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IPMOMI , PLTU PAITON 7 & 8

HAZARD RISK ASSESMENT FOR ACCESS TO PLANT

FOR:
28/02/2012

WorkToBeDone:

Equipment (to be accessed): 8CW-CRN-100


GANTRY CRANE UNIT 8

CHECKANDDISMANTLETRAVELLINGBEARING

ShutdownInservice
Confined Space Access?

Yes No

( refer to Paiton Instruction PP-05-03 and PI-05-02-01)

Work Order No: 1202281025

Permit No:

AssessorName:

WorkPeriod:8Hours

1.BAGUS

3.

Date&TimeStart

:28/02/201208:00

2.ShiftSPV

4.

Date&TimeFinish

:28/03/201316:00

Rangeofmethodsbywhichworkcouldbedone:
Method1

SHUTDOWNGANTRYCRANE,DISMANTLINGTRAVELLINGBEARING.

SelectedMethod

Detailanyworktobeperformedoutsidetheworkarea/spacethatmaycreateariskto
personnelwhilsttheyarewithintheworkarea/spacee.g.vehicle/stationaryenginefumes,
maintenanceactivities.N/A
Emergency procedures:
Station Emergency Procedures
Special Procedures as attached

HAZARDS IDENTIFIED

Tick appropriate Selections


HAZARDS

RISK

Hazardous Substances
Chemical Contaminant
Chlorine
Ammonia
Ozone
Carbon Monoxide
Carbon dioxide
Hydrogen Sulfide
Dust
Sulfur dioxide

YES

NO

Unsafe Oxygen Levels


Oxygen Deficiency
Fumes/Vapors

YES

NO

PI-05-03-01-F01

HAZARDS

Flammable Contaminants
Coal
Hydrogen gas
Fuel Oil
Lube Oil

Plant Process Hazards


Hot Water
Steam
Pressurized Air
Electrical Shock
Pressurized Water

RISK
YES

NO

YES

NO

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IPMOMI , PLTU PAITON 7 & 8


HAZARD RISK ASSESMENT FOR ACCESS TO PLANT

FOR:
28/02/2012

HAZARDS IDENTIFIED

Tick appropriate Selections


HAZARDS

RISK

HAZARDS

YES

NO

Fire Class
Class A: common combustible ( wood, paper, etc )
Class B: Flame able liquid and gas (gasoline,

Class C: Live Electrical Equipment (computer, Fax

Class D: Combustible metals (Magnesium, Lithium,

Ignition Sources

Class K :Cooking Media (Cooking oils and Fats)

Electrical applies for lighting & power

Work Environment
Lighting
Heat
Humidity
Cold
Slippery Surfaces
Traffic (Pedestrian)
Height/Falls

Work Process Hazards


Welding
Cutting
Grinding
Falling Material

Other
Manual Handling
Environmental Impact
Entrapment

YES

NO

propane & solvent )


Machine etc)
Titanium)

RISK
YES

NO

YES

NO

CONTROL MEASURES

Tick appropriate Selections


No Isolation Needed
Gas Tests required
Personal Gas monitor
Signs Erected
Barricades Erected
Empty vessel/draining
Clean/purge/flushing
Force Logic required
Fire Extinguisher prepared
Remove flammable materials
Communication: Radio channel 3 / 08121746209
Standby/watch person _____________________
Forced venting

Safety Helmet
Safety Shoes
Eye Protection
Hearing Protection (ear muff/ear plug)
Welding Mask
Leather apron/gauntlet
Leather gloves
Dust Mask
Rubber Gloves
Rubber apron
Safety boot for chemical
Safety Goggles
Safety harness
Self Contain Breathing Apparatus (SCBA)

Additional Control Measures (Please Specify)


VARIABLE ISOLATION CLOSE BREAKER
CHECK THE TOOLS TO MAKE SURE IT IN GOOD CONDITION
USE STANDART PPE

PI-05-03-01-F01

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IPMOMI , PLTU PAITON 7 & 8


HAZARD RISK ASSESMENT FOR ACCESS TO PLANT

FOR:
28/02/2012

The following tests are required to assess the atmospheric conditions within the nominated
space:
Test For

Relative Vapor
density to air

Station Standard

Test Required
(thick selection)
Yes

No

Ammonia

Less than 5 ppm

Carbon Dioxide

Less than 5000 ppm (0.5 %)

Carbon Monoxide

Less than 25 ppm

Chlorine

Less than 0.25 ppm

Hydrogen Sulfide

Less than 2 ppm

LEL

Lessthan5%

Oxygen

Greater than 19.5%

Lessthan23.5%
Ozone

Less than 0.1 ppm

Sulfur dioxide

Less than 2 ppm

NOTE: For clarification on the test required to be carried out refer PI-05-03-02 (Testing Of
Confined Spaces)

Signature:

( BAGUS WS )
PI-05-03-01-F01

) (

) (
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IPMOMI , PLTU PAITON 7 & 8


HAZARD RISK ASSESMENT FOR ACCESS TO PLANT

FOR:
28/02/2012

Applicant
Date

PI-05-03-01-F01

Shift Supervisor
: 28/02/2012

Time

: 09:00

Uncontrolled Copy if printed or copied

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