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HSE Weekly Report (No. 001/SECM-HR/PCSA/VI/2022)

Date Starting 30-May-22 Date Ending 5-Jun-22
Project Name PCSA PROJECT Reported by Dedy (HSE)

1. Statistical Data
Company Total /
No. Description Period Accummulated
SECM Mandays C-1 C-2 C-3 C-4
A Resources Data
1 Mgmt & Staff This Week 10 10
Last Week
2 Worker / Non-Staff This Week 2 2
Last Week
3 Man-Hours Worked This Week 630 126 756
Last Week
4 Man-Days Worked This Week 7 7 7
Last Week
5 Accum. Safe Man-hours This Week 630 126 756
Last Week
6 Nos. of Lost Workdays This Week
Last Week
7 Total Equipment Operated This Week
Last Week
8 Total Equipment Opr. Hours This Week
Last Week
9 Total Vehicles Operated This Week
Last Week
B Accident Case
1 Fatality This Week
(FAT) Last Week
2 Days Away From Work This Week
(DAFW) Last Week
3 Lost Time Accident This Week
(LTA = B1 + B2) Last Week
4 Restricted Work Activity This Week
(RWA) Last Week
5 Medical Treatment This Week
(MT) Last Week
6 Total Recordable Accident This Week
(TRA = B3 + B4 + B5) Last Week
7 First Aid Case This Week
(FAC) Last Week
8 Near Missed Accident This Week
(NMA) Last Week
9 Equipment Accident This Week
(EA) Last Week
10 Fire Case This Week
(FC) Last Week
C Ratio
1 Injury Frequency Rate This Week
(IFR = (B6 : A3) * (200000 : 12)) Last Week
2 Equipment Damage Freq. Rate This Week
(EDFR = (B9 : A8) * 1000) Last Week

2. HSE Activities Carried-Out in CURRENT & NEXT Week

2.1. HSE Activities Carried Out in CURRENT Week
No. Activities Remarks
1 TBM (Tool Box Meeting) 7

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2 Safety Induction 2
3

2.2. HSE Activities Planned for NEXT Week

No. Activities Remarks
1 Baricade working area
2 Complete personal protective equipment for workers
3 Safety training

2.3. HSE Activities for Promoting and Enhancing Awareness

No. Activities Remarks
1 Give workers vitamin C
2 Monitoring of personal safety equipment
3

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
2
3

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

No. Activities Remarks
1
2
3

3. HSE Training Carried-Out in CURRENT Week

3.1. HSE Orientation / Induction
Total of Attendant : Personnel
3.2. HSE Technical & Management Training
No. Training Subject Trainee Classification Total Remarks

4. HSE Personnel List

No. Name Classification Hire Date Remarks
1 Dedy Rikardo Tambunan Ahli K3 Umum

5. HSE Violations Identified In CURRENT Week (Put Mark 'V' in the Appropriate Box )
Fail to Wear Proper PPE (Prersonal Protective Equipment) = Case(s)
Poor Housekeeping = Case(s)
Fail to Eliminate Fire / Explosion Hazards = Case(s)
Improper Lifting or Crane Operation = Case(s)
Fail to Provide Effective Barricade or Life-Line = Case(s)
Environmental Pollution (e.g. Oil Spillage to Water, Noise, Black Smoke, etc.) = Case(s)
Etc. (please mention) = Case(s)

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6. HSE Objectives & Target Achieved In CURRENT Week

Objectives Target Actual Achieved
Injury Frequency Rate (IFR) 0 (Zero)
Equipment Damage Frequency Rate (EDFR) 0 (Zero)
Better HSE Performance At Least One Tool Box Meeting Per Day
Prevention of Land, Water & Air Pollution ZERO Oil / Diesel Fuel Spillage
Proper Handling of Chemical Materials/Waste ZERO Reported Incident Due To Improper
Chemical Materials / Waste Handling Per Week

Known by : Approved by : Reportyed by :

Construction Manager Project Manager / Site Engineer HSE Officer

Form by Dedy Rikardo Tambunan

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