ASPECT IMPACT GUIDLINE

Column Number Column Title Remark

1 No Sequence number of identified aspect
2 Manin Group Activity
3 Main Job
4 Specific Job
5 Additional Remarks
6 Activity, Product or Services Kinds of activity/product/service which has impact to environmental
7 Location The place where environmental aspect is occurred
Column 4 : Put the project number
Column 5 : Put “ASP”
8 - 10 Aspect Number
Column 6 : Sequence number of aspect
Example : 50019-ASP-1
Put “D” if the identified aspect is caused impact to environment directly
11 D/I Put "I" if the identified aspect is caused impact to environment indirectly

Function of Time Occuring :

12 P/C/F P = Past
C = Current
F = Future

Condition when impact occurred :

13 N/A/E N = if the activities/products/services is running in Normal condition
A = if the activities/products/services is running in Abnormal condition
E = if the activities/products/services is running in Emergency condition
The elements of activities/ process, products or services of PT JEL which may have interaction with
14 Aspect
the environment
Any environmental alteration, advantages or disadvantages, as a whole or partly, which are generate
15 Impact from environmental aspect of PT JEL

Scoring for Each Significant Impact Criterias :

16 - 21 Significant Impact Criteria 1.0 = Frequency and Probability
2.0 = Impact Consequence (Degreee of Impact)
3.0 = Geographical Range
4.0 = Impact to cost
5.0 = Impact to Public Relation (Mass Media and Community)
6.0 = Impact and degree of Recovery

22 Total Score Total score of significant impact criteria (sum of column 16 - 21)
"Y" if total score > 30
23 Significant Impact
"N" if total score ≤ 30

Column 24: Put "Y" if there are any related regulations or Put “N” if there are not any related
24 - 25 Regulation and Other Requirement regulations
Column 25 : Mention the related regulation (if only column 24 is “Y”)

The conclution :
"Yes" if there are any significant impact (column 23) and/or there are any regulation and other
26 Significant Aspect requirements (column 24)
"No" if there are not any significant impact (column 23) and there are not any regulation and other
requirements (column 24)
 ENVIRONMENTAL ASPECT-IMPACT
Prepared By Reviewed By Approved By Project Name : SRI U3 PROJECT
Identification Date Revision
Location : ANYER

Job No : L - 50019 - 00

2-Jan-17 0 Client : IKPT PT. JURONG ENGINEERING LESTARI

120 KTA SRI - U3 PROJECT
sign/date: sign/date: sign/date:

ACTIVITIES, SIGNIFICANT IMPACT SIGNIFICANT SIGNIFICANT

MAIN GROUP OF ADIITIONAL TOTAL REGULATION AND OTHER REQUIREMENT ASPECT CONTROL /
NO MAIN JOB SPECIFIC JOB PRODUCTS OR LOCATION ASPECT NUMBER D/I P/C/F N/A/E ASPECT IMPACT CRITERIA IMPACT ASPECT REMARK
ACTIVITY REMARKS MANAGEMENT
SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28)

- PP No 74 Tahun 2001 tentang Bahan

Beracun dan Berbahaya (B3)
- PP No.18 Tahun 1999 & PP No.85 Tahun
Transportation/ Fuel storage provided spill
1999 tentang Pengelolaan Limbah B3
1 General Heavy Vehicle Operation Re-Fueling Filling station PT.JEL ASP 1 D C A Fuel drip/ spillage to the ground Soil contaminated 5 3 1 1 3 1 14 N Y YES containment, spill kit, A void
- KepmenLH No 3 Tahun 2008 tentang Tata
equipment Re-fueling at site location
Cara Pemberian Simbol dan Label B3
- KepKa Bapedal No 5 tahun 1995 tenteng
simbol dan label limbah B3

- PermenLH No 5 Tahun 2006 tentang

Ambang Batas Emisi Gas Buang Kendaraan
Light Vehicle Man power/business Bermotor Lama Inspection the equipment
2 General Transportation Site and public area PT.JEL ASP 2 D C N gas emission from vehicle engine operation air pollution 10 3 3 1 1 1 19 N Y YES
Operation transportation regularly, rutine maintenance
- PP 41 Tahun 1999 tentang Pengendalian
Pencemaran Udara

crane engine start,

- PP 41 Tahun 1999 tentang Pengendalian
Piping setting the crane Inspection the equipment
3 Piping Work Lifting & Rigging site PT.JEL ASP 5 D C N gas emission from crane engine operation air pollution 10 3 3 1 1 1 19 N Y Pencemaran Udara YES
Instalation position including setting regularly, rutine maintenance
the outrigger

tidy up the area "don't

Piping Waste material such as bad sling, used barricade
4 Piping Work Lifting & Rigging leave any unsafe site PT.JEL ASP 4 D C N soil pollution 10 1 1 1 1 10 24 N N - No -
Instalation material, expired signage
condition"

- PP 41 Tahun 1999 tentang Pengendalian

Piping Clear area before flushing and
5 Piping Work Flashing/blowing Contaminated water site PT.JEL ASP 9 D F N contaminated water to soil, noise Soil/water polution 10 1 1 1 1 5 19 N y Pencemaran Udara No
Instalation blowing activity
Piping Clear area before flushing and
6 Piping Work Hydrotest contaminated water site PT.JEL ASP 11 D F N Contaminated water, high pressure water polution 10 1 11 11 1 1 35 Y N No
Instalation blowing activity
Collect all spill as hazardouse
Piping Flamaable, hazardous - PP No.18 Tahun 1999 & PP No.85 Tahun waste, Collect all can as
7 Piping Work Painting Workshop, ware house and site PT.JEL ASP 8 D F N spill pain, tinner, can soil pollution or fire 8 1 1 1 5 1 17 N Y YES
Instalation subtance 1999 tentang Pengelolaan Limbah B3 hazardous, treat as
hazardouse waste

- PP No 74 Tahun 2001 tentang Pengelolaan

Bahan Beracun dan Berbahaya (B3) Collect oil waste and all
8 Civil Work Support Facility Genset operation Site/ Generator room PT.JEL ASP 37 D C A oil spillage to the ground soil contaminated 5 5 1 3 1 3 18 N Y YES
- PP No.18 Tahun 1999 & PP No.85 Tahun hazardouse waste
1999 tentang Pengelolaan Limbah B3
 ACTIVITIES, SIGNIFICANT IMPACT SIGNIFICANT SIGNIFICANT
MAIN GROUP OF ADIITIONAL TOTAL REGULATION AND OTHER REQUIREMENT ASPECT CONTROL /
NO MAIN JOB SPECIFIC JOB PRODUCTS OR LOCATION ASPECT NUMBER D/I P/C/F N/A/E ASPECT IMPACT CRITERIA IMPACT ASPECT REMARK
ACTIVITY REMARKS MANAGEMENT
SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO

- PERMEN LH No. 13 tahun 2009 tentang

Baku Mutu Emisi Sumber Tidak Bergerak Bagi
Inspection the equipment
9 Civil Work Support Facility Genset operation Site/ Generator room PT.JEL ASP 38 D C A air emission air pollution 3 1 1 3 1 3 12 N Y Usaha YES
dan/atau Kegiatan MIGAS regularly, rutine maintenance

- KEPMEL LH No. 48 Tahun 1996 tentang

Baku Tingkat Kebisingan
Provide silence type genset
10 Civil Work Support Facility Genset operation Site/ Generator room PT.JEL ASP 39 D C N Noise environment/ecosystem disturbance 10 3 1 1 5 1 21 N Y - KEPMENAKER No: 13/MEN/X/2011 tentang YES
Nilai Ambang Faktor Fisika ditempat kerja (low noise)

- KEPMEL LH No. 48 Tahun 1996 tentang

Baku Tingkat Kebisingan
Carry out the job in the day
11 Civil Work Fabrication Workshop activities Workshop PT.JEL ASP 41 D C N Noise environment/ecosystem disturbance 10 3 1 1 5 1 21 N Y - KEPMENAKER No: 13/MEN/X/2011 tentang YES
Nilai Ambang Faktor Fisika ditempat kerja time

Paper waste from unnecessary pinting and miss

12 General office printing use of paper Site Office PT.JEL ASP 45 I C N Decrease natural resources 10 5 10 1 3 3 32 Y N YES Paperless program
printing

Wasting energy for unnecessary printing and

13 General office printing use of paper Site Office PT.JEL ASP 46 D C N Decrease natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light
misprinting

Clean up paper waste

14 Cleaning Service from photocopy room Site Office PT.JEL ASP 47 D C N Paper waste Soil pollution 10 3 1 1 3 1 19 N N NO
waste bin
Office activities- Wasting energi from unnecessary electricity using for
15 General office workstation Site Office PT.JEL ASP 48 D C N Decrease natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light
computer usage computers while unused

- UU No 18 Tahun 2008 tentang Pengelolaan

Sampah
16 General office printing Toner replacement Site Office PT.JEL ASP 49 D C A Scattered rugs (hazardous waste) aesthetics problem 5 3 1 1 3 1 14 N Y
- PP No.18 Tahun 1999 & PP No.85 Tahun
YES Housekeeping program
1999 tentang Pengelolaan Limbah B3

- UU No 18 Tahun 2008 tentang Pengelolaan

Garbage are mixed of : toilet papper, sanitary napkin waste management program,
Clean up waste bin from Sampah
17 Cleaning Service office cleaning Toilet PT.JEL ASP 51 D C N (classified as infectious waste, which is include in Soil pollution, health problem 10 3 1 1 3 1 19 N Y YES organic and non organic
toilet - PP No.18 Tahun 1999 & PP No.85 Tahun
hazardous waste) waste and hazardouse waste
1999 tentang Pengelolaan Limbah B3

Office activities-lamps
18 General office ligthning Site Office PT.JEL ASP 52 D C N Wasting energy for unnecessary lamps usage Decrease non renewable natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light
usage

- UU No 18 Tahun 2008 tentang Pengelolaan

Office activities- Used fluorescense lamp (contains hazardous waste)
Sampah treat by hazardouse waste
19 General office ligthning replacement of Site Office PT.JEL ASP 53 D C A are not properly stored as hazardous waste (contein Soil pollution, health problem 10 10 10 1 10 10 51 Y Y YES
- PP No.18 Tahun 1999 & PP No.85 Tahun management
fluorescense lamp mercury)
1999 tentang Pengelolaan Limbah B3

- UU No 18 Tahun 2008 tentang Pengelolaan

Office ativities-
Used dry batteries (contains hazardous waste,such as Sampah treat by hazardouse waste
20 General office cleaning replacement of dry Site Office PT.JEL ASP 54 D C A Soil pollution, health problem 10 10 10 1 10 10 51 Y Y YES
Ni,Cd) are not properly stored as hazardous waste - PP No.18 Tahun 1999 & PP No.85 Tahun management
bateries
1999 tentang Pengelolaan Limbah B3

Generates segregated garbage, between organic and

Clean up waste bin from UU No 18 Tahun 2008 tentang Pengelolaan provide organic and
21 Cleaning Service office cleaning Site Office PT.JEL ASP 55 D C N inorganic. These garbege will be mixed together ini Soil pollution 10 5 1 1 3 1 21 N Y YES
the office (indoor) Sampah unorganic waste bin
temporary landfill

Office ativities-Non CFC

22 General office air conditioning Site Office PT.JEL ASP 56 D C N Wasting energy for unnecessary air conditioning usage Decrease non renewable natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light
air conditioner usage

23 Facility office toilet Toilet usage Toilet PT.JEL ASP 57 D C N Generates waste water Water pollution 3 5 5 1 5 3 22 N N NO

Cleaning service-toilet
24 Cleaning Service office toilet Site Office PT.JEL ASP 58 D C N Non environmantal friendly cleaning agent is used Water pollution 3 1 1 1 1 1 8 N N NO
area

Scattered inorganic waste such as can, sachet, plastic, UU No 18 Tahun 2008 tentang Pengelolaan provide organic and
25 General office drinking Daily activities-drinking Site Office PT.JEL ASP 59 D C N aesthetics problem 5 3 1 1 1 1 12 N Y YES
etc Sampah unorganic waste bin
Scattered organic waste such as tea bag, coffee or tea UU No 18 Tahun 2008 tentang Pengelolaan provide organic and
26 General office drinking Daily activities-drinking Site Office PT.JEL ASP 60 D C N health and aesthetics problem 5 3 1 1 1 1 12 N Y YES
dregs, sugar, cream,etc Sampah unorganic waste bin

Clean up waste bin from Segregated garbage will be mixed together at UU No 18 Tahun 2008 tentang Pengelolaan provide organic and
27 Cleaning Service office cleaning Site Office PT.JEL ASP 61 D C N Soil pollution 10 3 1 3 3 5 25 N Y YES
pantry temporary landfill Sampah unorganic waste bin

28 Facility office cleaning Daily activities-smoking Smoking area PT.JEL ASP 62 D C N Scattered cigarettes waste, odor, smoke Soil pollution, aesthetics problem, health problem 10 3 1 3 3 5 25 N N NO

29 Cleaning Service office cleaning Clean up smoking area Smoking area PT.JEL ASP 63 D C A Cigarettes waste Soil pollution 10 3 3 1 1 1 19 N N NO
 ACTIVITIES, SIGNIFICANT IMPACT SIGNIFICANT SIGNIFICANT
MAIN GROUP OF ADIITIONAL TOTAL REGULATION AND OTHER REQUIREMENT ASPECT CONTROL /
NO MAIN JOB SPECIFIC JOB PRODUCTS OR LOCATION ASPECT NUMBER D/I P/C/F N/A/E ASPECT IMPACT CRITERIA IMPACT ASPECT REMARK
ACTIVITY REMARKS MANAGEMENT
SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO
unpleasant odor and potensially create health UU No 18 Tahun 2008 tentang Pengelolaan provide organic and
30 General office cleaning Lunch Site area PT.JEL ASP 64 D C N Scattered food waste 10 1 1 1 1 3 17 N Y YES
aesthetics problem Sampah unorganic waste bin

31 Cleaning Service office cleaning Windows cleaning Site Office PT.JEL ASP 65 D C N Scattered glass cleaner aesthetics problem 3 3 1 1 1 1 10 N N NO

Glass cleaner waste, dish cleaner/soap waste, floor

Cleaning service-clean
32 Cleaning Service office cleaning Site Office PT.JEL ASP 66 D C N cleaner waste, toilet cleaner waste, all cleaner Water pollution 10 5 5 1 1 1 23 N N NO
up all cleaner tools
container waste are not environmental friendly

Toner catridge
- PP No.18 Tahun 1999 & PP No.85 Tahun
33 Facility office printing replacement for Site Office PT.JEL ASP 68 D C A Scattered hazardous rugs (hazardous waste) Soil pollution 3 5 1 1 1 5 16 N Y YES Collect to hazardous waste
1999 tentang Pengelolaan Limbah B3
photocopy and printer

Clean water suplay

34 Facility office toilet Site PT.JEL ASP 69 D C A Tap leakage, which replaces as soon as it is identified Decrease natural resources(natural water) 3 5 1 1 1 1 12 N N NO
maintenance

Clean water suplay

35 Facility office toilet water pump PT.JEL ASP 70 D C A Pipe leakage Decrease natural resources(natural clean water) 10 5 1 1 1 1 19 N N NO
maintenance

Cleaning rooms and

36 Cleaning Service office cleaning Camp PT.JEL ASP 71 D C N Generates wastewater contain biodegradable cleaner Water pollution 10 3 1 1 1 1 17 N N NO
camp area

37 Cleaning Service office toilet Cleaning toilet Toilet PT.JEL ASP 72 D C N Generates wastewater contain biodegradable cleaner Water pollution 10 3 1 1 1 1 17 N N NO

Cleaning waste bins at Generates soil waste, that might be infectious (if mixed UU No 18 Tahun 2008 tentang Pengelolaan provide organic and
38 Cleaning Service office toilet Toilet PT.JEL ASP 73 D C N Soil pollution 10 3 1 1 1 1 17 N Y YES
toilet with sanitary napkins) Sampah unorganic waste bin
39 Facility office toilet Toilet usage Toilet PT.JEL ASP 74 D C N Generates wastewater contain detergent Water pollution 10 3 1 1 1 1 17 N N NO

40 Facility office toilet Toilet usage Toilet PT.JEL ASP 75 I C A Excessive toilet paper usage Decrease natural resources 3 5 1 1 1 1 12 N N NO

41 Facility office office Daily activities-television Mess and site office PT.JEL ASP 76 I C N Unecessary electricity usage while unused Decrease natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light

Daily activities-air
42 Facility office office Mess and site office PT.JEL ASP 77 I C N Unecessary electricity usage while unused Decrease natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light
conditioner

Daily activities-other
personal electronic
43 Facility office Mess and site office PT.JEL ASP 78 I C N Unecessary electricity usage while unused Decrease natural resources 10 5 10 1 3 10 39 Y N YES Switch off the Light
equipment (charging
IPOD,Cellphones,etc)

Grand Total Score : 999 Number of Significant Note: Local Gov Regulation will apply when available instead of National Regulation
Number of Aspects: #REF! Aspects 52
Average : #REF!
 ENVIRONMENTAL ASPECT-IMPACT
Prepared By Reviewed By Approved By Identification Date : 7 October 2012
Akhmad
Sriyono Rev : A
Mulyadi/Anandhoyo R M. Historya Ayanda
Remark

Date: Date: Date: Location : SENORO GAS DEVELOPMENT PROJECT

SIGNIFICANT IMPACT SIGNIFICAN SIGNIFICANT

Main Group of specific additional ACTIVITIE, PRODUCTS TOTAL REGULATION AND OTHER REQUIREMENT
No Main Job LOCATION Aspect Number D/I P/C/F N/A/E ASPECT IMPACT CRITERIA T IMPACT ASPECT
Activity Job remarks OR SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26)

1 Civil Work Transportation Vehicle Fueling Filling station 9544 ASP 1 D C A Fuell spillage to the ground Soil contaminated 5 3 1 1 3 1 14 N Y - PP No 74 Tahun 2001 tentang Pengelolaan Bahan YES
Operation Beracun dan Berbahaya (B3)
- PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
Pengelolaan Limbah B3
- KepmenLH No 3 Tahun 2008 tentang Pemberian Simbol
dan Logo B3

2 Civil Work Transportation Vehicle Driving Site and public area 9544 ASP 2 D C N gas emission from vehicle engine operation air pollution 10 3 3 1 1 1 19 N Y - PermenLH No 5 Tahun 2006 tentang Ambang Batas YES
Operation Emisi Gas Buang Kendaraan Bermotor Lama
- Pergub Sumsel No.15 Tahun 2005 tentang Baku Mutu
Emisi Sumber Tidak bergerak dan Ambang Batas Emisi
Gas Buang Kendaraan Bermotor
- PP 41 Tahun 1999 tentang Pengendalian Pencemaran
Udara
3 Mechanical Work Mechanical Lifting & crane engine start, setting the crane site 9544 ASP 3 D C N gas emission from crane engine operation air pollution 10 3 3 1 1 1 19 N Y - PP 41 Tahun 1999 tentang Pengendalian Pencemaran YES
Instalation Rigging position including setting the Udara
outrigger - Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

4 Mechanical Work Mechanical Lifting & tidy up the area " don’t leave any site 9544 ASP 4 D C N waste material such as bad sling, used soil pollution 10 1 1 1 1 10 24 N N NO
Instalation Rigging unsafe condition" barricade material, expired signage

5 Civil Work Site Preparation Clearing cutting tress using chain saw site 9544 ASP 5 D C N cutting tress decrease natural resources 10 1 1 1 1 1 15 N N NO

6 Civil Work Site Preparation Clearing cutting tress using chain saw site 9544 ASP 6 D C N gas emission air pollution, ecosystem 10 1 1 1 1 1 15 N Y - PP 41 Tahun 1999 tentang Pengendalian Pencemaran YES
disturbance Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

7 Civil Work Site Preparation Clearing cutting tress using dozer site 9544 ASP 7 D C N cutting tress decrease natural resources 10 1 1 1 1 1 15 N N NO

8 Civil Work Site Preparation Clearing cutting tress using dozer site 9544 ASP 8 D C N gas emission air pollution, ecosystem 10 1 1 1 1 1 15 N Y - PP 41 Tahun 1999 tentang Pengendalian Pencemaran YES
disturbance Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

9 Civil Work Site Preparation Clearing pilling tress using dozer site 9544 ASP 9 D C N blocking the water natural stream flow flooding 10 5 5 3 5 3 31 Y N YES

10 Civil Work Site Preparation Clearing pilling tress using dozer site 9544 ASP 10 D C N Messy pilling aesthetic problem 10 1 1 1 1 1 15 N N NO

11 Civil Work Site Preparation Clearing transportation to disposal site 9544 ASP 11 D C N gas emission air pollution 10 1 1 1 1 1 15 N Y - PermenLH No 5 Tahun 2006 tentang Ambang Batas YES
Emisi Gas Buang Kendaraan Bermotor Lama
- Pergub Sumsel No.15 Tahun 2005 tentang Baku Mutu
Emisi Sumber Tidak bergerak dan Ambang Batas Emisi
Gas Buang Kendaraan Bermotor
- PP 41 Tahun 1999 tentang Pengendalian Pencemaran
Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

12 Civil Work Site Preparation Clearing pilling the trees and vegetation in site 9544 ASP 12 D C N blocking the water natural stream flow flooding 10 5 5 3 5 3 31 Y N YES
disposal area

13 Civil Work Site Preparation Clearing finishing tidy up the area " don’t leave any site 9544 ASP 13 D C N messy organic waste Aesthetic problem 10 1 1 1 1 1 15 N N NO
unsafe condition"

14 Civil Work Site Preparation Grubbing transportation to the pilling area site 9544 ASP 14 D C N gas emission from running engine air pollution 10 3 3 1 1 1 19 N Y - PermenLH No 5 Tahun 2006 tentang Ambang Batas YES
Emisi Gas Buang Kendaraan Bermotor Lama
- Pergub Sumsel No.15 Tahun 2005 tentang Baku Mutu
Emisi Sumber Tidak bergerak dan Ambang Batas Emisi
Gas Buang Kendaraan Bermotor
- PP 41 Tahun 1999 tentang Pengendalian Pencemaran
Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

15 Civil Work Site Preparation Grubbing Pilling top soil site 9544 ASP 15 D C N messy pilling Aesthetic problem 10 1 1 1 1 1 15 N N NO

16 Civil Work Site Preparation Grubbing Pilling top soil site 9544 ASP 16 D C N blocking the water natural stream flow flooding 10 5 5 3 5 3 31 Y N YES

17 Civil Work Site Preparation Grubbing finishing tidy up the area " don’t leave any site 9544 ASP 17 D C N messy organic waste Aesthetic problem 10 1 1 1 1 1 15 N N NO
unsafe condition"

18 Civil Work Site Preparation Land cutting, loading soil to dump truck using site 9544 ASP 18 D C N gas emission air pollution 10 3 3 1 1 1 19 N Y - PermenLH No 5 Tahun 2006 tentang Ambang Batas YES
filling and loader Emisi Gas Buang Kendaraan Bermotor Lama
grading - Pergub Sumsel No.15 Tahun 2005 tentang Baku Mutu
Emisi Sumber Tidak bergerak dan Ambang Batas Emisi
Gas Buang Kendaraan Bermotor
- PP 41 Tahun 1999 tentang Pengendalian Pencemaran
Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

Form Number : SHE - 09.01.01, Rev 3

Page 5 of 8
 SIGNIFICANT IMPACT SIGNIFICAN SIGNIFICANT
Main Group of specific additional ACTIVITIE, PRODUCTS TOTAL REGULATION AND OTHER REQUIREMENT
No Main Job LOCATION Aspect Number D/I P/C/F N/A/E ASPECT IMPACT CRITERIA T IMPACT ASPECT
Activity Job remarks OR SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO
19 Civil Work Site Preparation Land cutting, borrow pit activity (cutting the land site 9544 ASP 19 D C N cutting the land land slide 10 1 1 3 5 1 21 N N NO
filling and and loading into the dumptruck using
grading excavator /loader)

20 Civil Work Site Preparation Land cutting, Soil transportation site 9544 ASP 20 D C N gas emission air pollution 10 3 3 1 1 1 19 N Y - PermenLH No 5 Tahun 2006 tentang Ambang Batas YES
filling and Emisi Gas Buang Kendaraan Bermotor Lama
grading - Pergub Sumsel No.15 Tahun 2005 tentang Baku Mutu
Emisi Sumber Tidak bergerak dan Ambang Batas Emisi
Gas Buang Kendaraan Bermotor
- PP 41 Tahun 1999 tentang Pengendalian Pencemaran
Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

21 Civil Work Site Preparation Land cutting, filling the land using buldozer site 9544 ASP 21 D C N blocking the water natural stream flow flooding 10 5 5 3 5 3 31 Y N YES
filling and
grading

22 Civil Work Site Preparation Land cutting, grading the area using grader site 9544 ASP 22 D C N gas emission air pollution 10 3 3 1 1 1 19 N Y - PP 41 Tahun 1999 tentang Pengendalian Pencemaran YES
filling and Udara
grading - Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

23 Civil Work Site Preparation Land cutting, stamping and compacting the land site 9544 ASP 23 D C N gas emission air pollution 10 3 3 1 1 1 19 N Y - PP 41 Tahun 1999 tentang Pengendalian Pencemaran YES
filling and using vibro roller, sheep foot roler, Udara
grading tire roller - Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

24 Civil Work Site Preparation Land cutting, finishing tidy up the area " don’t leave any site 9544 ASP 24 D C N messy soil piled aesthetic problem 10 1 1 1 1 1 15 N N YES
filling and unsafe condition"
grading

25 Civil Work Site Preparation Excavation / piling the soil at the designated area site 9544 ASP 25 D C N messy soil piled aesthetic problem 10 1 1 1 1 1 15 N N NO
Trenching

26 Civil Work Maintenance Equipment and detach/ dismantle the broken part Site 9544 ASP 26 D C N oil spill soil pollution 10 3 1 1 3 1 19 N Y - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang YES
vehicle Pengelolaan Limbah B3
maintenance

27 Civil Work Maintenance Equipment and cleaning up Site 9544 ASP 27 D C N cleaning agent (gazoline) spilled out soil pollution 10 3 1 1 3 1 19 N Y - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang YES
vehicle Pengelolaan Limbah B4
maintenance

28 Civil Work Maintenance Equipment and finishing clean & tidy up the area " don’t leave Site 9544 ASP 28 D C N broken part, used oil, cleaning agent, used soil pollution 10 3 1 1 3 3 21 N N NO
vehicle any unsafe condition" tyre, used part
maintenance
29 Civil Work Road Work Road Closure clean & tidy up the area " don’t leave Site 9544 ASP 29 D C N barricade material waste, rubish material soil pollution 10 1 1 1 1 1 15 N N NO
any unsafe condition"

30 Civil Work Pilling Piling operation - refueling at site Piling area 9544 ASP 30 D C A fuel spillage to the ground soil contaminated 5 5 1 3 1 3 18 N Y - PP No 74 Tahun 2001 tentang Pengelolaan Bahan YES
Beracun dan Berbahaya (B3)
- PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
Pengelolaan Limbah B3
- KepmenLH No 3 Tahun 2008 tentang Pemberian Simbol
dan Logo B3

31 Civil Work Pilling Piling operation Piling area 9544 ASP 31 D C A Oil spillage to the ground (from hidrolic soil contaminated 3 5 1 3 1 3 16 N Y - PP No 74 Tahun 2001 tentang Pengelolaan Bahan YES
lubricant) Beracun dan Berbahaya (B3)
- PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
Pengelolaan Limbah B3

32 Civil Work Pilling Piling operation Piling area 9544 ASP 32 D C A air emission air pollution 3 1 1 3 1 3 12 N Y - PP 41 Tahun 1999 tentang Pengendalian Pencemaran YES
Udara
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

33 Civil Work Support Facility Genset operation Site/ Generator room 9544 ASP 33 D C A oil spillage to the ground soil contaminated 5 5 1 3 1 3 18 N Y - PP No 74 Tahun 2001 tentang Pengelolaan Bahan YES
Beracun dan Berbahaya (B3)
- PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
Pengelolaan Limbah B3

34 Civil Work Support Facility Genset operation Site/ Generator room 9544 ASP 34 D C A air emission air pollution 3 1 1 3 1 3 12 N Y - PERMEN LH No. 13 tahun 2009 tentang Baku Mutu YES
Emisi Sumber Tidak Bergerak Bagi Usaha
dan/atau Kegiatan MIGAS
- Pergub Sumsel No.15 Tahun 2005 tentang Baku Mutu
Emisi Sumber Tidak bergerak dan Ambang Batas Emisi
Gas Buang Kendaraan Bermotor

35 Civil Work Support Facility Genset operation Site/ Generator room 9544 ASP 35 D C N Noise environment/ecosystem 10 3 1 1 5 1 21 N Y - KEPMEL LH No. 48 Tahun 1996 tentang Baku Tingkat YES
disturbance Kebisingan
- KEPMENAKER No. 51/MEN/1999 tentang Nilai Ambang
Batas Kebisingan
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

36 Civil Work Pilling Piling Site 9544 ASP 36 D C N Noise environment/ecosystem 10 3 1 1 5 1 21 N Y - KEPMEL LH No. 48 Tahun 1996 tentang Baku Tingkat YES
disturbance Kebisingan
- KEPMENAKER No. 51/MEN/1999 tentang Nilai Ambang
Batas Kebisingan
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

Form Number : SHE - 09.01.01, Rev 3

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 SIGNIFICANT IMPACT SIGNIFICAN SIGNIFICANT
Main Group of specific additional ACTIVITIE, PRODUCTS TOTAL REGULATION AND OTHER REQUIREMENT
No Main Job LOCATION Aspect Number D/I P/C/F N/A/E ASPECT IMPACT CRITERIA T IMPACT ASPECT
Activity Job remarks OR SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO
37 Civil Work Fabrication Workshop activities Workshop 9544 ASP 37 D C N Noise environment/ecosystem 10 3 1 1 5 1 21 N Y - KEPMEL LH No. 48 Tahun 1996 tentang Baku Tingkat YES
disturbance Kebisingan
- KEPMENAKER No. 51/MEN/1999 tentang Nilai Ambang
Batas Kebisingan
- Pergub Sumsel No 17 Tahun 2005 tentang Baku Udara
Ambien dan Baku Tingkat Kebisingan

38 Civil Work Site Preparation Land excavate the area using excavator Site 9544 ASP 38 D C N cutting the land land slide 10 1 1 3 5 1 21 N N NO
excavation with continuously ensure the position
is always supported by stable ground
surface.

39 Civil Work Site Preparation Land control the traffic if the excavation is Site 9544 ASP 39 D C N messy soil piled aesthetic problem 10 1 1 1 1 1 15 N N NO
excavation held in congested area

40 Civil Work Land excavation finishing park the equipment at the safe place Site 9544 ASP 40 D C N waste material (wood), mesy soil piled aesthetic problem 10 1 1 1 1 1 15 N N NO

41 General office printing use of paper Site Office 9544 ASP 41 I C N Paper waste from unnecessary pinting and Decrease natural resources 10 5 10 1 3 3 32 Y N YES
miss printing

42 General office printing use of paper Site Office 9544 ASP 42 D C N Wasting energy for unnecessary printing and Decrease natural resources 10 5 10 1 3 10 39 Y N YES
misprinting

43 Cleaning Service Clean up paper waste from Site Office 9544 ASP 43 D C N Paper waste Soil pollution 10 3 1 1 3 1 19 N N NO
photocopy room waste bin

44 General office workstation Office activities-computer usage Site Office 9544 ASP 44 D C N Wasting energi from unnecessary electricity Decrease natural resources 10 5 10 1 3 10 39 Y N YES
using for computers while unused

45 General office printing Toner replacement Site Office 9544 ASP 45 D C A Scattered rugs (hazardous waste) aesthetics problem 5 3 1 1 3 1 14 N Y - UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
- PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
Pengelolaan Limbah B3

46 Cleaning Service office printing Clean up waste toner Site Office 9544 ASP 46 D C A No dedicated area for used toner(hazardous Soil pollution 10 10 5 3 3 10 41 Y Y - UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
waste) in temporary lanfil - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
Pengelolaan Limbah B3

47 Cleaning Service office cleaning Clean up waste bin from toilet Toilet 9544 ASP 47 D C N Garbage are mixed of : toilet papper, Soil pollution, health problem 10 3 1 1 3 1 19 N Y - UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
sanitary napkin (classified as infectious - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
waste, which is include in hazardous waste) Pengelolaan Limbah B3

48 General office ligthning Office activities-lamps usage Site Office 9544 ASP 48 D C N Wasting energy for unnecessary lamps Decrease non renewable natural 10 5 10 1 3 10 39 Y N YES
usage resources

49 General office ligthning Office activities-replacement of Site Office 9544 ASP 49 D C A Used fluorescense lamp (contains hazardous Soil pollution, health problem 10 10 10 1 10 10 51 Y Y - UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
fluorescense lamp waste) are not properly stored as hazardous - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
waste (contein mercury) Pengelolaan Limbah B3

50 General office cleaning Office ativities- replacement of dry Site Office 9544 ASP 50 D C A Used dry batteries (contains hazardous Soil pollution, health problem 10 10 10 1 10 10 51 Y Y - UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
bateries waste,such as Ni,Cd) are not properly stored - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang
as hazardous waste Pengelolaan Limbah B3

51 Cleaning Service office cleaning Clean up waste bin from the office Site Office 9544 ASP 51 D C N Generates segregated garbage, between Soil pollution 10 5 1 1 3 1 21 N Y UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
(indoor) organic and inorganic. These garbege will be
mixed together ini temporary landfill

52 General office air conditioning Office ativities-Non CFC air Site Office 9544 ASP 52 D C N Wasting energy for unnecessary air Decrease non renewable natural 10 5 10 1 3 10 39 Y N YES
conditioner usage conditioning usage resources

53 Facility office toilet Toilet usage Toilet 9544 ASP 53 D C N Generates waste water Water pollution 3 5 5 1 5 3 22 N N NO

54 Cleaning Service office toilet Cleaning service-toilet area Site Office 9544 ASP 54 D C N Non environmantal friendly cleaning agent is Water pollution 3 1 1 1 1 1 8 N N NO
used

55 General office drinking Daily activities-drinking Site Office 9544 ASP 55 D C N Scattered inorganic waste such as can, aesthetics problem 5 3 1 1 1 1 12 N Y UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
sachet, plastic, etc

56 General office drinking Daily activities-drinking Site Office 9544 ASP 56 D C N Scattered organic waste such as tea bag, 5 3 1 1 1 1 12 N Y UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
coffee or tea dregs, sugar, cream,etc
health and aesthetics problem
57 Cleaning Service office cleaning Clean up waste bin from pantry Site Office 9544 ASP 57 D C N Segregated garbage will be mixed together Soil pollution 10 3 1 3 3 5 25 N Y UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
at temporary landfill

58 Facility office cleaning Daily activities-smoking Smoking area 9544 ASP 58 D C N Scattered cigarettes waste, odor, smoke Soil pollution, aesthetics 10 3 1 3 3 5 25 N N NO
problem, health problem

59 Cleaning Service office cleaning Clean up smoking area Smoking area 9544 ASP 59 D C A Cigarettes waste Soil pollution 10 3 3 1 1 1 19 N N NO

60 General office cleaning Lunch Site area 9544 ASP 60 D C N Scattered food waste unpleasant odor and potensially 10 1 1 1 1 3 17 N Y UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
create health aesthetics problem

61 Cleaning Service office cleaning Windows cleaning Site Office 9544 ASP 61 D C N Scattered glass cleaner aesthetics problem 3 3 1 1 1 1 10 N N NO

62 Cleaning Service office cleaning Cleaning service-clean up all cleaner Site Office 9544 ASP 62 D C N Glass cleaner waste, dish cleaner/soap Water pollution 10 5 5 1 1 1 23 N N NO
tools waste, floor cleaner waste, toilet cleaner
waste, all cleaner container waste are not
environmental friendly

63 Pest Control office cleaning Flies control Site Office 9544 ASP 63 D Scattered flies trap aesthetics problem and Water 1 3 5 1 1 3 14 N N NO
pollution

Form Number : SHE - 09.01.01, Rev 3

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 SIGNIFICANT IMPACT SIGNIFICAN SIGNIFICANT
Main Group of specific additional ACTIVITIE, PRODUCTS TOTAL REGULATION AND OTHER REQUIREMENT
No Main Job LOCATION Aspect Number D/I P/C/F N/A/E ASPECT IMPACT CRITERIA T IMPACT ASPECT
Activity Job remarks OR SERVICES
1 2 3 4 5 6 SCORE Y/N Y/N REGULATION YES/ NO
64 Facility office printing Toner catridge replacement for Site Office 9544 ASP 64 D C A Scattered hazardous rugs (hazardous waste) Soil pollution 3 5 1 1 1 5 16 N Y - PP No.18 Tahun 1999 & PP No.85 Tahun 1999 tentang YES
photocopy and printer Pengelolaan Limbah B3

65 Facility office toilet Clean water suplay maintenance Site 9544 ASP 65 D C A Tap leakage, which replaces as soon as it is Decrease natural 3 5 1 1 1 1 12 N N NO
identified resources(natural water)

66 Facility office toilet Clean water suplay maintenance water pump 9544 ASP 66 D C A Pipe leakage Decrease natural 10 5 1 1 1 1 19 N N NO
resources(natural clean water)

67 Cleaning Service office cleaning Cleaning rooms and camp area Camp 9544 ASP 67 D C N Generates wastewater contain biodegradable Water pollution 10 3 1 1 1 1 17 N N NO
cleaner

68 Cleaning Service office toilet Cleaning toilet Toilet 9544 ASP 68 D C N Generates wastewater contain biodegradable Water pollution 10 3 1 1 1 1 17 N N NO
cleaner

69 Cleaning Service office toilet Cleaning waste bins at toilet Toilet 9544 ASP 69 D C N Generates soil waste, that might be Soil pollution 10 3 1 1 1 1 17 N Y UU No 18 Tahun 2008 tentang Pengelolaan Sampah YES
infectious (if mixed with sanitary napkins)

70 Facility office toilet Toilet usage Toilet 9544 ASP 70 D C N Generates wastewater contain detergent Water pollution 10 3 1 1 1 1 17 N N NO

71 Facility office toilet Toilet usage Toilet 9544 ASP 71 I C A Excessive toilet paper usage Decrease natural resources 3 5 1 1 1 1 12 N N NO

72 Facility office office Daily activities-television Mess and site office 9544 ASP 72 I C N Unecessary electricity usage while unused Decrease natural resources 10 5 10 1 3 10 39 N N YES

73 Facility office office Daily activities-air conditioner Mess and site office 9544 ASP 73 I C N Unecessary electricity usage while unused Decrease natural resources 10 5 10 1 3 10 39 N N YES

74 Facility office Daily activities-other personal Mess and site office 9544 ASP 74 I C N Unecessary electricity usage while unused Decrease natural resources 10 5 10 1 3 10 39 N N YES
electronic equipment (charging
IPOD,Cellphones,etc)

Grand Total Score 1516 Number of Significant -

Number of Aspects 74 Aspects
Average 20.486

Form Number : SHE - 09.01.01, Rev 3

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