PT.

Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Working on Brake System

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Parking of equipment Operator, Interaction with people Fatality, Permanent 2 4 8 ADM 1. Use spotter as guide into parking 1 4 4
Mechanic, and equipment disability, Long term area
Supervisor. absence due to treatment ADM TAKE-5

EL/SUB 2. Park equipment on level area

EL/SUB 3. Ensure sufficient space aroud

equipment

EL/SUB 4. Place stop blocks behind wheels

EL/SUB 5. Select park brakes and neutral

gear

Lock Out and Tag Out Mechanic, Unauthorized start Fatality, Permanent 2 4 8 ADM 1. Multiple lock out and tag 1 4 4
Supervisor. Running / Engine disability, Long term ADM Strive for LIFE walk
moving Equipment absence due to treatment
ENG/SEG 2. Isolate all energy (electrical and
hydraulic)

Lift equipment with jack Mechanic, Slip off jack Permanent disability, Long 2 2 4 ADM 1. Use correct jack SWL 1 2 2
Supervisor. Unstable floor term absence due to ADM Monthly inspections/register
treatment
EL/SUB 2. Lift at correct position
ADM SWL certificates

ADM 3. Inspect jack prior to use

Uncontrolled Document When Printed 1 of 12 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Working on Brake System

Approved By :
4 2
(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

EL/SUB 4. Ask for assistance to move jack

into position

Support Equipment Mechanic, Nip points Permanent disability, Long 2 3 6 1. Use correct support stands SWL 1 3 3 Monthly inspections/register
Supervisor. Pinned Between term absence due to ADM
treatment
EL/SUB 2. Place support stand in correct SWL certificates
position

EL/SUB 3. Ensure stand is upright and floor

is stable and level

ADM 4. Inspect support stands prior to

use

5. Lower equipment slow onto

support stand and ensure
equipment is stable and secure
Removing wheels on equipment Mechanic, Pinned between Permanent disability, Long 3 3 9 EL/SUB 1. Stand at safe place when 1 3 3
Supervisor. Moving tyre handler term absence due to manouevring with tyre handler
Falling onto treatment
ENG/SEG 2. Use hooter to warn

ENG/SEG 3. Secure tyre in tyre handler

"claws"

EL/SUB 4. Do not throw tyre down

Uncontrolled Document When Printed 2 of 12 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members : 9 3

Working on Brake System

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

ENG/SEG 5. Use correct tools to undo bolts

and nuts

Uncontrolled Document When Printed 3 of 12 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Working on Brake System

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Working on brake system Mechanic, Nip points Permanent disability, Long 1 2 2 ENG/SEG 1. Use drip tray to contain spills 1 2 2
Supervisor. Hazard substance spill term absence due to
treatment
EL/SUB 2. Keep hand out of line of fire

PPE 3. Use PPE (Gloves)

BHV 4. Good clear communication

between workers

BHV 5. Use safety specs at all times

ADM 6. Set brake to OEM standards

ADM 7. Test brake to OEM standards

Places wheels back into position Mechanic, Pinned between Fatality, Permanent 2 3 6 BHV 1. Stand at safe position when tyre 1 3 3
Supervisor Moving equipment disability, Long term handler manouevring
absence due to treatment
ENG/SEG 2. Use hooter to warn

BHV 3. Good communication between

workers

Uncontrolled Document When Printed 4 of 12 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Working on Brake System

Approved By :
6 3
(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

ADM 4. Secure all nuts and torque as per

OEM

Lift equipment with jack Mechanic, Jack slip off Permanent disability, Long 2 3 6 EL/SUB 1. Lift at correct position 1 3 3
Supervisor term absence due to
treatment
ADM 2. Inspect jack before use

ADM 3. Ask for assistant to posision jack

Removal off support stands Mechanic, Nip points Permanent disability, Long 2 2 4 BHV 1. Ask for assistant to remove 1 2 2
Supervisor Cought between term absence due to support
treatment
EL/SUB 2. Keep hands and feet away from
nip points

ENG/SEG 3. Use handler to handle stands

Start of equipment Mechanic, Moving parts Fatality, Permanent 4 4 16 EL/SUB 1. Clear area around equipment, all 2 4 8
Supervisor Runnnig engine disability, Long term workers safe distance away
absence due to treatment
EL/SUB 2. All parts and tools removed

EL/SUB 3. All guard in place

Uncontrolled Document When Printed 5 of 12 LCI-HSE-FM-001A(02)

Feb 2010
PT. Leighton Contractors Indonesia

RISK ASSESSMENT REPORT

Risk Assessment Team

Business Unit / Project : BU3/ID205/Wahana Coal Mine Project
Names Dept - Position Sign Off
Date : 3-Aug-12

Team Leader : Richard Douglas HSE General Supt Team Members :

Reference Number :
Facilitator : :

Process/Activity : Team Members :

Working on Brake System

Approved By :

(PM/Delegated)
Note: Attach meeting attandance if more.

Hirarchy Control

Hirarchy Control
Risk Identified
People /
Process / Activity / Task Environment at Hazard / Cause of Incident / Adverse L1 C1 RFN ** Current Mitigating Controls L2 C2 RRN * Additional Controls Requ
Risk Adverse Effect / Effect / Environmental
Environmental Aspect Impact

Test of brake in workshop Mechanic, Moving equipment Fatality, Permanent 4 4 16 EL/SUB 1. Select 1st gear and test brakes 2 4 8
Supervisor Run away equipment disability, Long term
absence due to treatment
ADM 2. Select reversed and test brakes

ENG/SEG 3. If brake test correct - remove stop

blocks and clear area for equipment
to move out of the workshop.

Test brakes while driving Mechanic, Interact with equipment or Fatality, Permanent 2 4 8 EL/SUB 1. Select 1st gear 1 4 4
Supervisor people disability, Long term
absence due to treatment
ADM 2. Drive slow and test brake system
avoid traffic

ADM 3. Test brake as per OEM

Uncontrolled Document When Printed 6 of 12 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

ID205-HSE-PI-1033(02) - Isolation and Tagging

Procedure

Support equipment procedure

Removing wheel procedure

Working on brake system

SIMPER & JSEA

register

Uncontrolled Document When Printed 7 of 12 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

register

Uncontrolled Document When Printed 8 of 12 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 9 of 12 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 10 of 12 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 11 of 12 LCI-HSE-FM-001A(02)

Feb 2010
am

Names Dept. - Position Sign Off

ols Required By whom By When Status Legal and Other Requirements Reference

Uncontrolled Document When Printed 12 of 12 LCI-HSE-FM-001A(02)

Feb 2010