Regulations, Standards, Procedures, Rules &
Exact Position
which shift the
(Location) of the
Hazard exists.
Hukum, Regulasi, Standar, Prosedur, Peraturan &
Hazard. Menyiapkan
Tentukan waktu atau
SOP.
shift Bahaya yang
Tempat kejadian
ada.
Bahaya.
Grasberg Mine Surface All Shifts
(Pit) / Workshop
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
60
36
24
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Kontrol Peralatan :-
# Safety Induction
Jika ada peralatan / unit baru :-
# Inspeksi Peralatan Angkat (Daily / Quarterly)

# Penomoran dan Pelabelan
# Spesifikasi Pembelian
# P2H Crane
# Pelatihan Inspeksi Peralatan Angkat
5
5
5
4
4
4
3
3
3
60
60
60
2
2
2
4
4
4
3
3
3
24
24
24
36
36
36
Yes
Yes
Yes
11d Unsafe Manual Handling (Injury)
# Pemeriksaan kelayakan alat / unit
# Observasi Tugas
75
45
30
No
11e Unsafe Operation of Overhead Crane (Dropped Loads - Injury / Damage)
# Daily & Weekly Safety Talk
60
36
24
No
# Surat Izin Operasi Alat Angkat & Angkut

# Pelatihan Crane (PTFI)
60
36
24
No
(Slings, Hooks, Tripods, Jacks,

Shackles, Chains &
Attachments)
11a Unsafe Lifting Practice (Dropped Loads - Injury / Damage)

11b Unsafe Lifting Equipment (Dropped Loads - Injury / Damage)
11c Unsafe Support / Tripods (Vehicles fall off stands - Injury / Damage)
11f
Unsafe Operation of Overhead Crane (Crash into Vehicles / Structures Injury / Damage)

# Safety Talk
# Perawatan Harian
Kontrol General :# Standar Penanganan Peralatan Angkat

# SOP - When manually handling more than
20kg - must get assistance - other persons or
lifting gear.
# Follow safety procedures / rules of PTFI
No
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

2
2
2


(P x S x F)
3
( Tanpa Kontrol )
atau cedera Fatal
( Tanpa Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )
Ttingkat keparahan tetap
atau cedera Fatal
( Dengan Kontrol )
3
3
3

Targeted
responsible for
Completion
Date. Tanggal
Control Measures.
Tercapai Tujuan
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
36
( Tanpa Kontrol )
4
4
4
List any Additional Controls that are required to reduce

the Risk to an Acceptable level. Buat daftar Kontrol
yang lain yang diperlukan untuk mengurangi Resiko pada
tingkat yang dapat diterima.
24
24
24
45
36
36
Because of the human behaviour factor this remains a risk

activity and will require continous monitoring and control.
All Font Line Supervisors Daily / Ongoing

& Employees in the Plant
& Logistics Dept's
Because of the human behaviour factor and the weight of

suspended overhead loads, this remains a risk activity and
will require continous monitoring and control by means of
direct supervision and ongoing PTO's.
All Font Line Supervisors Daily / Ongoing

& Employees in the Plant
& Logistics Dept's
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Describe the Hazard in Detail:- Provide a detailed

Indicate at what
Item / Substance / Activity /
description of the
time of the day or Activities or Physical Conditions Regulations, Standards, Procedures, Rules
Exact Position
on which shift the
(Location) of the
Hazard exists.
Kegiatan / Kondisi
Hazard. Menyiapkan
Tentukan waktu
Peraturan & SOP.
Deskripsi Rinci
atau shift Bahaya
tentang Tempat
yang ada.
kejadian Bahaya.
Compressors & Air

12 Receivers
Grasberg Surface
Mine (Pit)
and Tyre Workshop
12a Unsafe Compressors - Explosion (Injury / Damage)

12b Unsafe Air Receivers - Explosion (Injury / Damage)
12c Unguarded V-belts - Injury to persons
All Shifts

# Safety Talk
# Perawatan Harian
Kontrol Peralatan :# Inspeksi Peralatan Bejana / Tabung Tekan

# Standard Guarding for V-belts
# Pelatihan Inspeksi Peralatan
# Observasi Tugas
# Safety Talk
# Pelatihan Penanganan Bejana Tekan
# Surat Izin Bekerja (Jika perlu)
Kontrol General :# Standar Pengendalian Bejana Tekan

# Ikut standar PTFI
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
75
30
45
Yes
45
45
27
Yes
Yes
Yes
5
5
5
5
5
3
3
3
3
75
75
45
2
2
2
5
5
3
3
3
3
30
30
18
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

5
( Tanpa Kontrol )
2
2
2

( Dengan Kontrol )
3
( Tanpa Kontrol )
cedera Fatal multiple
5
5
3

( Dengan Kontrol )
cedera Fatal multiple
(P x S x F)
30
( Tanpa Kontrol )
3
3
3
( Dengan Kontrol )
30
30
18

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Provide a detailed Indicate at what time of
description of the
the day or on which
Exact Position
shift the Hazard exists.
(Location) of the
/ Bahan / Kegiatan / Kondisi Hazard. Menyiapkan
Bahaya yang ada.
SOP.
Deskripsi Rinci
tentang Tempat
kejadian Bahaya.
Oxy/acetylene Bottles
13 & Torch Cutting
Grasberg Surface
Mine & Workshop
All Shifts
13a Unsafe Oxy / acetylene Sets - Flashback / Explosion (Injury / Damage)

13b Unsafe Cutting / Welding - Flashback / Explosion (Injury / Damage)
13c Unsafe Storage of Bottles - Fire / Explosion / Damage

Kontrol Peralatan :# Inspeksi Peralatan Oxy/ Acetylene Set (P2H)


# Safety Talk
# Perawatan Harian

# Safety Talk
# Pelatihan Penanganan Oxy/acetylene
# Hot Work Permit
# Special Welding / Cutting Bay in Workshop
# Permits to Work (hazardous areas)

Kontrol General :# Standar Pengendalian Oxy/acetylene

# Standar Trolley (chained / fire extinguisher)
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
60
24
36
5
5
5
4
4
4
3
3
5
60
60
100
2
2
1
4
4
4
3
3
5
24
24
20
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
36
36
80
Yes
Yes
Yes
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

4
( Tanpa Kontrol )
2
2
1

( Dengan Kontrol )
atau harta benda berkurang cukup signifikan karena kadang-kadang melakukan
pekerjaan ini dan botol selalu terpisah
3
( Tanpa Kontrol )
atau cedera fatal
4
4
4

(P x S x F)
( Dengan Kontrol )
atau cedera fatal
24
( Tanpa Kontrol )
3
3
5
( Dengan Kontrol )
24
24
20

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR
14
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT
OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Describe the Hazard in Provide a detailed Indicate at what time of

Detail:- Item /
description of the
the day or on which
Exact Position
Condition Deskripsi
(Location) of the
Bahaya Dengan Rinci:- Hazard. Menyiapkan
Bahaya yang ada.
SOP.
Benda / Bahan /
Deskripsi Rinci
Kegiatan / Kondisi
tentang Tempat
kejadian Bahaya.
Electrical Arc
Welding
Grasberg Surface
Mine & Workshop
All Shifts
14a Unsafe Welding Machines - Electrical Short (fire / damage)

14b Unsafe Welding Machines - Electrical Shock (Injury - electrocution)
14c Unsafe Welding - (Injury - electrocution)
Kontrol Peralatan :-
# Safety Induction
# Inspeksi Peralatan Welder (Harian / Bulanan)


# Safety Talk
# Perawatan Harian

# Safety Talk
# Pelatihan Penanganan Welder
# Hot Work Permit
# Permits to Work (hazardous areas)
# Special Welding / Cutting Bay in Workshop
Kontrol General :# Standar Pengendalian Welder
# Follow PTFI Rule - No additional Plugs /
Sockets on Welding Machines
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
60
24
36
5
5
5
4
4
4
3
3
3
60
60
60
2
2
2
4
4
4
3
3
3
24
24
24
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
36
36
36
Yes
Yes
Yes
RATING
RATING
RISK
RATING
PERSON IN CHARGE
DATE
SIGNATURE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN

4
( Tanpa Kontrol )
2
2
2

( Dengan Kontrol )
3
( Tanpa Kontrol )
atau cedera fatal
4
4
4

( Dengan Kontrol )
atau cedera fatal
(P x S x F)
24
( Tanpa Kontrol )
3
3
3
( Dengan Kontrol )
24
24
24

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai
Tanggal Selesai.
Tujuan
NUMBER / NOMOR

OPERATIONAL HAZARDS
DAFTAR PROSES DAN
BAHAYA SAAT OPERASI
Bahaya Dengan Rinci:Benda / Bahan / Kegiatan /
Kondisi
Ladders, Stairs,
15 Scaffolding & Working
at Heights
EXACT LOCATION
TEMPAT YANG TEPAT

Provide a detailed
description of the
Exact Position
(Location) of the
Hazard. Menyiapkan
Tempat kejadian
Bahaya.
TIME OF DAY
WAKTU

15c Working at Heights - Fall Down (Injury & Damage)
PENGARUH LAIN
Indicate at what
time of the day or
on which shift the
Hazard exists.
Tentukan waktu
atau shift Bahaya
yang ada.
Grassberg Mine Surface All Shifts

(Pit) / Workshop
OTHER INFLUENCES
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


SOP.
Kontrol Peralatan :# Inspeksi Peralatan (Bulanan)

RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
100
60
40
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
No

# Safety Talk

# Perawatan Harian
100
60
40
No

#
#
#
#
#
5
5
4
4
5
5
100
100
3
1
4
4
5
5
60
20
40
80
No
Yes
Pelatihan Prosedur Tugas

Observasi Tugas (PTO's)
Safety Talk
Pelatihan Penanganan Tangga
Permits to Work (hazardous areas - heights)
Kontrol General :# Standard Control of Scaffolding

# Standard Control of Ladders, Stairs & Walkways
RATING
RATING
RISK
RATING

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO




List any Additional Controls that are required to reduce the Risk to an Acceptable
level. Buat daftar Kontrol yang lain yang diperlukan untuk mengurangi Resiko pada tingkat
yang dapat diterima.
(P x S x F)
60
( Tanpa Kontrol )
( Tanpa Kontrol )
( Tanpa Kontrol )


atau cedera fatal

adalah banyak orang berkali-kali
setiap hari.
( Dengan Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )
60
3
1

4
4

atau cedera fatal
5
5
60
20
Due to the prevailing weather conditions and due to the fact that Pama employees make use
of ladders and stairways that are controlled and managed by PTFI, this remains a high risk
activity that requires ongoing high levels of awareness and supervision. Pama employees
must report any unsafe stairs / ladders immediately to the Safety Dept.
PERSON IN CHARGE
DATE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN
Targeted
Completion
Date. Tanggal
Tercapai Tujuan

Completion Date.
Tanda-Tangan dan
Tanggal Selesai.

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
All employees / PTFI

Supervisors (responsible
for stairs / ladders)
Daily / Ongoing
SIGNATURE
NUMBER / NOMOR
16

Risk
Machine Guarding (moving parts)

Use of Hand Tools
17a Unsafe Hand-tools - (Injury)
17b Unsafe use of Hand-tools - (Injury)
18
Tyre (Maintenance / Repair)

18a
18b
18c
18d
18e
19
Unsafe Tyre Handling - (Injury)

Unsafe Jacking-up Practice - (Injury & Damage)
Unsafe Removal of Tyres from Rims (repair) - (Injury)
Unsafe Inflation Practices - (Injury / Damage)
Unsafe Storage Practices - (Injury / Damage)
Environmental Contamination (Waste)

19a
19b
19c
19d
20
Unsafe Waste Disposal - (Injury)

Unsafe Waste Disposal - (Environmental Contamination)
Unsafe Waste Disposal - (Occupational Health Problems / Diseases)
Poor Community Relations (due to Environmental Incidents)
20a
20b
20c
20d
20e
20f
20g
20h
21
Fire - Injury & Damage

Lightning - Injury & Damage
Theft - Damage & Loss
Unauthorised Access - Damage & Loss
Major Ground Movement - Injury, Damage & Loss
Labour Unrest - Injury, Damage & Loss
Farmer Invasion / Protest - Injury, Damage & Loss

21a
21b
21c
21d
Risk
16a Unguarded Moving Parts - (Injury)

16b Unguarded Moving Parts - (Damage & Loss)
17
RISK
RISK
ASSESSMENT
ASSESSMENT
WITH NO
WITH
CONTROLS IN
CONTROLS IN
RISK
RISK REDUCTION
PENILAIAN
PLACE
PLACE
REDUCTION
REMARKS
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI
SITUASI TANPA
DENGAN
PENURUNAN
PENURUNAN
KONTROL
KONTROL
RESIKO
KOMENTAR RESIKO
Unsafe Vehicles (Poor Condition) - Incidents (Injury & Damage)

Unsafe Driving of Vehicles - Incidents (Injury & Damage)
Unqualified Person Driving Vehicles - Incidents (Injury & Damage)
Unapproved Vehicle Access to Pit - Incidents (Injury & Damage)
Amount
Jumlah
Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
5
5
5
3 5
3 5
3 5
75
75
75
2
2
2
3 5
3 5
3 5
30
30
30
45
45
45
Yes
5
5
5
3 5
3 5
3 5
75
75
75
2
2
2
3 5
3 5
3 5
30
30
30
45
45
45
Yes
5
5
5
5
5
5
4
3
4
3
4
4
2
2
2
2
2
3
40
30
40
30
40
60
3
3
3
3
3
2
4
3
4
3
4
4
2
2
2
2
2
3
24
18
24
18
24
24
16
12
16
12
16
36
Yes
5
5
5
5
5
3
3
3
3
3
5
3
5
5
5
75
45
75
75
75
2
2
2
2
2
3
3
3
3
3
5
3
5
5
5
30
18
30
30
30
45
27
45
45
45
Yes
5
5
5
5
5
5
5
5
5
3
5
5
5
3
3
5
3
3
5
5
5
5
5
5
5
5
5
75
125
125
125
75
75
125
75
75
2
1
2
1
2
2
2
2
2
3
5
5
5
3
3
5
3
3
5
5
5
5
5
5
5
5
5
30
25
50
25
30
30
50
30
30
45
100
75
100
45
45
75
45
45
Yes
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
125
125
125
125
125
2
2
2
1
1
5
5
5
5
5
5
5
5
5
5
50
50
50
25
25
75
75
75
100
100
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
No
No
Yes
Yes
NUMBER / NOMOR

OPERATIONAL HAZARDS
DAFTAR PROSES DAN
BAHAYA SAAT OPERASI
EXACT LOCATION
TEMPAT YANG TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN

Provide a detailed
Indicate at what
Detail:- Item / Substance / description of the Exact time of the day or
Activity / Condition Deskripsi Position (Location) of the on which shift the
Hazard. Menyiapkan
Hazard exists.
/ Bahan / Kegiatan / Kondisi
Tentukan waktu
Tempat kejadian Bahaya. atau shift Bahaya
yang ada.
16 Machine Guarding
Grassberg Mine Surface

(Pit) / Workshop
(moving parts)
All Shifts

16a Unguarded Moving Parts - (Injury)

16b Unguarded Moving Parts - (Damage & Loss)

# Safety Talk
# Perawatan Harian
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Kontrol Peralatan :# Inspeksi Peralatan (Bulanan)

RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
75
30
45
Yes
5
5
3
3
5
5
75
75
2
2
3
3
5
5
30
30
45
45
Yes
Yes

# Safety Talk
# Permits to Work (maintenance of
hazardous / moving machinery)
Kontrol General :# Machine Guarding Standard
# Register & Labelling
RATING
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

2
2


30
( Tanpa Kontrol )
( Tanpa Kontrol )
mencapai kerugian US$ 1000 -5000
atau cedera LTI
( Tanpa Kontrol )
setiap hari.
( Dengan Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )

3
3

antara US$ 1000 - 5000,-
5
5
(P x S x F)

dalam tingkat keseringan melakunnya.
30
30

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
DAFTAR PROSES DAN
BAHAYA SAAT OPERASI
Bahaya Dengan Rinci:- Benda /
Bahan / Kegiatan / Kondisi
17 Use of Hand-tools
EXACT LOCATION
TEMPAT YANG TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
Provide a detailed
Indicate at what
description of the
time of the day or
Exact Position
on which shift the
(Location) of the
Hazard exists.
Hazard. Menyiapkan
Tentukan waktu
Tempat kejadian
yang ada.
Bahaya.
All Areas
20a Unsafe Hand-tools - (Injury)

20b Unsafe use of Hand-tools - (Injury)
All Shifts
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA



Kontrol Peralatan Perkakas Tangan :# Inspeksi Peralatan (Bulanan)

# Palu 5kg lebih (must be soft type)

# Safety Talk
# Perawatan Harian

# Safety Talk

Kontrol General :# Register & Labelling of Toolboxes Std
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
75
30
45
Yes
5
5
3
3
5
5
75
75
2
2
3
3
5
5
30
30
45
45
Yes
Yes
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

2
2


30
( Tanpa Kontrol )
( Tanpa Kontrol )
atau cedera LTI
( Tanpa Kontrol )
setiap hari.
( Dengan Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )

3
3

antara US$ 1000 - 5000,-
5
5
(P x S x F)

dalam tingkat keseringan melakunnya.
30
30

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION

SAAT OPERASI
TEMPAT YANG TEPAT
Kegiatan / Kondisi
Tyre (maintenance /
18 repair)
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
Provide a detailed
Indicate at what
description of the
Exact Position
on which shift the
(Location) of the
Hazard exists.
Hazard. Menyiapkan
Tentukan waktu
Tempat kejadian
yang ada.
Bahaya.
All Areas
All Shifts

# Safety Talk
# Perawatan Harian
18a
18b
18c
18d
18e
Unsafe Tyre Handling - (Injury)

Unsafe Jacking-up Practice - (Injury & Damage)
Unsafe Removal of Tyres from Rims - (Injury)
Unsafe Inflation Practices - (Injury / Damage)
UnsafeStorage Practices - (Injury / Damage)

EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Kontrol Tyre / Tyre Tools :# Inspeksi Terencana (Bulanan)

# Kartu Inspeksi Peralatan (All Tyre Tools)
# Safety Talk
Kontrol General :# SOP Tyre Repair & Maintnance
# Register & Labelling of Tools
# Use Mechanical Tyre Handler
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
40
24
16
5
5
5
5
5
3
4
3
4
4
2
2
2
2
3
30
40
30
40
60
3
3
3
3
2
3
4
3
4
4
2
2
2
2
3
18
24
18
24
24
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
12
16
12
16
36
Yes
Yes
Yes
Yes
Yes
RATING
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

3
3
3
3
2


24
( Tanpa Kontrol )
( Tanpa Kontrol )
atau cedera fatal
( Tanpa Kontrol )
adalah beberapa orang setiap minggu.
( Dengan Kontrol )
( Dengan Kontrol )
atau cedera fatal
( Dengan Kontrol )
3
4
3
4
4
2
2
2
2
3
(P x S x F)
18
24
18
24
24

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN BAHAYA SAAT

OPERASI
TEMPAT YANG
TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
KONTROL YANG ADA

Describe the Hazard in Detail:- Item / Provide a detailed

Substance / Activity / Condition
description of the the day or on which shift Activities or Physical Conditions Regulations, Standards, Procedures, Rules &
Deskripsi Bahaya Dengan Rinci:- Benda /
Exact Position
the Hazard exists.
Bahan / Kegiatan / Kondisi
(Location) of the
Hazard. Menyiapkan
Bahaya yang ada.
& SOP.
Deskripsi Rinci
tentang Tempat
kejadian Bahaya.
19 Environmental Contamination
(Waste Disposal)
All Areas
Semua Shift Kerja
(Hazardous Waste / Office Waste)
Kontrol Lingkungan :# PSMS Element 14
# Contract Document (S,H&E Duties detailed)

# Letters of Appointment for all Employees

# Safety Talk
# Perawatan Harian
19a
19b
19c
19d
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
Unsafe Waste Disposal - (Injury)

Unsafe Waste Disposal - (Environmental Contamination)
Unsafe Waste Disposal - (Occupational Health Problems / Diseases)
Poor Community Relations (due to Environmental Incidents)


# Pelatihan Inspeksi Terencana
# Daily & Weekly Safety Talk
# Environmental Awareness Training
Kontrol General :# SOP Hazardous Waste Disposal
# SOP Waste Disposal - Office Waste
# Daily Supervision
# Environmental Management Standards
# Weekly & Monthly Planned Inspections
# Follow PFI Waste Disposal Standards
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
75
30
45
5
5
5
5
3
3
3
3
3
5
5
5
45
75
75
75
2
2
2
2
3
3
3
3
3
5
5
5
18
30
30
30
27
45
45
45
RISK REDUCTION
REMARKS
RISK
RATING
PERSON IN CHARGE
PENURUNAN
KOMENTAR
RESIKO

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Yes
Yes
Yes
Yes
Yes

2
2
2
2


30
( Tanpa Kontrol )
( Tanpa Kontrol )
( Tanpa Kontrol )


atau cedera LTI

adalah sedikit orang sekali dalam setahun.
( Dengan Kontrol )
( Dengan Kontrol )
Tingkat keparahan Tetap
atau cedera LTI
( Dengan Kontrol )
3
3
3
3
3
5
5
5
(P x S x F)
18
30
30
30

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
DATE
SIGNATURE
TANGGAL
TANDA-TANGAN
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai
Tanggal Selesai.
Tujuan
NUMBER / NOMOR

OPERATIONAL HAZARDS
DAFTAR PROSES DAN
BAHAYA SAAT OPERASI
Kegiatan / Kondisi
Emergency
20 Preparedness
EXACT LOCATION
TEMPAT YANG TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
KONTROL YANG ADA

Provide a detailed
Indicate at what
List the Existing Controls like; Laws, Regulations,
description of the Exact time of the day or Activities or Physical Conditions Standards, Procedures, Rules & SOPs. Buat daftar
Position (Location) of on which shift the
Kontrol yang ada seperti; Hukum, Regulasi, Standar,
the Hazard. Menyiapkan Hazard exists.
Tentukan waktu
Tempat kejadian Bahaya. atau shift Bahaya
yang ada.
All Areas
Fire
Flooding
Lightning
Security
Major Ground Movement
Labour Unrest
Farmer Invasion
Semua Shift Kerja

# Safety Talk
# Perawatan Harian
20a Fire - Injury & Damage
20b
20c
20d
20e
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE

Lightning - Injury & Damage
Theft - Damage & Loss
Unauthorised Access - Damage & Loss
20f Major Ground Movement - Injury, Damage & Loss

20g Labour Unrest - Injury, Damage & Loss
20h Farmer Invasion / Protest - Injury, Damage & Loss

RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
75
30
45
Yes

# Pelatihan Situasi Darurat (Simulasi / Drills)
125
25
100
Yes
#
#
#
#
5
5
5
5
5
5
3
3
5
5
5
5
125
125
75
75
2
1
2
2
5
5
3
3
5
5
5
5
50
25
30
30
75
100
45
45
No
Yes
Yes
Yes
5
5
5
5
3
3
5
5
5
125
75
75
2
2
2
5
3
3
5
5
5
50
30
30
75
45
45
No
Yes
Yes
Kontrol Situasi Darurat :# PSMS Element 7

# Pama SEPM (Emergency Procedures Manual)
# PTFI Emergency Management Plans
Safety Talks
Emergency Awareness Coaching
Fire Training
First Aid Training
Kontrol Peralatan / Kendaraan :# Program Pemeriksaan Mesin (PPM)

# Program Perawatan Harian (P2H / Pre-use)
# Program Regular Washing
Kontrol General :# Alarm Systems, Fire Detectors & Radios
# SEMP (Evacuation)
# Symbolic Signs & Colour Coding
# Standard PSMS - Fire Management
# Standard PSMS - First Aid Management
# Regular Planned Inspections
# PTFI Emergency Response Team
# Standard Lightning Control (earthing / monitoring)
# Security Checkpoints / Gates / etc.
Engineering Control :# Seismographic Controls & Warning Systems
# Safe Electrical Systems Design Installation
RATING
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

2
1
2
2
2
2
2


5
( Tanpa Kontrol )
atau cedera LTI
( Tanpa Kontrol )
adalah sedikit orang sekali
dalam setahun.
( Dengan Kontrol )
atau harta benda berkurang cukup signi-
( Dengan Kontrol )
Tingkat keparahan Tetap
( Dengan Kontrol )
fikan.
5
5
3
3
5
3
3
atau cedera LTI
5
5
5
5
5
5
5

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai Tujuan
30
( Tanpa Kontrol )
(P x S x F)
List any Additional Controls that are required to reduce

the Risk to an Acceptable level. Buat daftar Kontrol
yang lain yang diperlukan untuk mengurangi Resiko pada
tingkat yang dapat diterima.
25
50
25
30
30
50
30
30
Due to the high level of annual rainfall, flooding could

happen and therefor remains a high risk possibility for
possible emergency situations.
PTFI weather forecast /

early warning center
Daily / Ongoing
Due to the steep nature of the surrounding area / mountains

and the high rainfall, ground movements / rock slides can
occur at any time and thereforremains a high risk possibility
for possible emergency situations.
PTFI weather forecast /

early warning center &
PTFI Seismographic
center
Daily / Ongoing
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
EXACT LOCATION

SAAT OPERASI
TEMPAT YANG
TEPAT

Kegiatan / Kondisi
Vehicle Management &

21 Control
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA

Provide a detailed Indicate at what time of

description of the
the day or on which
Exact Position
(Location) of the
Tentukan waktu atau
Hazard. Menyiapkan shift Bahaya yang ada.
& SOP.
Deskripsi Rinci
tentang Tempat
kejadian Bahaya.
All Areas
Semua Shift Kerja
Heavy Vehicles
Light Vehicles
Personnel Transporters

# Safety Talk
# Perawatan Harian
21a Unsafe Vehicles (Poor Condition) - Incidents (Injury & Damage)

21b Unsafe Driving of Vehicles - Incidents (Injury & Damage)
21c Unqualified Person Driving Vehicles - Incidents (Injury & Damage)
21d Unapproved Vehicle Access to Pit - Incidents (Injury & Damage)

RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
Risk
Resiko
Risk
Resiko
Amount
Jumlah
125
50
75
# Surat Izin Operasi (PTFI KIMPER)
125
50
75
#
#
#
#
5
5
5
5
5
5
5
5
5
125
125
125
2
1
1
5
5
5
5
5
5
50
25
25
75
100
100
Kontrol Peralatan / Kendaraan / Bus :# Program Pemeriksaan Mesin (PPM)

Kontrol Operator / Driver :# Pelatihan Operator / Driver
# Safety Induction
Safety Talk Harian & Mingguan

Follow PTFI safety rules

Kontrol General :# PSMS & PTFI Vehicle Standards
# Follow PTFI light vehicle standard
# Follow PTFI Safety Procedures & Rules
RISK REDUCTION
REMARKS
RATING
RATING
RISK
RATING
PENURUNAN
KOMENTAR
RESIKO

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
Sufficient
Reduction ? Yes
or No Plus
additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
No



5
( Tanpa Kontrol )
atau mutiple Fatal insiden.
( Tanpa Kontrol )
adalah banyak orang setiap hari.
( Dengan Kontrol )
atau harta benda berkurang sangat
signifikan.
( Dengan Kontrol )
Dengan kontrol tingkat keparahan tetap
bisa mencapai kerugian > US$ 10.000
atau insiden multiple Fatal
( Dengan
)
Dengan kontrol
tetap Kontrol
ada frekuensi
tinggi
ada penurunan
dalam sub-poin 'a' & 'b', tetapi
dalam sub-poin 'c' & 'd' frekuensi
No
Yes
Yes
2
1
1
5
5
5
5
5
5

(P x S x F)
50
( Tanpa Kontrol )
No
terjadinya pasti turun drastis karena
50
ada banyak kontrol.
50
25
25
* Mungkin sedikit orang sekali dalam

setahun saja, karena faktor manusia.
Due to the fact that all our work and personnell transport depends on
vehicles, due to the human factor and due to the steep nature of the
area and the roads, this remains a high area of risk. Regular Safety
Talks and PTO's must be conducted on all drivers / operators to ensure
a high level of compliance at all times.
PERSON IN CHARGE
DATE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN
Targeted
Completion Date.
Tanggal Tercapai
Tujuan

Completion Date.
Tanda-Tangan dan
Tanggal Selesai.

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
All Front Line Supervisors, Daily / Ongoing

Dept Heads & Safety
Officers.
SIGNATURE
NUMBER / NOMOR
22

Risk
Various Task Risks (CTI / JSA / TSP / PTO)

Quality Control
23a Poor Quality Control (Road Design)
24
Working At High Altitudes

24a Medically Unfit Employees Sent to Site
24b Cold Weather / Lack of Oxygen Affects Employee Performance
24c Cold Weather / Lack of Oxygen Results in Illness
25
On- Site and Off-Site Travelling

25a
25b
25c
25d
25e
25f
25g
25h
26
Risk
Amount
Jumlah

22b Unsafe Conditions / Equipment - Incidents (Injury, Damage & Loss)
23
RISK
RISK
ASSESSMENT
ASSESSMENT
WITH NO
WITH
CONTROLS IN
CONTROLS IN
RISK
RISK REDUCTION
PENILAIAN
PLACE
PLACE
REDUCTION
REMARKS
PENILAIAN
RESIKO UNTUK
RESIKO UNTUK
SITUASI
SITUASI TANPA
DENGAN
PENURUNAN
PENURUNAN
KONTROL
KONTROL
RESIKO
KOMENTAR RESIKO
Unsafe On-Site Vehicles (Injury, Damage & Loss)

Travelling In Tram (Injury)
Travelling On-Site In Bus (Injury)
Travelling On-Site Via Underground Access (Injury, Damage & Loss)
Travelling On-Site Via HEAT Road (Injury, Damage & Loss)
Travelling Off-Site In Bus (Injury) (To Timika)
Travelling By Airfast / Garuda / Merpati (Injury)
Travelling Off-Site By Bus / Taxi (Injury)
Management and Control of Other Hazards

Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
5
5
5
5 5
5 5
5 5
125
125
125
2
2
2
5 5
5 5
5 3
50
50
30
75
75
95
No
5
5
5 5
5 5
125
125
2
2
5 3
5 3
30
30
95
95
Yes
5
5
5
5
4
4
4
3
5
5
5
5
100
100
100
75
2
1
2
3
4
4
4
3
3
5
3
2
24
20
24
18
76
80
76
57
Yes
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
125
125
125
125
125
125
125
125
125
3
2
2
3
4
3
3
3
4
5
5
5
5
5
5
5
5
5
5
3
5
5
3
3
3
3
3
75
30
50
75
60
45
45
45
60
50
95
75
50
65
80
80
80
65
No
5
5
5
4 5
4 5
4 5
100
100
100
2
2
2
4 3
4 3
4 3
24
24
24
76
76
76
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
Yes
Yes
NUMBER / NOMOR
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
TIME OF DAY
OTHER INFLUENCES
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG TEPAT
WAKTU
PENGARUH LAIN
KONTROL YANG ADA


Provide a detailed
description of the
of the day or on which Activities or Physical Conditions Regulations, Standards, Procedures, Rules
Exact Position
shift the Hazard
(Location) of the
exists. Tentukan waktu
Hazard. Menyiapkan atau shift Bahaya yang Bagaimana Jika?:- Bagaimana jika
Peraturan & SOP.
Kegiatan / Kondisi
ada.
Tempat kejadian
Bahaya.
All Areas
22 Various Task Risks
(CTI / JSA / TSP / PTO)
Semua Shift Kerja

Kontrol Karyawan :-
# Safety Induction
# Specialised Training / Coaching
#
#
#
#

# Safety Talk
# Perawatan Harian
Kontrol General :# PSMS Element 4

# Critical Task Inventory (CTI)
# Job Safety Analysis Process (JSA)
# Task Spesific Procedures (TSP's)
# Planned Task Observation System (PTO's)
# Operator / Driver Training
# Management & Supervisory Training

RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient Reduction
? Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
125
50
75
No
5
5
5
5
5
5
125
125
2
2
5
5
5
3
50
30
75
95
No
Yes
Safety Induction
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL

P
2
2


50
( Tanpa Kontrol )
( Tanpa Kontrol )
cedera multiple fatal
( Tanpa Kontrol )
( Dengan Kontrol )
( Dengan Kontrol )
cedera multiple fatal
( Dengan Kontrol )
5
5
5
3
(P x S x F)
50
30

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Date. Tanggal
Tercapai Tujuan
Due to the human factor and due to the All Department Heads, All Daily / Ongoing
nature of the work being done, specific Front Line Supervisors &
task risks will allways remain a high
All Employees
priority item. All Front Line Supervisors
and safety officers must conduct daily
PTO's and must utilise the Green Crad
system to report all unsafe acts and / or
conditions that they have observed.
Daily follow-up is essential to ensure
that remedial actions are implemented
as soon as possible.
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
TIME OF DAY
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG TEPAT
WAKTU

Provide a detailed
description of the
of the day or on which
Exact Position
shift the Hazard
(Location) of the
Hazard. Menyiapkan atau shift Bahaya yang
Kegiatan / Kondisi
ada.
Tempat kejadian
Bahaya.
23 Quality Control
Grasberg Surface Mine Semua Shift Kerja

(Pit Roads)
23a Poor Quality Control (Road Design)
OTHER INFLUENCES
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
PENGARUH LAIN
KONTROL YANG ADA


Activities or Physical Conditions Regulations, Standards, Procedures, Rules
Peraturan & SOP.
Kontrol Karyawan :-
# Safety Induction
# Specialised Training / Coaching
#
#
#
#
#

# Safety Talk
# Perawatan Harian
Safety Induction
Training QMS (ISO 9001/2000)
Kontrol General :# PSMS & QMS

# Engineering Design Control
# Daily Inspections to ensure compliance to
design specifications
# Follow-up on road condition report
# Pama has ISO 9001/2000 accreditation
SSESSMENT FOR
ATION WITH NO
TROLS IN PLACE
AN RESIKO UNTUK
I TANPA KONTROL
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
? Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
125
30
95
Yes
125
30
95
Yes
RATING

PROBABILITAS

KEPARAHAN


( Tanpa Kontrol )
( Tanpa Kontrol )
Fatal insiden.
( Dengan Kontrol )
( Dengan Kontrol )
Fatal insiden.
5
RATING
RISK
RATING

FREKUENSI
RESIKO
RATIO

(P x S x F)
30
( Tanpa Kontrol )
( Dengan Kontrol )
dalam tingkat keseringan cedera.
30

mengurangi Resiko pada tingkat yang
dapat diterima.
PERSON IN CHARGE
DATE
SIGNATURE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai Tujuan
Tanggal Selesai.
NUMBER / NOMOR
24
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
TIME OF DAY
DAFTAR PROSES DAN

BAHAYA SAAT OPERASI
TEMPAT YANG TEPAT
WAKTU

Provide a detailed
description of the
of the day or on which
Exact Position
shift the Hazard
(Location) of the
Hazard. Menyiapkan atau shift Bahaya yang
Kegiatan / Kondisi
ada.
Tempat kejadian
Bahaya.
Working At High
Altitudes
Grasberg Surface Mine Semua Shift Kerja
24a Medically Unfit Employees Sent to Site

24b Cold Weather / Lack of Oxygen Affects Employee Performance
24c Cold Weather / Lack of Oxygen Results in Illness
OTHER INFLUENCES
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
PENGARUH LAIN
KONTROL YANG ADA


Peraturan & SOP.

# Safety Talk
# Perawatan Harian

# Pre-employment Medical Exams
# Annual Medical Exams
# Special Warm Clothing Issued
# All vehicles / equipment fitted with heaters
# All employees issued with Thermos
# Vitamin C supplement provided to all

Kontrol General :# PSMS Element 9

# PSMS Element 12
5
5
5
4
4
3
5
5
5
SSESSMENT FOR
ATION WITH NO
TROLS IN PLACE
AN RESIKO UNTUK
I TANPA KONTROL
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
? Yes or No Plus
additional Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
100
24
76
Yes
100
100
75
1
2
3
4
4
3
5
3
2
20
24
18
80
76
57
Yes
Yes
Yes
1
2
3
RATING

PROBABILITAS

KEPARAHAN


( Tanpa Kontrol )
( Tanpa Kontrol )
atau insiden cedera fatal
( Dengan Kontrol )
signifikan.
( Dengan Kontrol )
atau insiden cedera fatal
4
4
3
5
3
2
RATING
RISK
RATING

FREKUENSI
RESIKO
RATIO

(P x S x F)
24
( Tanpa Kontrol )
( Dengan Kontrol )
Dengan kontrol yang ada, ada
Penurunan sangat signifikan dalam
frekuensi terjadinya insiden seperti ini
20
24
18

mengurangi Resiko pada tingkat yang
dapat diterima.
PERSON IN CHARGE
DATE
SIGNATURE
OLEH TANGGUNG
JAWAB
TANGGAL
TANDA-TANGAN

responsible for
Control Measures.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Targeted
Completion
Completion Date.
Date. Tanggal
Tanda-Tangan dan
Tercapai Tujuan
Tanggal Selesai.
NUMBER / NOMOR

OPERATIONAL HAZARDS
DAFTAR PROSES DAN
BAHAYA SAAT OPERASI
EXACT LOCATION
TIME OF DAY
TEMPAT YANG TEPAT
WAKTU

Provide a detailed
Detail:- Item / Substance / description of the Exact the day or on which shift
Position (Location) of the
the Hazard exists.
Hazard. Menyiapkan
Bahaya yang ada.
Kegiatan / Kondisi
Tempat kejadian Bahaya.
25 On-Site & Off-Site

Travelling
All Areas
All Shifts
Off Site
When Going On Leave
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Peraturan & SOP.
25a Unsafe On-Site Vehicles (Injury, Damage & Loss)
Jika ada aktifitas baru :-
25b Travelling In Tram (Injury)
# HIRA Assesment & Approval
25c Travelling On-Site In Bus (Injury)
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
125
75
50
No
125
30
95
Yes
Kontrol Operator / Driver :-
125
50
75
No
# Pelatihan Operator / Driver
125
75
50
No
Kontrol Peralatan / Kendaraan / Bus :# Program Pemeriksaan Mesin (PPM)

25d Travelling On-Site Via Underground Access Tunnel (Injury, Damage & Loss)
# Safety Induction / Orientation
125
60
65
No
25e Travelling On-Site Via HEAT Road (Injury, Damage & Loss)
# KIMPER Khusus
125
45
80
No
25f Travelling Off-Site In Bus (Injury) (To Timika)
# Safety Talk
# Izin Keluar
125
45
80
No
25g Travelling By Airfast / Garuda / Merpati (Injury)
# Perawatan Harian
125
45
80
No
125
60
65
No
25h Travelling Off-Site By Bus / Taxi (Injury)
Kontrol Karyawan :-

# Safety Induction
# Coaching regarding public transport
RATING
RATING
RISK
RATING
PERSON IN CHARGE
DATE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB
TANGGAL


5
( Tanpa Kontrol )
5
atau harta benda berkurang cukup signi-
fikan.

5
( Tanpa Kontrol )
cedera Fatal multiple.
( Dengan Kontrol )
75
( Tanpa Kontrol )
30
( Dengan Kontrol )
cedera Fatal multiple.
(P x S x F)
Targeted
an Acceptable level. Buat daftar Kontrol yang lain yang diperlukan responsible for compiling
Completion
Additional Control
Date. Tanggal
Measures. Nama yang
Tercapai Tujuan
bertanggung jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
Due to the number of passengers in a confined area with no proper

Tram Operator & All
seating and jerking of conveyance (power failures / etc), the risk of injury Employees
remains high. The Tram Operator and all employees to take special care
on a daily basis.
Daily / Ongoing
Due to the number of passengers in buses, the steep nature of the roads PTFI Bus Supervisors, All
and the prevailing weather conditions, the risk of incidents and resulting Bus Drivers & All
injuries remains high. All drivers and employees to take extra care on a Employees.
daily basis. Bus supervisors must ensure that all buses are in a 100%
condition and must do random daily PTO's on all bus drivers.
Daily / Ongoing
Due to the unsafe conditions in the two underground access tunnels

(inadequate traffic light controls / lack of disciplne to activate lights /
many lights out of order / road conditions poor), the risk of incidents
resulting in injury, damage and loss remains high. Minimise travel via
access tunnels and all drivers to take extra care on an ongoing basis. If
possible the conditions in these tunnels should be improved by PTFI.
PTFI U/G Section

Supervisors, All Drivers
with authority to use this
area.
Daily / Ongoing
Dept Heads & All Drivers

with authority to use this
area.
Daily / Ongoing
45
Due to the steep and winding nature of the road and the prevailing
weather conditions, the risk of incidents and resulting injuries, damage
and loss remains high. All drivers who have authority to use this road to
take extra care on a daily basis. Minimise travel via the HEAT road to
reduce risk.
PTFI Bus Supervisors, All

Bus Drivers & All
Employees.
Daily / Ongoing
45
Due to the number of passengers in buses, the steep nature of the road
to Timika and the prevailing weather conditions, the risk of incidents and
resulting injuries remains high. All drivers and employees to take extra
care on an ongoing basis. Bus supervisors must ensure that all buses
are in a 100% condition and must do random daily PTO's on all bus
drivers.
Daily / Ongoing
45
Due to the fact that these airlines are outside our area of control and
PTFI Airfast Co-ordinator
because we are not able to control the level of pilot training and aircraft
maintenance, this remains a high area of risk. Not much can however be
done to reduce this further at this time. PTFI should try to obtain
information from Airfast regarding these issues.
Ongoing
60
Due to the fact that these vehicles are outside our area of control and
because we are not able to control the level of driver skill or training and
vehicle maintenance / condition, this remains a high area of risk. Not
much can however be done to reduce this further at this time. All
employees must take care when going on leave and must try to use the
safest possible modes of transport.
50
( Dengan Kontrol )
Dengan kontrol ada penurunan
cukup signifikan dalam tingkat
keseringan terjadinya insiden.
75
60
All Employees
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.
NUMBER / NOMOR
LIST OF PROCESSES
AND OPERATIONAL
HAZARDS
EXACT LOCATION
DAFTAR PROSES DAN

BAHAYA SAAT
OPERASI
TEMPAT YANG TEPAT
TIME OF DAY
WAKTU
OTHER INFLUENCES
PENGARUH LAIN
EXISTING CONTROLS
RISK ASSESSMENT FOR

SITUATION WITH NO
CONTROLS IN PLACE
KONTROL YANG ADA


Provide a detailed
Detail:- Item /
description of the
of the day or on which Activities or Physical Conditions Regulations, Standards, Procedures, Rules
Exact Position
shift the Hazard
Condition Deskripsi
(Location) of the
Bahaya Dengan Rinci:- Hazard. Menyiapkan atau shift Bahaya yang Bagaimana Jika?:- Bagaimana jika
Peraturan & SOP.
Benda / Bahan /
ada.
Kegiatan / Kondisi
Tempat kejadian
Bahaya.
26 Management
Control Of 'Other'
Hazards
All Areas
Semua Shift Kerja

# Safety Talk
# Perawatan Harian


Kontrol Semua Peralatan / Kendaraan :# Program Pemeriksaan Mesin (PPM)

Kontrol Karyawan :# Pelatihan Karyawan
# Safety Induction
# Safety Talk
# Planned Inspection (weekly & monthly)
# Bi-annual PSMS audits
# Annual External audits
# Pama Green Card System (report
incidents)
# Pama Suggestion System
Kontrol General :# Pama 'PSMS' System (All 15 Elements)
# PTFI Safety Management System
RISK ASSESSMENT FOR

SITUATION WITH
CONTROLS IN PLACE
RISK
REDUCTION

SITUASI DENGAN
PENURUNAN
KONTROL
RESIKO
RISK REDUCTION
REMARKS
PENURUNAN
KOMENTAR
RESIKO
Sufficient
Reduction ? Yes or
No Plus additional
Remarks.
Penurunan Cukup ?
Ya atau Tidak Plus
Komentar Lain.
Risk
Resiko
Risk
Resiko
Amount
Jumlah
100
24
76
Yes
5
5
4
4
5
5
100
100
2
2
4
4
3
3
24
24
76
76
Yes
Yes
RATING
RATING
RISK
RATING
PERSON IN CHARGE

PROBABILITAS

KEPARAHAN

FREKUENSI
RESIKO
RATIO
OLEH TANGGUNG
JAWAB

2
2


24
( Tanpa Kontrol )
( Tanpa Kontrol )
atau insiden cedera Fatal
( Tanpa Kontrol )
( Dengan Kontrol )
signifikan.
( Dengan Kontrol )
Denagn kontrol tingkat keparahan tetap
atau insiden cedera Fatal
( Dengan Kontrol )
Dengan kontrol yang ada, ada
Penurunan sangat signifikan dalam
frekuensi terjadinya insiden seperti ini
4
4
3
3
(P x S x F)
24
24

responsible for
Control Measures.
dapat diterima.
jawab untuk
mengumpulkan Ukuran
Kontrol Yang Lain.
DATE
TANGGAL
Targeted
Completion
Date. Tanggal
Tercapai
Tujuan
SIGNATURE
TANDA-TANGAN
Completion Date.
Tanda-Tangan dan
Tanggal Selesai.

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PT Pamapersada Nusantara

FREEPORT ROAD CONTRACT

LIST OF PROCESSES AND OPERATIONAL HAZARDS

DAFTAR PROSES DAN BAHAYA SAAT OPERASI

TEMPAT YANG TEPAT

Describe the Hazard in Detail:- Item / Substance / Activity / Condition

FREEPORT ROAD CONTRACT

LIST OF PROCESSES AND OPERATIONAL HAZARDS

DAFTAR PROSES DAN BAHAYA SAAT OPERASI

Describe the Hazard in Detail:- Item / Substance / Activity / Condition

Operations, Surveying & Pedestrians

FREEPORT ROAD CONTRACT

LIST OF PROCESSES AND OPERATIONAL HAZARDS

DAFTAR PROSES DAN BAHAYA SAAT OPERASI

Planning, Mobilisation & Site Establishment

1d Transport from port to site

Operations, Surveying & Pedestrians

Initial Site clearance (* rock / material felling)

22a Unsafe Acts (Injury, illness, Damage & Loss)

All Untolerable Hazards / Risks (>32)

RISK REDUCTION REMARKS

Sufficient Reduction ? Yes

LIST OF PROCESSES AND OPERATIONAL HAZARDS

DAFTAR PROSES DAN BAHAYA SAAT OPERASI

Describe the Hazard in Detail:- Item / Substance / Activity / Condition

Planning, Mobilisation & Site Establishment

Operations, Surveying & Pedestians

Mine Planning / Survey

Loading (Shovels / Excavators & Wheel Loaders)

Operating Shovels / Excavators / Wheel Loaders

Crushing, Hauling, Tipping & Dumping

Operating Dump Truck / Haul Truck

4i Maintenance / Servicing of the Mobile Crusher

Road Maintenance & Road Contruction

Operating Bulldozer / Grader / Excavator / Wheel Loader

DAFTAR PROSES DAN

RISK ASSESSMENT FOR

KONTROL YANG ADA

PENILAIAN RESIKO UNTUK

Describe the Hazard in

Semua Shift Kerja

Jika ada orang (karyawan) baru :-

RISK ASSESSMENT FOR

PENILAIAN RESIKO UNTUK

Kontrol Karyawan & Peralatan:# Follow PTFI Systems for permission to

Jika kondisi fisik berubah :# Prosedur Bekerja yang Aman

Planning / Design / Layouts.

Jika ada peralatan / unit baru :# Pemeriksaan kelayakan unit

Safety Talk Harian & Mingguan

Kontrol Perencanaan Tambang / Mine

VERIFICATION OF SEVERITY RATING

ADDITIONAL CONTROLS REQUIRED

VERIFIKASI UNTUK RATING

VERIFIKASI UNTUK RATING

VERIFIKASI UNTUK RATING

KONTROL YANG LAIN YANG PERLU

OLEH TANGGUNG JAWAB

Justify the Severity Rating by using

Justify the Frequency Rating by using

List any Additional Controls that are

Name of person who is

Justify the Probability Rating by using

PTFI & Pama Log Dep Head