DATE 4-Dec 5-Dec 6-Dec 7-Dec 8-Dec

Mon Tue Wed Thu Fri

Perform Ex Perform Ex Perform Ex Perform Ex Perform Ex

Visual/Close Visual/Close Visual/Close Visual/Close Visual/Close
Inspection Inspection Inspection Inspection Inspection

Manpower loading loading

SARO 2 2 2 2 2

ETS 2 2 2 2 2

1
Wcentre CONTROL KEY
INT
Job Steps Work Unit Man Hours
apply for permit MHR 2 0.5
activity briefing and tool box talk
drive to site
perform inspection (1/2hr / Equipment) 2 6
perform air flow measurement (1/2hr / Equipment)

Total
Manhours
1
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
 A B C D E
1
2 COMPLY (Y/N)
3 Step Activity (Belting replacement) Y N N/A
4 1 Apply EPTW complete with EIC
5 2 Drive and Park to Site
6 3 Perform Ex close Inspection
7 4
8 5
9 6
10 7
11 8
12 9
13 10
14 11
15 12
16 13
17 14
18 15
19 16
20 17
 F
1
2
REMARKS
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
 Nama Jabatan / Syarikat Tandatangan Tarikh

ANALISA KESELAMATAN KERJA Disediakan oleh:

(JSA) Work Leader (WL)
Disemak oleh:
Work Supervisor (PGB)
No. Peralatan:
Diluluskan oleh:
Keterangan Aktiviti: Approving Authority (AA)
Langkah Kawalan Sedia Ada Peralatan Perlindungan Diri Yg Dipraktikan
Visual, Closed Inspection of Ex Equipment and Installation PTW Coverall, Safety Shoes, Safety helmet,
Safety glass, Gogles.
Tindakan Oleh Catatan
No. Langkah Kerja Hazad Akibat Langkah Kawalan Work leader RA/RAR
AA/AAR
Yes No Sign Yes No Sign
1 Preparation for PTW 1 Miss communication 1 Failure will cause damage to 1 Applicant to brief the Authorizing,Approval Signatories on
equipment and can cause the job.
harm to personnel
2 Clearly identified equipment to be inspected by referring to
equipment layout drawing, Ex database and hazardous area
classification mapping document
2 Drive and Park Vehicle to Site 1 The position or movement of 1 Car collission or crash 1 Ensure valid driving license
other road users, such as
other vehicles.
2 Apply journey route and plan ahead and drive to area that
well verse of traffic

3 Ensure car have been inspected and fit to drive

2 Curves or bends in the road. 1 Car collission or crash 1 Ensure valid driving license
pedestrian crossings.

2 Apply journey route and plan ahead and drive to area that
well verse of traffic

3 Ensure car have been inspected and fit to drive

3 changes in weather and road 2 Car collission or crash 1 Ensure valid driving license
conditions.

2 Apply journey route and plan ahead and drive to area that
well verse of traffic

3 Ensure car have been inspected and fit to drive

 4 Park Vehicle on uneven, soft 1 Car rooling back or front 1 Choose a firm and flat ground area
ground

2 Apply the parking brake; leave transmission in PARK

2 Perform Visual & Close Inspetion
1 Wrong Posture 1 Minor health issue, slight
back and neck pain (no time
off work)
1 Clearly identified equipment to be inspected by referring to
equipment layout drawing, Ex database and hazardous area
classification mapping document
2 To positioned corrctly so that the top third of the equipment
is at eye level

3 Feet should be flat on the floor during inspection

4 Take regular breaks

2 Extreme Hot Weather 1 Minor health issue, Heat 2

exhaustion Schedule the activity by having inspection at early morning

Wear loosefitting, lightweight clothing.

Drink plenty of fluids.

Avoid hot spots.

Let your body acclimate to the heat.

3 Trip hazard 1 first aid treatment (minor cut 3

and grazes) Aware on the any surface transitions or uneven

4
Works during daytime and under sufficient lighting

Refer to Hazard Effect Register (HER) number:

HEMP-PLB- MTB POB ABB E I M R 0 0 6 4

Note: -
Area owner process : - POA/UOA/SMA/POB/UOB/SMB/ET/ET Senior Exec. RA - Receiving Authority AAR - Representative Approving Authority
Area owner non-process : - Custodion of Building e.g. PAGS for GAC, MSA, MSB, PMM for warehouse
Daily Validation Table:
Date Work Leader Name Initial RA/RAR Name Initial AA/AAR Name Initial

Doc. No.: - HSE-WI-09-002/A02 Issue No.: - 1 Revision No.: - 2 Date: - Page No.: -
Title: - ANALISA KESELAMATAN KERJA
Location of HP & LP Pump
 Material Description Material Spec
1 N/A
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Parts No. Material No.
 Descriptions Quantity Make Model NoSerial No. Calibration
Date
1 Ex Camera 1
2 Anemometer 1 proskit
3
4
5
6
7
Inspection Remarks
Date
1 Crane Spec requirement ton

2 Scaffolding requirement H L W Total (m)

3 Blinding requirement Blind specs Pcs

4 Other requirement Specification ENERGY ISOLATION

1. ELECTRICAL CERT
2. PIC

5 Insulation

6 Barge/Cargo Boat
 Service Company Name Person In Charge Identitification No
1
2
3
4
5
6
7
8
9
10
11
12
BOSOS/BOSIET Cert.BOSOS/BOSIETExpiry DMedical Expiry DateOGSP No. OGSP Expiry Date
Safety Induction DaWork Leader DateEmergency Contact NoPO number
013 211 9326
013 943 0670
Trainees name Skills requirement Training Requirement Training Providers