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  • Praditya CP - Kurnia F - Laode Muh Syahrul - Form Request MCU - Pre Employment

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    This document is a full MCU request form containing information about 3 individuals - Praditya Putra Cahyana, Kurnia Futri, and Laode Muh Syahrul. It includes their names, ID numbers, dates of birth, positions, addresses, contact details, and status for an MCU (fitness for work) or periodic medical check. The form seeks approval from the safety coordinator and OH Section of IGP for the secondment of these 3 contractors from PT Arlie Labora Utama to IGP.

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    Praditya CP_Kurnia F_Laode Muh Syahrul_Form Request MCU_Pre Employment

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    This document is a full MCU request form containing information about 3 individuals - Praditya Putra Cahyana, Kurnia Futri, and Laode Muh Syahrul. It includes their names, ID numbers, dates of birth, positions, addresses, contact details, and status for an MCU (fitness for work) or periodic medical check. The form seeks approval from the safety coordinator and OH Section of IGP for the secondment of these 3 contractors from PT Arlie Labora Utama to IGP.

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    © All Rights Reserved
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    2 views1 page

    Praditya CP - Kurnia F - Laode Muh Syahrul - Form Request MCU - Pre Employment

    Uploaded by

    ssfvpbdgzb
    This document is a full MCU request form containing information about 3 individuals - Praditya Putra Cahyana, Kurnia Futri, and Laode Muh Syahrul. It includes their names, ID numbers, dates of birth, positions, addresses, contact details, and status for an MCU (fitness for work) or periodic medical check. The form seeks approval from the safety coordinator and OH Section of IGP for the secondment of these 3 contractors from PT Arlie Labora Utama to IGP.

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    © All Rights Reserved
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    of 1

    FULL MCU REQUEST FORM

    Contract Owner : IGP


    Contractor Name : PT Arlie Labora Utama
    Activity : IGP Secondment Services
    Cost Center : 1. WBS#G800119.06.01.0001 (Praditya & Kurnia), 2. WBS#G801520.08.03 (Laode)
    Project Manager : Faisal Sign Here Digitally signed by rbq0739Contac Person : 08114094969

    rbq0739 DN: cn=rbq0739


    Date: 2023.03.23 11:00:45
    +07'00'

    EHS Safety Coordinator : Felix Lebukan Sign Here Digitally signed by


    C0623998
    C0623998 DN: cn=C0623998
    Date: 2023.03.23 13:33:41
    +08'00'

    OH Section (MCU) : Andi Syamsul Bachri J. Sign Here Digitally signed by uwc3044

    uwc3044 DN: cn=uwc3044


    Date: 2023.03.24 08:55:04
    +08'00'

    Operational/ Pre
    DOB(Date/Mo
    No Name BN KTP Number Last MCU Position Address CP non employment/
    nth/Years)
    operational periodik
    Junior Jl. Alam Mekongga No.
    Non Pre
    1 Praditya Putra Cahyana 7471101604960004 16-Apr-1996 Geologist_Po 4 Kel. Laloeha, Kab. 0823-4019-7008
    Operational employment
    malaa Kolaka
    Junior BTN Green Ville Huko -
    Non Pre
    2 Kurnia Futri 3171044507961001 5-Jul-1996 Geologist_Po Huko No. 16 D, 0813-3883-3787
    Operational employment
    malaa Pomalaa,

    HR JL. Trans Sulawesi, No.


    Pre
    3 Laode Muh Syahrul 7206052606930003 26-Mar-93 Officer_Bung 100, Kel. Lamberea, 0858-2553-0993
    employment
    ku Timur Kec. Bungku Tengah,
    Kab. Morowali,
    Kolaka,

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