HSE DAILY REPORT

Location : Timbau REPORT No : 1

Project : Intermediate Stokpile

WEATHER CONDITION

07.00 08.00 09.00 10.00 11.00 12.00 13.00 14.00 15.00

Additional Note : (IF ANY)

PERSON ON BOARD RECORD

No Description Unit POB No Description
1 Construction Manager Man 16 Masonry
2 Project Manager Man 17 Digger
3 Site Manager Man 18 Electrition
4 Site Supervisor Man 19 Welder
5 Electrical Engineer Man 20 Skill
6 HSE Man 21 Visitor
7 Helper Man 22 Client (AES/AEI)
8 Adminitration Man 23 Guest :
9 Surveyor Man 24 Other (e.g. driver)
10 Operator Heavy (eq.) Man
11 Driver Man
12 Carpenter Man

DAILY MAN HOURS

DESCRIPTION Today POB Previous MH Today MH
MANHOURS
PT. Borneo Bandar Segara
[ Contractor under PT. BBS ]
[ Contractor under PT. BBS ]
Guest and Others
HSE INPUT TARGET Previous Today
Safety Observation Program 20 0 0
Safety Induction (no.of person) Reported 0 0
Safety Talk Weekly 46 0 0
Toolbox Meeting Daily 100 0 0
HSE Trainings (event) 6
HSE Audit 2
HSE Inspections 66
HSE Daily report 144
HSE Monthly Report 11
 Management Visits 2
Emergency Drill 1
HSE OUTPUT TARGET Previous This Period
Lost Time Incident (LTI) 0
First Aid Case 0
Medical Treatment 0
Non Work Related Medevac 0
Nearmisses 0
Oil Spill 0
Equipment Damage (ED) 0
Fatality 0

Topic of Daily Morning Safety Talk :

SUMMARY OF ACCIDENT AND INCIDENT/NEARMISS THIS PERIOD: NO ACCIDENT OCCURS

HSE DAILY ACTIVITIES REPORT

Pengawasan Pekerjaan Sipil
- Inspection : APD & P3K
- Training :
- Emergency Drill :
(attach the attendance list / inspection report)
HSE WORK PLAN NEXT SHIFT / DAY
- Inspection :
- Training :
- Emergency Drill :
Prepared & Reported by,

PT. Borneo Bandar Segara

ORT
DATE : [ ________ ]

TION

15.00 16.00 17.00 18.00

RECORD
Unit POB TOTAL POB : Person
Man Note(s) :
Man
Man
Man
Man
Man
Man
Man
Man

RS
Today MH Proj. To Date Remarks

Today Proj. To Date Remarks

0 0
0 0
0 0
0 0
 This Period Proj. To Date Remarks

O ACCIDENT OCCURS

REPORT

SHIFT / DAY