Tamplate Jsaa

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(Nama Perusahaan) (Nama Proyek)

ANALISIS KESELAMATAN KERJA Nama Para Pekerja : Perusahaan/Divisi:

Lokasi Kerja:

PPE yang disyaratkan atau disarankan : POTENSI BAHAYA/RISIKO

URUTAN LANGKAH KERJA

PIKIRKAN LEBIH DAHULU APAKAH POTENSI RISIKO KEMATIAN MUNCUL SETIAP URUTAN KERJA

1.1. 1

1.2. dst

Nama Perusahaan) (Nama Proyek)

Tanggal :

SUPERVISOR :

Dianalisis oleh:

Departemen :

Direvisi oleh :

Baru

Disetujui oleh:

ENSI BAHAYA/RISIKO

KONTROL RISIKO YANG DISARANKAN

H DAHULU APAKAH POTENSI PASTIKAN KONTROL RISIKO TINGGI/KEMATIAN AN MUNCUL SETIAP URUTAN TERIDENTIFIKASI KERJA 1.1.1.

1.1.2.

1.1.3. dst

1.2.1.

Revisi

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