FORM & CHECKLIST No.

TRUB-HSE-404
Tgl. Terbit : 29-Jan-22
DAILY REPORT HSE Tgl. Disetujui : 31-Jan-22
Revisi : 00

Reporting date : 16 April 2022

Project site : PT Trub, jobsite BL

A. ACCIDENT RECORD
31-Mar-22 1-Apr-22 2-Apr-22 3-Apr-22 4-Apr-22 5-Apr-22 6-Apr-22 7-Apr-22 8-Apr-22

NIHIL NIHIL NIHIL NIHIL NIHIL NIHIL NIHIL NIHIL NIHIL

9-Apr-22 10-Apr-22 11-Apr-22 12-Apr-22 13-Apr-22 14-Apr-22 15-Apr-22 16-Apr-22 17-Apr-22

NIHIL NIHIL NIHIL NIHIL NIHIL NIHIL NIHIL

18-Apr-22 19-Apr-22 20-Apr-22 21-Apr-22 22-Apr-22 23-Apr-22 24-Apr-22 25-Apr-22 26-Apr-22

27-Apr-22 28-Apr-22

ACCIDENT RECORD BY DEPARTMENT

ACCIDENT APRIL 2022 Jan-22
CATEGORY ENG PROD PLANT LOG HSE HRGA FIN TOTAL ENG PROD PLANT LOG HSE HRGA FIN TOTAL
F - - - - - - - - - - - - - - - -
LTI - - - - - - - - - - - - - - - -
RDI - - - - - - - - - - - - - - - -
MTI - - - - - - - - - - - - - - - -
FAI - - - - - - - - - - - - - - - -
PDA - - - - - - - - - - - - - - - -
PDI - - - - - - - - - - - - - - - -
NM - - - - - - - - - - - - - - - -
Total Accident - - - - - -
Remarks :
Fatality Accident (F)
Lost Time Injury (LTI)
Restricted Duties Injury (RDI)
Medical Treatment Injury (MTI)
First Aid Injury (FAI)
Property Damage Major (PDA) - > 5,000 USD
Property Damage Minor (PDI) - < 5,000 USD
Near Miss (NM)

DETAILS OF ACCIDENT THIS MONTH

Date Time Location Department Supervisor Category Description
-

B. SETTLINGPOND MONITORING
Ph STANDART Ph TSS ACT DISCHARGE RAINFALL (mm) RAINFALL
LOCATION TSS STANDART REMARKS
MIN MAX ACT (mg/l) (mg/l) SHIFT 1 SHIFT 2 CUMM
6 9 300 mg/l - - -