Risk Assessment Form Template for Indonesia

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Key Requirements PROMPT example:

Risk Assessment Form

"I need a Risk Assessment Form for our new chemical manufacturing facility in Jakarta, opening in March 2025, that specifically addresses hazardous material handling and includes both laboratory and production floor risks."

Document background

The Risk Assessment Form is a crucial document required under Indonesian workplace safety regulations, specifically mandated by Government Regulation No. 50 of 2012 and Law No. 1 of 1970. This document should be used whenever organizations need to evaluate workplace hazards, implement new processes, or conduct regular safety reviews. The form captures essential information about potential risks, their severity and likelihood, existing control measures, and required actions for risk mitigation. It serves as both a legal record and a practical tool for maintaining workplace safety standards in Indonesia. The document must be regularly reviewed and updated, particularly when new hazards are identified or workplace conditions change significantly. It forms a key component of an organization's overall Occupational Safety and Health Management System (SMK3) as required by Indonesian law.

Suggested Sections

1. Document Information: Form identification number, date of assessment, revision number, and next review date

2. Assessment Team Details: Names and roles of personnel conducting the risk assessment, including the assessment leader and team members

3. Work Area Information: Specific location, department, or process being assessed, including relevant equipment or materials

4. Hazard Identification: Systematic listing of all potential hazards identified in the workplace or process

5. Risk Analysis: Evaluation of each identified hazard including likelihood and severity ratings

6. Current Control Measures: Existing safety measures and controls currently in place

7. Risk Rating: Calculated risk levels based on likelihood and severity, using a defined risk matrix

8. Proposed Control Measures: Additional controls required to reduce risks to acceptable levels

9. Action Plan: Specific actions required, including responsible persons and timeframes for implementation

10. Monitoring and Review: Schedule and methods for monitoring control effectiveness and reviewing risk assessment

Optional Sections

1. Chemical Risk Assessment: Detailed assessment of chemical hazards when workplace involves hazardous substances

2. Environmental Impact: Assessment of environmental risks when activities may affect the environment

3. Emergency Response Procedures: Specific emergency procedures when high-risk activities are identified

4. Training Requirements: Specific training needs identified through the risk assessment process

5. Contractor Management: Additional risk considerations when contractors are involved in the work

6. Health Surveillance Requirements: Health monitoring requirements for specific hazards that require medical surveillance

Suggested Schedules

1. Risk Matrix: Standard risk evaluation matrix used for risk rating calculations

2. Hazard Checklist: Comprehensive checklist of potential hazards by category

3. Control Measures Hierarchy: Reference guide for hierarchy of control measures

4. PPE Requirements Chart: Matrix of required personal protective equipment for identified risks

5. Incident Report Form: Template for reporting incidents related to identified risks

6. Risk Assessment Review Log: Record of assessment reviews and updates

7. Reference Standards: List of applicable Indonesian safety standards and regulations

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Manufacturing

Construction

Mining

Oil and Gas

Chemical Processing

Agriculture

Healthcare

Transportation

Warehousing

Food Processing

Pharmaceutical

Electronics Manufacturing

Textile Industry

Shipping and Maritime

Educational Institutions

Retail

Hospitality

Relevant Teams

Health and Safety

Operations

Production

Quality Assurance

Facility Management

Maintenance

Human Resources

Compliance

Risk Management

Environmental Health

Occupational Health

Project Management

Emergency Response

Training and Development

Relevant Roles

Health and Safety Manager

Risk Assessment Specialist

Operations Manager

Facility Manager

Production Supervisor

Quality Control Manager

Environmental Health Officer

Compliance Officer

Plant Manager

Project Manager

Site Safety Coordinator

Industrial Hygienist

Occupational Health Nurse

Safety Engineer

Department Head

Line Supervisor

Maintenance Manager

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Let's create your Risk Assessment Form

Authors

Alex Denne

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