The Hazard Identification Form is a critical workplace safety document required under Indonesian occupational health and safety regulations, specifically aligned with Government Regulation No. 50 of 2012 and Law No. 1 of 1970. This document should be used whenever new processes are introduced, existing workflows are modified, or during regular safety reviews as mandated by Indonesian law. The form captures essential information about potential workplace hazards, risk levels, existing control measures, and required actions for risk mitigation. It serves as both a practical tool for maintaining workplace safety and a legal document demonstrating compliance with Indonesian safety regulations. Regular updates and reviews of the Hazard Identification Form are necessary to maintain its effectiveness and ensure ongoing compliance with evolving safety standards.
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1. Document Information: Basic information including form number, date, location, and department
2. Assessment Team: Names and roles of personnel conducting the hazard identification
3. Work Area Details: Specific information about the workspace, equipment, or process being assessed
4. Hazard Categories: Structured checklist of potential hazard types (physical, chemical, biological, ergonomic, psychological)
5. Hazard Description: Detailed description of identified hazards including location, nature, and potential consequences
6. Risk Assessment: Evaluation of risks using likelihood and severity matrix as per Indonesian standards
7. Existing Control Measures: Documentation of current safety measures and their effectiveness
8. Required Actions: Recommended additional control measures and improvements
9. Implementation Timeline: Deadlines and responsibilities for implementing control measures
10. Approval Section: Signatures of assessment team, supervisor, and safety officer
1. Environmental Impact Assessment: Additional section for activities with potential environmental hazards, required when complying with PP No. 22 of 2021
2. Chemical Risk Assessment: Detailed chemical hazard evaluation section for workplaces handling hazardous substances
3. Machine/Equipment Specific Hazards: Detailed assessment of machinery-related hazards for manufacturing or industrial settings
4. PPE Requirements: Specific section detailing required personal protective equipment as per PER.08/MEN/VII/2010
5. Emergency Response Procedures: Special considerations for high-risk activities requiring specific emergency protocols
1. Risk Matrix Template: Standard risk assessment matrix used for evaluating hazard severity and likelihood
2. Hazard Pictogram Guide: Visual reference guide for common workplace hazard symbols
3. Control Measures Hierarchy: Reference guide showing the hierarchy of hazard control measures
4. PPE Selection Guide: Reference chart for selecting appropriate personal protective equipment
5. Incident Report Form: Template for reporting any incidents related to identified hazards
6. Review History Log: Record of previous hazard assessments and updates
Relevant legal definitions
Clauses
Relevant Industries
Manufacturing
Construction
Mining
Oil and Gas
Chemical Processing
Healthcare
Logistics and Warehousing
Agriculture
Food Processing
Pharmaceuticals
Transportation
Energy Production
Waste Management
Automotive
Aerospace
Relevant Teams
Health and Safety
Operations
Quality Assurance
Maintenance
Production
Facilities Management
Environmental Compliance
Risk Management
Project Management
Industrial Hygiene
Emergency Response
Process Safety
Occupational Health
Relevant Roles
Health and Safety Manager
Risk Assessment Specialist
Operations Director
Plant Manager
Site Safety Coordinator
Compliance Officer
Production Supervisor
Maintenance Manager
Quality Assurance Manager
Environmental Health Officer
Facility Manager
Project Manager
Industrial Hygienist
Safety Engineer
Process Safety Specialist
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