DOKUMENTASI HSE DAILY REPORT ACTIVITY

ToolBox Meeting
 HSE DAILY ACTIVITY

KONTRAK PAYUNG PEMELIHARAAN KONSTRUKSI RINGAN

PT. PERTAMINA GAS OPERATION WESTERN JAVA AREA

NO LAPORAN : PJAS-WJA-001-HSE-HDR-001 Hari : SENIN

AREA : Ms. Cilegon Tgl : 03 OKTOBER 2022
Cuaca √ CERAH
POS MENDUNG
HUJAN

SAVE WORK DAY :1 Day Stop Card : Unsafe : Safe : 1

No MANPOWER Person Qty Manhours Prev Man Total Manhours No

QTY
Today Hours Cumm Construction Equipment Unit QT Description
Prev Today Cumm
Toolbox meeting
A INDIRECT MANPOWER
1 TMC Unit 0 0 1 1
Safety drill
1 Project Director 1 0 0 0 2 Excavator Unit 0 0 0 0
Safety inspection
2 Project manager 1 0 0 0 3 Molen manual Unit 0 0 1 1
Safety
3 Site Manager 0 0 0 0 4 Plate Compactor Unit 0 training*(Hours) 0 0 0
Safety publication
4 Koordinator Coomdev 0 0 0 0 5 Vibrator concrete Unit 0 0 0 0
Safety alert
5 HSE Manager 1 0 0 0 6 Bolt cutter Unit 0 distribution 0 0 0
Stop
Card/SMC/PEKA
6 Project Control 0 0 0 0 7 gerinda Unit 2 0 0 0
JSA/RA
7 Finance Site 0 0 0 0 8 Genset Unit 0 0 1 1
Noise monitoring
8 Document Control 0 0 0 0 9 Pompa air Unit 0 0 0 0
Permit to work
9 Enginering Manager 0 0 0 0 10 Gergaji Mesin Unit 0 0 1 1
Safety induction
10 Field Engineer 0 0 0 0 11 Kendaraan Operasional Unit 1 0 0 0
Audit
11 Security 0 0 0 0 12 Bore pile SET 0 0 0 0
HSE Monthly
meeting
12 QA / QC 0 0 0 0 13 Stamper Unit 0 0 0 0
HSE reward
13 Procurement 0 0 0 0 0 0 0
Management visit
14 Office Boy 0 0 0 0 0 0 0
 KM (KM
B DIRECT MANPOWER kendaraan)
138851 1.1 138852.1
Safety patrol
15 HSE Koordinator 0 0 0 0 0 0 0
Hazadous waste
16 Paramedik 1 0 0 0 0 0 0
No hazadous waste

17 Supervisor 1 8 0 8 0 0 0
Light Monitoring
18 HSE Officer 1 8 0 8 0 0 0
Fatality
19 Foreman 1 0 0 0 0 0 0
Lost Time Incident
(LTI.s)
20 Site Coomdev 0 0 0 0 0 0 0
Day Lost
21 Tukang / Helper 6 48 0 48 0 0 0
Lost Time
Injury(LTI)
22 Driver 0 0 0 0 0 0 0
First Aid Case (FAC)
23 Operator TMC 0 0 0 0 0 0 0
Severty Rate (SR)
24 Operator Excavator 0 0 0 0 0 0 0
Frequency Rate
(FR)
25 Rigger TMC 0 0 0 0 0 0 0
Environmental
Damage
26 Helper TMC 0 0 0 0 0 0 0
Property Damage
(PD)
27 Surveyor 0 0 0 0 0 0 0
Motor Vehicle
Accident (MVA)
28 Safetyman 0 0 0 0 0 0 0
Fire
Incident/Explosion
29 Bore Pile 0 0 0 0 0 0 0
Security Case
0 0 0
Villager Complaint
0 0 0
Media Attention
0 0 0
Near Miss
0 0 0
HSE weekly
Meeting 0 0 0
TOTAL 13 64 0 64
 NO AKTIFITAS HARI INI LOKASI NO RENCANA BESOK LOKASI
1 Toolbox Meeting Pagi Ms. Cilegon 1 Toolbox Meeting Pagi Ms. Cilegon
2 Pemeriksaan Peralatan Kerja Ms. Cilegon 2 Observasi APD Ms. Cilegon
3 Routing Area Kerja Ms. Cilegon 3 Penggalian Pondasi Pagar Panel Arkon Ms. Cilegon
4 4
5 5
6 6
7 7
8 8 `
9 9
10 10

PREPARED BY ACKNOWLEDGE BY ACKNOWLEDGE BY

TTD : TTD : TTD :

Nama : Aditiya Sendi Pratama Nama : Ragil Tri Hadianto Nama : Grafelia Fette W
Posisi : HSE Posisi : Supervisor Posisi : Spv. HSSE Distrik Bitung
Perusahaan : PT.Berkah Anugrah Khaifara Perusahaan : PT.Berkah Anugrah Khaifara Perusahaan : PT.Pertamina Gas