CHECK LIST FOR ARC WELDING MACHINE

Type / Jenis :
Tgl/ Jam/ Date/ Time :
Lokasi Kerja/ Work Area :
Kontraktor/ Contractor :

Keberadaan/Availability Kondisi/ Condition

NO CHECK ITEM
Ada/ Tidak/ Not
Baik/ Good
Available available
1 On/ Off switch/ Tombol sakelar on/ off

2 Regulator with indiator/ Indikator regulator

Connecction Welding cables to the welding

3 machine/ Sambungan kabel pengelasan ke
mesin las
Insulation of welding cable/ Isolasi kabel
4 mesin las
Electrode rod holder and earth holder/
5 Tempat batang elektroda dan pembumian

Industrial type plug for power tapping cable of

6 welding machine/ Kabel daya mesin las

Electrical parts of weldng machine/ Bagian

7 listrik mesin las

8 Trolley of wheels/ Troli roda

Fire Extinguisher/ APAR
9

Keterangan
Hasil Pemeriksaan dinyatakan/ Result of inspection :
[ ] layak untuk dioperasikan/ Worthy for operated
[ ] Dalam pantauan pengawas lapangan dalam pengoperasiannya/ Under the supervision of the field supervisor in op
[ ] Tidak layak dioperasikan/ Worthy for operated

Batam, …../…../……….

Diperiksa Oleh Operation Supervisor

(………………………………..) (………………………..)
 FC-SCN Group-08-89 Rev 00
Effective date : 6 Des 2021

ING MACHINE

Kondisi/ Condition
Keterangan/ Remarks
Rusak/ broken
pervision of the field supervisor in operations

Mengetahui,

(HSE Officer)
 CHECK LIST FOR PORTABLE GRINDING MACHIN
Type / Jenis :
Tgl/ Jam/ Date/ Time :
Lokasi Kerja/ Work Area :
Kontraktor/ Contractor :

Keberadaan/Availability Kondisi/ Conditio

NO
Ada/ Tidak/ Not
CHECK ITEM Available available Baik/ Good

Fore handle without daamage/ Pegangan

1 depan tanpa kerusakan
Wheel guard ( Covering 3/4th area )/ Pelindung
2 roda ( Mencakup area 3/4 )
Grinding wheel without any crack/ Roda
3 gerinda tanpa retak
Rear handle without anyy damage/ Pegangan
4 belakang tanpa kerusakan apapun

Presence of cord strain reliever ( Glands )/

5 Adanya pereda ketegangan tali pusat
( Kelenjar )

Trigger switch without damage/ Sakelar

6 pemicu tanpa kerusakan

7 presence of switch lock/ kunci sakelar

Electric wire without cuts and joints/ Kawat

8 listrik tanpa potongan dan sambungan

Keterangan
Hasil Pemeriksaan dinyatakan/ Inspection result is declared :
[ ] layak untuk dioperasikan/ is feasible to be operated
[ ] Dalam pantauan pengawas lapangan dalam pengoperasiannya/ is in monitoring of supervisor in its operation
[ ] Tidak layak dioperasikan/ is not feasible to be operated

Batam, …../…../……….

Diperiksa Oleh Operation Supervisor

(………………………………..) (………………………..)
NDING MACHINE

Kondisi/ Conditio
Keterangan/ Remarks
Rusak/ broken
g of supervisor in its operation

Mengetahui,

(HSE Officer)
 CHECK LIST FOR METAL CUTTING MACHINE
Type / Jenis :
Tgl/ Jam/ Date/ Time :
Lokasi Kerja/ Work Area :
Kontraktor/ Contractor :

Keberadaan/Availability Kondisi/ Conditio

NO
Ada/ Tidak/ Not
CHECK ITEM Available available Baik/ Good

Crack & damage of the Cutting plate/ Retak &

1 kerusakan pelat Pemotongan
Presence of Cutting plate guard/ Kehadiran
2 pelindung pelat pemotong
Presence locking system for the plate & guard/
Sistem penguncian kehadiran untuk pelat &
3 pelindung

Presence of job clamp and its condition/

4 Adanya job clamp dan kondisinya

Presence of handle and iits condition/

5 Kehadiran pegangan dan kondisinya

Cable condition ( Any cut, wear etc )and

presence of wire top plug/ Kondisi kabel
6 (Terpotong, aus, dll) dan adanya steker atas
kawat

Presence Cutting dus tguard/ Kehadiran

7 Pemotongan pelindung debu
Keterangan
Hasil Pemeriksaan dinyatakan/ Inspection result is declared :
[ ] layak untuk dioperasikan/ is feasible to be operated
[ ] Dalam pantauan pengawas lapangan dalam pengoperasiannya/ is in monitoring of supervisor in its operation
[ ] Tidak layak dioperasikan/ is not feasible to be operated

Batam, …../…../……….

Diperiksa Oleh Operation Supervisor

(………………………………..) (………………………..)
TING MACHINE

Kondisi/ Conditio
Keterangan/ Remarks
Rusak/ broken
g of supervisor in its operation

Mengetahui,

(HSE Officer)