CONTRACTOR Job No.

9851 Document Number

OWNER Project No.

REV.
2401

Method Statement for Field Test DATE: 03-Apr-2024 SHEET 1 OF 24

0

AGPA Refinery Complex PROJECT

Method Statement for Field Test

PT. AGPA Refinery Complex

BALIKPAPAN, EAST KALIMANTAN
INDONESIA

CONTRACTOR OWNER
REV. DATE PAGE DESCRIPTION
PREP’D CHK’D APP’D CHK’D APP’D

0 03-APR-24 ALL ISSUED FOR APPROVAL

RESTRICTED EPCC OF 1500 TPD PHYSICAL REFINERY & 1200 TPD DRY
FRACTIONATION PLANT

Review & Approval Notes

Approved by:

NAME JOB TITLE DATE SIGN

Method Statement for Field Test 2

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TABLE OF REVISION

REV. PAGE DESCRIPTION COMMENT REVISION/RESPONSE

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TABLE OF CONTENTS
1. INTRODUCTION ........................................................................................................... 5

2. GENERAL ..................................................................................................................... 5

2.1 Scope of Work ............................................................................................................... 5

2.2 Execution Plan ............................................................................................................... 6

2.2.1. Material and Field Equipment ........................................................................................ 6

2.2.2. Quality Control (QC)/Quality Assurance (QA) ................................................................ 6

2.2.3 Project Staffing .............................................................................................................. 7

2.2.4. Safety ............................................................................................................................ 8

2.2.5. Last Minute Risk Assessment (LMRA) ........................................................................... 9

2.2.6. Hazard Indentification for Total Safety (HITS) .............................................................. 12

3. GEOTECHNICAL DRILLING ....................................................................................... 13

3.1. Preparation .................................................................................................................. 13

3.2. Drilling.......................................................................................................................... 14

3.3. Standard Penetration Test (SPT) ................................................................................. 15

3.4 Undisturbed Sampling .................................................................................................. 15

3.5 Ground Water Level Observation ................................................................................. 16

3.6 Boring Log ................................................................................................................... 17

4. ENGINEERING ANALYSIS AND REPORTING ........................................................... 17

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1. INTRODUCTION
The primary objective of Geotechnical Investigation is to determine, within practicable
limits of time, but without sacrificing the main purpose, the stratigraphy and physical
properties of the soil under-laying the site, particularly the strength and deformation
characteristics of the soil strata, so that a desirable and satisfactory lay-out of the
proposed structure and economical foundation may be designed.

In addition, information regarding the technical properties of soil and ground water should
be determined to provide data for evaluating any possible hazardous corrosion that may
attack foundation piling. PT. SOILENS has many experiences in executing the
geotechnical investigation for Power Plant in Indonesia.

2. GENERAL

2.1 Scope of Work

2.1.1. General

The main scopes of work for geotechnical study are as follows:

▪ On land drilling include borehole quantity, depth borehole, and SPT interval
2.1.2. The work to be performed and setting up of field test locations by surveyor at
given coordinates. If find any obstacles, should be informed and discussed with
main contractor to move location or further instructions. Consists of furnishing all
labor, equipment & materials, licenses, and technical services; and any
supervision in performing any and all work required for:

(1) Drilling, sampling and testing of exploration

(2) Sealing, boxing, storing and transporting of samples
(3) Cleaning up site and demobilizing
(4) Positioning and leveling for drilling location
(5) Preparing complete soil boring logs and recording field operations on a daily
basis while the work is being performed
(6) Preparing and submitting to the Client a performed drilling plan, boring
locations, boring logs, and boring reports required by specifications
2.1.3. Sampling and testing in overburden include the following:

(1) Standard Penetration Test, with interval 1.5 m

(2) Undisturbed soil sampling, with thin-walled tube sampling at each different
layer for cohesive soil, or every interval 5.0m depth each borehole.
(3) Pocket Penetrometer (on clayey soil in test of disturbed and undisturbed
sample)
(4) Groundwater Observation during drilling
(5) Permeability Test

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2.2 Execution Plan

2.2.1. Material and Field Equipment

We will maintain our own equipment for soil investigation, laboratory testing
and office furnishing including materials, parts, tools, and supplies to meet the
requirements for the work. All equipment will be capable of securing satisfactory
samples of the required diameters at the required drilling depths.

All accessories for drilling, sampling, and testing such as casing, drill rods, drill
bits, piping, pumps, meters, gauges and other materials or supplies necessary
for the work, will be furnished.

The equipment will be in satisfactory operating condition and capable of

performing the work set forth herein safety, quality, and efficiency. The
equipment will be subjected to any possible inspection by the Client at all times
and, if deemed unsatisfactory, will be removed from the work site and replaced
by other satisfactory equipment.

If we are appointed to carry out this assignment, to meet the Contract schedule
we will mobilize the drilling rigs which consist of the rotary-type TOHO
Standard Drill, Sanchin Bean Royal and SC-45 speed pumping unit, and other
related accessories. This drilling equipment is capable of penetrating 80 meter
deep.

List of Equipment
No Item Quantity
1 Drilling Machine (500 kg) 1 set
2 Water Pump (50 kg and 75 kg) 2 set
3 Drilling Bit 5 set

List of Tools
No Item Quantity
1 Stang Rod 4 set
2 Cassing 2 set
3 Hammer 4
4 Wrench 6
5 Chainsaw 2
6 Screwdriver 2
7 Waterpass 1
8 Bentonite 3
9 Water tank 2

2.2.2. Quality Control (QC)/Quality Assurance (QA)

To meet expectations of the Client, a QC /QA procedure will be fully integrated
into our services. Our Safety & QC/QA Manager will set up appropriate QC/QA
Procedures and practices to facilitate quality control during performing the
services. The QC/QA will be equally applied to the services. To ensure this

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quality control, we have proposed that an integrated QC/QA program will be

implemented from the earliest possible stage of the project.

2.2.3 Project Staffing

For successfully executing the field and laboratory works, we will employ
qualified personnel. The formation of the personnel is arranged to achieve
maximum efficiency in executing the works.

The functions, tasks and responsibilities of each personnel are the following:

a. Field Team Leader (Field)

He is a Geotechnical Engineer who is familiar with geotechnical

investigation, surveying and laboratory works. The job descriptions are:

• To coordinate preliminary site survey, and approach local authority

including permit arrangement at the Client
• To coordinate the execution of all works in the field as well as in the
laboratory
• To check, examine and complete all draft records prepared by Drilling
Master and CPT operator
• To make continuous counseling and discussion required with the
engineer from the Client
• To prepare daily progress reports, and work programs
• To attend regular weekly meeting with the Client Representative

b. Drilling Master (Field)

Drilling Master should be experienced personnel in operating drilling rig

apparatus on various soil types. The job descriptions are:

• To perform borings, SPT testing, continuous coring, taking

undisturbed samples, performing field vane shear test, measuring
water level, preparing core-box, and others
• To assist the supervisors in furnishing draft records of drilling results
and another field testing

c. Laboratory Technician (Office)

Laboratory Technician should be experienced personnel who is familiar

with laboratory equipment. The job description should include, but not
limited to:

• Performing laboratory testing for disturbed and undisturbed samples

taken from boring and test pit
• Evaluating test results and then submitting them to the Chief
Laboratory person for data processing

d. Data Processing (Office)

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Data processing personnel should be experienced personnel and

computer literate who is familiar with any software used for processing
the laboratory data. The job description should include, but not limited to:

• Performing data processing for laboratory test data in accordance

with standard format for presenting laboratory test result

e. Geotechnical Engineer (Office)

Geotechnical Engineer should be a Civil Engineer with over 15 years of

experiences in analyzing geotechnical data, and familiar with using
geotechnical software and geotechnical report preparation and certified
as Professional Geotechnical Engineer (G-1) by Indonesian Society for
Geotechnical Engineers. The job description should include, but no
limited to:

• Checking and evaluating the field test results, and reviewing the
laboratory test results
• Preparing engineering analysis based on field and laboratory test
results
• Preparing recommendation of the foundation, slope stability,
excavation, site filling, dynamic soil properties, road construction and
others
• Preparing final report and others

f. Safety & QC/QA Manager (Office)

He will be responsible for initiating the safety program, ensuring that

project safety requirements and procedures are being accomplished.

He also prepares QC/QA procedures and ensures that all performed

works meet the standard procedures.

g. Safety Representative (Field)

He will be responsible for a continuing survey of the operations, ensuring
that any probable causes of injury or accident are controlled and that
operating equipment, tools and facilities are used, inspected and
maintained as required by applicable safety and health regulations. He
will also supervise the fieldwork to meet the quality standards.
List of PPE
No Item Quantity
1 Team Leader 1
2 Driller 4
3 HSE 1

2.2.4. Safety
We fully recognize that safety is essential for the welfare of mind kind and also
important contributor to corporate growth.

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In order to ensure the safety of all people concerned, we will comply with the
following codes of conduct for safety:
- Recognize that every manager, supervisor and employee have a duty and
responsibility for safety
- Enhance safety consciousness and knowledge through education and
training
- Establish safety regulations and comply therewith to eliminate unsafe
activities and procedures
- Assess every situation which presents a possibility of an accident and take
all precautionary measures against such possible accident
- Ensure a hazard free and clean work environment
- Create interest and enthusiasm in safety effort through recognition of
safety performance; every accident is preventable
We will perform the work by paying a lot of attention to safety aspects. We will
also take measures to ensure public safety as well as the safety of employees
are fully maintained and will take all measures required to comply with
applicable laws and regulations. Drilling safety guide as standard procedures of
our work is enclosed in this proposal. We will make the work permits, gate pass
and other permits as the regulation applies. We will show the permits that we
have made which in Attachment 1.
List of PPE
No Item Quantity
1 Hand Gloves For all personnel
2 Safety Shoes For all personnel
3 Safety Helm For all personnel
4 Sadety Glasses For all personnel
5 First Aid Bag For all personnel
6 APAR 6 Kg 1

2.2.5. Last Minute Risk Assessment (LMRA)

1 Apakah Penerbit Izin (PI) mendiskusikan bahaya dan Ya Tidak
Kontrol dengan Pemegang ada
Izin (PH)?
2 Apakah Pemegang Izin memperingatkan pihak lain yang Ya Tidak
dapat terdampak oleh ada
pekerjaan anda?
3 Apakah ada konflik pekerjaan yang berdampak pada Ya Tidak
anda? ada
4 Apakah kelompok kerja mengetahui alarm darurat dan Ya Tidak
tindakan yang diperlukan ada
apabila muncul alarm atau kecelakaan?
5 Apakah kelompok kerja tahu rute penyelamatan diri Ya Tidak
yang paling efektif dan lokasi ada
titik kumpul terdekat?
6 Apakah kelompok kerja tahu lokasi membilas mata Ya Tidak
terdekat, shower darurat, ada
peralatan pertolongan pertama, dan perangkat AED?

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Apakah ada bahaya tambahan yang harus dikontrol? Jika bahaya

teridentifikasi adalah perubahan material terhadap izin, hubungi Permit
Issuer!

No Bahaya Langkah-langkah control / perbaikan

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Sebutkan Aturan Penyelamatan jiwa (Live Saving Rules) yang berlaku

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2.2.6. Hazard Indentification for Total Safety (HITS)

Tanggal / Jam :
Lokasi :
Perusahaan :
Departemen :
Nama Permit Holder :
Nama Pembicara :

Topik / Materi :

No Nama Nomor ID Posisi Tanda Tangan

1 1 2
2
3 3 4
4
5 5 6
6
7 7 8
8
9 9 10
10
11 11 12
12
13 13 14
14
15 15 16
16
17 17 18
18
19 19 20
20
21 21 22
22
23 23 24
24

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3. GEOTECHNICAL DRILLING

3.1. Preparation
a. Wear PPE (Personal Equipment) consisting of gloves, coverall (with reflector), safety
helmet, safety glasses, safety shoes, ear Plug and full body hardness.
b. Check the drilling machine and the completeness of the equipment used before the
drilling work is carried out.
c. Make a flat drilling machine working yard of + 8 x 6 m2, at the location of the drilling
point to be carried out.
d. Make trenches and small ponds for the circulation of drilling water and install safety
line surrounding the trenches.
e. Move the drilling machine (with weight around 500 Kg) to the working court (at the
location of the drill point to be carried out). We will show the method that we have
made which in Attachment 2.
f. Place the water pump (with weight around 50 Kg to 75 Kg) at the location of the water
intake plan that will be used for drilling and connect water pipes to the drilling site.
g. Assemble the tripod along with pulleys / pulleys in the work court, lift the tripod at the
meeting of the 3 ends of the tripod pole manually as high as 1 meter and prop it up
with a drum.
h. Install the holder to put the handlebar drill in the right location so that the drilling
process can take place safely and efficiently.
i. Install the rope/mine on the pulley to make it easier to install the sling on the pulley
after the tripod is standing.
j. Hook the toe of a tripod that is in line with the drilling machine using an alternating
connected to the drilling machine.
k. Start the machine, pull the alternating so that the toe of the tripod in line with the
drilling machine shifts towards the drilling machine and the tripod in the center is
raised.
l. If the height of the tripod and position are right, strengthen the position of the 3 feet of
the tripod pole by installing iron or wooden pegs and strengthen the tripod pole by
installing a reinforcing iron rod using a ladder.
m. Move the drilling machine forward until the rod hole at the head of the drilling machine
is just above the drilling point to be carried out.
n. Strengthen the position of the drilling machine by installing the armature and
tying/hooking the machine mount to the armature.
o. Install the slings and hooks on the pulleys, using the mines that have been installed to
pull the slings into the pulleys.

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p. Make sure the position of the rod hole at the head of the drilling machine is in line with
the pulley.
q. Check the horizontal position of the drilling machine with a waterpass, if it is still tilted
with wood on the drilling machine holder

3.2. Drilling
Drillings are made to determine the true nature, arrangement, thickness, and texture of
various soil strata as they exist in the ground. Every effort should be made to locate and
record the datum elevation at which any change in stratification occurs. Truly
representative samples of the soil comprising each stratum as it exists in the ground
including its natural moisture
content must be obtained. Prior to
commencement of drilling location
and drilling depth will be submitted
to the Client for confirmation and
approval. The final position and
elevation will be provided for each
bore hole locations.

Continuous disturbed sample for

lithologic soil description will be
taken by utilizing single tube core
barrel and utilizing double or triple
core barrels on any rock condition encountered.

Steel casing will be driven as required to maintain an open hole for field testing and
sampling operations. The casing will be advanced to a depth greater than the depth at
which field testing of sampling is to be undertaken. Drilling without flushing water for the
purpose of obtaining better core recovery will be admitted in soft materials such as clayey
soil. Drilling rigs will be operated in such a speed and with such water pressure to ensure
perfect core recovery in whatever kind of soil strata is being drilled.

Core samples taken from each bore hole will be placed in wooden box, each of which has
5 grooves with 1 m of length to contain the drill core. The shallowest core will be placed in
the top left corner; cores from SPT will also be placed in the core boxes at the correct
relative depth. The core samples of moist soft rock will be wrapped air-tightly with
transparent vinyl sheet before being placed in the core box. Depth will be indicated on the
core box by permanent markers at the beginning and end of each drill run. Rigid core
spacer will be used to indicate missing length. The project name, location, bore hole
number and depth of coring contained in each core box will be clearly indicated at the
core box. The core will be protected from direct heat and sunlight. At the end of each
day’s work, core boxes will be stored securely from any interference and protected from
the weather.

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Prior to examination of the core, our Supervisor will take photographs of the cores. The
time between commencement of preparation and the examination of the prepared and
photographed cores will be minimized to prevent loss of moisture from the core samples.

The cores will be examined and described on site by our experienced Geologist in
accordance with Unified Soil Classification System (ASTM D-2487).

3.3. Standard Penetration Test (SPT)

Standard Penetration Test will be performed in accordance with ASTM D-1586. For
accuracy we assumed that this test will be conducted at every change of strata and within
a continuous stratum. The sampler will be driven with a guided hammer or ram into
undisturbed soil below the bottom of the boring after the boring has been cleaned to
remove all loose and foreign materials. The sampling spoon will be 2 inches OD split
barrel sampler with an inside diameter of 1 3/8 inches. The inside of the split barrel will be
flushed with the inside of the drive shoe.

SPT split spoon

SPT apparatus

The hammer used to drive sampler have weight of 63.5 kg and will fall freely through a
height of 75 cm. The number of blows required to drive the sampler every 15 cm for a
total depth of 45 cm will be observed and recorded. The record will clearly show the
number of blows for every 15 cm of penetration. In hard materials requiring more than 50
blows/15 cm of penetration, the blows for smaller amount of penetration may be observed
and recorded with special note of the amount of penetration actually obtained.

Immediately upon removal from the hole, the sample will be carefully disassembled and
the soil classified. The samples will be wrapped in a transparent vinyl sheet and then
placed in the core box.

3.4 Undisturbed Sampling

In fine grained or cohesive soils, undisturbed sample
will be recorded for laboratory testing purposes and will
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Thin walled Shelby tube

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be performed in accordance with ASTM D-1587. For accuracy of data we assumed that
undisturbed samples will be taken at every 3 meter interval.

Undisturbed soil samples are to be recorded by means of a thin walled Shelby tube
having 70 mm inside diameter and 80 cm length. Shelby tubes will be seamless steel,
properly cleaned and polished on the inside. The sampler will be pushed with hydraulic
pressure fed continuously by boring machine not by driving to minimize disturbance of the
undisturbed sample.

The sampler with its contained soil sample should remain in place for about 5 minutes.
The drill rod will then be rotated for two complete revolutions or until the soil immediately
below the sample has sheared. The tube containing the sample will later be carefully
removed from the boring and detached from the driving
head.

Bottom end of each sample will be cleaned and tested with

Pocket Penetrometer and Hand Vane Shear.

Hand Vane Shear test is most useful in determining the in-

place shear strength of soft clays, and unsuitable for stiff
and hard clays and for clays containing gravel pieces. A
Pocket Penetrometer vane tester consists of a pair of thin steel blades connected
to a vertical shaft. The tester is pushed into the bottom
samples and a torque is applied on the shaft. This test
will be performed in accordance with ASTM D-2573.

The soil sample in the tube will be carefully squared at

each end, not less than ½ inch back of the ends of the
tube, and both end spaces will be completely filled with
hot sealing wax. Hand Vane Shear

Undisturbed soil sample will be clearly, accurately and permanently marked to show the
number of bore hole, the depth from which the sample was taken, top and bottom of the
sample and many other information which may be helpful in determining sub-surface
condition.

All undisturbed samples will be protected in every possible way to avoid disturbance of
the samples during transportation. All samples will be protected from excessive heat and
carefully packed to prevent damage during storage or transportation.

3.5 Ground Water Level Observation

Water levels in all holes will be taken and recorded in the
daily field records and logs at the following period:

• Before the drilling commenced in the morning

• After the drilling finished in the evening
• When a hole has been completed

Deepmeter

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3.6 Boring Log

A field boring log will be prepared as boring progresses for each of the boring and
information in the boring log will include, but not be limited to, the following:

• Name of Contractor, driller and supervisor

• Name of supervising engineer
• Identification of project
• Date and weather condition when borehole was drilled
• Number and location of borehole
• Elevation of surface with respect to reference datum, water depth and state of tide, as
applicable
• Depth of different strata and to each sample
• Depth of groundwater and any contributing factors
• Type of sample
• Descriptions of each soil sample and soil stratum according to the Unified Soil
Classification System
• Results of all pocket penetrometer and shear vane tests
• Descriptions of all equipment used in performing the investigation and pertinent data
regarding obtaining of samples and field tests such as weight of hammer fall used,
size and type of samples, standard penetration blow counts on sample, and others.

Any obstruction and/or difficulties encountered.

4. ENGINEERING ANALYSIS AND REPORTING

Daily Report

The daily report will be submitted to the Client’s representative which consist of:
- Daily activity
- Draft of boring logs
- Manpower record
- Program for next day work
Preliminary report

Soilens to submit Preliminary Report shall be submitted 2 weeks after finished field work
for some areas if required by Contractor

Final report

The Final report will be submitted according to the attached schedule. The report consists
of:
▪ A map showing the location of all boreholes and their elevation referenced to the
existing permanent bench mark
▪ Description on the geology of the area
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▪ A brief discussion of field drilling and sampling procedures and equipment used
▪ Boring Log graph
▪ Description of laboratory test performed and test results
▪ Summary of soil properties obtained from various test required for the site preparation
and foundation design.
If required, we can also provide discussion and recommendations with respect to:
- Recommendation and discussion for site preparation including road and site
grading
- Recommendation on foundation types and depths of deep and shallow foundation
- Allowable bearing capacity at various recommended depth for spread foundation.
Allowable bearing capacity indicated as being gross of net values, allowable
passive and active pressure to resist horizontal loads.
- Allowable capacities of deep foundations for downward, uplift and horizontal
loads. Plots of depth versus pile capacity for various pile diameters will be
provided. The effect of group action will also be provided.
- Possibility of harmful sulfate attack on concrete below and advisability of the use
sulfate resistant portland cement
- And any others topics as required by the Client
Engineering analysis for foundations will be performed based on field and laboratory test
data encountered. Previous soil data will also be reviewed for these analyses. The
engineering analysis will be performed using relevant geo-technical software as follows:
• PLAXIS, for slope stability analysis, soil deformation, soil settlement, shallow
foundation and bearing capacity, pile group analysis, seepage analysis, sheet pile
analysis, stability of sheet pile and others.
PLAXIS is a finite element package that has been developed specifically for the
analysis of deformation and stability in geotechnical engineering. The simple
graphical input procedures enable a quick generation of complex finite element
models, and the enhanced output facilities provide a detailed presentation of
computational results.
The finite element program of PLAXIS is selected because:
- PLAXIS analyzes steady state pore pressures;
- PLAXIS allows for the development of excess pore pressure due to undrained
loading and subsequent dissipation of this excess pore pressure through
consolidation. Deformations coupled with the dissipation of excess pore pressure
are included in the consolidation calculations;
- PLAXIS incorporates large deformation theory in the soil model.
The ability to handle these complexities with a single integrated code is highly
desirable for geotechnical analysis.
The results of the analysis will be presented in chart or graph, or table as required.
PILE for analysis of ultimate compressive and uplift (tension), pile capacity. The
ultimate pile capacity is developed based on static capacity.

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The characteristic side friction versus pile movement (T-Z) or load transfer curves for
cohesive soils is based on the results of model and full-scale pile load tests, tests
reported by Seed and Reese.
End bearing or tip load is assumed to increase with displacement of the pile tip. The
tip movement producing full mobilization of the ultimate end bearing is assumed to be
10 % of the pile diameter. Values of the ultimate end bearing correspond to those
used in the pile capacity computations. The ultimate tip load corresponds to the unit
end bearing values times the gross end area of the pile.
The results of this analysis will be presented in graph showing the relation of
downward displacement vs compressive load, upward displacement vs tension load
at the top of pile head and base of pile.
• And others software for analysis and presentation of Boring log graph results

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RA/JHA
Dilampirkan ke Permit :
No.

Judul Permit : Pengeboran Tanah

Tim : PT. Soilens

Langkah Tugas Bahaya Tindakan Kontrol PIC

1. Persiapan alat Anggota tubuh tergores, tersayat Pasang pelindung terpasang pada peralatan yang tajam P PH
pekerjaan Jari tangan terjepit alat Tempatkan peralatan di tempat yang aman
Jaga jarak aman anggota tubuh dari benda yang bersisi atau
berujung tajam.
Memakai sarung tangan selama melakukan
Pekerjaan
Lakukan koordinasi sesama rekan kerja dengan baik
Lakukan pengecekan alat sebelum digunakan
Gunakan PPE yang lengkap Helmet, coverall, hand glove,
safety glass, dan safety shoes
2. Tool Box Meeting PTW Belum di setujui dari pihak yang Semua PTW harus ditandatangani dan disetujui oleh pihak S PH
berwenang, operasi yang berwenang
PTW Belum di validasi sebelum memulai kerja Memastikan PTW sudah bisa disimpan oleh HSE
Peralatan kerja sudah beroperasi sebelum PTW Harus divalidasi sesuai peraturan yang berlaku
inspeksi Semua peralatan kerja maupun transportasi harus melalui
Prosedure keselamatan kerja tidak dimengerti / inspeksi dan ditagging sebelum beroperasi
tidak di patuhi tidak mengerti dengan pekerjaan Pada saat TBM sosialisasikan JSA dan Method statment ke
yang akan dilakukan. pekerja agar mereka memahami pekerjaan mereka beserta
Pekerja tidak fokus dengan jobdesknya bahaya yang menyertainya.
APD yang dipakai tidak standard dan tidak Memastikan pekerja berada dalam kondisi sehat
sesuai dengan pekerjaan yang dilakukan. Pastikan pekerja membawa air minum yang cukup
Jelaskan kepada seluruh pekerja yang terlibat untuk
mematuhi peraturan keselamatan yang berlaku.
Pastikan kelengkapan APD dan apabila ada pekerja yang
belum lengkap tidak diijinkan untuk bekerja.

Method Statement for Field Test 20

Revision 0 – Issue For Construction
RESTRICTED EPCC OF 1500 TPD PHYSICAL REFINERY & 1200 TPD DRY FRACTIONATION PLANT

3. Menaikan dan Mobil bergerak Pastikan kendaraan diarahkan oleh falgman S PH

menurunkan alat bor Terpeleset Pastikan rem tangan mobil berfungsi dengan baik
(loading unloading) Terjepit Ban mobil diganjal dengan baik
Tertimapa material Pastikan pekerja menggunakan APD lengkap
Pekerja mengalami kelelahan Pastikan beban yang diangkat tidak lebih dari 23 kg, minta
Hujan dan cuaca buruk bantuan pekerja lain jika beban yang diangkat melebihi berat
Gangguan binatang 23 kg
Pastikan pekerja tidak menginjak material
Hindari sisi dan ujung benda yang tajam
Pastikan semua personel memahami jobdesknya
Pastikan petugas P3K standby dilokasi dan membawa first
aider bag
Pastikan pekerja membawa air minum dan bisa beristirahat
sejenak 5-10 menit
Pastikan semua material berada dalam posisi aman dan
personel tidak berada dibawah material yang menggantung
Merapihkan semua material yang tidak terpakai
Pastikan pemasangan barikade di area pekerjaan
Pastikan pekerjaan dihentikan sementarak ketika cuaca buruk
Pastikan pekerja tidak berada dilokasi terbuka saat cuaca
buruk terjadi
Pastikan pekerja tidak panik atau terburu-buru saat cuaca
buruk terjadi
Pastikan melakukan pengecekan peralatan dan area sekitar
pekerjaan terlebih dahulu misal melakukan pengecekan
dipipa-piapa pengeboran dan aksesoris pengeboran lainya
Memindahkan mesin Terpeleset Pastikan pekerja menggunakan Apd lengkap S PH
bor dan aksesoris Terjepit Pastikan pekerja dalam kondisi fit atau sehat
(moving) Tertimpa Hindari permukaan yang licin atau tidak rata
Terbentur Perhatikan jalan saat berjalan
Pekerja Kelelahan Hindari titik jepit
Hujan atau cuaca buruk Pastikan beban yang diangkat tidak lebih dari 23 kg, minta
Gangguan binatang bantuan pekerja lain juka beban yang diangkat melebihi berat
23 kg
Gunakan bantuan tali untuk mengangkat barang berat atau
pengungkit
Method Statement for Field Test 21
Revision 0 – Issue For Construction
RESTRICTED EPCC OF 1500 TPD PHYSICAL REFINERY & 1200 TPD DRY FRACTIONATION PLANT

Perhatikan arah peralatan yang diangkat

Pastikan pekerja membawa air minum dan bisa beristirahat
sejenak 5-10 menit
Pastikan petugas P3K standby dilokasi dan membawa first
aider bag
Pastikan pekerjaan dihentikan sementara ketika cuacaa
buruk
Pastikan pekerja tidak berada dilokasi terbuka saat cuaca
buruk berlangsung
Pastikan pekerja tidak panik atau terburu-buru saat cuaca
buruk terjadi
Pastikan sebelum aktifitas dimulai melakukan pengecekan
peralatan dan area kerja terlebih dahulu misal melakukan
pengecekan dipipa-piapa pengeboran dan aksesoris
pengeboran lainya
Persiapan alat dan Tersandung Pastikan pekerja menggunakan APD lengkap S PH
peralatan bor (setting) Terpeleset Pastikan sebelum aktifitas dimulai melakukan pengecekan
Terkilir peralatan dan area kerja terlebih dahulu misal melakukan
Terjepit pengecekan dipipa-piapa pengeboran dan aksesoris
Pekerja kelelahan pengeboran lainya
Tertimpa Pastikan peralatan dalam kondisi rapih
Hujan atau cuaca buruk Pastikan beban yang diangkat tidak lebih dari 23 kg, minta
Gangguan binatang bantuan pekerja lain juka beban yang diangkat melebihi berat
Penggalian angkur 23 kg
Pastikan pekerja menghindari titik jepit atau material bergerak
Pastikan pekerja membawa air minum dan bisa beristirahat
sejenak 5-10 menit
Pastikan petugas P3K standby dilokasi dan membawa first
aider bag
Pastikan didalam galian dibuatkan slope
Pasang barikade pada saat melakukan penggalian
Melakukan pengawasan pada saat mendirikan tripod
Gunakan tangga pada saat pemasangan skor
Pastikan pekerja tidak berada di bawah material yang
menggantung atau menghindari line off fire
Merapihkan semua material yang tidak terpakai dan
Method Statement for Field Test 22
Revision 0 – Issue For Construction
RESTRICTED EPCC OF 1500 TPD PHYSICAL REFINERY & 1200 TPD DRY FRACTIONATION PLANT

memasang baricade diarea pekerjaan

Pastikan pekerjaan dihentikan sementara ketika cuacaa
buruk
Pastikan pekerja tidak berada dilokasi terbuka saat cuaca
buruk berlangsung
Pastikan pekerja tidak panik atau terburu-buru saat cuaca
buruk terjadi
Pastikan alat yang digunakan sesuai fungsinya
Pastikan pada saat penggalian tidak ada anggota tim yang
berada terlau dekat
Pastikan dipasang barikade
Memulai pekerjaan Gangguan binatang Pastikan setiap pekerja menggunakan APD S PH
pengeboran Terjepit Pastikan sebelum aktifitas dimulai melakukan pengecekan
Tergores peralatan terlebih dahulu misal melakukan pengecekan
Terpeleset dipipa-piapa pengeboran dan aksesoris pengeboran lainya
Tertimpa hammer Pastikan pekerja menghindari titik jepit atau material bergerak
Tersandung Pastikan pekerja fokus pada apa yang dikerjakan atau fokus
Pekerja mengalami pusing pada jobdesk masing-masing
Pastikan sirkulasi air berada pada posisi yang seharusnya
Membuat bantalan pada jalur aliran air
Pastikan agar jarak antara hammer dan pekerja dalam radius
aman saat melakukan SPT
Gunakan tali tambang untuk pengganti tangan memegang
road saat melakukan SPT
Pastikan peralatan berada pada posisi yang seharusnya atau
dalam kondisi rapih
Pastikan pekerja tidak mengalami dehidrasi atau minum yang
cukup
Pastikan petugas P3K standby dilokasi dan membawa first
aider bag
Pastikan peralatan berada pada kondisi rapih sebelum dan
sesudah pekerjaan selesai
Bongkar Mesin bor Tersandung Pastikan pekerja menggunakan APD lengkap S PH
(Unsetting) Terpeleset Pastikan peralatan dalam kondisi rapih
Terkilir Pastikan beban yang diangkat tidak lebih dari 23 kg, minta
Terjepit bantuan pekerja lain juka beban yang diangkat melebihi berat
Method Statement for Field Test 23
Revision 0 – Issue For Construction
RESTRICTED EPCC OF 1500 TPD PHYSICAL REFINERY & 1200 TPD DRY FRACTIONATION PLANT

Pekerja kelelahan 23 kg
Tertimpa Pastikan pekerja menghindari titik jepit atau material bergerak
Hujan atau cuaca buruk Pastikan pekerja membawa air minum dan bisa beristirahat
Gangguan binatang sejenak 5-10 menit
Pastikan petugas P3K standby dilokasi dan membawa first
aider bag
Melakukan pengawasan pada saat mendirikan tripod
Gunakan tangga pada saat pemasangan skor
Pastikan pekerja tidak berada di bawah material yang
menggantung atau menghindari line off fire
Merapihkan semua material yang tidak terpakai dan
memasang baricade diarea pekerjaan
Pastikan pekerjaan dihentikan sementara ketika cuacaa
buruk
Pastikan pekerja tidak berada dilokasi terbuka saat cuaca
buruk berlangsung
Pastikan pekerja tidak panik atau terburu-buru saat cuaca
buruk terjadi
Pastikan sebelum aktifitas dimulai melakukan pengecekan
peralatan dan area kerja terlebih dahulu misal melakukan
pengecekan dipipa-piapa pengeboran dan aksesoris
pengeboran lainya
House keeping Gangguan binatang Pastikan setiap pekerja menggunakan APD lengkap S PH
Terperosok Pastikan sebelum aktifitas dimulai melakukan pengecekan
Terpeleset diarea kerja terlebih dahulu
Pastikan lubang galian bekas sirkulasi ditutup kembali
Pastikan disetiap titik bor disediakan tempat sampah
Pastikan area kerja rapih dan bersih sebelum dan sesudah
kerja
Pastikan lubang bekas pengeboran dipasang barikade

Catatan : * Pilih P (Pre-requisite) kontrol tindakan harus dilakukan terlebih dahulu sebelum pekerjaan dimulai
** Pilih S (Site action by action party) kontrol tindakan yang perlu dilakukan saat dilapangan

Method Statement for Field Test 24

Revision 0 – Issue For Construction