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KPS-HSES-FR-SF-055 Form Confined Spaces Checklist - 密闭空间进入许可点检表
KPS-HSES-FR-SF-055 Form Confined Spaces Checklist - 密闭空间进入许可点检表
KALTARA PROJECT
CHECKLIST 密闭空间进入许可点检表
PT Kalimantan Aluminium Industry
PT Kaltara Power Indonesia
SITE KAI-KPI BARU/新 Nomor Izin / 许可编号:KPS-HSES-FR-SF-055
PERPANJANGAN/延期 _____/CS/________/________
Tanggal Jam /
/Date/ Time/
日期 时间
Di isi oleh safety inspector / Fill by Safety Inspector / Yes No Di isi oleh Supervisor / Fill by Supervisor / Yes No
由安全检查员填写 是 否 由安全检查员填写 是 否
1. Telah diadakan test terhadap gas 1. Kerangan-kerangan yg berhubungan dgn
beracun, explosive gas dan kadar O2 / Does bejana telah ditutup / Does all valve and pipe
explosive gas, hazardous gas and O2 gas have been that connect to confined space have been
tested /爆炸性气体、有害气体、氧气是否经过检 closed.
测 是否所有连接密闭空间的阀门和管道都已
关闭。
2. Alat pelindung pernafasan dan tali pengaman 2. Kerangan-kerangan yang ditutup telah
tersedia / Does respirator equipment and Line Life dipasang safety tag / Does all valve and pipe
apply / 呼吸器设备和 Line Life 是否适用 has been install with lock out and tag out /
是否所有阀门和管道都已安装上锁和挂牌
3. Digunakan alat listrik yg sesuai dgn 3. Sistem sudah bebas dari pressure dan suhu
Ketentuan / Does electric equipment suitable with tinggi / Does this system has been free from
requirement /电器是否符合要求 pressure and high temperature/本系统是否
已没有压力和高温
4. Diperlukan ventilasi buatan / Does more ventilation 4. Sistem sudah dipurging dan diflushing /
need /是否需要更多通风 Does this system has been purging and
flushing/系统是否一直在吹扫和冲洗
5. Telah menugaskan seseorang utk 5. Blind-Blind sudah dipasang dan diberi
menjaga diluar bejana / Does safety man has been tanda / Does all blind has been install and
appointed/是否已安排安全员在外面 give sign/是否所有百叶窗都已安装并给出
标志
6. Zat-zat berbahaya telah disingkirkan / Does 6. Operator DCS telah dihubungi / Does DCS
hazardous material has rip off / 有害物质是否被撕 has been call/是否所有百叶窗都已安装并
掉 给出标志
7. Tersedia sarana seperti: Alat berat, 7. Perintah kerja aman telah dimengerti oleh
tangga, atau peralatan lainnya / Does facility such pelaksana / Does the supervisor has been
as: ladder, heavy equipment and so on are apply /梯 understand with the safe operation
子、重型设备等设施是否适用 procedure/主管是否了解安全操作程序
8. Lain-Lain / Other / 其他: 8. Lain-Lain / Other/其他: