AVN-MAR-PIP-RA-004 - R0 - Removal and Replacement of Hot Water Pipes

RISK ASSESSMENT FORM
Company / Department : PT Arina Veritas Nusantara Approved by : Romansyah

RA Leader : Mahmud Efendi (HSE Supervisor) Designation : Project Manager
Removal and Replacement of Portable
Process/ Location : Hot Water Pipes in Accommodation Signature :
Quarters RA Member 1 : Noldy Pijoh (HSE Officer)
RA Member 2 : Taufik Roman (Engineering
Original Assessment Date : 22/03/2019 Date : 25/03/2019
Manager)
Last Review Date : NA RA Member 3 : Ahmad Do Hamid (Supervisor)
Next Review Date : 22/03/2020 Doc No. : AVN-MAR-PIP-RA-004
1. Hazard Identification 2. Risk Evaluation 3. Risk Control
1a 1b 1c 1d 2a 2b 2c 2d 3a 3b
Action
Degree Of Risk
Officer,
Probability
Possible Accident / Designation,
Severity
No Work Scope / Work Ill Health & Due date
Hazard Persons-at-Risk / Implemented Risk Control Additional Risk Control
. Activity/ Sub Activity
HSE impact
1. Removal of ceiling panel - Falling object - Hit by object - Cordon off -

for access 2 2 4
- Working at - Body injury - Proper platform -

height 2 2 4
- Contact with - Skin irritation - Protective clothing -

insulation 2 2 4
2 Remove pipe insulation - Falling object - Hit by object - Cordon off -

2 2 4
- Working at - Body injury - Proper platform -

height 2 2 4

insulation 2 2 4
1
Manager)
1a 1b 1c 1d 2a 2b 2c 2d 3a 3b
Action
Degree Of Risk
Officer,
Probability
Severity
HSE impact
3 Dismantle bolt-nut & - Contact with - Burn - Shut off system - Close supervision
clamps Piping
hot water - Drain the system 3 1 3
Supervisor
- Strike by - Finger injury - Use proper tools -

hammer - Use chisel with cap
- Hand glove 3 3 9
- Adequate lighting
4 Shift out pipe - Caught in - Finger injury - Use hand gloves -

between - Use mechanical handling of pipes 2 2 4
5 Transfer pipes to - Forklift - Struck by moving - Qualified operator - Periodic safety induction by
workshop operation vehicle - Forklift checklist Supervisor
4 2 8 HSE Officer
- Observe speed limit
- Loose material - Object slip from - Secure object by web sling -

fork 2 2 4
2
Manager)
1a 1b 1c 1d 2a 2b 2c 2d 3a 3b
Action
Degree Of Risk
Officer,
Probability
Severity
HSE impact
6 Fabricated pipes in - Hot work - Fire - PTW systems -

workshop - Valid hot work tools 3 1 3
- Electrocution - Burn - Proper insulation of electrical -

tools
3 1 3
- Ensure body not wet
- Flying particles - Eye injury - Eye protection; proper eye -

protection 3 2 6
- Radiation - Arc eye - Eye protection; proper eye -

protection 2 2 4
- Strike by - Finger injury - Proper tools -

- Hand glove 3 2 6
7 Transport back the pipes - Forklift - Struck by moving - Qualified operator - Periodic safety induction by
to ship operation vehicle - Forklift checklist Supervisor
4 2 8 HSE Officer
- Observe speed limit
3
Manager)
1a 1b 1c 1d 2a 2b 2c 2d 3a 3b
Action
Degree Of Risk
Officer,
Probability
Severity
HSE impact
- Loose material - Object slip from - Secure object by web sling -

fork 2 2 4
8 Box up pipe - Contact with - Burn - Shut off system -

hot water - Drain the system 3 1 3
- Strike by - Finger injury - Use proper tools -

hammer - Use chisel with cap
- Hand glove 3 3 9
- Adequate lighting
9 System test - Slip and trip - Body injury - Cordon off -

- Housekeeping
2 1 2
- Warning sign
10 Box up insulation - Falling object - Hit by object - Cordon off -

2 2 4
4
Manager)
1a 1b 1c 1d 2a 2b 2c 2d 3a 3b
Action
Degree Of Risk
Officer,
Probability
Severity
HSE impact
- Falling from - Body injury - Proper platform -

height 2 2 4

insulation 2 2 4
5
Manager)
1a 1b 1c 1d 2a 2b 2c 2d 3a 3b
Action
Degree Of Risk
Officer,
Probability
Severity
HSE impact
RISK MATRIX
Probability (P) Severity (S) S S1 S2 S3 S4 S5 Risk level Risk Acceptability Recommended Action
1 =Rare 1 =Negligible 1. No additional risk control measures may be needed.
P Low Risk 2. Frequent review and monitoring of hazards are required to
2 =Unlikely 2 =Minor P5 Acceptable
(1 - 3) ensure that the risk level assigned is accurate and does not
5 10 15 20 25
increase over time.
3 = Possible 3 =Moderate 1. A careful evaluation of the hazards should be carried out to
P4
4 =Likely 4 =Major 4 8 12 16 20 ensure that the risk level is reduced to as low as reasonably
Medium practicable (ALARP) within a defined time period.
5 =Almost Certain 5 =Catastrophic P3 Risk Tolerable 2. Interim risk control measures, such as administrative controls or
3 6 9 12 15
(4 – 12) PPE, may be implemented while longer term measures are being
P2 established.
2 4 6 8 10 3. Management attention is required.
1. High Risk level must be reduced to at least Medium Risk before
P1 1 2 3 4 5 work commences.
2. There should not be any interim risk control measures. Risk
High Risk
Not control measures should not be overly dependent on PPE or
(15 – 25)
acceptable appliances.
3. If practicable, the hazard should be eliminated before work
commences.
4. Management review is required before work commences.

AVN-MAR-PIP-RA-004 - R0 - Removal and Replacement of Hot Water Pipes

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AVN-MAR-PIP-RA-004 - R0 - Removal and Replacement of Hot Water Pipes

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RISK ASSESSMENT FORM

Company / Department : PT Arina Veritas Nusantara Approved by : Romansyah

1. Hazard Identification 2. Risk Evaluation 3. Risk Control

1. Removal of ceiling panel - Falling object - Hit by object - Cordon off -

- Working at - Body injury - Proper platform -

- Contact with - Skin irritation - Protective clothing -

2 Remove pipe insulation - Falling object - Hit by object - Cordon off -

- Working at - Body injury - Proper platform -

- Contact with - Skin irritation - Protective clothing -

1. Hazard Identification 2. Risk Evaluation 3. Risk Control

- Strike by - Finger injury - Use proper tools -

4 Shift out pipe - Caught in - Finger injury - Use hand gloves -

- Loose material - Object slip from - Secure object by web sling -

1. Hazard Identification 2. Risk Evaluation 3. Risk Control

6 Fabricated pipes in - Hot work - Fire - PTW systems -

- Electrocution - Burn - Proper insulation of electrical -

- Flying particles - Eye injury - Eye protection; proper eye -

- Radiation - Arc eye - Eye protection; proper eye -

- Strike by - Finger injury - Proper tools -

1. Hazard Identification 2. Risk Evaluation 3. Risk Control

- Loose material - Object slip from - Secure object by web sling -

8 Box up pipe - Contact with - Burn - Shut off system -

- Strike by - Finger injury - Use proper tools -

9 System test - Slip and trip - Body injury - Cordon off -

10 Box up insulation - Falling object - Hit by object - Cordon off -

1. Hazard Identification 2. Risk Evaluation 3. Risk Control

- Falling from - Body injury - Proper platform -

- Contact with - Skin irritation - Protective clothing -

1. Hazard Identification 2. Risk Evaluation 3. Risk Control

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