TeamworX

HSE Weekly Report (001)

Date Starting November 13, 2021 Date Ending November 19, 2021

Project Name 4142 - API Mezzanine Project Reported by Anggik Tyas ADP

1.Statistical Data

Client CM Contractor
No. Description Total
API TX HG TIE

A Resources Data
a. Max management & staff per day in this week Person 2 2 2 6 12
1
b. Max management & staff per day in last week Person 2 2 2 6 12

a. Max non-staff per day in this week Person 0 0 2 28 30

2
b. Max non-staff per day in last week Person 0 0 0 18 18
a. Man-Hours Worked This Week Hours 90 50 264 2717 3.121

b. Accumulated Man hours up to This Week Hours 1408 1348 13129 13381 29.266

c. Accumulated Man hours up to Last Week Hours 1318 1298 12865 10664 26.145
3
Accumulated Man hours up to This Week Since
d. Lost Time Accident Hours 1408 1348 13129 13381 29.266

Accumulated Man hours up to Last Week Since

e. Lost Time Accident Hours 1318 1298 12865 10664 26.145

a. Man-Days Worked Days 12 7 28 209 256

4 b. Accumulated Man-Days up to This Week Days 188 179 1206 1260 2.833
c. Accumulated Man-Days up to Last Week Days 176 172 1178 1051 2.577
a. Lost Workdays Days 0 0 0 0 -
5
b. Accumulated of Lost Workdays Days 0 0 0 0 -
a. Total Equipment Operated This Week Unit 0 0 0 0 -
6
b. Total Equipment Operated Last Week Unit 0 0 1 2 3
a. Total Equipment Opr. Hours This Week Hours 0 0 0 34 34
7 b. Accum. Total Eqmt Opr. Hours This Week Hours 0 0 216,5 106 323
c. Accum. Total Eqmt Opr. Hours Last Week Hours 0 0 216,5 72 289
8 a. Total Vehicles Operated This Week Unit 0 0 0 0 -
b. Total Vehicles Operated Last Week Unit 0 0 0 0 -
9 a. Total Kilometers Driven This Week KM 0 0 0 0 -
b. Accum. Total KM Driven up to This Week KM 0 0 0 0 -
c. Accum. Total KM Driven up to Last Week KM 0 0 0 0 -

B Accident Case
1 a. Fatality Case This Week FAT 0 0 0 0 -
b. Accumulated Fatality AFAT 0 0 0 0 -

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2 a. Days Away From Work This Week DAFW 0 0 0 0 -
b. Accummulated Days Away From Work ADAFW 0 0 0 0 -
3 a. Lost Time Accident (B1a + B2a) This Week LTA 0 0 0 0 -
b. Accum. Lost Time Accident (B1b + B2b) ALTA 0 0 0 0 -
4 a. Restricted Work Activity This Week RWA 0 0 0 0 -
b. Accmulated Restricted Work Activity ARWA 0 0 0 0 -
5 a. Medical Treatment Case This Week MT 0 0 0 0 -
b. Accumulated Medical Treatment AMT 0 0 0 0 -
6 a. Recordable Incd. (B3a + B4a + B5a) This Week RI 0 0 0 0 -
b. Accm. Recordble Incdt (B3b + B4b + B5b) ARI 0 0 0 0 -

7 a. First Aid Case This Week FAC 0 0 0 0 -

b. Accumulated First Aid Case AFAC 0 0 0 0 -

8 a. Near Missed Accident Case This Week NMA 0 0 0 0 -

b. Accumulated Near Missed Accident ANMA 0 0 0 0 -

9 a. Unsafe Action This Week UA 0 0 0 0 -

b. Accumulated Unsafe Action AAU 0 0 0 0 -

10 a. Unsafe Condition This Week UC 0 0 0 0 -

b. Accumulated Unsafe Condition AUC 0 0 0 0 -

11 a. Equipment Accident Case This Week EA 0 0 0 0 -

b. Accmulated Equipment Accident AEA 0 0 0 0 -

12 a. Motor - Vehicle Crash Case This Week MVC 0 0 0 0 -

b. Accumulated Motor - Vehicle Crash AMVC 0 0 0 0 -

13 a. Property Damaged Case This Week PD 0 0 0 0 -

b. Accmulated Property Damaged APD 0 0 0 0 -

14 a. Environmental Pollution Case This Week EP 0 0 0 0 -

b. Accmulation Environmental Pollution AEP 0 0 0 0 -

15 a. Fire Case This Week FC 0 0 0 0 -

b. Accumulated Fire Case AFC 0 0 0 0 -

C Ratio
Injury Frequancy Rate This Week
a. IFR = (B6a : A3b) * (200000 : 12)
IFR 0,00 0,00 0,00 0,00 0,00
1
Accum. Injury Frequancy Rate
b. AIFR = (B6b : A3b) * (200000 : 12)
AIFR 0,00 0,00 0,00 0,00 0,00

Motor-Vehicle Crash Freq. Rate This Week

a. MVCFR=(B12a : A9b) * 10. 000
MVCFR 0,00 0,00 0,00 0,00 -
2
Accum. Motor-Vehicle Crash Freq Rate AMVCFR =
b. (B12b : A9b) * 10. 000
AMVCFR 0,00 0,00 0,00 0,00 -

Equipment Damage Freq. Rate

3 a. EDFR = (B11a : A7b) * 1000
EDFR 0,00 0,00 0,00 0,00 0,00

Accm. Equipment Damage Freq. Rate

b. AEDFR = (B11b : A7b) * 1000
AEDFR 0,00 0,00 0,00 0,00 0,00

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2. HSE Activities Carried-Out in CURRENT & NEXT Week
2.1. HSE Activities Carried Out in CURRENT Week
No. Activities Remarks
1 Internal meeting with TX, TIE and HG
2 Site inspection
3 Weekly Report Training
4 Safety Patrol
5 HSE Joint Inspection

2.2. HSE Activities Planned for NEXT Week

No. Activities Remarks
1 Continue to control, monitoring and guiding contractor to comply API HSE regulation
2 HSE coordination meeting
3 Continue HSE induction and training
4 Continue to control and monitor general construction work
5 Preparing and establishing HSE committee

2.3. HSE Activities for Promoting and Enhancing Awareness

No. Activities Remarks
-
2.3.1. Name of Conscious Workers / Staffs in CURRENT Week
No. Name Classification Department
-

2.4. Description of Critical Tasks / Activities in CURRENT Week

No. Activities Remarks
1 Pipe Support Fabrication
2 Steel Erection

2.5. Description of Critical Tasks / Activities planned for NEXT Week

No. Activities Remarks
1 Wiring Instalation
2 Pipe instalation
3 Pipe Support Fabrication
4 Machine Instalation

2.6. Permit Released Current Week

No Type of Permit Released Period Number
1 General work permit Daily 14
2 Hot work permit As per activity 14

3.HSE Training Carried-Out in CURRENT Week

3.1. HSE Orientation / Induction
Total of Attendant : 0 Personnel TX 0 HG 0 TIE 0

3.2. HSE Technical & Management Training

No. Training Subject Trainee Classification Total Remarks
1

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4.HSE Personnel List
No. Name Classification Hire Date Remarks
1 Anggik Tyas ADP Safety Officer 02-Aug-21 PT. TeamworX Indonesia
2 Jayeng Safety Officer 29-Aug-21 PT. Harjaguna
3 Abdullah Safety Officer 27-Sep-21 PT. Taikisha Indonesia

5.HSE Violations Identified In CURRENT Week

Type of Violation Case (s) Remarks
Fail to Wear Proper PPE (Prersonal Protective Equipment) 2
Poor Housekeeping 2
Fail to Eliminate Fire / Explosion Hazards 3
Improper Lifting or Crane Operation 1
Fail to Provide Effective Barricade or Life-Line 3
Environmental Pollution (e.g. Oil Spillage to Water, Noise, Black Smoke, etc.) 0
Etc (smoking HSElter, safe access, scaffolding, material placement, etc) 1

6.HSE Objectives & Target Achieved In CURRENT Week

Objectives Target Actual Remarks
Injury Frequency Rate (IFR) 0 (Zero) Achieved
Equipment Damage Frequency Rate (EDFR) 0 (Zero) Achieved
Better HSE Performance At Least One Tool Box Meeting Per Day Achieved
General Safety Patrol & Coordination Meeting At Least 1 Patrol & 1 Meeting per week Achieved

7.Attachments
7.1. Histogram (HSE Leading & Lagging Indicator)

LAGGING INDICATOR LEADING INDICATOR

1,2
This Week Last Week
133

133
132

1
88

0,8

0,6
36

14
14

14
13

11
0,4
7

6
1

1
0

0
0

0
0

0,2

0
1

Saverity Rate Frequency Rate

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7.2. Executive Summary Manpower Record

Peak Manpower This Week 42

Recorded Start on August 2, 2021

Accumulated Mandays 2.833

Accumulated Manhours 29.266
Accumulated Safe Manhours Since Lost Time Injury 29.266

7.3. Histogram (Man Power, Mandays, Manhours, Accident Statistic and Accident Frequency Rate)

MANPOWER ACCIDENT STATISTIC

35

30

25

20

15

10

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0
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Sabtu Minggu Senin Selasa Rabu Kamis Jumat

Staff Non Staff

MANDAYS AND ACCIDENT FREQUENCY RATE

1,00
MANHOURS 0,90
0,80
0,70
0,60
29.266
0,50
0,40
0,30
0,20
2.833 0,10
0,00
1 IFR AIFR MVCFR AMVCFR EDFR AEDFR

Mandays Manhours Series1 Series2 Series3

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8. Photographs
Daily TBM

Site Inspection

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