The Activity Based Risk Assessment Form is a mandatory safety management tool required under Indonesian workplace safety regulations, specifically aligned with Government Regulation No. 50 of 2012 and Minister of Manpower regulations. This document must be completed before undertaking any significant workplace activity that may pose risks to workers, property, or the environment. It serves as both a preventive tool and legal documentation, requiring detailed analysis of potential hazards, risk levels, and control measures. The form is particularly crucial in high-risk industries and must be regularly updated to reflect changing conditions or when new hazards are identified. It forms part of an organization's broader safety management system and may be subject to review during regulatory inspections.
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1. Document Control Information: Form tracking details including document number, revision date, and approval status
2. Activity Details: Specific information about the activity being assessed, including location, date, and brief description
3. Assessment Team: Names and roles of personnel conducting the risk assessment
4. Activity Breakdown: Step-by-step breakdown of the activity into discrete tasks or components
5. Hazard Identification: Identification of potential hazards associated with each step of the activity
6. Risk Analysis: Assessment of initial risk levels using likelihood and consequence matrices
7. Control Measures: Existing and proposed control measures to mitigate identified risks
8. Residual Risk Assessment: Evaluation of remaining risk levels after implementation of control measures
9. Action Plan: Specific actions required, responsible persons, and timeframes for implementation
10. Authorization: Sign-off section for relevant authorities and stakeholders
1. Emergency Response Procedures: Special emergency procedures specific to the activity, used when high-risk activities are being assessed
2. Environmental Impact Assessment: Assessment of environmental risks and controls, included when activity has potential environmental impacts
3. Equipment Requirements: Detailed list of required equipment and safety gear, used for complex technical activities
4. Training Requirements: Specific training or certification requirements, included when specialized skills are needed
5. Permit Requirements: Details of required permits or certifications, used for regulated activities
6. Stakeholder Consultation: Documentation of consultation with affected parties, included when activity impacts multiple departments or external parties
1. Risk Matrix: Standard risk assessment matrix used for risk evaluation
2. Hazard Checklist: Standard checklist of common hazards by category
3. Control Measure Hierarchy: Reference guide for hierarchy of control measures
4. PPE Requirements Chart: Matrix of required personal protective equipment for different activities
5. Incident Response Flowchart: Standard procedures for responding to incidents
6. Reference Standards: List of applicable Indonesian safety standards and regulations
7. Previous Risk Assessments: Historical risk assessments for similar activities for reference
Authors
Relevant legal definitions
Clauses
Relevant Industries
Manufacturing
Construction
Mining
Oil and Gas
Transportation
Logistics
Chemical Processing
Agriculture
Forestry
Maritime
Healthcare
Energy
Infrastructure Development
Food Processing
Telecommunications
Relevant Teams
Health Safety Environment
Operations
Production
Maintenance
Quality Assurance
Project Management
Risk Management
Compliance
Facility Management
Engineering
Site Operations
Emergency Response
Environmental Management
Relevant Roles
Health and Safety Manager
Risk Assessment Specialist
Operations Manager
Project Manager
Site Supervisor
Safety Officer
Compliance Manager
Department Head
Production Supervisor
Maintenance Manager
Quality Control Manager
Environmental Officer
Facility Manager
Technical Supervisor
HSE Coordinator
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