Doc.

Number 26071-JO-HSE-F-002
Effective Date 28-Feb-20
Subcontractor Daily HSE Statistics Report No. of Revision 000
Page 1/1

Subcontractor Name PT. ANUGRAH MIRAN MANDIRI Total Working Days : 120 Prepared By Approved By

: TEMPORARY ELECTRIC POWER SOURCE AT Safe Working Days : 120

Scope of Work
KARIANGAU AREA BY USING PLN

PO No. / Subcontractor No. : PROJECT RDMP-R-SC-TF-018 Total Manhour YTD : 23.496

Starting Date 07-Dec-20 : 23.496 Donna Hendra Ajinata
Total Safe Manhour Without LTI
Reported Date 05-Apr-21 HSE Coord. Project Manager

Cummulative
Item UOM 5-Apr-21 WEATHER REPORT
Year To Date

INCIDENT Time Status Time Status

Fatality Number of Case - - 07:00 - 08:00 Sunny 18.00 - 19.00
Lost Time Injury (LTI) Number of Case - - 08:00 - 09:00 Sunny 19.00 - 20.00
Restricted Work Case Number of Case - - 09:00 - 10:00 Sunny …..
Medical Treatment Case Number of Case - - 10:00 - 11:00 Sunny
Incident impact to environmental pollution Number of Case - - 11:00 - 12:00 Sunny
Incident impact to fire / asset damage Number of Case - - 12:00 - 13:00 Sunny
Environmental Damage Number of Case - - 13:00 - 14:00 Sunny
First Aid Case Number of Case - - 14:00 - 15:00 Sunny
Nearmiss Number of Case - - 15:00 - 16:00 Sunny
Emergency Evacuation Number of Case - - 16:00 - 17:00 Sunny
17:00 - 18:00 Sunny
LTIFR 0,00 -
LTISR 0,00 -
TRIR 0,00 -

POB & Manhour HSE Activity

No. of Total HSE Personnel person 2 265 1 TBM Area 75 & 37
Day Shift 2 DCU
POB Direct person 28 2.474 3 CIVIL WORK (area 37)
POB Indirect person 8 753
POB Total person 36 3.227 4 Terminasi Over Head Cable (Scafolding No.3 SS 3 Area 4B)
Working Hour hour 8 720
MH day shift 288 22.504
5 Merger & Continuity Test SS-1 (Area 2A)
Extended Work
POB Extended Work person - -
Working Hour hour - -
MH Extended Work - -
Total MH Day Shift 288 22.504
POB Night Shift
POB Direct person 2 124
POB Indirect person - -
POB Total 2 124
Working Hour hour 8 496
MH NIght shift 16 992
No. of Register Equipment
Light Vehicle Number 1 95
Heavy Vehicle Number - 4
Crane Number - 18
Heavy Equipment Number 1 41
Electrical Tools Number - -
Genset Number 1 50
Total KM Driven KM 34 3.036
Total HM Run hour 5 222
ID Badge
ID Badge Issued Number - 49
ID Badge Out Number - -
OTHER
PTW Number 2 169
e-COP Number 2 169
HSE Periodic Inspections conducted Object number 1 45
Premob Inspection conducted Object number - 2
Random Alcohol Test Person - -
Submit MCU Record Person - 54
General HSE Talk Number - 4
Toolbox Meeting Number 1 123
Updated Job Safety Analysis Number - -
Domestic Waste M3 - -
Construction Waste M3 - -
Hazardous Waste M3 - -

ACTIVITY (Picture & Caption)

TBM Area 75 & 37 DCU Merger & Continuity Test SS-1 (Area 2A)

Terminasi Over Head Cable SS - 3