Scribd Logo
Upload

Welcome to Scribd!

  • Form Safety Inspection

    Uploaded by

    Ayeeb KSM
    129 views8 pages
    This document is a heavy equipment safety inspection checklist from PT Indokal Mandiri Pratama. It lists 21 items that are checked for condition and notes. The items include fire extinguishers, first aid kits, lights, seat belts, backup alarms, mirrors, radios, and air conditioning. The checklist provides space to note the condition of each item as either good or damaged. It is dated for inspection in 2018 and signed by the SHE supervisor.

    Original Description:

    Form inspeksi safety tambang

    Copyright

    © © All Rights Reserved

    Available Formats

    XLSX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a heavy equipment safety inspection checklist from PT Indokal Mandiri Pratama. It lists 21 items that are checked for condition and notes. The items include fire extinguishers, first aid kits, lights, seat belts, backup alarms, mirrors, radios, and air conditioning. The checklist provides space to note the condition of each item as either good or damaged. It is dated for inspection in 2018 and signed by the SHE supervisor.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    129 views8 pages

    Form Safety Inspection

    Uploaded by

    Ayeeb KSM
    This document is a heavy equipment safety inspection checklist from PT Indokal Mandiri Pratama. It lists 21 items that are checked for condition and notes. The items include fire extinguishers, first aid kits, lights, seat belts, backup alarms, mirrors, radios, and air conditioning. The checklist provides space to note the condition of each item as either good or damaged. It is dated for inspection in 2018 and signed by the SHE supervisor.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 8

    PT INDOKAL MANDIRI PRATAMA

    HEAVY EQUIPMENT

    NO. UNIT : DATE : …… ………………


    MODEL/TYPE

    KONDISI
    NO. PEMERIKSAAN
    BAIK RUSAK

    1 APAR ( Alat Pemadam Api Ringan ) / Fire Extinguisher


    2 Kotak P3K / First Aid Kit Box
    3 Lampu Rotari / Rotary Lamp
    4 Sabuk Pengaman / Seat Belt
    5 Alarm Mundur / Backward Alarm
    7 Kaca Spion Kanan & Kiri / Rearview Mirror
    8 Radio Komunikasi / Radio Communication
    9 Air Conditioner (AC)
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22

    KETERANGAN :
    Ampah Site Office | Jl. A. Yani RT.01 No.
    QUIPMENT SAFETY INSPECTION

    ………………………….. 2018

    IMP.HSE/ISP-0001
    SI
    KETERANGAN
    TDK ADA
    Prepared by,

    Sayyid Yacob Alattas


    SHE Spv.

    PT. INDOKAL MANDIRI PRATAMA


    Yani RT.01 No.14 Desa Rodok | Ampah, Kal-Teng | INDONESIA
    PT INDOKAL MANDIRI PRATAMA HEAVY EQUIPMEN

    NO. UNIT : DATE : …… ………………


    MODEL/TYPE : EXCAVATOR

    KONDISI
    NO. PEMERIKSAAN
    BAIK RUSAK
    1 APAR 5Kg. ( Alat Pemadam Api Ringan ) / Fire Extinguisher
    2 Kotak P3K / First Aid Kit Box
    3 Lampu Rotari / Rotary Lamp
    4 Sabuk Pengaman / Seat Belt
    5 Alarm Mundur / Backward Alarm
    7 Kaca Spion Kanan & Kiri / Rearview Mirror
    8 Radio Komunikasi / Radio Communication
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22

    KETERANGAN :
    QUIPMENT SAFETY INSPECTION

    ………………………….. 2018

    IMP.HSE/ISP-0001
    SI
    KETERANGAN
    TDK ADA
    Prepared by,

    Sayyid Yacob Alattas


    SHE Spv.

    You might also like