PERSONAL PROTECTIVE EQUIPMENT FOR

DISTRIBUTION FORM

Doc. No. Rev. No.

ATTACHMENT 2
QC-HSE HSE-FF-C.2 D
PLTU SUMBAR PROJECT Date: 15/06/2007 Page 1 of 1

NAME POSITION DEPT. EMP.NO

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NO. DATE REMARKS SIGN

GEN.
TOTAL
RETURNED QUANTITY CHECKED BY APPROVED
BY

TOTAL

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