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RENCANA KERJA DAN SYARAT - SYARAT
PEKERJAAN PEMBONGKARAN, PENGANGKUTAN DAN PEMUSNAHAN ASBESTOS CONTAINING MATERIALS (ACM) EX MESS PLN UNTUK PROYEK
PENGEMBANGAN DIENG UNIT 2
Nomor : RKS-034-PRO/GDE/VI/2021 Tanggal : 03 Juni 2021
Head Office:
Gedung Aldevco Octagon Lantai 2 Jl. Warung Jati Barat No. 75 - Jakarta Selatan
Tel. (021) 7982925 - Fax. (021) 7982930 www.geodipa.co.id
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PENGESAHAN
Nama Pekerjaan : Pekerjaan Pembongkaran, Pengangkutan Dan Pemusnahan Asbestos Containing Materials (ACM) Ex Mess PLN Untuk Proyek Pengembangan Dieng Unit 2
Mata Anggaran/WBS : GD2-CP-01-10-01-A10 Overhead Cost Dieng - Safeguard - Pembuangan Limbah B3 Dieng GD2-CP-01-09-01-A2 Building
Jakarta, 03 Juni 2021
Disiapkan Oleh:
Ferry Iskandar Procurement Manager PMU
Disetujui Oleh:
Supriadinata Marza General Manager Project
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BAB 1 PENDAHULUAN & JADWAL
1. Nama Pekerjaan
Pekerjaan Pembongkaran, Pengangkutan Dan Pemusnahan Asbestos Containing Materials (ACM) Ex Mess PLN Untuk Proyek Pengembangan Dieng Unit 2.
2. Para Pihak
2.1. Para Pihak yang bertanggung jawab atas pelaksanaan pekerjaan jasa adalah:
No Para Pihak Pejabat Terkait Keterangan
1 Pengguna HSE & Safeguard Manager Perencana Pekerjaan
2 Pejabat Berwenang General Manager Project Pemberi Kerja
3 Direksi Pekerjaan HSE & Safeguard Manager
4 Pengawas Lapangan HSE Superintendent
5 Pelaksana Pengadaan Procurement Manager PMU
2.2. Pemberi Kerja, berwenang untuk:
a. Menyetujui & Menetapkan Pemenang pengadaan. b. Menandangani SKPP, PO dan Perjanjian. c. Menandatangani Berita Acara Serah Terima Pekerjaan (BAST). d. Menyetujui usulan dan menandatangani Addendum Perjanjian.
2.3. Direksi Pekerjaan, berwenang untuk:
a. Mengawasi pelaksanaan pekerjaan. b. Menandatangani Berita Acara Penyelesaian Pekerjaan (BAPP) termasuk memeriksa mutu
pekerjaan. c. Memberikan Surat Peringatan bila diperlukan. d. Mengusulkan Addendum Kontrak jika diperlukan.
2.4. Pengawas Lapangan, berwenang untuk:
a. Melakukan pengawasan pelaksanaan pekerjaan jasa sehari-hari di lapangan.
3. Metoda Pengadaan
Metode Pengadaan adalah:
No Metode Pengadaan Beri Tanda Usulan Nama Penyedia
1 Pelelangan Dengan Prakualifikasi - -
2 Pelelangan Dengan Pascakualifikasi -
3 Pemilihan Langsung - -
4 Penunjukan Langsung - -
4. Jadwal Pengadaan
Jadwal Pengadaan adalah sebagai berikut:
No Tahapan Hari/Tanggal/Waktu Tempat
1 Penjelasan RKS Senin, 14 Juni 2021 pukul 10:00 WIB Online Meeting
2 Kunjungan Lapangan TBA TBA
3 Pemasukan Penawaran Senin, 21 Juni 2021, pukul 14:00 WIB Online Meeting
4 Pembukaan Penawaran Senin, 21 Juni 2021, pukul 14:15 WIB Online Meeting
4
5 Klarifikasi dan Negosiasi: TBA TBA
6 Verifikasi Fisik TBA TBA
Alamat:
• Kantor GDE Pusat: PT Geo Dipa Energi (Persero), Gedung Aldevco Octagon, Lantai 2, Jl Warung Jati Barat No.75, Jakarta.
• PLTP Dieng Unit 2: PT Geo Dipa Energi (Persero) Unit Dieng, Jl Raya Dieng Batur PO BOX 01, Banjarnegara, Jawa Tengah.
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BAB 2 INSTRUKSI KEPADA PENYEDIA
5. Syarat Penyedia
5.1. Kualifikasi Penyedia
Penyedia Kriteria
Bentuk Badan Hukum Perseroan Terbatas
Kualifikasi Usaha Kecil/Menengah/Besar
Bidang Sipil dan Pengelolaan Limbah B3
Sub Bidang Pemusnahan dan Pengangkutan Limbah B3
5.2. Ijin usaha yang dimiliki yang masih berlaku:
Ijin Usaha Beri Tanda
SIUP/IUT
TDP/NIB
Domisili
SIUJK
SBU
5.3. Memiliki Pengalaman:
Pengalaman Sejenis Waktu Pelaksanaan Minimal Jumlah & Nilai
Pekerjaan Pembongkaran, Pengelolaan
Dan Pemusnahan Bangunan yang
mengandung Asbestos Containing
Materials (ACM)
2021 - 2015 Minimal 2 Pekerjaan dengan nilai
minimal Rp. 800.000.000,-
5.4. Larangan
Larangan Beri Tanda
Badan Hukum tidak sedang dinyatakan pailit
Kegiatan usaha Badan Hukum tidak sedang dihentikan
Badan Hukum tidak sedang dalam pengawasan pengadilan
Badan Hukum / Pengurus Badan Hukum tidak sedang menjalani sanksi pidana
6. Metode Penyampaian Dokumen Penawaran
6.1. Metode Penyampaian Dokumen Penawaran
Metode Penyampaian Dokumen Penawaran Beri Tanda
1 Tahap 1 Sampul
1 Tahap 2 Sampul -
2 Tahap 2 Sampul -
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6.2. Format Surat-surat
Metode Penyampaian
Dokumen Penawaran
Beri Tanda
Format Keterangan
Surat Pengantar Penawaran
Administrasi & Teknis
Sesuai Lampiran RKS
Surat Pengantar Penawaran
Harga
Sesuai Lampiran RKS • Masa Berlaku Penawaran 60 hari
Jaminan Penawaran x Sesuai Format Bank • Nilai Minimal 1%
• Masa berlaku penawaran harga ditambah 14 hari kalender
Pakta Integritas Sesuai Lampiran RKS
Surat-Surat Pernyataan Sesuai Lampiran RKS
6.3. Dokumen Administrasi Teknis
Dibuat dalam rangkap 2 (dua) yang terdiri dari 1 (satu) asli dalam bentuk hardcopy dan 1 (satu) copy dalam bentuk softcopy disimpan dalam Flash disk, terdiri dari:
No Dokumen Hard File Soft Copy
Dokumen Administrasi
1 Surat Pengantar Penawaran Administrasi & Teknis
√ √
2 Surat Pernyataan Bermaterai Bahwa Tidak Sedang Dalam Pengawasan
Pengadilan, Tidak Pailit, Kegiatan Usaha Tidak Sedang Dihentikan Dan Atau
Direksi Yang Berwenang Menandatangani Perjanjian Atau Kuasanya Tidak
Sedang Menjalani Hukuman Penjara.
√ √
3 Surat Pernyataan Bahwa Data Yang Diberikan Adalah Benar Dan Sesuai Dengan
Aslinya
√ √
4 Pakta Integritas √ √
5 Copy Surat Izin Usaha (Siup/Iut) √
6 Copy Surat Domisili Perusahaan √
7 Copy Surat Tanda Daftar Perusahaan (TDP) Atau NIB √
8 Copy Akta Pendirian/Anggaran Dasar Serta Perubahan Akta Terakhir √
9 Copy Surat Pengesahan Badan Hukum Oleh Menteri Kehakiman √
10 Surat Referensi Bank Atau Keterangan Rekening Bank √
11 Copy Nomor Pokok Wajib Pajak (Npwp) √
12 Copy Nomor Pengukuhan Pengusaha Kena Pajak (Nppkp) √
13 Laporan Keuangan Tahun 2019 Audited Oleh Kantor Akuntan Publik (KAP) √
14 Susunan Pengurus Dan Pemilik Modal √
15 Copy SIUJK Dan SBU √
Dokumen Teknis
16 Surat Pernyataan Sedang Tidak Bermasalah Lingkungan √
17 Daftar Pengalaman & Lampiran Bukti SPK/PO/Perjanjian √
18 Memiliki Sertifikat Training Pembongkaran Asbestos √
19 Memiliki Izin Pengangkutan dan Pemanfaatan/Pemusnahan Kode Limbah B3
B102d atau A108d
√
20 Bukti telah terdaftar akun festronik untuk Pengangkutan dan
Pemanfaatan/Pemusnahan Kode Limbah B3 B102d atau A108d
√
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No Dokumen Hard File Soft Copy
21 Memiliki Izin dari Dinas Perhubungan Darat untuk Alat Transportasi
Pengangkutan Limbah B3
√
22 Daftar Key Personil Minimum Dilengkapi dengan CV √
23 Daftar Peralatan Disertai Dengan Foto √
24 Metode Pekerjaan & SOP, Covid-19 Procedure √
25 Program Kerja & Time Schedule √
26 HSE Plan & Contoh Job Safety Analysis (JSA) √
6.4. Dokumen Penawaran Harga
No Dokumen Hard File Soft Copy
1 Surat Pengantar Penawaran Harga √ √
2 Lampiran Surat Penawaran Harga √ √
3 Jaminan Penawaran - -
6.5. Penyampaian Dokumen
a. Surat Penawaran berikut kelengkapannya ini disampaikan di dalam sampul tertutup yang tidak tembus baca, dilem, dan tidak mencantumkan nama dan alamat Perusahaan.
Metode Penyampaian Beri Tanda
1 Tahap 1 Sampul • Seluruh dokumen dimaskukan kedalam satu sampul berisi dokumen administrasi, teknis dan penawaran harga dilengkapi Flash Disk.
1 Tahap 2 Sampul - • Dipisahkan berdasarkan sampul, sampul pertama berisi dokumen administrasi dan teknis dilengkapi Flash Disk serta sampul kedua berisi dokumen penawaran harga dilengkapi Flash Disk. Kedua sampul dimasukan kedalam amplop penutup yang lebih besar.
• Apabila didalam Sampul Penawaran Administrasi dan Teknis Peserta Pengadaan terdapat Data/Dokumen Harga, maka penawaran akan dianggap gugur.
2 Tahap 2 Sampul - • Sampul pertama berisi dokumen administrasi dan teknis dilengkapi Flash Disk disampaikan pada tahap pertama
• Sampul kedua berisi dokumen penawaran harga dilengkapi Flash Disk.
• Apabila didalam Sampul Penawaran Administrasi dan Teknis Peserta Pengadaan terdapat Data/Dokumen Harga, maka penawaran akan dianggap gugur.
b. Surat penawaran ditujukan kepada Panitia Pengadaan/Pejabat Pengadaan PT Geo Dipa
Energi (Persero). c. Dokumen Penawaran disampaikan pada waktu dan tempat yang telah ditentukan. Dokumen
penawaran yang disampaikan melewati batas waktu dan tempat yang telah ditentukan dianggap gugur.
7. Pembukaan Dokumen Pengadaan
7.1. Jumlah Dokumen Penawaran yang masuk dihitung (surat pengunduran diri tidak dihitung sebagai dokumen penawaran) dan dan dibuka dengan disaksikan oleh wakil Pengguna dan wakil Penyedia.
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7.2. Dokumen Penawaran yang sudah disampaikan tidak boleh diubah, ditambah, atau dikurangi, kecuali hanya untuk memenuhi kekurangan pada meterai, tanggal, dan tanda tangan. Penambahan tersebut dilaksanakan seketika pada pembukaan.
7.3. Dalam hal softcopy yang disampaikan oleh Penyedia tidak terbaca, atau tidak dapat digandakan (di copy), Penyedia dapat menyampaikan softcopy dokumen penawaran baik melalui CD/flashdisk, atau dikirim melalui email ke alamat procurementd2p2@geodipa.co.id pada saat pembukaan penawaran.
7.4. Apabila terdapat perbedaan isi dokumen antara versi hardcopy dan softcopy, dokumen yang diakui dan dianggap sah oleh Panitia Pengadaan adalah versi hardcopy.
8. Metode Evaluasi & Kriteria Evaluasi
8.1. Metode evaluasi yang dipilih adalah:
Metode Evaluasi Beri Tanda Keterangan
Sistem Gugur -
Sistem Nilai Persentase Penilaian Administrasi & Teknis 60%
Penilaian Harga 40%
Sitem Nilai Dengan Passing Grade
Teknis
- Passing Grade Penilaian Teknis %
Persentase Penilaian Administrasi & Teknis %
Persentase Penilaian Harga %
Kombinasi Sistem Gugur dan
Sistem Nilai
- Penilaian Administrasi Sistem Gugur
Passing Grade Penilaian Teknis %
Persentase Penilaian Teknis %
Persentase Penilaian Harga %
Sistem Harga Terendah -
Sistem Tunjuk Langsung -
8.2. Evaluasi Administrasi
Dilakukan pemeriksaan kelengkapan dokumen dan pemenuhan kelengkapan persyaratan administrasi. Penawaran yang memenuhi persyaratan administrasi dan dinyatakan lengkap akan disertakan dalam evaluasi tahap selanjutnya.
8.3. Evaluasi Teknis
Dilakukan pemeriksaan terhadap faktor-faktor teknis dan kesesuaiannya terhadap persyaratan dokumen RKS dan perubahannya. Bilamana diperlukan dalam Evaluasi Teknis dapat dilakukan klarifikasi teknis atau presentasi teknis Penawaran yang memenuhi persyaratan teknis akan disertakan dalam evaluasi tahap selanjutnya.
Aspek yang akan dinilai dalam penilaian ini mencakup berikut namun tidak terbatas pada:
a. Surat Pernyataan Sedang Tidak Bermasalah Lingkungan b. Kemampuan Keuangan c. Pengalaman Perusahaan d. Sertifikasi Training Pembongkaran Asbestos e. Izin Pengangkutan dan Pemanfaatan/Pemusnahan Kode Limbah B3 B102d atau A108d f. Bukti telah terdaftar akun festronik untuk Pengangkutan dan Pemanfaatan/Pemusnahan
Kode Limbah B3 B102d atau A108d g. Izin dari Dinas Perhubungan Darat untuk Alat Transportasi Pengangkutan Limbah B3 h. CV Personil Minimal i. Kelengkapan peralatan
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j. Metode Pekerjaan & SOP, Covid-19 Procedure k. Program Kerja & Time Schedule l. HSE Plan & Contoh Job Safety Analysis (JSA)
8.4. Evaluasi Penawaran Harga
Dilakukan pemeriksaan terhadap struktur harga penawaran dan kesesuaiannya terhadap struktur harga dalam Dokumen RKS dan perubahannya. Dilakukan perbandingan antara penawaran dengan Harga Perhitungan Sendiri (HPS) dan/atau penawaran Penyedia lainnya, serta pemeriksaan kewajaran harga.
8.5. Berdasarkan seluruh hasil evaluasi, dibuat daftar urutan penawaran dengan nilai evaluasi tertinggi sampai dengan terendah.
9. Klarifikasi & Negosiasi
9.1. Klarifikasi Teknis
a. Klarifikasi dapat dilakukan kepada satu, sebagian atau seluruh Penyedia. b. Klarifikasi adalah kegiatan meminta penjelasan kepada Penyedia terkait Dokumen yang
disampaikan. Klarifikasi bersifat memperjelas Dokumen Penawaran tanpa mengubah subtansi penawaran.
c. Klarifikasi dapat dilakukan melalui surat, email atau tatap muka.
9.2. Negosiasi
a. Pelaksanaan dan urutan negosiasi disesuaikan dengan metode evaluasi yang telah ditetapkan.
b. Negosiasi adalah kegiatan untuk mencapai kesepakatan dengan Penyedia terkait Dokumen Penawaran yang disampaikan. Proses negosiasi dapat mengubah substansi penawaran agar tercapai kesepakatan baik terkait teknis maupun harga.
c. Negosiasi dapat dilakukan melalui surat, email atau tatap muka.
9.3. Aspek-aspek yang dapat diklarifikasi dan negosiasi adalah:
a. Rencana Kerja. b. Spesifikasi/Kualitas Material. c. Volume Kegiatan. d. Waktu Pelaksanaan. e. Struktur Harga/Biaya. f. Harga.
10. Verifikasi Fisik
Sebagai bagian dari evaluasi, dapat dilakukan verifikasi fisik terhadap data dan informasi yang
diberikan oleh Penyedia dalam Dokumen Penawaran, termasuk namun tidak terbatas pada
pengecekan dokumen legalitas asli, pengecekan alat berat, pengecekan peralatan kerja, pengecekan
kantor dan lainnya untuk memastikan kesiapan Penyedia jika ditunjuk sebagai pelaksana pekerjaan.
Setiap biaya yang ditumbulkan oleh aktifitas ini menjadi beban PT Geo Dipa Energi (Persero).
11. Penetapan Calon Pemenang Dan Pengumuman Pemenang
11.1. Panitia Pengadaan membuat kesimpulan proses Pengadaan dan dituangkan dalam Berita Acara Hasil Pengadaan (BAHP).
11.2. BAHP disampaikan kepada Pejabat Berwenang untuk mendapatkan persetujuan atas usulan pemenang.
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11.3. Pejabat Berwenang memberikan persetujuan dan pengesahan penetapan pemenang berdasarkan BAHP yang diampaikan Panitia Pengadaan.
11.4. Panitia mengumumkan pemenang pengadaan dan memberitahukan kepada seluruh Penyedia paling lambat 2 (dua) hari kerja setelah diterimanya persetujuan dan pengesahan penetapan pemenang dari Pejabat berwenang.
12. Sanggahan
12.1. Penyedia yang berkeberatan atas penetapan pemenang diberi kesempatan untuk mengajukan sanggahan secara tertulis paling lambat dalam waktu 3 (tiga) hari kerja setelah pengumuman pemenang.
12.2. Sanggahan disampaikan kepada Pejabat Yang Berwenang yang menetapkan pemenang pengadaan.
12.3. Penyedia yang melakukan sanggahan wajib menyampaikan Jaminan Sanggahan berupa uang jaminan sebesar 1% (satu persen) dari nilai penawaran Penyedia yang dikirim ke rekening PT Geo Dipa Energi (Persero).
12.4. Jaminan Sanggahan akan dicairkan dan menjadi milik PT Geo Dipa Energi (Persero) jika sanggahan tidak terbukti benar
12.5. Sanggahan dapat diajukan apabila;
a. Panitia Pengadaan atau Pejabat Yang Berwenang menyalahgunakan wewenangnya; dan atau
b. Pelaksanaan pengadaan menyimpang dari ketentuan yang telah ditetapkan dalam RKS; dan atau
c. Terjadi praktek Korupsi, Kolusi dan Nepotisme (KKN) di antara Penyedia dengan Penyedia, Panitia Pengadaan atau Pejabat Yang Berwenang; dan atau
d. Terdapat rekayasa pihak-pihak tertentu yang mengakibatkan Proses Pengadaan tidak adil, tidak transparan, dan tidak terjadi persaingan yang sehat.
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BAB 3
FORMAT PERJANJIAN
13. Metode, Jangka Waktu Perjanjian & Draft Perjanjian 13.1. Metode Perjanjian & Jangka Waktu Perjanjian
Metode Perjanjian Beri Tanda
Jangka Waktu Perjanjian
Beri Tanda
Single Year Multi Years
Lump Sum -
Unit Price - - -
Unit Price & Kontrak Payung - - -
Gabungan Lump Sum dan Unit Price - - -
Turn Key - - -
Sewa - - -
Sewa Beli - - -
Jenis Perjanjian Lain - - -
13.2. Draft Perjanjian Terlampir
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BAB 4
LINGKUP PEKERJAAN
14. Latar Belakang
PT Geo Dipa Energi (Persero) berencana akan menggunakan area Mess PLN untuk digunakan sebagai
well pad 38 serta area pembangunan PLTP Dieng Unit 2. Sehingga dibutuhkan pembongkaran
bangunan yang tidak terpakai yang diketahui sebagai ex-Mess PLN, di Dieng – Jawa Tengah beserta
pembersihan areanya. Berdasarkan hasil kajian LPPKM FKM UI, material atap mengandung asbestos
sehingga diperlukan pengelolaan khusus Asbestos Containing Materials (ACM).
Sebelum pelaksanaan pembongkaran ACM dilakukan, LPPKM FKM UI akan memberikan pelatihan
terkait lingkup pekerjaan kepada penyedia jasa. Selain itu, selama kegiatan pembongkaran hingga
pemusnahan limbah asbestos, LPPKM FKM UI akan memberikan supervisi, melakukan pemantauan
udara ambien serta paparan terhadap pekerja.
Proses pembongkaran dan pengelolaan ACM harus dilakukan dengan baik dan mematuhi regulasi
serta mendapatkan persetujuan dari Asian Development Bank (ADB) representative, sehingga
mengurangi dampak terhadap lingkungan dan juga dampak terhadap kesehatan masyarakat dan
pekerja. Oleh karena itu, PT Geo Dipa Energi (Persero) memerlukan penyedia jasa profesional yang
berpengalaman di dalam penanganan ACM.
15. Daftar Pekerjaan Yang Akan Dilaksanakan
No Nama Jasa Satuan Jumlah
1 Pembongkaran material asbestos pada atap ex-Mess PLN AU 1
2 Pengemasan dan pengelolaan limbah ACM AU 1
3 Pengangkutan dan pemusnahan / pemanfaatan limbah ACM AU 1
16. Spesifikasi Teknis
16.1. Penyedia harus memastikan bahwa jasa yang dilaksanakan adalah sesuai dengan spesifikasi teknis yang ditetapkan dan pengaturan serta ketetapan lain dalam Perjanjian ini.
16.2. Jasa yang dilaksanakan dalam Perjanjian ini harus sesuai dengan standar (baik nasional maupun internasional) yang ditetapkan dalam Perjanjian ini. Jika dalam Perjanjian ini tidak menetapkan suatu standar rujukan, maka standar yang digunakan terkait pelaskanaan jasa yang dilaksanakan, minimal setara atau lebih baik dari standar resmi yang diaplikasikan di Indonesia.
16.3. Dalam hal dalam Perjanjian ini menetapkan suatu standar rujukan (baik nasional maupun internasional) maka edisi atau revisi standar yang digunakan adalah yang ditetapkan dalam Perjanjian ini. Dalam hal terjadi perubahan edisi atau revisi standar pada saat pelaksanaan pekerjaan, maka perubahan dapat diaplikasikan sepanjang disepakati oleh Para Pihak dan dituangkan dalam Addendum Perjanjian.
16.4. Kecuali jika secara tegas dinyatakan, kewajiban Penyedia mencakup pelaksanaan seluruh pekerjaan jasa termasuk Penyediaan pekerjaan sementara, material, dan hal lainnya yang dibutuhkan untuk menyelesaikan pekerjaan jasa sesuai dengan rencana, prosedur, spesifikasi, gambar, kode, dan dokumen lainnya sebagaimana ditentukan dalam Perjanjian ini.
16.5. Penyedia jasa memiliki pengetahuan dan pengalaman dalam kegiatan pembongkaran, pengelolaan, pengangkutan hingga pemusnahan / pemanfaatan limbah ACM dan dibuktikan dengan sertifikat pelatihan.
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16.6. Penyedia jasa memberikan slot tenaga kerja lokal di area Desa Karang Tengah.
16.7. Penyedia jasa menyediakan HSE Plan dan COVID-19 Plan selama kegiatan berlangsung.
16.8. Penyedia jasa akan melakukan pengelolaan limbah ACM sebagaimana limbah B3, sesuai dengan regulasi terkait.
16.9. Penyedia jasa dalam kegiatan pengangkutan dan pemusnahan / pemanfaatan wajib memiliki perizinan yang masih valid untuk pengelolaan limbah B3, khususnya limbah asbes.
16.10. Spesifikasi Teknis detail dari Jasa yang dilaksanakan adalah sebagai berikut:
No Nama Jasa Deskripsi Teknis Detail Satuan Jumlah
1 Pembongkaran material asbestos pada atap ex-Mess PLN
• Total luasan asbestos ±5983m2, ketebalan ±5mm, dengan rincian sumber material asbestos:
1. Atap bangunan utama 2. Atap barrack 1 3. Atap barrack 2 4. Atap barrack 3 5. Atap laboratorium 6. Atap poliklinik
• Proses pembongkaran harus meminimasi potensi paparan kepada pekerja serta pencemaran udara dan tanah
• Proses pembongkaran akan disupervisi oleh LPPKM FKM UI dan mengacu pada dokumen Asbestos Management Plan
AU 1
2 Pengemasan dan pengelolaan limbah ACM
• Estimasi volume timbulan limbah ACM adalah 5983 m2 * 0,005 m = 29,915m3, atau dibulatkan menjadi ± 30 m3.
• Untuk 1 m3 asbes gelombang beratnya 1300 kg maka total berat 300 * 1.3 ton = 390 ton ACM.
• Pengemasan dan pengelolaan limbah ACM akan disupervisi oleh LPPKM FKM UI dan mengacu pada dokumen Asbestos Management Plan.
AU 1
3 Pengangkutan dan pemusnahan / pemanfaatan limbah ACM
• Pengangkutan dan pemusnahan / pemanfaatan limbah ACM diperbolehkan untuk diserahkan kepada pihak ketiga berizin yang masih valid dan memiliki festronik untuk limbah ACM.
• Certificate of Treatment akan diserahkan kepada PT Geo Dipa Energi (Persero) setelah limbah dimusnahkan / dimanfaatkan.
• Kegiatan pengangkutan dan pemusnahan / pemanfaatan limbah ACM akan disupervisi oleh LPPKM FKM UI dan mengacu pada dokumen Asbestos Management Plan.
AU 1
*Dokumen Asbestos Management Plan akan dilampirkan.
17. Organisasi, Personil, Dokumen dan Laporan Kemajuan Pekerjaan
17.1. Penyedia harus menyediakan bagan yang menunjukkan struktur organisasi yang diusulkan yang untuk melaksanakan pekerjaan jasa dan mencakup identitas para personel kunci. Setiap perubahan atas struktur organiasasi Penyedia harus diberitahukan secara tertulis kepada Pemberi Kerja.
17.2. Personil kunci minimal yang dipersyaratkan berdasarkan Perjanjian ini adalah:
No Personil Kunci Beri Tanda
1 Supervisor lapangan
2 Pelaksana pembongkaran atap mengandung asbestos
3 Helper (tenaga lokal)
4 Transporter (Driver pengangkut limbah ACM)
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17.3. Penyedia harus menyerahkan kepada Pemberi Kerja atau Direksi Pekerjaan yang ditunjuk, dokumen-dokumen berikut sebelum memulai pelaksanaan pekerjaan jasa:
No Dokumen Beri Tanda
1 Phase 3 – Asbestos Management Plan
2 Materi pelatihan dari LPPKM FKM UI
3 Phase 2 – Laporan Survey ACM
17.4. Dalam hal Pemberi Kerja atau Direksi Pekerjaan memberikan catatan atau permintaan perubahan atas dokumen-dokumen tersebut, maka Penyedia harus memperbarui dan merevisi dokumen sebagaimana catatan atau permintaan tersebut dan menyerahkan kembali kepada Pemberi Kerja atau Direksi Pekerjaan.
17.5. Penyedia harus senantiasi memonitor kemajuan pekerjaan jasa sesuai dengan program kerja terperinci yang telah diserahkan dan melaporkan secara berkala kepada Pemberi Kerja atau Direksi Pekerjaan setiap bulan. Laporan kemajuan pekerjaan harus dapat menunjukan:
a. Persentase penyelesaian pekerjaan, termasuk perbandingan persentase penyelesaian pekerjaan aktual dengan rencana dalam program kerja;
b. Aktifitas yang persentase penyelesaian pekerjaan tertlambat dan tidak sesuai dengan program kerja, serta disertai catatan, kemungkinan risiko dan tindakan korektif apa yang akan dilakukan.
18. Peralatan Kerja Penyedia 18.1. Semua peralatan kerja Penyedia yang dibawa oleh Penyedia ke lapangan akan dianggap
dimaksudkan untuk digunakan secara eksklusif untuk pelaksanaan pekerjaan jasa sebagaimana dalam Perjanjian ini.
18.2. Setelah menyelesaikan seluruh pekerjaan jasa sebagaimana dalam Perjanjian ini, Penyedia berkewajiban untuk memobilisasi seluruh peralatan kerja Penyedia dari lapangan termasuk jika terdapat kelebihan bahan/material terkait dengan pekerjaan jasa.
18.3. Peralatan kerja Penyedia minimal yang dipersyaratkan berdasarkan Perjanjian ini adalah:
No Peralatan Kerja Beri Tanda
1 HEPA filter, spray / alat coating dan dokumen perizinan
2 Kemasan limbah B3 (minimal jumbo bag double liner)
3 APD dan semua peralatan yang dipersyaratkan pada Asbestos Management Plan
4 Transportasi
19. Kewajiban Pemberi Kerja
Pemberi Kerja akan menunjuk LPPKM FKM UI untuk melakukan supervisi selama pekerjaan dalam
lingkup Perjanjian ini dilaksanakan.
20. Gambar-Gambar Teknis (Tidak Diperlukan)
20.1. Penyedia harus membuat gambar detail atau gambar kerja (detail/working drawing) berdasarkan gambar dasar (basic drawing) yang diberikan oleh Pemberi Kerja sesuai dengan ketentuan-ketentuan dan standar-standar dalam Perjanjian, atau jika tidak ditentukan, maka dilakukan sesuai dengan praktik rekayasa/engineering yang baik.
15
20.2. Gambar Teknis yang harus disediakan:
No Nama Jasa
Drawing
Beri Tanda
Basic Drawing
Pemberi Kerja
Detail/Working Design
Penyedia
1 [input data] [input data] [input data]
2 [input data] [input data] [input data]
3 [input data] [input data] [input data]
21. Perijinan
Setiap perijinan yang terkait dengan pelaksanaan pekerjaan jasa menjadi tanggung jawab Penyedia.
22. Health, Safety and Environment (HSE)
22.1. Penyedia harus setiap saat mengambil tindakan pencegahan yang wajar untuk menjaga kesehatan dan keselamatan Personil Penyedia serta perlindungan lingkungan. Bekerja sama dengan fungsi HSE yang dimiliki oleh Pemberi Kerja, untuk senantiasi memastikan bahwa akses terhadap fasilitas medis, fasilitas pertolongan pertama, rumah sakit, dan layanan ambulans tersedia setiap saat di lapangan.
22.2. Penyedia harus menunjuk safety officer di lapangan, yang bertanggung jawab untuk menjaga keselamatan dan perlindungan terhadap kecelakaan. safety officer harus memenuhi syarat untuk tanggung jawab ini, dan akan memiliki wewenang untuk mengeluarkan instruksi dan mengambil tindakan perlindungan untuk mencegah kecelakaan.
23. Asuransi
23.1. Seluruh peralatan Penyedia yang digunakan dalam pelaksanaan pekerjaan jasa dalam Perjanjian ini harus diasuransikan untuk memberikan perlindungan atas resiko kerusakan dan kehilangan baik selama proses transportasi, penyimpanan sementara, transit, penerimaan dan penggunaan di lapangan.
23.2. Seluruh tenaga kerja Penyedia yang melaksanakan pekerjaan jasa terkait yang dilaksanakan sesuai dengan Perjanjian ini harus dilindungi minimal dengan asuransi tenaga kerja yang diwajibkan oleh Pemerintah.
24. Garansi
24.1. Penyedia menjamin bahwa setiap pekerjaan jasa yang dilaksanakan adalah bebas dari cacat yang timbul dari tindakan atau kelalaian Penyedia atau sub kontraktornya, atau yang timbul dari desain, bahan baku, dan pengerjaan.
24.2. Jika karena alasan yang menjadi tanggung jawab Penyedia, spesifikasi teknis pelaksanaan pekerjaan jasa yang ditetapkan tidak terpenuhi baik secara keseluruhan atau sebagian, Penyedia dengan biayanya sendiri akan melakukan perbaikan yang mungkin diperlukan untuk memenuhi setidaknya tingkat minimum spesifikasi teknis pelaksanaan pekerjaan jasa tersebut.
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24.3. Jangka waktu garansi adalah:
Jangka Waktu Garansi Sejak
12 bulan Pekerjaan selesai dilakukan
24.4. Dalam hal terjadi klaim atas garansi oleh Pemberi Kerja, maka Pemberi Kerja harus memberikan
pemberitahuan tertulis kepada Penyedia, yang menyatakan sifat dari setiap cacat atau kerusakan yang terjadi bersama dengan semua bukti yang tersedia. Pemberi Kerja harus memberikan semua peluang dan kesempatan kepada Penyedia untuk memeriksa cacat atau kerusakan tersebut.
24.5. Setelah menerima pemberitahuan tersebut, Penyedia akan, dalam waktu maksimal 7 (tujuh) hari kalender harus segera memperbaiki setiap cacat atau kerusakan atau bagian-bagiannya, dan tanpa biaya tambahan kepada Pemberi Kerja.
25. Jangka Waktu
25.1. Jangka waktu pelaksanaan pekerjaan jasa adalah sesuai dengan jangka waktu sebagai berikut:
No Pekerjaan Jasa Durasi Pelaksanaan
1 Pembongkaran, Pengangkutan dan Pemusnahan Asbestos Containing
Materials (ACM) di Mess PLN untuk Pengembangan Proyek Dieng 2
150 hari kalender
25.2. Perjanjian dianggap tetap berlaku meskipun waktu pelaksanaan pekerjaan jasa telah dilaksanakan atau telah selesai atau terlampaui (termasuk masa garansi dan atau perpanjangan masa garansi bila ada), selama masih terdapat hak dan kewajiban Pemberi Kerja atau Penyedia yang belum dipenuhi oleh masing-masing pihak.
25.3. Tanpa harus dinyatakan secara tegas, Perjanjian dinyatakan secara serta merta berakhir bilamana seluruh hak dan kewajiban Pemberi Kerja dan Penyedia sebagaimana diatur dalam Perjanjian telah dipenuhi.
25.4. Apabila seluruh hak dan kewajiban Pemberi Kerja dan Penyedia sebagaimana diatur dalam Perjanjian telah dipenuhi, maka Pemberi Kerja dan Penyedia wajib menjamin dan membebaskan masing-masing pihak dari segala gugatan dan/atau tuntutan hukum apapun termasuk namun tidak terbatas pada kelalaian kewajiban pembayaran terkait penyelesaian kewajiban Penyedia kepada pihak lain yang menjadi Subkontraktor atau sub vendor atau supplier dan atau pihak lain.
17
26. Perpanjangan Jangka Waktu
26.1. Jika dalam jangka pelaksanaan pekerjaan jasa, Penyedia atau Subkontraktornya atau sub vendornya atau suppliernya harus menghadapi kondisi yang menghalangi pelaksanaan pekerjaan jasa secara tepat waktu, maka Penyedia harus segera memberi tahu Pemberi Kerja secara tertulis tentang adanya keterlambatan tersebut, termasuk durasi keterlambatan yang terjadi dan penyebabnya. Segera setelah menerima pemberitahuan dari Penyedia, Pemberi Kerja harus mengevaluasi situasi tersebut dan dapat memberikan keputusan apakah dapat memberikan perpanjangan jangka waktu pelaksanaan pekerjaan jasa tersebut. Dalam hal perpanjangan jangka waktu diberikan, maka atas perubahan tersebut harus dituangkan dalam Addendum Perjanjian.
26.2. Perpanjangan jangka waktu juga dapat diberikan dalam hal terjadinya peristiwa/kejadian Force Majeure sebagaimana ketentuan Perjanjian ini atau bila terdapat perubahan undang-undang atau adanya regulasi Pemerintah Republik Indonesia yang secara nyata dapat dibuktikan secara signifikan mempengaruhi jangka waktu pelaksanaan pekerjaan jasa. Dalam hal perpanjangan jangka waktu diberikan, maka atas perubahan tersebut harus dituangkan dalam Addendum Perjanjian.
26.3. Kecuali dalam hal terjadinya peristiwa/kejadian Force Majeure atau terdapat perubahan undang-undang atau adanya regulasi Pemerintah Republik Indonesia baru atau dalam hal perpanjangan jangka waktu diberikan, maka setiap keterlambatan dalam jangka waktu pelaksanaan pekerjaan jasa akan dikenakan denda keterlambatan.
27. Denda
27.1. Jika Penyedia terlambat atau gagal untuk melaksanakan salah satu bagian atau seluruh pekerjaan jasa, tanpa mengurangi hak Pemberi Kerja untuk menggunakan solusi lain sesuai dengan pengaturan Perjanjian ini, maka Penyedia akan dikenakan denda yang jumlahnya diatur berdasarkan Perjanjian ini atas setiap hari keterlambatan yang terjadi sampai dengan seluruh pelaksanaan jasa selesai dilaksanakan. Pengenaan denda akan langsung dikurangkan dari pembayaran atas Harga Pekerjaan. Jika nilai denda telah mencapai nilai maksimum yang ditetapkan, maka Pemberi Kerja berhak untuk melakukan terminasi atas Perjanjian ini secara sepihak.
27.2. Pengenaan denda adalah sebagai berikut:
Pengenaan Denda Beri Tanda Nilai Denda
Perhari
Maksimum Hari
Keterlambatan
Maksimum Nilai
Denda
Denda Parsial Tehadap
Bagian Perjanjian - - %
-
Hari Kalender - %
Denda Terhadap
Keseluruhan Perjanjian 0,1 %
50
Hari Kalender 5 %
28. Pembebasan Denda
Pengenaan denda dapat dibebaskan dalam hal keterlambatan atau kegagalan untuk melaksanakan
salah satu bagian atau seluruh pekerjaan jasa terjadi karena hal-hal yang diakibatkan oleh terjadinya
peristiwa/kejadian Force Majeure, terdapat perubahan undang-undang atau adanya regulasi
Pemerintah Republik Indonesia baru yang berdampak pada pelaksanaan pekerjaan jasa, dalam hal
perpanjangan jangka waktu diberikan oleh Pemberi Kerja, atau jika terjadi penundaan pelaksanaan
Perjanjian atas permintaan tertulis dari Pemberi Kerja.
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29. Tahapan Pembayaran
29.1. Tahapan pembayaran sebagai berikut:
No Tahap Pembayaran Persentase Milestones
1 Tahap 1 50%
Pekerjaan Pembongkaran ACM dinyatakan selesai yang dibuktikan dengan diterbitkannya BAPP
2 Tahap 2 50% Pekerjaan dinyatakan selesai yang dibuktikan dengan diterbitkannya BAPP dan BAST serta
Laporan akhir pengelolaan ACM dari LPPKM FKM UI telah disetujui oleh ADB
30. Rekening Bank
30.1. Pembayaran atas Harga dilaksanakan secara transfer ke rekening Penyedia. Biaya transfer menjadi tanggung jawab Penyedia yang dipotong langsung dari pembayaran tersebut.
30.2. Perubahan nomor rekening dapat dilakukan dengan pemberitahuan tertulis.
31. Dokumen Penagihan dan Pembayaran
31.1. Penagihan oleh Penyedia dilakukan secara tertulis, disertai dokumen tagihan dan dokumen terkait lainnya, dengan detai sebagai berikut:
No Dokumen
1 Surat Permohonan Pembayaran
2 Invoice rangkap 4 (empat), 1 (satu) bermaterai cukup dan 3 (tiga) copy
3 Kuitansi rangkap 4 (empat), 1 (satu) bermaterai cukup dan 3 (tiga) copy
4 Faktur Pajak Elektronik rangkap 3 (tiga) sesuai dengan SE-50/PJ/2011 tanggal 3 Agustus 2011 dengan
kode faktur pajak WAPU (030.xxx)
5 Copy NPWP
6 Copy Purchase Order (PO) dan Copy Perjanjian
7 Berita Acara Penyelesaian Pekerjaan (BAPP) ditandatangani oleh Direksi Pekerjaan
8 Service Acceptance (SA)
9 Berita Acara Serah Terima (BAST) barang yang ditandatangani oleh penandatangan Perjanjian
10 Jaminan Pemeliharaan/Perpanjangan Jaminan Pelaksanaan
31.2. Penagihan dialamatkan kepada: PT Geo Dipa Energi (Persero) u.p. Direktur Keuangan.
31.3. Pemberi Kerja akan membayar tagihan dalam waktu 30 (tiga puluh) hari kerja terhitung mulai tanggal seluruh dokumen tagihan dan dokumen terkait lainnya dinyatakan lengkap dan benar.
31.4. Pemberi Kerja berhak menahan atau memotong pembayaran atas tagihan dengan ketentuan sebagai berikut :
a. Menahan
i. Apabila terdapat terdapat kesalahan dan atau ketidaklengkapan dokumen tagihan dan dokumen terkait lainnya.
ii. Apabila diketahui bahwa Jaminan Pelaksanaan yang telah diberikan sudah habis masa berlakunya dan Penyedia belum menyerahkan perpanjangan Jaminan Pelaksanaan.
iii. Apabila terdapat tuntutan ganti rugi dari pihak lain atau sub kontraktor Penyedia yang diterima Pemberi Kerja dan tidak dapat diselesaikan oleh Penyedia.
b. Memotong
i. Apabila terjadi kelebihan pembayaran oleh Pemberi Kerja yang berhubungan dengan pembayaran sebelumnya dalam Perjanjian ini.
19
ii. Apabila terdapat sanksi dan atau denda yang dibebankan kepada Penyedia sesuai dengan Perjanjian ini.
32. Jaminan – Jaminan
32.1. Jaminan Pelaksanaan
a. Penyedia harus menyerahkan Jaminan Pelaksanaan (Performance Security) kepada Pemberi Kerja. Jaminan Pelaksanaan berupa garansi bank (bank guarantee) dengan kondisi unconditional dan irrevocable, harus diterbitkan oleh Bank BUMN, sebesar 5% (lima persen) dari total nilai Harga Pekerjaan termasuk PPN.
b. Jaminan Pelaksanaan wajib diserahkan Penyedia kepada Pemberi Kerja paling lambat 7 (tujuh) hari kerja setelah SKPP diterbitkan. Masa berlaku Jaminan Pelaksanaan adalah sekurang-kurangnya berlaku sejak tanggal diterbitkan sampai dengan 30 (tiga puluh) hari kalender setelah tanggal berakhirnya Jangka Waktu Pelaksanaan Pekerjaan.
c. Penyedia wajib memperpanjang Jaminan Pelaksanaan sampai dengan berakhirnya Jangka Waktu Pelaksanaan Pekerjaan apabila terjadi perpanjangan masa Jangka Waktu Pelaksanaan Pekerjaan. Apabila Penyedia tidak bersedia untuk memperpanjang masa berlaku Jaminan Pelaksanaan dalam hal dibutuhkan perpanjangan, maka Pemberi Kerja berhak tanpa perlu adanya persetujuan terlebih dahulu Penyedia untuk mencairkan Jaminan Pelaksanaan tersebut, serta hasil pencairannya menjadi milik Pemberi Kerja.
d. Jaminan Pelaksanaan dapat dicairkan sewaktu-waktu oleh Pemberi Kerja berdasarkan alasan-alasan yang diatur dalam Perjanjian ini, termasuk jika Penyedia tidak dapat menyelesaikan pekerjaannya baik sebagian atau seluruhnya, tanpa perlu persetujuan terlebih dahulu dari Penyedia.
e. Jaminan Pelaksanaan akan dikembalikan oleh Pemberi Kerja kepada Penyedia setelah Jangka Waktu Pelaksanaan Pekerjaan beserta perpanjangannya (jika ada) telah habis.
32.2. Jaminan Pemeliharaan (Tidak Digunakan)
a. Penyedia harus menyerahkan Jaminan Pemeliharaan kepada Pemberi Kerja. Jaminan Pemeliharaan berupa garansi bank (bank guarantee) dengan kondisi unconditional dan irrevocable, harus diterbitkan oleh Bank BUMN, sebesar 5% (lima persen) dari total nilai Harga Pekerjaan termasuk PPN. Jaminan pemeliharaan dapat berupa Jaminan Pelaksanaan yang diperpanjang masa berlakunya sampai dengan berakhirnya masa garansi.
b. Jaminan Pemeliharaan wajib diserahkan Penyedia kepada Pemberi Kerja bersama dengan permohonan pembayaran. Masa berlaku Jaminan Pemeliharaan adalah sekurang-kurangnya berlaku sejak tanggal diterbitkan sampai dengan 30 (tiga puluh) hari kalender setelah tanggal berakhirnya masa garansi.
c. Jaminan Pemeliharaan akan dikembalikan setelah pelaksanaan masa garansi selesai dan tidak terdapat perpanjangan masa garansi dan ditandai dengan ditandatanganinya Berita Acara Selesai Masa Garansi.
20
LAMPIRAN – LAMPIRAN
33. ASBESTOS MANAGEMENT PLAN PHASE 3
34. PHASE 2 ASBESTOS SURVEY AND SAMPLING REPORT OF EX-PLN BUILDING SITE
35. PRELIMINARY ASBESTOS SURVEY REPORT
1
LPPKM FKM UI
ASBESTOS MANAGEMENT PLAN PHASE 3
DIENG, CENTRAL JAVA PREPARED FOR: PT. GEO DIPA ENERGI (PERSERO) – DIENG UNIT 2 PROJECT
2
LPPKM FKM UI
ASBESTOS MANAGEMENT PLAN PHASE 3
[Subject]
DIENG, CENTRAL JAVA
[Keywords]
Prepared by Prepared for
LPPKM FKM UI PT. GEO DIPA ENERGI (PERSERO) – DIENG UNIT 2 PROJECT
i
LPPKM FKM UI
Table of Content
1. Objective ………………………………………….………... 1
2. Scope of Work ………………………………………….………... 1
3. Asbestos Demolition Activities ………………………………………….………... 2
3.1. Risk Assessment ………………………………………….………... 2
3.2. Preparation ………………………………………….………... 2
3.3. Execution of Work ………………………………………….………... 3
3.4. Clearance ………………………………………….………... 4
3.5. Transportation ………………………………………….………... 4
4. Standard Procedure ………………………………………….………... 6
4.1. Asbestos Containing Material Procedure ………………………………………….………... 6
4.2. Emergency Condition Procedure ………………………………………….………... 12
4.3. Dispose of Personal protective Equipment
(PPE) ………………………………………….………... 12
4.4. Dispose of Asbestos Waste ………………………………………….………... 12
5. Implementation of Training ………………………………………….………... 12
6. Schedule of Asbestos Demolition Activities ………………………………………….………... 13
ii
LPPKM FKM UI
List of Appendix
1. Appendix I - References ………………………………………….………... 14
2. Appendix II - Sub-contractor Criteria ………………………………………….………... 15
3. Appendix III - Personal Protective Equipment ………………………………………….………... 16
4. Appendix IV - SOW of Demolishing Building
Project Dieng 2 for Sub Contractor ………………………………………….………... 18
5. Appendix V - Training material of asbestos
demolish building. ………………………………………….………... 30
6. Appendix VI – Safe Work Method Statement
Removal of Asbestos Containing Material and
Minor Damage of ACM
………………………………………….………... 31
pg. 1
INTERNAL. This information is accessible to ADB Management and staff. It may be shared outside ADB with appropriate permission.
LPPKM FKM UI
1. OBJECTIVE / TUJUAN
Asbestos Management Plan aims to manage Asbestos Containing Material (ACM) in preparation of
any demolition work of building. It also aims to guide in the permanent and safe disposal of ACM in
accordance with Government Regulation No. 101/2014 regarding Hazardous Material Waste
Management and Regulation of Ministry of Manpower No. 5/2018 regarding Occupational Health and
Safety in the Workplace.
Asbestos Management Plan ditujukan untuk kegiatan pengelolaan Asbestos Containing Material
(ACM) yang meliputi perencanaan, pelaksanaan pekerjaan pembongkaran, pewadahan dan
pengangkutan limbah material Asbestos Containing Material (ACM) ke pembuangan akhir sesuai
dengan aturan atau tata cara yang direkomendasikan oleh Peraturan Pemerintah No. 101/2014 tentang
Pengelolaan Limbah Bahan Beracun dan Berbahaya dan Peraturan Menteri Ketenagakerjaan No. 5
Tahun 2018 tentang Keselamatan dan Kesehatan Kerja Lingkungan Kerja.
2. SCOPE OF WORK / RUANG LINGKUP PEKERJAAN
This Asbestos Management Plan applies to all ACM handling activities which are identified in PT. Geo
Dipa Energi. The scope of work of this asbestos management plan are:
Setting up of the plan for preparation of demolition, execute of ACM demolition activity,
sampling, and clearance activity in accordance with Minister of Manpower Regulation No. PER-
03-/MEN/1985 on occupational safety and health in the use of asbestos and international
practice. (Note: UI Lemtek consultant prepared the document for ACM plan and will supervise
activity of asbestos demolition.)
Setting up of the Scope of Work (SOW) on transportation of ACM waste to final disposal in
accordance to guidelines or regulation recommended by Government Regulation No. 101/2014
regarding Hazardous Material Waste Management and Government Regulation No. 22/2021
regarding Implementation of Environmental Protection and Management.
Setting up of Scope of Work (SOW) of preparation of demolition activity, execution of demolition
and clearance activities for sub contractor.
Criteria requirement for third party sub contractor who will execute the ACM demolition and
clearance activities.
Training materials and conduct of training regarding demolition activities for sub contractor.
Work equipment and manpower for building demolition activities on Project Dieng 2 site area.
Asbestos Management Plan berlaku untuk semua penanganan ACM yang ada di PT. Geo Dipa Energi.
Ruang lingkup Asbestos Management Plan ini antara lain:
Menyusun rencana kegiatan persiapan demolish, pelaksanaan demolish ACM, pengambilan
sampel, serta kegiatan setelah demolish bangunan (clearance) sesuai dengan Peraturan
Menteri Ketenagakerjaan No. 03-/MEN/1985 tentang Keselamatan dan Kesehatan Kerja
Pemakaian Asbes dan standard internasional (Catatan: Konsultan UI Lemtak menyiapkan
dokumen untuk rencana kegiatan pembongkaran ACM dan akan mensuperbisi kegiatan
pembongkaran ACM).
pg. 2
INTERNAL. This information is accessible to ADB Management and staff. It may be shared outside ADB with appropriate permission.
LPPKM FKM UI
Menyusun Scope of Work (SOW) transportasi limbah ACM ke pembuangan akhir sesuai
dengan aturan atau tata cara yang direkomendasikan oleh Peraturan Pemerintah No.
101/2014 tentang Pengelolaan Limbah Bahan Beracun dan Berbahaya dan Peraturan
Pemerintan No. 22/2021 tentang Penyelenggaraan Perlindungan dan Pengelolaan Lingkungan
Hidup.
Menyusun scope of work (SOW) kegiatan persiapan, pembongkaran dan kegiatan setelah
pembongakaran (clearance) untuk sub kontraktor.
Menyusun persyaratan kriteria sub kontraktor.
Menyusun materi pelatihan dan melaksanakan kegiatan pelatihan tentang kegiatan demolish
bangunan bagi sub kontraktor.
Menyusun daftar peralatan kerja dan tenaga kerja untuk kegiatan pembongkaran bangunan
Project Dieng 2.
3. Asbestos Demolition Activities/ Kegiatan Pekerjaan Demolish Asbes
3.1. Risk Assessment/ Penilaian Risiko
Risk assessment is carried out prior to start of mobilization activities to plan and prepare the
work equipment and tools, identify the site management plans for erecting scaffolding and
carrying out demolition activities, design the sampling and measurement of air samples,
personal samples and soil samples of ACM, and plan the transportation of asbestos waste as
well as demobilization activities. A presurvey report and survey report have been prepared
based on the results of the risk assessment containing the qualification criteria for the
company to be selected or engaged in asbestos removal. This qualification criteria is in
Appendix II.
Melakukan kajian risiko untuk setiap tahapan pekerjaan mulai dari kegiatan mobilisasi,
persiapan peralatan dan perlengkapan kerja, pemasangan perancah, pelaksanaan demolish,
pengukuran sampel asbes di udara, pekerja dan tanah, dan kegiatan transportasi limbah
asbes serta kegiatan demobilisasi. Laporan Presurvey dan Laporan Pelaksanaan Survei telah
disiapkan berdasarkan hasil penilaian risiko yang berisi kriteria kualifikasi untuk Perusahaan
yang dipilih atau terlibat dalam kegiatan demolish asbes. Kriteria kualifikasi tercantum pada
Lampiran II.
3.2. Preparation/ Persiapan
3.2.1. Mobilization of Work Equipment
Mobilisasi Peralatan Kerja
Sub contractor will carry out mobilization of work equipment in the project area. The list
of work equipment can be referred from Appendix IV (SOW Demolishing Building
Project Dieng 2 for Sub Contractor). For AMP, prior approval is GDE is needed.
Sub kontraktor melaksanakan mobilisasi peralatan kerja di lokasi project. Daftar
peralatan kerja terlampir di Lampiran IV (SOW Demolishing Building Project Dieng 2
pg. 3
INTERNAL. This information is accessible to ADB Management and staff. It may be shared outside ADB with appropriate permission.
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for Sub Contractor).
3.2.2. Preparation of Equipment and Tools/ Persiapan Peralatan dan Perlengkapan
The work equipment and tools placed at certain location in project area location.
Peralatan dan perlengkapan ditempatkan pada lokasi yang ditentukan di lokasi
proyek.
Prepare the equipment which will be used for erect the scaffolding.
Menyiapkan peralatan yang akan dipergunakan untuk memasang perancah.
Prepare work tools such as PPE and others.
Menyiapkan perlengkapan kerja seperti APD dan lainnya.
Prepare generator set for power needed and water for spraying the dust.
Menyiapkan genset untuk kebutuhan listrik dan air untuk penyemprotan debu.
Prepare vaccum HEPA filter, assembly tarpaulin surrounding work area, utility set
and bowplank, carry out excavation, hoarding, stamper for soil compaction, as well
as disposal of soil and silica
Menyiapkan Vacuum HEPA filter, memasang terpal disekitar area kerja, utility set
and bowplank, melakukan penggalian, penimbunan, pemadatan tanah,
pembuangan tanah dan silika
3.2.3. Erection of Scaffolding, Temporary Bluesheet Fence, Work Platform & handrail,
Temporary Habitat, Space Isolation wall/ Pemasangan Perancah, Temporary
Bluesheet Fence, Work Platform & handrail, Temporary Habitat, Space Isolation wall
Conduct the work on scaffolding erection, as well as erection of Temporary
Bluesheet Fence, Work Platform & handrail, Temporary Habitat, Space Isolation
wall
Melaksanakan pekerjaan pemasangan perancah, serta pemasangan Temporary
Bluesheet Fence, Work Platform & handrail, Temporary Habitat, Space Isolation
wall
Set up the tarpaulin/cover, blower and exhaust.
Pemasangan terpal/penutup, blower dan exhaust.
3.3. Execution of Work/ Pelaksanaan Pekerjaan
3.3.1. Carry out the work to remove ACM at roof.
Pekerjaan melepaskan ACM pada atap
3.3.2. Set up the removed ACM at the predetermined location in accordance to procedure
Menyusun bahan ACM yang sudah dilepas di lokasi yang telah ditentukan sesuai
prosedur
3.3.3. Wrap the ACM with Polyethylene (plastic) to prevent potential of asbestos fibre
release to the air that could cause exposure and hazards to workers.
Membungkus ACM dengan plastik Polyethylene untuk mencegah potensi serat
asbes terbang dan memapar pekerja
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3.3.4. Measure asbestos concentration on air by collecting 8 samples in the predetermined
location
Pengukuran konsentrasi asbes di udara sebanyak 8 sampel di lokasi yang telah
ditentukan
3.3.5. Measure asbestos concentration on 12 samples at workers through Accredited
Laboratory (KAN).
Pengukuran konsentrasi asbes personal sebanyak 12 sampel pada sampel pekerja
yang telah ditentukan dan analisis laboratorium adalah laboratorium terakreditasi.
3.3.6. Measure asbestos soil sample as much as 2 samples in the predetermined location
Pengukuran konsentrasi asbes di tanah sebanyak 2 sampel di lokasi yang telah
ditentukan
3.4. Clearance/ Kegiatan Pembersihan
3.4.1. Carry out clearance work from debris in the location
Pekerjaan pembersihan lokasi dari puing-puing bangunan
3.4.2. Conduct measurement of air sampling of asbestos as much as 8 samples in the
predetermined location
Pengukuran konsentrasi asbes di udara sebanyak 8 sampel pada lokasi yang telah
ditentukan
3.4.3. Conduct measurement asbestos soil sample as much as 2 samples in the
predetermined location
Pengukuran konsentrasi asbes di tanah sebanyak 2 sampel pada lokasi yang telah
ditentukan
3.4.4. Demobilization of work equipment from project area
Demobilisasi peralatan kerja dari lokasi proyek
3.5. Transportation of ACM to Disposal/ Transportasi ACM ke Pembuangan Akhir
The packed asbestos waste will be sent to PPLI/TLI in accordance to applicable regulation
or procedure (Government Regulation No. 22/2021 regarding Implementation of
Environmental Protection and Management). PPLI and TLI are company which has
permission/license from Government to treat hazardous material in accordance to
Government Regulation No. 22/2021 regarding Implementation of Environmental Protection
and Management). Sub contractor who carry out ACM waste transportation to final disposal
are required to submit formal application to the MOEF and complete the requirements
accordance with Article 311 paragraph 3 of the Government Regulation No. 22/2021. The
ACM transport application should contain the following details:
a. Applicant’s identity;
b. Establishment of business entity;
c. Proof of the ownership and guarantee fund for restoration of the area and surrounding
environment;
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d. Proof of equipment transportation; and
e. Hazardous waste transportation documents.
Sub contractor should complete the Hazardous Material Waste Transportation Document
(Article 311 paragraph 4 of Government Regulation No. 101/2014) which includes:
a. Type and number of transportations/trips;
b. Source, name and characteristics of hazardous material waste which being
transported;
c. Hazardous material waste management procedure in emergency conditions;
d. Equipment for handling hazardous material waste; and
e. Procedures for loading hazardous material waste.
The sub-contractor is required to complete the Hazardous Waste Transport Document (ACM
waste) in accordance with Article 311 paragraph 4 of Government Regulation No. 22/2021,
which includes:
a. type and number of equipment transportation;
b. the source, name and characteristics of the hazardous waste being transported;
c. hazardous waste management procedures in emergency conditions;
d. equipment for handling hazardous waste; and
e. procedures for loading hazardous waste.
Sub contractor is required to secure a recommendation letter of hazardous material waste
transportation which issued by Ministry of Environment and Forestry prior to the conducting
of transporting ACM waste, in accordance with Article 312 paragraph 3 (a) of Government
Regulation No. 22/2021. Recommendation as referred to in Article 312 paragraph 3 (a) of
Government Regulation No. 22/2021 are:
a. The manifest code of the hazardous material waste transporter
b. The name of ACM (chrysotile) and characteristics of hazardous material waste which
will be transported; and
c. Recommendation validity period.
Limbah asbes yang sudah dikemas dilakukan pengiriman ke PPLI/TLI sesuai dengan
regulasi maupun prosedur yang berlaku (Peraturan Pemerintah No. 22/2021 tentang
Penyelenggaraan Perlindungan dan Pengelolaan Lingkungan Hidup). PPLI ataupun TLI
merupakan perusahaan yang sudah memiliki ijin dari Pemerintah terkait pengelolaan limbah
B3 sesuai dengan Peraturan Pemerintah No. 22/2021 tentang Penyelenggaraan
Perlindungan dan Pengelolaan Lingkungan Hidup. Sub kontraktor yang melaksanakan
transportasi limbah B3 ke pembuangan akhir harus mengajukan permohonan secara tertulis
kepada Menteri dan dilengkapi dengan persyaratan sesuai dengan pasal 311 ayat 3 PP No.
22/2021) yang meliputi:
a. identitas pemohon;
b. akta pendirian badan usaha;
c. bukti kepemilikan atas dana penjaminan untuk pemulihan fungsi lingkungan hidup:
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d. bukti kepemilikan alat angkut; dan
e. dokumen Pengangkutan Limbah B3
Sub kontraktor harus melengkapi Dokumen Pengangkutan Limbah B3 (limbah ACM) sesuai
pasal 311 ayat 4 pada Peraturan Pemerintah No. 22/2021 yang memuat antara lain:
a. jenis dan jumlah alat angkut;
b. sumber, nama, dan karakteristik Limbah B3 yang diangkut;
c. prosedur penanganan Limbah B3 pada kondisi darurat;
d. peralatan untuk penanganan Limbah B3; dan
e. prosedur bongkat muat limbah B3.
Sub kontraktor harus mendapatkan surat rekomendasi pengangkutan limbah B3 (limbah
ACM) yang diterbitkan oleh Kementerian Lingkungan Hidup dan Kehutanan sebelum
pelaksanaan pengangkutan limbah B3 (limbah ACM) sesuai dengan pasal 312 ayat 3 (a)
pada PP No. 22/2021. Rekomendasi sebagaimana dimaksud pada pasal 312 ayat 3 (a) pada
PP No. 22/2021 memuat:
a. kode manifes Pengangkut Limbah B3;
b. nama ACM (chrysotile) dan karakteristik limbah B3 yang diangkut; dan
c. masa berlaku rekornendasi.
4. STANDARD PROCEDURE / PROSEDUR STANDAR
4.1. ACM General Procedure / Prosedur Umum ACM
4.1.1. Removal of ACM is conducted to all building which located in Project Dieng 2 area.
Asbestos Management Plan is to be implemented for all such work.
Pembongkaran ACM dilakukan pada seluruh bangunan yang berada di area Project
Dieng 2. Asbestos Management Plan dapat diimplementasikan untuk semua pekerjaan
tersebut.
4.1.2. Sub-contractor selection will be based on experience and competence to carry out the
demolition work. Sub-contractor selection should refer to sub-contractor criteria in
Appendix II.
Pemilihan sub kontraktor akan didasarkan pada pengalaman dan kompetensi untuk
melaksanakan pekerjaan pembongkaran (demolish). Pemilihan sub kontraktor harus
merujuk pada Kriteria Sub Kontraktor di Lampiran II
4.1.3. A Risk assessment shall be completed by consultant and reviewed or approved by the
Technical Director & EHS manager before any work can commence and, thereafter sent
to the EHS Department for Work Permit Collection. An integral part of the risk assessment
is registered to identify control measures and the PPE required for the work. Consultant
will provide training regarding work method for preparation, execution and after demolition
work. Material of training must address all relevant safety risks including working at height
and walking on fragile roofs.
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Penilaian risiko dilakukan oleh konsultan dan direview atau disetujui oleh Direktur Teknik
dan Manajer EHS sebelum pekerjaan dapat dimulai dan setelah itu dikirim ke Departemen
EHS untuk pengumpulan ijin kerja. Penilaian risiko yang menyeluruh
dibutuhkan/diperlukan untuk mengidentifikasi tindakan pengendalian dan PPE yang
dibutuhkan. Konsultan akan memberikan pelatihan mengenai metode kerja untuk
persiapan, pelaksanaan, dan pasca pembongkaran.
Materi pelatihan mencakup semua risiko keselamatan yang relevan, termasuk bekerja di
ketinggian dan berjalan diatap yang rapuh
4.1.4. The EHS Department shall assess the competence of the workers to execute the job. If If
the competency requirements are appropriate, the sub-contractor must provide the PPE
needed as attached in Attachment III. Safety briefing will be given by EHS Department
which will include a discussion on all hazards associated with the work including working
at height.
EHS Departemen akan menilai kompetensi para pekerja untuk melakukan pekerjaan itu.
Jika telah memenuhi persyaratan kompetensi, maka sub kontraktor harus menyediakan
APD yang diperlukan seperti yang terlampir pada Lampiran III. Briefing keselamatan kerja
akan diberikan oleh Departemen EHS yang akan mencakup diskusi tentang semua
bahaya yang berhubungan dengan pekerjaan termasuk bekerja di ketinggian
4.1.5. Sub-contractors should create ACM work permit. The work permit is granted if approved
by the Project Manager & EHS Manager. Afterwards it is, sent to The Technical
Department. The contractor can then start the work upon reception for his work permit.
Sub kontraktor harus membuat Izin untuk Pekerjaan Penanganan ACM. Izin kerja
diberikan apabila disetujui oleh Manajer Proyek dan Manajer EHS. Setelah itu dikirim ke
Departemen Teknik, kontraktor dapat memulai bekerja setelah izin kerja disetujui atau
diterima.
4.1.6. Before any work can commence, the sub-contractor must provide and install a police line
around the work area and marked “ACM job is being carried out, Do Not Enter,
Authorized Personnel Only”. Before entering the ACM area all people need to be briefed
by the EHS Department about the nature of the ongoing works and need to be equipped
for the duration of the works with appropriate PPE.
Sebelum pekerjaan dapat dimulai, sub kontraktor harus menyediakan dan memasang
barikade di sepanjang area kerja dan diberi tanda "Pekerjaan ACM Sedang Dilakukan,
Tidak Boleh Masuk, Hanya Petugas yang Berwenang". Sebelum memasuki area ACM
semua orang perlu pengarahan oleh Departemen EHS tentang sifat dari pekerjaan yang
sedang berlangsung dan selama pekerjaan harus dilengkapi dengan APD yang sesuai.
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4.1.7. Appropriate PPE’s should be use at all times including disposable coveralls, hazmat,
safety googles, safety footwear, N-100 mask, body harness, and gloves (annex III).
APD yang tepat harus dipergunakan setiap saat termasuk pakaian kerja lengkap
(coverall), hazmat, kacamata keselamatan, sepatu keselamatan, respirator N-100, body
harness, dan sarung tangan (lampiran III).
4.1.7.1. Disposable coveralls should be used once to prevent the contamination. The used
disposable coverall should be bagged to predetermined container
Hazmat hanya digunakan sekali pakai untuk mencegah terjadinya kontaminasi.
Setelah dipakai, pakaian tersebut harus dibuang ke tempat penampungan yang
telah disediakan
4.1.7.2. Safety helmet and disposable gloves should also be worn.
Menggunakan helm dan sarung tangan sekali pakai saat pekerjaan berlangsung.
4.1.7.3. Cleanes the coverall from dust by using vaccum cleaner.
Bersihkan pakaian dari debu yang menempel dengan menggunakan vaccum
cleaner
4.1.7.4. After the work is completed, do vacuuming of coveralls and remove coveralls as
ACM waste
Setelah pekerjaan selesai, lakukan vacuum atau penyedotan pada pakaian dan
dibuang setiap hari diperlakukan seperti limbah asbes.
4.1.8. Before any work can commence, the entire area (building) must be cleaned of all debris
and dust. This must be conducted by using vacuums fitted with fibre filter and all debris
must be double bagged and disposed as asbestos waste. It is prohibited to brushed or
use of water.
Sebelum pekerjaan dilakukan, seluruh area (bangunan) harus dibersihkan dari semua
kotoran dan debu. Hal ini harus dilakukan dengan menggunakan Vacuums dilengkapi
dengan filter serat dan semua puing-puing harus dibungkus secara ganda dan dibuang
sebagai limbah asbes. Tidak diijinkan untuk disikat atau menggunakan air.
4.1.9. Before any roof sheets, ceiling and any others ACM are demolished the entire floor of the
building must be covered with a plastic sheet (with the thickness is 0,5 mm) and all joints
taped. All debris falling on to the plastic sheets after the roof work commences must be
treated as asbestos waste and handled accordingly.
Sebelum lembaran atap, plafon dan material ACM lainnya dibongkar seluruh lantai
bangunan harus ditutupi dengan lembaran plastik (dengan ketebalan 0,5 mm) dan semua
sambungan diisolasi. Semua puing-puing jatuh ke lembaran plastik setelah pekerjaan
atap dimulai harus diperlakukan sebagai limbah asbes dan ditangani sesuai prosedur.
4.1.10. Before removal the ACM sheets shall be sprayed with a water into both surfaces to bind
any loose fiber to the sheet thereby preventing its release. Both sides of the sheets should
be sprayed using water and special attention needs to be given to damaged areas/broken
comers as they are most sensitive for fiber release.
Sebelum pembersihan, lembaran ACM harus disemprot dengan air di kedua sisi nya
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untuk mengikat setiap serat longgar pada lembaran sehingga mencegah pembebasan
serat atau kontaminasi dengan udara. Kedua sisi dari sheet harus disemprot dengan air
dan perhatian khusus harus diberikan kepada bagian-bagian yang rusak / patah karena
bagian-bagian tersebut yang paling sensitif untuk terjadi pembebasan serat.
4.1.11. Power tools should never be used to release the sheets from their fixings. This should
only be done using a hand tool and be caution to not damage the sheets.
Daya listrik tidak boleh digunakan untuk melepaskan lembaran dari perlengkapannya. Ini
hanya harus dilakukan dengan menggunakan peralatan tangan dan berhati-hati untuk
tidak sampai merusak lembaran/sheet
4.1.12. When removing the sheets particular attention must be given to the overlaps as there may
be a buildup of fibers in these areas. Overlaps should be vacuumed with a vacuum fitted
with a fibre filter as the sheets are being removed. (Shadow vacuuming).
Do not damage material on purpose, do not drop material, do not throw material from
ladders or roof and do not drive over material. The method of removal cannot shatter,
crumble, pulverize, or reduce the material to dust. Place the ACM material on the ground
in a non-work area or in separate containers.
Saat melepas sheet, perhatian khusus harus diberikan kepada sheet yang berlapis
karena mungkin terjadi penumpukan serat. Pelapisan disedot dengan vacuum dilengkapi
dengan filter serat seperti lembaran yang sedang dibersihkan (shadow vaccum).
Jangan merusak material, jangan jatuhkan material, jangan membuang material dari
tangga atau atap dan tidak berjalan di atas material. Metode pembongkaran tidak bisa
dengan cara penghancuran, meruntuhkan, pelumatan, atau menghancurkan material
menjadi debu. Tempatkan material lembaran (sheet) ACM di tanah pada area non-kerja
atau dalam wadah terpisah.
4.1.13. When removing ACM roof sheets, the ACM sheets should be stacked on top of pallet to
eaves level and supported using a teleporter or other suitable pallet handling machine.
Ketika melakukan pembongkaran atap, lembar ACM harus ditumpuk di atas palet
diangkat ke atap dan didukung menggunakan teleporter atau penanganan pallet mesin
lainnya yang sesuai
4.1.14. These should then be lowered to ground level for double wrapping and labeling prior to
storage in a designated area.
Kemudian harus diturunkan sampai permukaan tanah untuk dibungkus ganda dan diberi
label sebelum penyimpanan di area yang telah ditentukan
4.1.15. This designated waste storage area should be properly cordoned off and suitable signs
erected to advise all of the contents and risks
Area limbah penyimpanan yang ditunjuk harus benar-benar diblok atau dipagari dan
diberi tanda untuk menginformasikan mengenai isi/konten dan risikonya.
4.1.16. At the end of each working day the debris falling on to the plastic sheets on the floor
must be removed for double bagging and storage prior to disposal. This should be
done using a vacuum fitted with fibre filter. Larger pieces of debris should be double
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bagged and evacuate to the assigned area for storing. This work area will be cleaned
by using vacuum mounted with HEPA filter.
Pada tiap pekerjaan selesai dilakukan, puing-puing yang jatuh ke lembaran plastik di
lantai harus dibersihkan untuk dibungkus ganda dan disimpan sebelum dibuang. Hal ini
harus dilakukan dengan menggunakan vakum dilengkapi dengan filter serat. Potongan
yang lebih besar harus dibungkus ganda dan pindahkan ke area yang telah disediakan
untuk menyimpan. Area tersebut harus dibersihkan dengan cara di vakum yang memakai
HEPA filter
4.1.17. A Quarantined place to temporarily store the old ACM sheets should be identified and
cordoned off.
Sebuah tempat sementara untuk meletakkan sisa/bekas penggantian ACM harus
diidentifikasi.
4.1.18. Walking on the roof sheets is strictly prohibited. Walking on the roof shall be done strictly
with aid of crawling boards / walkway constructed of either timber or aluminum and
completed with a hand rail. Workers who work at a height above 1.8 meters are required
to wear a full body harness. Before the demolition work start, a safety net should be
installed to prevent drop object/materials falling into the ground and can harm the workers
on the ground.
Berjalan pada lembaran atap sangat dilarang. Berjalan di atas atap harus dilakukan
secara ketat dengan bantuan papan pijakan / jalan terbuat dari kayu atau aluminium dan
dilengkapi dengan pegangan tangan. Pekerja yang bekerja pada ketinggian diatas 1.8
meter diwajibkan memakai full body harness. Jaring pengaman dipasang untuk
mencegah bahan material yang langsung jatuh ke bawah dan dapat membahayakan
pekerja yang berada di bawah sebelum pekerjaan pembongkaran dimulai dimulai.
4.1.19. The crawling boards / roof walkway shall be wide enough to enable the work to be carried
out safely and must be fitted with a hand rail, had space from the ACM sheets being
removed to conduct the work easier.
Papan pijakan harus cukup lebar untuk memungkinkan pekerjaan yang harus dilakukan
dengan aman dan harus dilengkapi dengan hand rail, ada jarak dari lembaran ACM yang
akan dilakukan pembongkaran agar memudahkan pekerjaan
4.1.8. A safe means of roof access and egress must be provided to minimize the risk of people
falling from height.
Sebuah cara aman utuk akses pada atap harus disediakan untuk meminimalkan risiko
pekerja jatuh dari ketinggian.
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4.1.9. Photographs of various activities shall be taken by sub contractor for record purposes,
ACM waste must be properly wrapped in double plastic, labeled symbol and labeled as
ACM waste on the container. The full project documentation must be kept for 60 years
and all ACM works must be added to the ACM register and kept in original in the EHS
Department as well as in copy by the HR/legal department.
Dokumentasi berbagai kegiatan harus diambil oleh sub kontraktor untuk keperluan
rekaman, limbah ACM harus benar dibungkus plastik ganda, diberikan simbol dan label
limbah ACM pada kemasan. Dokumentasi harus disimpan untuk 60 tahun kedepan dan
semua pekerjaan ACM harus ditambahkan atau di perbaharui di daftar ACM. Dokumen
asli dipegang oleh Departemen EHS dan salinan nya dipegang oleh Departemen
HR/Legal
4.1.10. Evacuated ACM is stored temporarily in the assigned place and the storage shall be
organized by the Technical department and EHS Department. The ACM sheets shall be
covered with tarpaulin and alerted with a safety line tied around metal poles awaiting
evacuation to the dump site.
Evakuasi ACM disimpan sementara di tempat yang sudah ditentukan dan dilakukan oleh
Departemen Teknik dan Departemen EHS, lembaran ACM harus ditutupi dengan terpal
dan diberi tanda/garis pembatas dan menunggu evakuasi selanjutnya.
4.1.11. All ACM handling at PT. Geo Dipa Energi have permanent supervision by EHS team to
check compliance with the ACM guidelines
Semua penanganan ACM di PT. Geo Dipa Energi harus mendapatkan pengawasan
langsung oleh Tim EHS untuk memeriksa kesesuaian dengan pedoman penanganan
ACM
4.1.12. When the work is completed the polythene cover on the floor must be cleaned and shall
be removed and disposed of as asbestos waste.
Ketika pekerjaan telah selesai, lapisan polythene di lantai yang telah dibersihkan harus
dibuang sebagai limbah asbes.
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4.1.13. After the demolition work has done, it is required to conduct air monitoring same as before
conducting of demolition work.
Setelah pekerjaan pembongkaran selesai, wajib melakukan montoring udara kembali
sama seperti sebelum dilakukannya pekerjaan pembongkaran
4.2. Emergency Condition Procedure / Prosedur Keadaan Darurat
In case of Emergency such as when the roof (which contains ACM) falling or briittle in the building
area which executing of demolition work, following some treatment must be applied;
Dalam keadaan darurat seperti ketika atap (yang mengandung ACM) jatuh atau rapuh di area bangunan
yang sedang dilakukan pembongkaran (demolish), berikut beberapa perlakuan yang diterapkan;
4.2.1. Sub-contractor workers must immediately contact the EHS
Pekerja sub kontraktor harus segera menghubungi EHS
4.2.2. EHS Department should immediately install the safety line (barricade) around ACM debris
Departemen EHS harus segera memasang barikade disekitar area runtuhan ACM
4.2.3. Sub-contractor provide required PPE for ACM handling
Sub kontraktor menyediakan seluruh peralatan pelindung diri untuk penanganan ACM
4.2.4. EHS Department make sure that the ACM removed to ACM Storage Area
Departemen EHS memastikan bahwa ACM dipindahkan ke Area Penyimpanan ACM
4.3. Dispose of PPE
For handling and containment of used PPE, container is required. For disposal of PPE which has been
used during the survey will be transported to PPLI/TLI (as accordance to Government Regulation No.
101/2014 regarding Hazardous Material Waste Management).
Untuk penanganan dan pewadahan APD yang telah dipakai, perlu disediakan wadah. Sementara
untuk pembuangan akhir APD yang telah digunakan akan dikirimkan ke PPLI/TLI (sesuai dengan
Peraturan Pemerintah No, 101 Tahun 2014 tentang Pengelolaan Limbah B3).
4.4. Dispose of asbestos waste
Asbestos waste will be handled, transported and disposed by sub-contractor (PPLI/TLI).
Limbah ACM akan dikelola, ditransportasikan dan dibuang oleh sub kontraktor (PPLI/TLI).
5. Implementation of Training/ Kegiatan Pelatihan
The training material, in detail regarding:
Materi pelatihan meliputi:
5.1. Procedure of demolition activities, starting to preparation phase, demolish activity phase,
and clearance phase.
Prosedur tentang kegiatan demolish, mulai dari tahap persiapan, pelaksanaan demolish
dan clearance
5.2. Procedure working at height
Prosedur bekerja di ketinggian
pg. 13
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5.3. The use required PPE
Penggunaan APD
5.4. Risk assessment of demolition asbestos.
Penilaian risiko untuk kegiatan asbestos demolish.
6. Schedule of Asbestos Demolition Activities
Activities February March April Mei June 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Asbestos management plan
Procurement Process
Training
Asbestos demolition activities
Asbestos sampling
Asbestos analysis laboratory
Transportation ACM waste to disposal waste
Draft Report
Presentation
Final Report
pg. 14
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Appendix I/ Lampiran I
REFERENCE / REFERENSI
1. Safe Work Australia – Demolition Work: Code of Practice:
Safe Work Australia – Demolition Work: Code of Practice:
2. Managing Asbestos Guidelines, Sydney Australia
Managing Asbestos Guidelines, Sydney Australia
3. NIOSH Manual of Analytical Methods (NMAM) 7400 for asbestos air sampling and NIOSH Manual
of Analytical Methods (NMAM) 9002 for asbestos bulk sampling
NIOSH Manual of Analytical Methods (NMAM) 7400 untuk sampel asbes di udara and NIOSH
Manual of Analytical Methods (NMAM) 9002 untuk sampel asbes bulk
4. Government Regulation No. 101/2014 regarding Hazardous Material Waste Management
Peraturan Pemerintah No. 101 Tahun 2014 tentang Pengelolaan Limbah Bahan Berbahaya dan
Beracun
5. Government Regulation No. 22/2021 regarding Implementation of Environmental Protection and
Management
Peraturan Pemerintah No. 22 Tahun 2021 tentang Penyelenggaraan dan Pengelolaan Lingkungan
Hidup
6. Regulation Ministry of Manpower No. 3/1985 regarding Occupational Health and Safety the Use of
Asbestos
Peraturan Menteri Ketenagakerjaan No. 3 Tahun 1985 tentang Keselamatan dan Kesehatan Kerja
Pemakaian Asbes
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Appendix II/ Lampiran II
Sub-contractor Criteria
Kriteria Sub Kontraktor
1. Sub-contractor should have experience in carrying out asbestos demolition work in accordance to
Safe Work Australia – Demolition Work: Code of Practice and HSE UK HSG264 Asbestos: The
Survey Guide.
Sub kontraktor telah memiliki pengalaman melaksanakan pekerjaan demolish asbes sesuai
dengan Safe Work Australia – Demolition Work: Code of Practice dan HSE UK HSG264 Asbestos:
The Survey Guide.
2. Sub-contractor is required to involve the local workers during demolition activities. Local workers will be
trained by sub contractor and supervised by consultant (LPPKM FKM UI)
Sub kontraktor wajib melibatkan tenaga kerja lokal dalam pekerjaan demolish (pembongkaran). Pekerja
lokal akan diberikan pelatihan oleh sub kontraktor dan dalam pelaksanaan pekerjaan akan diawasi oleh
konsultan (LPPKM FKM UI).
3. Sub-contractor is required to requirement in the Scope of Work Demolishing Building Porject Dieng 2
For Sub-Contractor (Appendix IV).
Sub kontraktor wajib mengikuti persyaratan yang tertuang pada Scope of Work Demolishing Building
Project Dieng 2 For Sub-Contractor (Lampiran IV).
4. Sub-contractor should have work experience working at height.
Sub kontraktor memiliki pengalaman pekerjaan dengan bekerja di ketinggian.
5. Sub contractor should conduct demolition ACM work by follow Safe Work Method Statement (SWMS) in
this Appendix VI.
Sub kontraktor wajib melaksanakan pekerjaan demolish ACM dengan mengikuti Safe Work Method
Statement (SWMS) pada Lampiran VI
6. Sub-contractor should provide certified resources which refer to Scope of Work Demolishing Building
Porject Dieng 2 For Sub-Contractor, they are:
Safety Officer : Certified AK3 Umum
Scaffolder : Certified by Disnaker
Lifting Operator : Certified by Disnaker(K3 License/SIO)
Post Frame, Scaffolding pipe : JIS Standard
Runner Frame, Scaffolding pipe : JIS Standard
Diagonal Frame, Scaffolding pipe : JIS Standard
Sub kontraktor memiliki sumberdaya yang memiliki sertifikat merujuk pada Scope of Work Demolishing
Building Project Dieng 2 For Sub-Contractor, yaitu:
Safety Officer : Sertifikat AK3 Umum
Scaffolder : Sertifikat oleh Disnaker
Lifting Operator : Sertifikat oleh Disnaker (Lisensi K3/SIO)
Post Frame, pipa perancah : JIS Standard
Runner Frame, pipa perancah : JIS Standard
Diagonal Frame, pipa perancah : JIS Standard
pg. 16
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Appendix III / Lampiran III
Personal Protective Equipment / Alat Pelindung Diri 1. Respirator Using HEPA Filter / Masker menggunakan HEPA Filter
Ex : 3M 6000 Series Using HEPA Filter or 8233 Disposable Respirator P1 or P2
2. Disposable Coveralls (Hazmat) / Pakaian sekali pakai (Hazmat)
3. Rubber Boots / Sepatu Karet
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4. Cotton Rubber Glove / Sarung Tangan Kain Karet
5. Full Body Harness
6. Safety Helmet / Helm Keselamatan
7. Safety Googles/ Kacamata Keselamatan
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Appendix IV / Lampiran IV
SOW of Demolishing Building Project Dieng 2 for Sub Contractor.
Lingkup Pekerjaan Kegiatan Demolish Bangunan Asbes Proyek Dieng 2 untuk Sub Kontraktor
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SCOPE OF WORKS
DEMOLISHING BUILDING PROJECT DIENG 2
FOR SUB-CONTRACTOR
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Background
PT Geo Dipa Energi “GeoDipa” (Persero) or GDE
is State-owned Company of Geothermal that
committed to occupational health, safety and
environment management in company operational
activities. The development of Unit Dieng 2 and
Patuha, GDE committed to comply with
government regulation, environmental Impact
Analysis and IEE from the results of the ADB
study. Asbestos Containing Material (ACM) is
hazardous material which can cause asbestosis if
inhaled to the lung, and can caused mesothelioma
(lung cancer) for long term exposure.
PT. Geo Dipa Energi (Persero) planned to conduct
demolition work of ACM at ex-mess PLN building
(abandoned building) in Dieng, West Java, and
clearance the area for construction of Geothermal
Power Plant Unit Dieng 2. The building material is
suspected to contain asbestos. The ACM
management is required and the asbestos waste
management is required to manage in compliance
with MOEF regulations to minimize the impact to
environment and minimize the risk to the workers
and community. In ACM management, it is
required that a management plan and procedure
as guidelines for demolition work needs approval
by GDE and ADB.
PT. Geo Dipa Energi (Persero) needs assistance
from third party who has experience and
competency on asbestos demolition work
management. This asbestos demolition work
should comply to the international good practice
standard and to Indonesia regulation and standard
Latar Belakang
PT Geo Dipa Energi “GeoDipa” (Persero) atau GDE
sebagai Badan Usaha Milik Negara (BUMN) panas
bumi yang berkomitmen kepada pengelolaan
Kesehatan dan keselamatan kerja serta lindung
lingkungan didalam kegiatan operasional perusahaan.
Didalam pengembangan unit 2 Dieng dan Patuha
GDE berkomitmen untuk mengikuti pengelolaan
lingkungan sesuai dengan regulasi pemerintah,
Dokumen Amdal dan juga IEE hasil kajian ADB.
Asbestos containing material (ACM) merupakan
bahan berhaya yang dapat mengakibatkan asbestosis
apabila serat asbestos masuk kedalam paru – paru
yang dalam jangka waktu lama dapat mengakibatkan
mesothelioma (kanker paru).
PT Geo Dipa Energi (Persero) berencana untuk
melakukan demolition bangunan yang tidak terpakai
yang di ketahui sebagai ex mess PLN, di Dieng Jawa
Tengah dan pembersihan area untuk pembangunan
PLTP unit 2 Dieng. Material Bangunan dimungkinkan
mengandung asbestos / Asbestos Containing
Material. Pengelolaan ACM dalam demolish
diperlukan dan pengelolaan limbahnya yang di
lakukan dengan baik sesuai regulasi akan mengurangi
dampak terhadap lingkungan dan juga dampak
terhadap kesehatan masyarakat dan pekerja. Dalam
pengelolaan ACM diperlukan management plan dan
prosedur sebagai acuan dalam pelaksanaan yang di
setujui oleh GDE dan juga representative ADB.
Untuk itu PT Geo Dipa Energi (persero) memerlukan service dari pihak ketiga sub kontraktor yang mempunyai pengalaman didalam penanganan demolish asbestos. Pekerjaan ini harus mengikuti standar good practice standard international dan complience terhadap peraturan dan standard Indonesia.
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Objective
In this term of reference, asbestos demolition work
covers preparation, mobilization and
demobilization activities plan, transportation of
material/ work equipment, preparation, execution
and after demolishing activities (clearance); as
well as marking the area where the activity will be
carried out.
List of Job to be Carried Out
The activities that will be conducted for asbestos
demolition work are:
1. Preparation of demolition work
Sub-contractor should plan all work
equipment/material which will be used
for demolition work, as attached in
Appendix I – List of Work Equipment
and Manpower for Demolition Work of
Project Dieng 2.
Sub-contractor should conduct
erection of Scaffolding & Temporary
Bluesheet Fence, Work Platform &
handrail, Temporary Habitat, Space
Isolation wall for demolition work.
Sub-contractor should prepare
Vacuum HEPA filter, Work Platform,
Temporary terpaulin fence arround of
working site, Utility set and bowplank,
excavation, back fill, compaction of soil
surface, soil and silica disposal.
2. Execution of demolition work
Sub-contractor should conduct ACM
removal at roof; to avoid the release of
asbestos fiber, the asbestos
connecting tacks are sprayed with
water before its cutting.
Sub-contractor should provide a
quarantined place to temporarily store
the ACM.
Tujuan
Dalam kerangka acuan kerja ini adalah pekerjaan
asbestos demolish meliputi perencanaan persiapan
kegiatan mob demob, transportasi material/ peralatan
kerja saat persiapan, pelaksanaan, dan setelah
pekerjaan demolish (clearance); serta pemberian
tanda/ barikade dimana pekerjaan akan dilakukan.
Daftar Pekerjaan Yang Akan Dilaksanakan
Pekerjaan yang dilakukan untuk kegiatan asbestos
demolish adalah sebagai berikut;
1. Persiapan pekerjaan demolish
Sub kontraktor akan melakukan mob
demob semua peralatan/perlengkapan
kerja yang akan dipergunakan pada
pekerjaan asbestos demolish, seperti
terlampir pada Daftar Peralatan Kerja dan
Tenaga Kerja untuk Pekerjaan Demolish
Bangunan Project Dieng 2.
Sub kontraktor melakukan pemasangan
Scaffolding & Temporary Bluesheet Fence,
Work Platform & handrail, Temporary
Habitat, Space Isolation wall untuk
pekerjaan demolish bangunan.
Sub kontraktor mempersiapkan Vacuum
HEPA filter, memasang terpal disekitar area
kerja, utility set & bowplank, melakukan
penggalian, penimbunan, pemadatan
tanah, pembuangan tanah dan silika.
2. Pelaksanaan pekerjaan demolish
Sub kontraktor melakukan pembongkaran
material atap bangunan yang mengandung
asbes, untuk menghindarkan timbulnya
serat asbes maka paku payung
penyambung asbes disemport air terlebih
dahulu sebelum dilakukan pemotongan
Sub kontraktor menyediakan tempat
sementara untuk meletakkan material yang
mengandung asbes.
pg. 22
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Sub-contractor should ensure ACM waste is collected and removed for double bagging, labeled with symbol and labeled as ACM waste.
Sub-contractor should ensure the ACM sheets are covered with tarpaulin and alerted with a safety line tied around metal poles awaiting collection and final disposal of hazardous waste material and ACM waste through PPLI and TLI (final disposal). A Certificate of treatment will be issued by PPLI/ TLI.
Sub-contracture should ensure
handling and containment of used
PPE, plastic bag. The disposal of PPE
which has been used during the survey
will be transported to PPLI/TLI. A
Certificate of Treatment will be issued
by PPLI/TLI.
Sub-contractor should conduct
clearance of the area after demolition
work is done.
3. After Demolition Work (Clearance)
Sub-contractor should conduct
demobilization of work equipment.
4. Sub-contractor is required to comply HSE
rules, such as Job Safety Analysis (JSA),
work permit, safety induction, cit in duty,
procedures, etc.
5. Sub-contractor is required to enroll training
from consultant regarding demolition work
procedures before the work is conducted.
Phase of Work
The demolition work will be conducted gradually,
starting from 1st phase, i.e. main building and
laboratory, and will continue to 2nd phase parallelly
barrack 1 and barrack 2. The 3rd phase is barrack
3 building, polyclinic and security post.
Sub kontraktor memastikan limbah ACM harus
dikumpulkan dan dibungkus plastik ganda,
diberikan simbol dan label limbah ACM.
Sub kontraktor memastikan lembaran ACM
harus ditutupi dengan terpal dan diberi
tanda/garis pembatas dan menunggu
evakuasi selanjutnya (pembuangan akhir).
Sub kontraktor memastikan bahwa
penanganan dan pewadahan APD yang telah
dipakai ditempatkan dalam kantong plastic,
dan untuk pembuangan akhir APD yang telah
digunakan akan dikirimkan ke PPLI/TLI.
Sub kontraktor melakukan pembersihan area
setelah pekerjaan demolish.
3. Setelah Pekerjaan Demolish (Pembersihan)
Sub kontraktor melakukan demobilisasi peralatan
kerja.
4. Sub kontraktor diwajibkan untuk mematuhi
dokumentasi HSE, seperta Analisis Kerja Aman
(JSA), ijin kerja, induksi keselamatan, cit in duty,
prosedur, dan lainnya.
5. Sub kontraktor wajib mengikuti pelatihan dari
konsultan mengenai prosedur kerja pembongkaran
(demolish) sebelum pekerjaan dilaksanakan.
Tahapan Pekerjaan
Pekerjaan demolish dilaksanakan secara bertahap
dimulai dari tahap 1 yaitu bangunan utama dan
laboratorium, kemudian dilanjutkan tahap 2 secara
bersama-sama/paralel bangunan barrack 1 dan barrack
2. Tahap 3 adalah barrack 3, bangunan poliklinik dan pos
keamanan.
Work Material, Equipment and Manpower Peralatan dan Perlengkapan Kerja serta SDM
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Sub-contractor is required to provide work material
and equipment as well as manpower which
needed for demolition of ACM at each phase and
must complete the work of each phase according
to predefined schedule. The list of equipment and
manpower is enclosed in Appendix IV in this SOW.
Schedule of Work
Sub-contractor is required to complete the
demolition work according to predefined schedule
Sub Kontraktor wajib menyiapkan peralatan dan
perlengkapan kerja serta SDM yang diperlukan
untuk pekerjaan demolish ACM pada masing-
masing tahapan dan menyelesaikan pekerjaan
masing-masing tahap sesuai dengan jadwal yang
telah ditetapkan. Daftar peralatan kerja dan SDM
mengacu pada Lampiran IV dalam SOW ini.
Jadwal Pekerjaan
Sub kontraktor wajib menyelesaikan pekerjaan
demolish sesuai dengan jadwal yang telah
ditetapkan.
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Schedule of Demolition Work
Phase of Work February 2021 March 2021 April 2021 May 2021 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Appointment of Sub Contractor
Preparation, Execution and Clearance of demolition work as well as demobilization:
1. Main building 2. Laboratory 3. Barrack 1 4. Barrack 2 5. Barrack 3 6. Polyclinic 7. Security post
pg. 25
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APPENDIX
LIST OF WORK EQUIPMENT, MANPOWER DEMOLISHING BUILDING WORK PROJECT DIENG 2
NO. DESCRIPTION QTY UNIT
SCOPE OF WORKS
REMARKS Sub-
Contractor PPLI or TLI
PT. Geo Dipa Energi
DEMOLISHING BUILDING PROJECT DIENG 2
1
Measuring & Marking
a. Main Building 180 m √
b. Barrack 1 56 m √
c. Barrack 2 57,8 m √
d. Barrack 3 58 m √
e. Laboratory 28 m √
f. Polyclinic 73,5 m √
g. Security Post 8 m √
2 Transportation, Material Delivery & Mob Demob
1,00 Ls √
3
Project Management Team (SPV, HSE)
1,00 Ls √
- Supervisor 1 person √ Not Certified ACM removal
- Safety Officer 2 person √ Certified AK3
Umum
- Scaffolder 4 person √ Certified by Disnaker
- Lifting Operator 2 person √ Certified by Disnaker(K3 License/SIO)
- Workers 1,00 Ls √
4 Astek/ BPJS 1,00 Ls √
5
Personal Protective Equipment (PPE) ;
1,00 Ls √
* Coverall √
* Safety Shoes √
* Safety Glasses (ANSI Z87.1-1989)
√
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NO. DESCRIPTION QTY UNIT
SCOPE OF WORKS
REMARKS Sub-
Contractor PPLI or TLI
PT. Geo Dipa Energi
* Safety Helmet MSA c/w chinstrap (ANSI Z89.1-1986)
√
* Mask Medium Masker Gas 3M 8233, N100
√
* Cotton hand glove √
* Hazmat √
* Full Body Harness √
6 HSE Programs ; 1,00 Ls √
B BUILDING PROJECT DIENG 2 (ASBESTOS-CONTAINING MATERIAL/ ACM REMOVAL)
1
Scaffolding & Temporary Bluesheet Fence
1,00 lot √ Temporary Habitat, Space Isolation wall for ACM Removal ;
* Post Frame, Scaffolding pipe 6m lght
√ JIS Standart,
rent
* Post Frame, Scaffolding pipe 4m lght
√ JIS Standart,
rent
* Runner Frame, Scaffolding pipe 6m lght
√ JIS Standart,
rent
* Diagonal Frame, Scaffolding pipe 6m lght
√ JIS Standart,
rent
* Diagonal Frame, Scaffolding pipe 3m lght
√ JIS Standart,
rent
* Diagonal Frame, Scaffolding pipe 2m lght
√ JIS Standart,
rent
* Work Platform √ Rent
* Jack Base (base √ Rent
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NO. DESCRIPTION QTY UNIT
SCOPE OF WORKS
REMARKS Sub-
Contractor PPLI or TLI
PT. Geo Dipa Energi
plate)
* Rigid Clamp √ Rent
* Swivel Clamp √ Rent
* Temporary terpaulin fence arround of working site ;
√ Rent
* Blower 2 pcs √ Rent
* Exhaust 2 pcs
2
Vacuum HEPA filter 1,00 lot √
- Rent Vacuum w/ HEPA Filter
√
3
Dismantle & dispose existing Roof Cover
m2 √
Main Building 2.500,00 m2 √
Barrack 1 620,00 m2 √
Barrack 2 1.090,00 m2 √
Barrack 3 640,00 m2 √
Laboratory 280,00 m2 √
Polyclinic 780,00 m2 √
Security Post 73,00 m2 √
- Chemical coating or sealing for existing roof, 2-sided
√
- Dismantling
existing roof √
- Wrapping for dismantled roof & ridge
√
4 Dismantling existing wooden roof frame & support
√
5 Dismantling existing ceiling
553,56 m2 √
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NO. DESCRIPTION QTY UNIT
SCOPE OF WORKS
REMARKS Sub-
Contractor PPLI or TLI
PT. Geo Dipa Energi
- Chemical oating or sealing for existing roof,work at an altitude
√
- Dismantling
existing plafond √
- Wrapping for dismantled plafond
√
6 Dismantling existing wall, Partition
- - - √
7 Dismantling existing doors & windows
- - - √
8 Dismantling existing Concrete (beam, column)
- - - √
9 Demolish existing floor - - - √
10
Removal of sanitation facility (septic tank, closet, etc)
- - - √
- Septictank (empty out)
- - - √
- Closet - - - √
- fill the septic tank with sand
- - - √
11 Removal of electrical panel at main building
√
C LAND PREPARATION
1 Access entrance to building
√
2 Silica temporary dumpsite cleaning at Main Building
√
3
Leveling and compaction of ground for scaffolding of foothold around the building
√
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NO. DESCRIPTION QTY UNIT
SCOPE OF WORKS
REMARKS Sub-
Contractor PPLI or TLI
PT. Geo Dipa Energi
D Electrical Power (generator set)
2 set √
E Asbestos Waste Transportation and Disposal
√
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Appendix V / Lampiran V
Training material of asbestos demolish building.
Materi pelatihan tentang kegiatan demolish bangunan yang mengandung asbes
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Appendix V I/ Lampiran VI
Safe Work Method Statement – Removal of Asbestos Containing Material and Minor Damage of ACM
Safe Work Method Statement – Removal of Asbestos Containing Material and Minor Damage of ACM
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LPPKM FKM UI
PHASE 2 ASBESTOS SURVEY AND SAMPLING REPORT OF
EX-PLN BUILDING SITE [Subject]
DIENG, CENTRAL JAVA
PREPARED FOR:
PT GEO DIPA ENERGI (PERSERO) – DIENG UNIT 2 PROJECT
2
LPPKM FKM UI
PHASE 2 ASBESTOS SURVEY AND SAMPLING REPORT OF
EX-PLN BUILDING SITE [Subject]
DIENG, CENTRAL JAVA
-- REPORT OR PROJECT ID --
Prepared by Prepared for
LPPKM FKM UI PT GEO DIPA ENERGI (Persero) –
DIENG UNIT 2 PROJECT
3
LPPKM FKM UI
REPORT CONTENTS
1. EXECUTIVE SUMMARY ........................................................................................ 5
2. INTRODUCTION .................................................................................................... 7
2.1 BACKGROUND ....................................................................................................... 7
2.2 OBJECTIVES .......................................................................................................... 7
2.3 SURVEY TEAM AND SCHEDULE ...................................................................... 8
2.4 LIMITATIONS OF THIS REPORT ............................................................................ 8
3. SAMPLING AND LABORATORY ANALYTICAL METHODS.............................. 9
3.1 ASBESTOS CONTAINING MATERIAL ...................................................................... 9
a. Sampling Location ............................................................................................ 9
b. ACM Samples Collected .................................................................................. 9
c. Laboratory Analysis ............................................................................................. 9
3.2 ASBESTOS ANALYSIS IN AMBIENT AIR ............................................................ 9
3.3 ASBESTOS ANALYSIS IN SOIL ............................................................................... 11
4. ASBESTOS ANALYTICAL RESULTS ................................................................ 12
4.1. SAMPLING AREA AND INFORMATION .......................................................... 12
4.2. ASBESTOS IN BULK SAMPLES ...................................................................... 13
4.3. AMBIENT AIR ANALYTICAL RESULTS ............................................................ 14
4.4. SOIL ANALYTICAL RESULTS .......................................................................... 14
5. CONCLUSIONS AND RECOMMENDATIONS ................................................... 15
4
LPPKM FKM UI
LIST OF FIGURES
LIST OF TABLES TABLE 1. SURVEY TEAM AND SCHEDULE ………………………………………………. 8
TABLE 2. BULK SAMPLE ANALYSIS RESULT
……………………………………………… 13
TABLE 3. AIR SAMPLE ANALYSIS RESULT
……………………………………………… 14
TABLE 4. SOIL ANALYTICAL RESULT ……………………………………………… 14
FIGURE 1. ASBESTOS SAMPLING LOCATIONS
WITHIN THE EX-PLN BUILDING SITE, DIENG …………………………………………. 5
5
LPPKM FKM UI
1. EXECUTIVE SUMMARY
The ‘Lembaga Pelayanan dan Pengabdian Kesehatan Masyarakat (LPPKM) - Fakultas
Kesehatan Masyarakat Universitas (FKM), Universitas Indonesia’ (UI) in Depok was
commissioned by PT. Geo Dipa Energi (Persero) in September 2020 to conduct a survey and
sampling of asbestos containing materials (ACM) that may exist in the building’s components
used at the ex-PLN building site in Karang Tengah village, Dieng in Central Java. The survey
and sampling of ACM is conducted in the following steps and reporting:
(i) Developing the preliminary asbestos survey proposal (Phase 1 survey);
(ii) Reporting the results of Phase 1 survey (dated 16 November 2020);
(iii) Developing the asbestos sampling and analysis proposal (Phase 2 survey);
(iv) Reporting the results of Phase 2 survey (“this report dated 22 December 2020”);
(v) Developing an asbestos management plan (AMP) as reference for GDE and its
contractor to conduct a safe demolition and removal of asbestos wastes.
Prior to conducting the asbestos surveys, the surveyors and GDE representatives reviewed
with the Asbestos Survey/Sampling Proposal to which ADB safeguard consultant provided
some inputs. These survey/sampling proposal and reporting reflects best industry practice,
enabling asbestos materials and wastes managed in systematic and sound manner. This report
presents the results of the Phase 2 survey, whereas the report of Phase 1 survey is reported
separately. Roof, ceiling, indoor and outdoor ambient air, and soil samples within the ex-PLN
buildings were collected for analysis using accredited laboratory as shown in Figure 1.
Note: 1: Ex-main building, 2: Ex-laboratory, 3: Ex-barrack 1, 4: Ex-barrack 2,
5: Ex-barrack 3, 6: Ex-polyclinic, 7: Ex-security post
Figure 1: Asbestos Sampling Locations within the ex-PLN building site, Dieng
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The samples were analyzed to detect the presence of Chrysotile asbestos in those samples1.
The analytical results of these samples indicate the following:
• 6 (six) samples collected from the roof of the ex-PLN buildings in Dieng i.e., the main
building, Barrack 1, Barrack 2, Barrack 3, laboratory, and polyclinic contain Chrysotile
asbestos. This amounts to approximately 6,000 m2 of asbestos roof.
• 6 (six) samples of ceiling from the ex-PLN buildings mentioned earlier do not contain
Chrysotile asbestos.
• 6 (six) indoor ambient air samples collected from the ex-main building, barrack 1, 2, 3,
laboratory, and clinic as well as 2 (two) outdoor ambient air samples collected from the ex-
main building and barrack 3 indicate 0.001 – 0.003 fibers/cc of air. The number of fibers
detected is well below the threshold value of 0.1 fiber/cc stipulated in the Ministry of
Manpower Regulation No. 5/2018 on Occupational and Health and Safety Standard.
• 2 (two) soil samples collected from near the main building and barrack 3 are not detected
to contain Chrysotile asbestos.
Based on the above result, an asbestos management plan shall be developed as reference for
GDE and its contract to conduct best practices and regulatory compliant demolition and disposal
of asbestos wastes from the ex-PLN buildings as the future site of Dieng power plant unit 2.
1 Chrysotile asbestos is the main type of asbestos reportedly exists in Indonesia (reference: Regulation of Ministry
of Manpower No. 5/2018 regarding Safety and Health of Work Environment, National Indonesia Standard (SNI) 1027-
2015 regarding Flat Cement Sheet and SNI 2050-2015 regarding Corrugated Cement Sheet, and Regulation of
Ministry of Health No.70/2016 regarding Environmental Health Standard at Industrial)
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2. INTRODUCTION
2.1 BACKGROUND
The ‘Lembaga Pelayanan dan Pengabdian Kesehatan Masyarakat (LPPKM) - Fakultas
Kesehatan Masyarakat Universitas (FKM), Universitas Indonesia’ (UI) in Depok was
commissioned by PT. Geo Dipa Energi (Persero) in September 2020 to conduct a
survey and sampling of potential asbestos containing materials (ACM) that may exist in
the building’s components used at the ex-mess PLN site in Karang Tengah village,
Dieng in Central Java. The asbestos survey was undertaken in two phases:
• The preliminary asbestos survey (PAS) or Phase 1 survey was conducted on 8 – 10
October based on the preliminary asbestos survey plan prepared by LPPKM-FKM UI
dated 3 October 2020 and approved by GDE on 5 October 2020. The key objective
of the PAS is, among other, to obtain accurate information on the location, amount,
and condition of suspected ACM, considering that GDE’s documentation on this
matter is lacking.
• The Phase 2 asbestos survey, involving sampling and analyzes of asbestos sample,
ambient air quality and soil, was conducted on 22 – 25 November 2020. The key
objective of this survey is, among other, to confirm the type of ACM present in the
roof and ceiling of the ex-mess PLN buildings and identify whether the ambient air
and soil within the site contain ACM. This report presents the results of this Phase 2
survey.
2.2 OBJECTIVES
The objectives of the Phase 2 asbestos survey are:
• to collect samples of the suspected asbestos containing materials (ACM) from the
roof and ceiling of the ex-mess PLN buildings;
• to collect ambient air quality and soil samples and analyze them for ACM;
• to analyze the samples using the laboratory accredited by the Indonesian
Accreditation Commission (Komisi Akreditasi Nasional);
• to obtain accurate information which parts of the building’s materials containing
asbestos or not; and
• to develop an appropriate asbestos management plan that will guide GDE and the
contractor (to be appointed) to safely demolish and remove the ACM based on the
results presented in this report.
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2.3 SURVEY TEAM AND SCHEDULE
The Phase 2 asbestos survey was conducted on behalf Lembaga Pelayanan dan
Pengabdian Kesehatan Masyarakat (LPPKM) FKM UI, Depok by key experts as follows:
• Lead asbestos surveyor : Dr. Sjahrul M. Nasri, MSc., Ind. Hyg.
• Leader of Sampling Team : Mr. Heickel, S.ST
• Technical assistance : Mr. Imam Santoso
The implementation of the Phase 2 asbestos survey was undertaken based on the
following schedule.
Table 1: Phase 2 Survey and Sampling Schedule in 2020
Activities November December January
3 4 1 2 3 4 1
Visit Project Area Dieng
Discussion and interview representative of PT. Geo Dipa Energi at Project Area Dieng
Site visit to collect samples of the suspected asbestos containing materials (ACM) for laboratory analyses
Laboratory analysis result
Report development
Submit the Phase 2 asbestos survey and sampling report to GDE
2.4 LIMITATIONS OF THIS REPORT
This survey of asbestos containing building materials was carried out in a professional
manner by experienced personnel. However, the extent of the survey was bound by the
limits of non-destructive methods which preclude any major physical damage to
equipment, walls, floors, partitions, etc. During this survey, every attempt was made to
inspect all ex-mess PLN buildings. This report contains approximate estimations of
quantities of ACMs only and not to be treated as specific or accurate measurements.
Drawings presented in this report are for illustration only and therefore not presented in
accurate scale.
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3. SAMPLING AND LABORATORY ANALYTICAL METHODS
3.1 ASBESTOS CONTAINING MATERIAL
Based on the results included in the PAS report (dated 16 November 2020) submitted
to GDE, the surveyors have taken roof and ceiling parts as samples of ACM. The
samples have been collected for analysis at the Industrial Hygiene and Occupational
Health Agency Laboratory – Ministry of Manpower, Jakarta. The accreditation certificate
of the laboratory is included in Appendix III.
Only small portions of the samples have been collected, as much as possible, without
causing any damage to the materials at a diameter size of approximately 3 – 5 cm.
However, the sampled material could not be replaced, and small damages could have
been caused during sampling. The hole possibly created in the material was attached
by using tape and/or spray glue. The equipment used for the ACM sampling are water
sprayer or sealant, duct tape, cutter, pliers, and plastic bag.
a. Sampling Location
The ACM samples, called bulk sampling, were collected from the roof and ceiling at all
ex-mess PLN buildings in Dieng as shown in Appendix II.
b. ACM Samples Collected
1 (one) ACM sample was taken of the roof and 1 (one) ACM sample was taken of ceiling
from each of the building, hence a total of 12 ACM samples were collected. The samples
were collected from:
• Roof Main Building
• Roof Barack 1
• Roof Barack 2
• Roof Barack 3
• Roof Laboratory
• Roof Clinic
• Ceiling Main Building
• Ceiling Barack 1
• Ceiling Barack 2
• Ceiling Barack 3
• Ceiling Laboratory
• Ceiling Clinic
c. Laboratory Analysis
The bulk sample analysis was performed by Polarized Light Microscope (PLM) of
NIOSH Manual of Analytical Methods (NMAM) 9002.
3.2 ASBESTOS ANALYSIS IN AMBIENT AIR
The ambient air sampling was conducted by using static sampling. The equipment
used are:
1. Sampling pump.
2. Asbestos media, three-piece cassette with ca. 50-mm electrically conductive
extension cowl and cellulose ester filter, 0.45-to 1.2-µm pore size, and backup pad.
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3. Flow calibrator
4. Tripod
5. Phase Contras of Microscope (PCOM), with Graticule, Walton-Beckett type
6. Acetone vaporization hot block.
• Pre-sampling
1. Make sure that the battery in the pump is enough for measurement for 8 hours.
2. Place the filter cassette (asbestos media) in the filter holder.
3. Connect the filter holder with the personal pump.
4. Perform calibration pre-flow by:
5. Connect the personal pump with the flow calibrator.
6. Activate the pump and flow calibrator, by pressing the ON button.
7. Set the air flow rate at 2 Liters per minute (LPM) +/- 5%.
8. After obtaining the flow rate as desired, record the flow rate as pre-flow calibration,
and turn off both devices.
9. Equipment are ready to use.
• Measurement
1. Place the ambient air sampling equipment at the designated sampling point
2. Activate the pump. Note: measurement location, start time
3. Sampling is carried out for 8 hours
4. When finished, turn off the equipment. Note: Time of measurement completion.
5. Perform post-flow calibration as during pre-flow calibration, note: the results of flow
rate measurements are post-flow calibration.
6. Remove the filter (asbestos media) from the filter holder, and close both ends.
7. Paste the information label on the cassette filter.
8. Send samples to the laboratory.
a. Sampling Location
The ambient air samples were collected from eight locations (i.e., indoor and outdoor)
within ex-mess PLN building site in Dieng as shown in Appendix II.
b. Ambient Air Samples Collected
Ambient air sampling was collected indoor and outdoor due to the different condition
each part inside the roof and ceiling. In course of air sampling in buildings (indoor),
due to different conditions of the inside of the roof and ceiling, the possibility of
asbestos fibers can be released in each building also different, hence 1 (one) sample
of ambient air was collected from each building. For the outdoor air sampling, due to
the homogeneous environmental condition only 2 (two) outdoor air sampling samples
were taken, i.e., at the main building and barrack 3.
A total of 8 (eight) ambient air samples were collected, in details:
• 1 Outdoor Main Building with Volume Sampel = 812 L
• 1 Outdoor Barack 3 with Volume Sampel = 807 L
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• 1 Indoor Main Building with Volume Sampel = 809 L
• 1 Indoor Barack 3 with Volume Sampel = 816 L
• 1 Indoor Barack 2 Volume Sampel = 808 L
• 1 Indoor Barack 1 with Volume Sampel = 816 L
• 1 Indoor Laboratory with Volume Sampel = 813 L
• 1 Indoor polyclinic with Volume Sampel = 813 L
c. Laboratory Analysis
The ambient air sample analysis was performed by Phase Contrast Microscope (PCM)
method used Indonesia National Standard (SNI) 16 – 7059 – 2004 and NIOSH Manual
of Analytical Methods (NMAM) 7400.
3.3 ASBESTOS ANALYSIS IN SOIL
Soil sampling are carried out by taking a small part of the soil using a cement
taper/trowel and put in a plastic bag, then labeled.
a. Sampling Location
The sampling location for the soil are outside the main building and outside the
barrack 3 building as shown in Appendix II.
b. Soil Samples Collected
A total of 2 (two) soil sample were collected as a representative of all the building
location, due to it is assumed that the roof, soil, and vegetation conditions at outside
of all buildings are relatively homogeneous.
c. Laboratory Analysis
The soil analysis was performed by Polarized Light Microscope (PLM) NIOSH
Manual of Analytical Methods (NMAM) 9002.
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4. ASBESTOS ANALYTICAL RESULTS
4.1. SAMPLING AREA AND INFORMATION
The following buildings at the ex-mess PLN site, covering an area of approximately 6
hectares were inspected:
• Main building (roof, ceiling, wall, floor and, surrounding of building).
• Barrack 1, 2 and 3 (roof, ceiling, wall, floor and, surrounding of building)
• Laboratory building (roof, ceiling, wall, floor and, surrounding of building)
• Polyclinic building (roof, ceiling, wall, floor and, surrounding of building).
• Security post (roof, ceiling, and surrounding of building).
Estimated areas of the buildings including related components are as follows:
a. Main building
• Roof : 2,500 m2
• Ceiling: 216 m2
• Wall : 720 m2
• Floor : 1,008 m2
b. Barrack 1
• Roof : 620 m2
• Ceiling : 67.20 m2
• Wall : 320 m2
• Floor : 20 m x 8 m = 160 m2
c. Barrack 2
• Roof : 1,090 m2
• Ceiling : 69.36 m2
• Wall : 320 m2
• Floor : 170.98 m2
d. Barrack 3
• Roof : 640 m2
• Ceiling : 69.6 m2
• Wall : 320 m2
• Floor : 20.70 x 8.3 = 171.81m2
e. Laboratory building
• Roof : 280 m2
• Ceiling : 33.6 m2
• Wall : 160 m2
• Floor : 48 m2
f. Polyclinic building
• Roof : 780 m2
• Ceiling : 88.2 m2 • Wall : 400 m2
• Floor : 270 m2
g. Security post
• Roof : 73 m2
• Ceiling : 9.6 m2
• Wall : 6 m2
• Floor : 4 m2
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4.2. ASBESTOS IN BULK SAMPLES
A complete list of all analytical results of the bulk samples from the roof and ceiling of
all ex-mess PLN buildings are displayed in the following table. The laboratory results
confirm that all samples collected from the roof contain chrysotile asbestos and,
therefore considered as hazardous wastes if these materials are to be demolished and
safely disposed. All samples collected from the ceiling do not indicate the presence of
Chrysotile asbestos.
Table 2: Asbestos Analytical Result in Bulk Samples
Building Sampling Location
Product Type Analytical Result Quantity
Roof
Roof Main Building Administrative office building (temporary storage of silica scale)
Solid corrugated roof
Chrysotile asbestos detected
2,500 m2
Roof Barrack 1 Roof building Solid corrugated roof
Chrysotile asbestos detected
620 m2
Roof Barrack 2 Roof building Solid corrugated roof
Chrysotile asbestos detected
1,090 m2
Roof Barrack 3 Roof building Solid corrugated roof
Chrysotile asbestos detected
640 m2
Roofing laboratory Laboratory room Solid corrugated roof
Chrysotile asbestos detected
280 m2
Roofing polyclinic Polyclinic room Solid corrugated roof
Chrysotile asbestos detected
780 m2
Total roof area 5,910 m2
Ceiling
Main Building Main building Flat Sheet Ceiling material
No chrysotile asbestos detected
216 m2
Outer Ceiling Barrack 1
Room building Flat Sheet Ceiling material
No chrysotile asbestos detected
67.20 m2
Outer Ceiling Barrack 2
Room building Flat Sheet Ceiling material
No chrysotile asbestos detected
69.36 m2
Outer Ceiling Barrack 3
Room building Flat Sheet Ceiling material
No chrysotile asbestos detected
69.6 m2
Outer Ceiling laboratory
Room building Flat Sheet Ceiling material
No chrysotile asbestos detected
33.6 m2
Outer Ceiling Polyclinic
Polyclinic room Flat Sheet Ceiling material
No chrysotile asbestos detected
88.2 m2
Total ceiling area 543.96 m2
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4.3. AMBIENT AIR ANALYTICAL RESULTS
The laboratory analytical results of ambient air collected at eight locations within the ex-mess
PLN buildings in Dieng indicate asbestos contents of 0.001 to 0.003 fibers/cc. This number
of fibers detected in the ambient is well below the threshold value of 0.1 fiber/cc stipulated in
the Ministry of Manpower Regulation No. 5/2018 on Occupational and Health and Safety
Standard.
Table 3: Ambient Air Analytical Result
No. Location Sampling Location
Analytical Result
(fibers/cc) Methods
Fiber Concentration TLV (fibers/cc)
1 Main building Indoor 0.001 SNI. 16 – 7059 - 2004 0.1
2 Main building Outdoor 0.002 SNI. 16 – 7059 - 2004 0.1
3 Barrack 1 Indoor 0.002 SNI. 16 – 7059 - 2004 0.1
4 Barrack 2 Indoor 0.003 SNI. 16 – 7059 - 2004 0,1
5 Barrack 3 Indoor 0.001 SNI. 16 – 7059 - 2004 0.1
6 Barrack 3 Outdoor 0.001 SNI. 16 – 7059 - 2004 0.1
7 Laboratory Indoor 0.002 SNI. 16 – 7059 - 2004 0,1
8 Polyclinic Indoor 0.001 SNI. 16 – 7059 - 2004 0.1
4.4. SOIL ANALYTICAL RESULTS
The laboratory analytical results indicate no chrysotile asbestos content in the soil samples collected outside the main building and barrack 3 at the ex-PLN building site.
Table 4: Soil Analytical Result
No. Sampling location Samples Analytical Result
1 Outside main building Surface soil No chrysotile asbestos detected
2 Outside barrack 3 Surface soil No chrysotile asbestos detected
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5. CONCLUSIONS AND RECOMMENDATIONS
The conclusions drawn from the Phase 2 asbestos survey, including sampling and laboratory analysis, are as follow:
• 6 (six) samples of roofing sheet collected from the ex-PLN buildings in Dieng i.e., the main building, Barrack 1, Barrack 2, Barrack 3, laboratory, and polyclinic contain Chrysotile asbestos.
• 6 (six) samples of ceiling from the ex-PLN buildings mentioned earlier do not contain Chrysotile asbestos.
• 6 (six) indoor ambient air samples collected from the ex-main building, barrack 1, 2, 3, laboratory, and clinic as well as 2 (two) outdoor ambient air samples collected from the ex-main building and barrack 3 indicate 0.001 – 0.003 fibers/cc of air. The number of fibers detected is well below the threshold value of 0.1 fiber/cc stipulated in the Ministry of Manpower Regulation No. 5/2018 on Occupational and Health and Safety Standard.
• 2 (two) soil samples collected from near the main building and barrack 3 are not detected to contain Chrysotile asbestos.
Based on the above conclusions, the roof in all of the ex-PLN buildings in Dieng, when demolished, must be managed according to the requirements of Government Regulation (Peraturan Pemerintah) No. 101/2014 regarding Hazardous and Toxic Waste Management. Therefore, an asbestos management plan according to the requirements of HSE UK Asbestos: The Survey Guide HSG 264 and the aforementioned government regulation as guideline for GDE and its contractor to conduct a safe demolition and removal of asbestos wastes.
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APPENDIX I APPROVED JOB SAFETY ANALYSIS
Job Safety Analysis (JSA) for Site and Building Inspection
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Job Safety Analysis (JSA) for Working at Height
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Job Safety Analysis (JSA) for Asbestos Bulk Sampling
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Job Safety Analysis (JSA) for Soil Sampling
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Job Safety Analysis (JSA) for Air Sampling
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APPENDIX II SAMPLING LOCATIONS
- Main Building
- Laboratory
- Barrack 1
Indoor air Sampling point
Outdoor air Sampling point
Soil (bulk) sampling point
Roof bulk sampling Ceiling
bulk sampling
Indoor air Sampling point
Roof bulk
sampling
Ceiling bulk sampling
Indoor air Sampling point
Roof bulk sampling
Ceiling bulk sampling
Entrance
Entrance
Entrance
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- Barrack 2
- Barrack 3
- Polyclinic
Indoor air Sampling point
Indoor air Sampling point
Soil Sampling Outdoor air Sampling point
Indoor air Sampling point
Roof bulk sampling
Ceiling bulk sampling
Entrance
Entrance
Roof bulk sampling
Ceiling bulk sampling
Roof bulk sampling
Ceiling bulk sampling
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APPENDIX III LABORATORY ANALYTICAL RESULTS
Bulk Sampling Analysis
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Air Sampling Analysis
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APPENDIX IV LABORATORY ACCREDITATION CERTIFICATE
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APPENDIX V
PHOTOS TAKEN DURING THE FIELD SAMPLING
No. Location Photos
1 Bulk sample at main building
2 Bulk sample at barrack 1
3 Bulk sample at barrack 2
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No. Location Photos
4 Bulk sample at barrack 3
5 Bulk sample at laboratory
6 Bulk sample at clinic
7 Indoor air sampling
main building
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No. Location Photos
8 Outdoor air sampling main building
9 Indoor air sampling barrack 1
10 Indoor air sampling barrack 2
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No. Location Photos
11 Indoor air sampling barrack 3
12 Outdoor air sampling barrack 3
13 Indoor air sampling laboratory
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No. Location Photos
14 Indoor air sampling clinic
15 Soil sample outside the main building
16 Soil sample outside barrack 3
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No. Location Photos
17 PPE for Sampling
LPPKM FKM UI
PRELIMINARY ASBESTOS SURVEY REPORT
PT. GEO DIPA ENERGI – PROJECT DIENG 2
DIENG, CENTRAL JAVA
PREPARED FOR:
PT GEO DIPA ENERGI – PROJECT DIENG 2
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PRELIMINARY ASBESTOS SURVEY REPORT
PT. GEO DIPA ENERGI – PROJECT DIENG 2
DIENG, CENTRAL JAVA
-- REPORT OR PROJECT ID --
Prepared by Prepared for
LPPKM FKM UI PT GEO DIPA ENERGI – PROJECT
DIENG 2
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INDEX
REPORT CONTENT
1. EXECUTIVE SUMMARY ........................................................................................ 6
2. INTRODUCTION .................................................................................................... 8
2.1. BACKGROUND ....................................................................................................... 8
2.2. OBJECTIVE AND THE SCOPE OF THE PRELIMINARY ASBESTOS SURVEY ........ 8
2.3. SURVEY TEAM AND SCHEDULE ...................................................................... 9
2.4. LIMITATIONS OF THE SURVEY/REPORT ............................................................ 9
3. METHODOLOGY/REPORTING OF THE PRELIMINARY ASBESTOS SURVEY10
3.1. EHS RISK ASSESSMENT TO CONDUCT THE SURVEY ............................... 10
3.2. SITE AND BUILDING INSPECTION ..................................................................... 10
3.3. MATERIAL ASSESSMENT AND PRIORITY ASSESSMENT OF SUSPECTED ACM
10
4. PRELIMINARY ASBESTOS SURVEY RESULT ................................................ 11
4.1. SITE EQUPIMENT AND INFORMATION ......................................................... 11
4.1.1. Desk research ............................................................................................. 13
4.1.2. Interview Results ......................................................................................... 14
4.2. SUSPECTED ASBESTOS CONTAINING MATERIALS ................................... 15
4.3. NOT SUSPECTED ASBESTOS CONTAINING MATERIAL ............................................. 23
4.4. INVENTORY OF SUSPECTED ACM ................................................................ 27
4.5. MATERIAL ASSESSMENT AND PRIORTY ASSESSMENT ........................... 27
5. PROPOSED SAMPLING METHODS .................................................................. 38
5.1. SAMPLING METHOD........................................................................................ 38
5.2. TOTAL SAMPLE(S) ........................................................................................... 38
5.3. SAMPLING LOCATION ..................................................................................... 38
5.4. SCHEDULE FOR SAMPLING ........................................................................... 41
5.5. EXPERTISE ....................................................................................................... 41
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LIST OF TABLES TABLE 1. SURVEY TEAM AND SCHEDULE ………………………………………………. 9
TABLE 2. NON-SUSPECTED ASBESTOS CONTAINING MATERIAL ……………………………………………… 23
TABLE 3. MATERIAL ASSESSMENT ALGORITHM ……………………………………………… 27
TABLE 4. PRIORITY ASSESSMENT ALGORITHM
……………………………………………… 29
TABLE 5. SUMMARY OF RESULT OF MATERIAL ASSESSMENT AND PRIORITY ASSESSMENT
……………………………………………… 31
TABLE 6. SUSPECTED ASBESTOS CONTAINING MATERIAL SUMMARY ……………………………………………… 32
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LIST OF FIGURES
FIGURE 1. SITE PLAN OF DIENG PROJECT 2
…………………………………. 13
FIGURE 2. MAIN BUILDING AND LABORATORY
…………………………………. 14
FIGURE 3. BARRACK 1 AND BARRACK 2
…………………………………. 14
FIGURE 4. BARRACK 3 …………………………………. 14
FIGURE 5. POLYCLINIC
…………………………………. 14
FIGURE 6. SECURITY POST
…………………………………. 14
FIGURE 7. MAIN BUILDING, ROOF OF MAIN
BUILDING
…………………………………. 16
FIGURE 8. CEILING MAIN BUILDING, SILICA
TEMPORARY DUMPSIT
…………………………………. 16
FIGURE 9. LABORATORY, ROOF OF LABORATORY,
CEILING OF LABORATORY
…………………………………. 17
FIGURE 10. BARRACK 1, ROOF OF BARRACK 1,
CEILING OF BARRACK 1
…………………………………. 18
FIGURE 11. BARRACK 2, ROOF OF BARRACK 2,
CEILING OF BARRACK 2
…………………………………. 19
FIGURE 12. BARRACK 3, ROOF OF BARRACK 3,
CEILING OF BARRACK 3
…………………………………. 20
FIGURE 13. POLYCLINIC, ROOF OF POLYCLINIC,
CEILING OF POLYCLINIC
…………………………………. 21
FIGURE 14. SECURITY POST …………………………………. 22
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1. EXECUTIVE SUMMARY
The ‘Lembaga Pelayanan dan Pengabdian Kesehatan Masyarakat (LPPKM) - ‘Fakultas
Kesehatan Masyarakat Universitas (FKM), Unversitas Indonesia’ (UI) in Depok was commissioned
by PT. Geo Dipa Energi (Persero) or GDE to conduct an asbestos survey at the ex-mess PLN
building site in Dieng, Central Java, Indonesia.
The ex-mess PLN building suspected contains asbestos containing materials (ACM), primarily in
its roofs and ceiling, and this building will be demolished as part of land clearing required for
construction of future Dieng Unit 2 power plant. The ACM is generally recognized as hazardous
materials and its wastes must be managed according to the requirements of Government
Regulation No. 101/2014. Therefore, asbestos survey and sampling are required to enable
development and execution of asbestos demolition plan to meet ADB’s requirements as well as
comply with the prevailing regulations in Indonesia.
The objectives of the PAS are to obtain accurate information project on the location, amount and
condition of suspected asbestos-containing materials (ACMs); to identify the location of suspected
ACM to be sampled and the number of samples required; to identify all the suspected ACMs to be
removed before demolition work; to assess the level of damage or deterioration in the suspected
ACMs; and to develop an asbestos algorithm and priority.
The PAS was carried out in a professional manner by experienced LKPPM – FKM of UI personnel
using non-destructive method i.e., visual observations. Surveyors conducted the preliminary
survey based on job safety analysis (JSA) which have been made before site visit.
Prior to conducting the PAS, the surveyors and GDE representatives reviewed the survey plan to
which ADB safeguard consultant provided some inputs. The PAS plan was then revised and
mutually approved by the surveyors and GDE on 5 October 2020. Based on this approval, the
surveyors mobilized to Dieng and conducted the site/building inspection on 8 to 10 October 2020.
Survey methodology involving desk research, conduct interview the PT. GDE representative from
head office and representative of Dieng Project, and observation by visit the project area.
In the course of the visit it, the surveyors developed an inventory and sampling plan for any material
being eventually suspicious of ACM. Every set of building material appears similar and performs
the same function is grouped together under the denomination “Homogeneous Sample Group”
and presented as a “source”. The surveyors made a photographic report to incorporate the
images to the report for every source (group of homogeneous samples), as well as for any
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especially relevant event, such as breakages, damages by water, very much crumbled materials,
etc.
Based on preliminary survey result, the suspected area ACM are roof and ceiling of each building
from total 7 buildings, i.e.: roof of main building 2.500 m2, ceiling of main building 216 m2, roof of
barrack (1) 620 m2, ceiling of barrack (1) 67,20 m2, roof of barrack (2) 1.090 m2, ceiling of barrack
(2) 69,36 m2, roof of barrack (3) 640 m2, ceiling of barrack (3) 69,6 m2, roof of laboratory 280 m2,
ceiling of laboratory 33,6 m2, roof of polyclinic 780 m2, ceiling of polyclinic 88,2 m2, roof of security
post 73 m2, and ceiling of security post 9,6 m2. Meanwhile, the area suspected non ACM are wall
and floor parts of each building from total 7 buildings.
In the surrounding of building are plantation/vegetable farms, meanwhile in main building still has
active electrical box panels and is used by GDE as temporary dumpsite for silica scaling. While
conducting survey, there were not found of isolation of services, gas, chemicals, working
machinery or plant, and presence of underground ducts or shafts.
The material which assessed due to suspected ACM are roof and ceiling. Material assessment
itself explained: (1) Material assessment algorithm, i.e. to obtain the product type; extent of
damage or deterioration; surface treatment; and asbestos type; (2) Priority assessment Algorithm,
involve: Normal occupant activity, Likelihood of disturbance, Human exposure potential,
Maintenance activity.
The condition of roof and ceiling are severely damage, crack, and friable, it has possibility the
suspected asbestos fibres release into the ambient air. It is recommended to take bulk sampling
for roof and ceiling materials, and also recommended to take air sampling and soil sampling.
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2. INTRODUCTION
2.1. BACKGROUND
The ‘Lembaga Pelayanan dan Pengabdian Kesehatan Masyarakat (LPPKM) - ‘Fakultas
Kesehatan Masyarakat Universitas (FKM), Unversitas Indonesia’ (UI) in Depok was
commissioned by PT. Geo Dipa Energi (Persero) or GDE to conduct an asbestos survey at the ex-
mess PLN building site in Dieng, Central Java, Indonesia. The asbestos survey will be conducted
in stages, with the preliminary asbestos survey (“the PAS”) was performed on 8 to 10 October
2020. The survey was conducted based on the preliminary asbestos survey plan prepared by
LPPKM-FKM UI (dated 3 October 2020) and approved by GDE on 5 October 2020.
The ex-mess PLN building suspected contains asbestos containing materials (ACM), primarily in
its roofs and ceiling, and this building will be demolished as part of land clearing required for
construction of future Dieng Unit 2 power plant. The ACM is generally recognized as hazardous
materials and its wastes must be managed according to the requirements of Government
Regulation No. 101/2014. Therefore, asbestos survey and sampling are required to enable
development and execution of asbestos demolition plan to meet ADB’s requirements as well as
comply with the prevailing regulations in Indonesia.
2.2. OBJECTIVE AND THE SCOPE OF THE PRELIMINARY ASBESTOS SURVEY
The objectives of the PAS are to:
• to obtain accurate information project on the location, amount and condition of suspected
asbestos-containing materials (ACMs);
• to identify the location of suspected ACM to be sampled and the number of samples required;
• to identify all the suspected ACMs to be removed before demolition work;
• to assess the level of damage or deterioration in the suspected ACMs; and
• to develop an asbestos algorithm and priority.
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2.3. SURVEY TEAM AND SCHEDULE
This preliminary survey conducted on behalf Lembaga Pelayanan dan Pengabdian Kesehatan
Masyarakat (LPPKM) FKM UI, Depok.
Personnel which conducted this survey are:
1. Lead asbestos surveyor : Dr. Sjahrul M. Nasri, MSc., Ind. Hyg.
2. Surveyor : Fiori Amelia Putri, SKM
3. Technical assistance : Imam Santoso
Table 1
Survey Team and Schedule
Activities October
1 2 3 4
Visit Project Area Dieng
Discussion and interview representative of PT. Geo Dipa Energi at Project Area Dieng
Site visit to:
• obtain accurate information project on the location, amount and condition of suspected asbestos-containing materials (ACMs);
• identify the location of suspected ACM to be sampled and the number of samples required;
• identify all the suspected ACMs to be removed before demolition work;
• assess the level of damage or deterioration in the suspected ACMs; and
• develop an asbestos algorithm and priority
Report development
Submit preliminary report
2.4. LIMITATIONS OF THE SURVEY/REPORT
The results of the PAS described in this report include: survey methodology; suspected ACM
information as obtain based on building inspection; and develop an asbestos algorithm and priority.
The PAS was carried out in a professional manner by experienced LKPPM – FKM of UI personnel
using non-destructive method i.e., visual observations. However, the extent of this PAS was bound
by the limits of non-destructive methods which preclude any major physical damage to equipment,
walls, floors, partitions, etc. Thus, while the surveyors are confident that all suspected ACM have
been identified and assessed, no guarantees are made that the surveyed ex-mess PLN building
is absolutely free of asbestos. Future demolition activities may well reveal asbestos containing
materials in areas inaccessible by the surveyors.
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3. METHODOLOGY/REPORTING OF THE PRELIMINARY ASBESTOS SURVEY
3.1. EHS RISK ASSESSMENT TO CONDUCT THE SURVEY
Surveyors conducted the preliminary survey based on job safety analysis (JSA) which have
been made before site visit. JSA enclosed in Appendix I.
3.2. SITE AND BUILDING INSPECTION
- Prior to conducting the PAS, the surveyors and GDE representatives reviewed the survey plan
to which ADB safeguard consultant provided some inputs. The PAS plan was then revised
and mutually approved by the surveyors and GDE on 5 October 2020. Based on this approval,
the surveyors mobilized to Dieng and conducted the site/building inspection on 8 to 10 October
2020.
- The field works started with an inspection visit throughout the building perusing the drawings,
in order to visually ascertain the existence of suspected ACM. All mechanical systems, floors,
walls, ceilings, and insulation of any kind were inspected as far as they were visible and
accessible.
- In the course of the visit it, the surveyors developed an inventory and sampling plan for any
material being eventually suspicious of ACM. Every set of building materials appears similar
and performs the same function is grouped together under the denomination “Homogeneous
Sample Group” and presented as a “source”. The surveyors made a photographic report to
incorporate the images to the report for every source (group of homogeneous samples), as
well as for any especially relevant event, such as breakages, damages by water, very much
crumbled materials, etc.
3.3. MATERIAL ASSESSMENT AND PRIORITY ASSESSMENT OF SUSPECTED ACM
The material assessment including: (1) Material assessment algorithm, i.e. to obtain the product
type; extent of damage or deterioration; surface treatment; and asbestos type; (2) Priority
assessment Algorithm, involve: Normal occupant activity, Likelihood of disturbance, Human
exposure potential, Maintenance activity.
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4. PRELIMINARY ASBESTOS SURVEY RESULT
4.1.SITE EQUPIMENT AND INFORMATION
The following buildings at the ex-mess PLN site, covering an area of approximately 6
hectares were inspected:
- Main building (roof, ceiling, wall, floor and, surrounding of building).
- Barrack 1, 2 and 3 (roof, ceiling, wall, floor and, surrounding of building)
- Laboratory building (roof, ceiling, wall, floor and, surrounding of building)
- Polyclinic building (roof, ceiling, wall, floor and, surrounding of building).
- Security post (roof, ceiling, and surrounding of building).
Estimated areas of the buildings including related components are as follows:
a. Main building
• Roof : 2,500 m2
• Ceiling : 216 m2
• Wall : 720 m2
• Floor : 1,008 m2
b. Barrack 1
• Roof : 620 m2
• Ceiling : 67.20 m2
• Wall : 320 m2
• Floor : 20 m x 8 m = 160 m2
c. Barrack 2
• Roof : 1,090 m2
• Ceiling : 69.36 m2
• Wall : 320 m2
• Floor : 170.98 m2
d. Barrack 3
• Roof : 640 m2
• Ceiling : 69.6 m2
• Wall : 320 m2
• Floor : 20.70 x 8.3 = 171.81m2
e. Laboratory building
• Roof : 280 m2
• Ceiling : 33.6 m2
• Wall : 160 m2
• Floor : 48 m2
f. Polyclinic building
• Roof : 780 m2
• Ceiling : 88.2 m2
• Wall : 400 m2
• Floor : 270 m2
g. Security post
• Roof : 73 m2
• Ceiling : 9.6 m2
• Wall : 6 m2
• Floor : 4 m2
The buildings in the ex-mess PLN complex were constructed around 1985 and suspected to
use ACM roofing and harplex ceiling. All 6 (six) buildings in the complex are abandoned, were
not maintained, and most of building are severely damaged, such as roofing, ceiling, wall, and
floor condition. The number of building are 6 building in total with the number of rooms:
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• Main building : 21 rooms ● Barrack 3 : 4 rooms
• Barrack 1 : 4 rooms ● Laboratory : 1 room
• Barrack 2 : 4 rooms ● Polyclinic : 3 room
• Security post : 1 room
- In the surrounding of building are plantation/vegetable farms such as cabbage, potato, and
carrot of surrounding people.
- The main building still has active electrical box panels and is used by GDE as temporary
dumpsite for silica scaling generated by the operation of Dieng Unit 1 power plant.
- On course of the PAS, the followings were not found: isolation of services, gas, chemicals,
working machinery or plant, and presence of underground ducts or shaft.
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4.1.1. Desk research
The following information was available for desk-research:
- Site maps
Figure 1
Site Plan of Dieng Project 2
2
3 4
6
7
5
1
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Figure 2
1. Main Building
2. Laboratory
Figure 3
3. Barrack 1
4. Barrack 2
The following information was taken using satellite, i.e. some parts of building are suspected
contain asbestos containing material (ACM), such as roofing and ceiling.
4.1.2. Interview Results
The following interviews were conducted at head office and on site:
- Mr. Andhika Yudiaji, HSE Assistance Manager Corporate
- Mr. Cahyo, Superintendent Project of Dieng
- Mr. Sholimin, EHS Officer of Dieng
The following information were conducted with Mr. Andhika:
- Area of ex-mess PLN will be used for geothermal power plant construction.
- Roofing part material use harplex material for roof and ceiling.
- Area and building in Project Dieng location will be demolished for geothermal power
plant construction Project Dieng 2.
The following information were conducted with Mr. Cahyo
Figure 4
5. Barrack 3
Figure 5
6. Polyclinic
1
2
3 4
6
7
Figure 6
7. Security post
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- In the end of year 2020 will be started the land clearing activities demolished for
geothermal power plant construction Project Dieng 2.
The following information were conducted with Mr. Sholimin
- The main building is using as silica temporary dumpsite.
- In the surrounding of building are plantation/vegetable farms such as cabbage, potato,
and carrot of surrounding people.
- There was electrical current to electrical panel box at the main building.
There were no isolation of services, gas, chemicals, working machinery or plant, presence of
underground ducts or shafts, and no access area of pathway to building.
4.2. SUSPECTED ASBESTOS CONTAINING MATERIALS
A complete list of all suspected contain asbestos materials are displayed in this report In this
report are the results of the visual inspection. Pictures in the report are also included for the
visualization the examined materials.
The location of the suspected ACM in the pictures, the following color codes:
- Pictures showing a red color, is suspected asbestos material.
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Main building layout:
Suspected ACM for roofing and ceiling
Figure 7
(left) Main building, (right) roof of main building
Figure 8
(left) ceiling main building, (right) silica temporary dumpsite
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Laboratory layout:
Suspected ACM for roofing and ceiling
Figure 9
(left) laboratory, (center) roof of laboratory, (right) ceiling of laboratory
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Barrack 1 layout:
Suspected ACM for roofing and ceiling
Figure 10
(left) barrack 1, (center) roof of barrack 1, (right) ceiling of barrack 1
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Barrack 2 layout:
Suspected ACM for roofing and ceiling
Figure 11
(left) barrack 2, (center) roof of barrack 2, (right) ceiling of barrack 2
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Barrack 3 layout:
Suspected ACM for roofing and ceiling
Figure 12
(left) barrack 3, (center) roof of barrack 3, (right) ceiling of barrack 3
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Polyclinic building layout:
Suspected ACM for roofing and ceiling
Figure 13
(left) polyclinic, (center) roof of polyclinic, (right) ceiling of polyclinic
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Security post layout:
Suspected ACM for roofing and ceiling
Figure 14
Security post
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4.3. NOT SUSPECTED ASBESTOS CONTAINING MATERIAL
Surveyors identification wall and floor parts. Walls are from red brick covered by aggregate
cement (mixing cement and sand), meanwhile floor used ceramic tiles. It is clear wall and floor
parts are not suspected ACM. The locations of suspected non-ACM’s are also displayed in this
below:
Table 2
Non-Suspected Asbestos Containing Material
No. Existing Location Picture
1 Wall Main Building
2 Floor Main Building
3 Silica temporary dumpsite
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No. Existing Location Picture
4 Wall Barrack 1
5 Floor Barrack 1
6 Wall Barrack 2
7 Floor Barrack 2
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No. Existing Location Picture
8 Wall Barrack 3
9 Floor Barrack 3
10 Wall Laboratory
11 Floor Laboratory
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No. Existing Location Picture
12 Wall Polyclinic
13 Floor Polyclinic
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4.4. INVENTORY OF SUSPECTED ACM
• Suspected ACM conditions and description at each building at the ex-mess PLN site
The suspected ACM at ex-mess PLN building are roof and ceiling part. The condition of roof
are locally cracking and abrasive on specific area (severely damage), as well as ceiling
condition are Locally cracking and abrasive on specific area (severely damage).
• Areas inaccessible for the survey; possible hidden ACM.
On course of survey, all areas are accessible.
• Areas suspected to contain ACM
The area suspected to contain ACM are the roof and ceiling of main building, barrack 1, barrack
2, barrack 3, laboratory, polyclinic and security post.
• Area not suspected to contain ACM
The area not suspected to contain ACM are the wall and floor of main building, barrack 1,
barrack 2, barrack 3, laboratory, polyclinic and security post.
4.5. MATERIAL ASSESSMENT AND PRIORTY ASSESSMENT
4.5.1 The risk assessment includes a material assessment and a priority assessment. The
combined material and priority assessment results should be used to establish the priority
for those ACMs needing remedial action and the type of action that will be taken.
1. Material Assessment Algorithm
The four main parameters which determine the amount of fibre released from an ACM when
subject to disturbance are: (1) product type, (2) extent of damage or deterioration, (3) surface
treatment; and (4) asbestos type. In the material assessment process, the main factors
influencing fibre release are given a score which can then be added together to obtain a
material assessment rating.
Table 3
Material Assessment Algorithm
A) PRODUCT TYPE B) EXTENT OF DAMAGE OR DETERIORATION
Score Description Score Description
1 Asbestos reinforced composites (plastics, resins, mastics, roofing felts, vinyl floor tiles, semi-rigid paints or decorative finishes, asbestos cement etc.).
0 Good condition, no visible damage.
2 Asbestos insulating board, millboards, other low density insulation boards, asbestos textiles, gaskets, ropes and woven textiles, asbestos paper and felt.
1 Low damage, a few scratches or Surface marks, broken edges on boards, tiles etc.
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3 Thermal insulation (e.g. pipe and boiler lagging) sprayed asbestos, loose asbestos, asbestos mattresses and packing.
2 Medium damage, significant breakage of materials or several small área where material has been damaged revealing loose asbestos fibres.
3 High damage or delamination of materials, sprays and termal insulation. Visible asbestos debris.
C) SURFACE TREATMENT D) ASBESTOS TYPE
Score Description Score Description
0 Composite material containing asbestos; reinforced plastics, resins, vinyl tiles.
1 Chrysotile.
1 Enclosed sprays and lagging, AIB (with exposed fase painted or encapsulated), asbestos cement sheets etc.
2 Amosite, Tremolite, Actinolite or Anthopyllite
2 Unsealed AIB, or encapsulated lagging and sprays.
3 Crocidolite.
3 Unsealed lagging and sprays.
TOTAL MATERIAL SCORE= A+B+C+D
Materials with assessment scores of 10 or more are rated as having a high potential to release
fibres, if disturbed. Scores of between 7 and 9 are regarded as having a medium potential,
and between 5 and 6 a low potential. Scores of 4 or less have a very low potential to release
fibres.
Based on survey, the material score for main building roof as below:
• Score of product type of roof (A) : 1 (asbestos cement)
• Score of extent of damage or deterioration (B): 3 (Visible asbestos debris)
• Score of surface treatment (C) : 1 (asbestos cement sheets/corrugated)
• Score of asbestos type (D) : 1 (chrysotile)
• All the score above added and total score are 6.
• The type, surface treatment, condition, and the level of damage of roof for other
buildings (barrack 1, barrack 2, barrack 3, laboratory, polyclinic and security post) also
obtain an equal score
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2. Priority Assessment Algorithm
There are 4 main sections. Within each subsection, choose the most appropriate description
and take the associated score. Average the scores for each subsection. Add the normal
occupant activity score to the three average scores from the likelihood of disturbance, human
exposure potential and maintenance activity sections to get a total priority score.
Table 4
Priority Assessment Algorithm
A) NORMAL OCCUPANT ACTIVITY
A1) MAIN ACTIVITY A2) SECONDARY ACTIVITIES
Score Description Score Description
0 Rare disturbance activity (e.g. Little used store room)
0 Rare disturbance activity (e.g. Little used store room)
1 Low disturbance activities (e.g. office type activity).
1 Low disturbance activities (e.g. office type activity).
2 Periodic disturbance (e.g. industrial or vehicular activity which may contact ACMs)
2 Periodic disturbance (e.g. industrial or vehicular activity which may contact ACMs)
3 High levels of disturbance (e.g. fire door with AIB sheet in constant use)
3 High levels of disturbance (e.g. fire door with AIB sheet in constant use)
B) LIKELIHOOD OF DISTURBANCE
B1) LOCATION B2) ACCESSIBILITY B3) EXTENT/ AMOUNT
Score Description Score Description Score Description
0 Outdoors 0 Unusually inaccessible or unlikely to be disturbed
0 Small amounts or items (e.g. strings, gaskets)
1 Large rooms or well ventilated areas>100 m2
1 Occasionally likely to be disturbed
1 ≤10m2or ≤10m pipe run
2 Rooms up to 100m2. 2 Easily Disturbed. 2 >10 to <50m2 or>10 to <50 m pipe run
3 Confined Spaces 3 Routinely disturbed 3 >50m2 or >50m pipe run.
C) HUMAN EXPOSURE POTENTIAL
C1) NUMBER OF OCCUPANTS
C2) FREQUENCY OF USE C3) AVERAGE TIME EACH USE
Score Description Score Description Score Description
0 None 0 Infrequent 0 <1 hour
1 1 – 3. 1 Monthly 1 >1 to <3 hours.
2 4 – 10 2 Weekly. 2 >3 to <6 hours
3 >10 3 Daily 3 >6 hours
D) MAINTENANCE ACTIVITY
D1) TYPE OF MAINTENANCE ACTIVITY D2) FREQUENCY OF MAINTENANCE ACTIVITY
Score Description Score Description
0 Minor disturbance (e.g. possibility of contact when gaining access)
0 ACM unlikely to be disturbed for maintenance.
1 Low disturbance (e.g. changing light bulbs in asbestos ceiling).
1 ≤1 per year
2 Medium disturbance (e.g. lifting one or two AIB ceiling tiles to access a valve)
2 >1 per year
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3 High levels of disturbance (e.g. removing a number of AIB ceiling tiles toreplace a valve or for recabling)
3 >1 per month
TOTAL PRIORITY SCORE = A+B+C+D Where A=(A1+A1)/2; B=(B1+B2+B3)/3; C=(C1+C2+C3)/3; D=(D1+D2)/2
Based on survey, the priority score for main building roof as below:
• Score of normal occupant activity (A): main activity part i.e. 1 (Low disturbance activities);
B. secondary activity i.e. 1 (Low disturbance activities). The average score are 1.
• Score of likelihood of disturbance (B): location part i.e. 2 (Rooms up to 100m2);
accessibility i.e. 2 (easily disturbed); extent/amount i.e. 3 (>50m2). The average score are
2,3
• Score of human exposure potential (C): number of occupants i.e. 1 (1-3 occupants);
frequency of use i.e. 2 (weekly) average time each use, i.e. 1 (>1 to <3 hours.). The
average score are 1,3
• Score of maintenance activity (D): type of maintenance activity i.e. 1 (low disturbance);
frequency of maintenance activity i.e. 0 ACM unlikely to be disturbed for maintenance).
The average score are 0,5.
• The total of priority score are 5,1.
• The occupant activity, likelihood of disturbance, human exposure potential, and
maintenance activity of roof for other buildings (barrack 1, barrack 2, barrack 3, laboratory,
polyclinic and security post) also obtain an equal score.
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Table 5
Summary of Result of Material Assessment and Priority Assessment
No Location Location area /machinery
description Product Type Analysis result Quantity
Material Scoring
Priority Scoring
1. Roof Main Building Administrative Office – building, silica temporary dumpsite
Suspected ACM corrugated No laboratory analysis yet
2.500,00 m2 6 5,1
2. Outer Ceiling Main Building Main building Suspected ACM sheet No laboratory analysis yet
216 m2 6 5,1
3. Roof Barrack 1 Roof building Suspected ACM corrugated No laboratory analysis yet
620,00 m2 6 5,1
4. Outer Ceiling Barrack 1 Room building Suspected ACM sheet No laboratory analysis yet
67,20 m2 6 5,1
5. Roof Barrack 2 Roof building Suspected ACM corrugated No laboratory analysis yet
1.090,00 m2 6 5,1
6. Outer Ceiling Barrack 2 Room building Suspected ACM sheet No laboratory analysis yet
69,36 m2 6 5,1
7. Roof Barrack 3 Roof building Suspected ACM corrugated No laboratory analysis yet
640,00 m2 6 5,1
8. Outer Ceiling Barrack 3 Room building Suspected ACM sheet No laboratory analysis yet
69,6 m2 6 5,1
9. Roofing laboratory Laboratory room Suspected ACM corrugated No laboratory analysis yet
280,00 m2 6 5,1
10. Outer Ceiling laboratory Room building Suspected ACM sheet No laboratory analysis yet
33,6 m2 6 5,1
11. Roofing polyclinic Polyclinic room Suspected ACM corrugated No laboratory analysis yet
780,00 m2 6 5,1
12. Outer Ceiling Polyclinic Polyclinic room Suspected ACM sheet No laboratory analysis yet
88,2 m2 6 5,1
13. Roof Security Post Security room Suspected ACM corrugated No laboratory analysis yet
73,00 m2 6 5,1
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Table 6 Suspected Asbestos Containing Material Summary
No. Building, Floor& Room
Location Area /machinery description
Product type description
Quantity m2
(specify UoM) General condition of
the roof (incl. Accessibility)
Type of asbestos
Recommendation Overall Risk Assessment
I
Main Building
1. Roof Main Building
Administrative Office – building, silica temporary dumpsite
Wave Roof material
2.500,00 m2 Locally cracking and abrasive on specific area (severely damage)
Suspected ACM
To be identificated low risk
2. Outer Ceiling Main Building
Main building Flat Sheet Ceiling material
216 m2 Locally cracking on specific area (severely damage)
Suspected ACM
To be identificated low risk
3. Wall Main Building
Main building Building material : red brick
720 m2 Locally abrasive on specific area (severely damage)
Non ACM Recommended to
be removed
low risk
4. Floor Main Building
Main building Building material : Ceramic Tile
1.008 m2 Locally cracking on
specific area (severely
damage)
Non ACM Recommended to
be removed
low risk
II
Barrack 1
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1. Roof Barrack 1 Roof building Building material : wave roof
620,00 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
2. Outer Ceiling Barrack 1
Room building Building material : Flat Sheet
67,20 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
3. Wall Barrack 1 Room building Building material : red Brick
320,00 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Non ACM Recommended to
be removed
low risk
4. Floor Barrack 1 Room building Building material : Ceramic Tile
160 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Non ACM Recommended to
be removed
low risk
III
Barrack 2
1. Roof Barrack 2 Roof building Building material : wave roof
1.090,00 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
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2. Outer Ceiling Barrack 2
Room building Building material : Flat sheet
69,36 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
3. Wall Barrack 2 Room building Building material : red brick
320 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Non ACM Recommended to
be removed
low risk
4. Floor Barrack 2 Room building Building material : Ceramic tile
170,98 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Non ACM Recommended to
be removed
low risk
IV
Barrack 3
1. Roof Barrack 3 Roof building Building material : wave roof
640,00 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
2. Outer Ceiling Barrack 3
Room building Building material : Flat sheet
69,6 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
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3. Wall Barrack 3 Room building Building material : red brick
320 m2 Locally abrasive on
specific area (severely
damage)
Non ACM Recommended to
be removed
low risk
4. Floor Barrack 3 Room building Building material : CeramicTile
171,81 m2 Locally cracking on
specific area (severely
damage)
Non ACM Recommended to
be removed
low risk
V
Laboratory
1. Roofing laboratory Laboratory room Building material : wave roof
280,00 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
2. Outer Ceiling laboratory
Room building Building material : Flat sheet
33,6 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
3. Wall laboratory Room building Building material : red Brick
160 m2 Locally abrasive on
specific area (severely
damage)
Non ACM Recommended to
be removed
low risk
4. Floor laboratory Room building Building material : Ceramic Tile
48 m2 Locally cracking on
specific area (severely
damage)
Non ACM Recommended to
be identificated
low risk
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VI Polyclinic
1. Roofing polyclinic Polyclinic room Building material : wave roof
780,00 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
2. Outer Ceiling Polyclinic
Polyclinic room Building material : Flat sheet
88,2 m2 Locally cracking and
abrasive on specific
area (severely
damage)
Suspected ACM
Recommended to
be removed
low risk
3. Wall Polyclinic Polyclinic room Building material : red brick
400 m2 Locally abrasive on
specific area (severely
damage)
Non ACM Recommended to
be removed
low risk
4. Floor Polyclinic Polyclinic room Building material : Ceramic Tile
228 m2 Locally cracking on
specific area (severely
damage)
Non ACM Recommended to
be removed
low risk
VII Security Post
1
Roofing Post
Security Post room
Building material : Wave roof
73,00 m2
Locally cracking on
specific area (severely
damage)
Suspected ACM
Recommended to
be identificated
low risk
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4.5.2. Remedial/Maintenance Actions Required.
The objective of project Dieng 2 is to identification whether there are ACM at ex-mess
PLN building in Dieng, and if obtain ACM, the ACM will be demolished, hence in this
project will not conduct remedial/maintenance action to the buildings.
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5. PROPOSED SAMPLING METHODS
Based on the PAS, the primary ACM found at the buildings of ex-mess PLN are in the roof and ceiling parts,
hence to ensure about this, needed the identification of those materials. The condition of roof and ceiling are
severely damage, crack, and friable, it has possibility the suspected asbestos fibres release into the ambient
air. Beside take bulk sampling for roof and ceiling materials, it is also recommended to take air sampling and
soil sampling.
5.1. SAMPLING METHOD
For each building will be taken bulk sample from roof and ceiling, as well as take sample for each
building, i.e. 1 (one) air sampling inside the building, and 1 (one) air ambient sampling outside the
building. For soil, sample will be taken only one sample as representative of all buildings, due to the
potential for suspected asbestos fiber released from the building roof is assumed to be in same pattern.
It is because all material roofing for all building comes from the same manufacture and was established
in the same year, i.e. around 1985s, hence all soil condition are homogeneous, samples are planned to
be taken in main building.
Bulk sample analysis will be performed by Polarized Light Microscope (PLM) NIOSH Manual of
Analytical Methods (NMAM) 9002. The air sample analysis will be performed by Phase Contrast
Microscope (PCM) used NIOSH Manual of Analytical Methods (NMAM) 7400.
5.2. TOTAL SAMPLE(S)
- Bulk sample of roof : 6 samples
- Bulk sample of ceiling : 6 samples
- Air sampling inside building : 6 samples
- Air ambient sampling outside the building : 6 samples
- Soil sampling (bulk sample) outside the main building: 1 sample
5.3. SAMPLING LOCATION
- Main Building
Indoor air Sampling point
Outdoor air
Sampling point
Soil (bulk) sampling point
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- Laboratory
- Barrack 1
- Barrack 2
Indoor air Sampling point
Outdoor air Sampling point
Indoor air Sampling point
Outdoor air Sampling point
Indoor air Sampling point
Outdoor air Sampling point
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- Barrack 3
- Polyclinic
- Security Post
Indoor air Sampling point
Outdoor air Sampling point
Indoor air Sampling point
Outdoor air Sampling point
Indoor air Sampling point
Outdoor air Sampling point
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5.4. SCHEDULE FOR SAMPLING
The schedule to take samples will be conducted on 5 to 7 November 2020.
5.5. EXPERTISE
• Consultant : Dr. Sjahrul M. Nasri, MSc., Ind. Hyg.
• Leader of Sampling Team : Heickel, S.ST
• Sampling Team Member : Fiori Amelia Putri, SKM
• Technical Assistance : Imam Santoso
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APPENDIX I
Job Safety Analysis (JSA) Site and Building Inspection
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Job Safety Analysis (JSA) Working at Height
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-
APPENDIX II
DOCUMENTATION OF SURVEY
No. Existing Location
Picture Note
1 Main Building
2 Silica temporary dumpsite
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No. Existing Location
Picture Note
3 Vegetable plant near main building
4 Barrack 1
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No. Existing Location
Picture Note
5 Vegetable plant near barrack 1
6 Barrack 2
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No. Existing Location
Picture Note
7 Vegetable farm near barrack 2
8 Barrack 3
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No. Existing Location
Picture Note
9 Vegetable farm near barrack 3
10 Laboratory
11 Vegetable farm near laboratory
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No. Existing Location
Picture Note
12 Polyclinic
13 Vegetable farm near polyclinic
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No. Existing Location
Picture Note
14 Security post
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