VISITORS SAFETY INDUCTION REPORT

Nama Visitor 1. 2. 3. Kode Dokumen

No. ID 4/20/24 3:20 AM
Jabatan
Tujuan/Purposed
Tanggal/Date

BAGIAN YANG DIBAHAS ( Berikan Tanda √) jika sdh dijelaskan dan sudah mengerti
Dijelaskan Paham
ITEMS COVERED (Mark √)
Pengunjung/tamu memahami arti " Skema Sirene Tanda Bahaya"
1
Visitor(s) has acknowledged to understand Emergency Siren Scheme.
Pengunjung/tamu memahami "rute keadaan darurat" yang perlu diambil apabila ada bahaya
2
Visitor(s) has acknowledged to understand Emergency Route
Pengunjung/tamu mengetahui "lokasi Muster Point"
3
Visitor(s) has acknowledged to know where Muster Station points are.
Pengunjung/tamu mengetahui "Bahaya-bahaya yang ada" di area kerja
4
Visitor(s) has acknowledged to know that it is imperative to wear Personal Protection Equipment.
Pengunjung/tamu memahami untuk "tidak berjalan sendiri" dalam kunjungan, selalu kelompok dan akan mengikuti Petugas pemandu
5 Visitor(s) has acknowledged to know that it is forbidden to abandon the group while working on the field and therefore it is mandatory to follow
designated person in charge at all time.
Pengunjung/tamu "memahami dan harus mematuhi" semua rambu-rambu yang terdapat di area kerja
6
Visitor(s) has acknolegded to know and to obey all symbols in working area.
Pengawas Petugas K3 / Safety Officer Tamu/Visitor Tamu/Visitor Tamu/Visitor

Nama dan Tanda Tangan. Nama dan Tanda Tangan. Nama dan Tanda Tangan. Nama dan Tanda Tangan. Nama dan Tanda Tangan.
Name and Signature. Name and Signature. Name and Signature. Name and Signature. Name and Signature.