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Ceklist Alat Untuk QHSEHSE
Ceklist Alat Untuk QHSEHSE
Altenator
Indikator Ampere
Indikator Voltage
þ Oke
Injection Pump
Tutup Radiator
ý Tidak (cek ulang)
Stop Enggine
Turbo Carge
Motor Stater
Tanggal
Generator
ENGGINE
Box Fuse
Fuel Fiter
Van Belt
Oil Filter
Radiator
Bulan
Air Filter
Battery
Stik Oil
RPM
10
1
2
3
4
5
8
9
A
6
7
5
1
6
4
3
B
2
9
24 25
10 11 12 13 14 15 16 17 18 19 20 21 22 23
JANUARI
9
8
7
6
5
4
3
2
1
27 28 29 30 31
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Indikator Compresor
Status :
Selenoide Enggine
Saparator Hydrolic
Pump Compresor
House Hydrolic
Tutup Radiator
House Meter
Motor Stater
Tanggal
Hand Break
C HYDROLIC
A ENGGINE
Fuel Fiter
Box Fuse
Van Belt
Kenalpot
Oil Filter
Radiator
Bulan
Air Filter
Battery
Stik Oil
Stik Oil
RPM
10
10
1
2
3
4
5
8
9
1
2
3
5
4
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Indikator Compresor
Status :
Selenoide Enggine
Saparator Hydrolic
Pump Compresor
House Hydrolic
Tutup Radiator
House Meter
Motor Stater
Tanggal
Hand Break
C HYDROLIC
ENGGINE
Fuel Fiter
Box Fuse
Van Belt
Kenalpot
Oil Filter
Radiator
Bulan
Air Filter
Battery
Stik Oil
Stik Oil
RPM
10
10
1
2
3
4
5
8
9
1
2
3
5
4
A
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Indikator Compresor
Status :
Selenoide Enggine
Saparator Hydrolic
Pump Compresor
House Hydrolic
Tutup Radiator
House Meter
Motor Stater
Tanggal
C HYDROLIC
ENGGINE
Fuel Fiter
Box Fuse
Van Belt
Kenalpot
Oil Filter
Radiator
Bulan
Air Filter
Battery
Stik Oil
Stik Oil
RPM
10
10
1
2
3
4
5
8
9
1
2
3
5
4
A
6
7
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Mundur
ELECTRIC SYSTEM
Status :
Indikator Ampere
Kampas Kopling
Kopling
Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
ý
Seal Cylinder
Tidak (c
House Meter
KampasMaju
Motor Stater
Tanggal
Hand Break
C HYDROLIC
Compresor
ENGGINE
TRANMISI
Fuel Fiter
Gear Box
Box Fuse
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Handel
Battery
Stik Oil
Lampu
Break
RPM
10
D
10
12
11
1
2
3
4
5
9
1
2
3
1
2
3
4
5
8
A
6
7
5
1
6
3
B
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
I
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Mundur
ELECTRIC SYSTEM
Status :
Indikator Ampere
Kampas Kopling
Kopling
Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
ý Tidak (c
House Meter
KampasMaju
Motor Stater
Tanggal
Hand Break
C HYDROLIC
Compresor
ENGGINE
TRANMISI
Fuel Fiter
Gear Box
Box Fuse
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Handel
Battery
Stik Oil
Lampu
Break
RPM
10
D
10
12
11
1
2
3
4
5
9
1
2
3
1
2
3
4
5
8
A
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Mundur
ELECTRIC SYSTEM
Status :
Indikator Ampere
Kopling
Kopling
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
ý
Seal Cylinder
Tidak (c
House Meter
KampasMaju
Motor Stater
Tanggal
Hand Break
C HYDROLIC
Compresor
ENGGINE
TRANMISI
Fuel Fiter
Gear Box
Box Fuse
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Handel
Battery
Stik Oil
Lampu
Break
RPM
10
D
10
12
11
1
2
3
4
5
9
1
2
3
1
2
3
4
5
8
A
6
7
5
1
6
3
B
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Status :
Status :
Altenator
Deferensial Gardan
Status :
Selenoid Hydrolic
Filter Oil Hydrolic
Indikator Ampere
Join Kopling
Kampas Kopling
Kopling
Kampas Kopling
Oil Kopling
Kampas Kopling
þ Oke
Oil Tranmisi
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Turbbo Carger
Seal Cylinder
ý Tidak (cek ulang)
House Meter
Motor Stater
Tanggal
Hand Break
C HYDROLIC
ENGGINE
Pin Bucket
TRANMISI
Fuel Fiter
Box Fuse
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Bucket
Pump
Break
Filter
RPM
Bolt
Stik
10
D
10
12
9
2
4
11
1
2
3
4
5
8
1
3
5
7
1
2
3
4
5
A
6
7
6
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Paraf dan
Altenator
Deferensial Gardan
Status :
Selenoid Hydrolic
Filter Oil Hydrolic
Indikator Ampere
Join Kopling
Kampas Kopling
Kopling
Kampas Kopling
Oil Kopling
Kampas Kopling
þ Oke
Oil Tranmisi
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Turbbo Carger
Seal Cylinder
ý Tidak (cek ulang)
House Meter
Motor Stater
Tanggal
Hand Break
C HYDROLIC
ENGGINE
Pin Bucket
TRANMISI
Fuel Fiter
Box Fuse
Selenoid
Van Belt
Kenalpot
Oil Filter
Bulan
Radiator
Kampas
Kampas
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Bucket
Pump
Break
Filter
RPM
Bolt
Stik
10
D
10
12
9
2
4
11
1
2
3
4
5
8
1
3
5
7
1
2
3
4
5
A
6
7
6
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
I
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Paraf dan
Altenator
Deferensial Gardan
Status :
Selenoid Hydrolic
Filter Oil Hydrolic
Indikator Ampere
Join Kopling
Kampas Kopling
Kopling
Kampas Kopling
Oil Kopling
Kampas Kopling
þ Oke
Oil Tranmisi
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Turbbo Carger
Seal Cylinder
ý Tidak (cek ulang)
House Meter
Motor Stater
Tanggal
Hand Break
C HYDROLIC
ENGGINE
Pin Bucket
TRANMISI
Fuel Fiter
Box Fuse
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Bucket
Pump
Break
Filter
RPM
Bolt
Stik
10
D
10
12
9
2
4
11
1
2
3
4
5
8
1
3
5
7
1
2
3
4
5
A
6
7
6
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
I
9
8
7
6
5
4
3
2
1
27 28 29 30 31
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Diferensial Gardan
Join Kopling
JoinKopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
ý Tidak (cek ulang)
Lampu Besar
Motor Stater
Tanggal
Hand Break
Hand Break
C HYDROLIC
7 Lampu Sen
ENGGINE
TRANMISI
Fuel Fiter
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Break
Wiper
Break
Yuke
Bolt
10
D
10
1
2
3
4
5
8
9
1
2
3
1
2
3
4
4
A
6
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Diferensial Gardan
Join Kopling
JoinKopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
Lampu Besar
ý Tidak (cek ulang)
Motor Stater
Tanggal
Hand Break
Hand Break
C HYDROLIC
7 Lampu Sen
ENGGINE
TRANMISI
Fuel Fiter
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Break
Wiper
Break
Yuke
Bolt
10
D
10
1
2
3
4
5
8
9
1
2
3
1
2
3
4
4
A
6
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Diferensial Gardan
Join Kopling
JoinKopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
ý Tidak (cek ulang)
Lampu Besar
Motor Stater
Tanggal
Hand Break
Hand Break
C HYDROLIC
7 Lampu Sen
ENGGINE
TRANMISI
Fuel Fiter
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Break
Wiper
Break
Yuke
Bolt
10
D
10
1
2
3
4
5
8
9
1
2
3
1
2
3
4
4
A
6
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Diferensial Gardan
Join Kopling
JoinKopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
ý Tidak (cek ulang)
Lampu Besar
Motor Stater
Tanggal
Hand Break
Hand Break
C HYDROLIC
7 Lampu Sen
ENGGINE
TRANMISI
Fuel Fiter
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Break
Wiper
Break
Yuke
Bolt
10
D
10
1
2
3
4
5
8
9
1
2
3
1
2
3
4
4
A
6
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Diferensial Gardan
Join Kopling
JoinKopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
ý Tidak (cek ulang)
Lampu Besar
Motor Stater
Tanggal
Hand Break
Hand Break
C HYDROLIC
7 Lampu Sen
ENGGINE
TRANMISI
Fuel Fiter
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Klakson
Battery
Stik Oil
Break
Wiper
Break
Yuke
Bolt
10
D
10
1
2
3
4
5
8
9
1
2
3
1
2
3
4
4
A
6
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Selang Spray
Spuyer Spray
Pump Spray
Tanggal
ENGGINE
Fuel Filter
Radiator
Selenoid
Air Filter
Bulan
Van Belt
Stik Oil
A
5
1
6
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
J
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Selang Spray
Spuyer Spray
Pump Spray
Tanggal
ENGGINE
Fuel Filter
Radiator
Selenoid
Air Filter
Bulan
Van Belt
Stik Oil
A
5
1
6
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Tanggal
Karburator
ENGGINE
Fuel Filter
Selenoid
Air Filter
Bulan
Stik Oil
6 Knalpot
Starter
7 Baut
A
5
1
4
3
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
þ Oke
Kampas Kopling
Kampas Kopling
Kampas Kopling
ý Tidak (cek ulang)
Tanggal
ENGGINE
Karburator
Fuel Filter
Selenoid
Air Filter
Bulan
Stik Oil
Knalpot
Starter
Baut
A
1
6
3
5
4
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Kabel Elektroda
Stang Elektroda
Amper Meter
6 Stang Massa
Input Power
Tanggal
ENGGINE
Selenoid
Bulan
5
1
4
3
2
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Kabel Elektroda
Stang Elektroda
Amper Meter
Stang Massa
Input Power
Tanggal
ENGGINE
Selenoid
Bulan
A
1
6
3
5
4
2
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
6 27 28 29
2
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
2 Kabel Elektroda
5 Stang Elektroda
4 Amper Meter
6 Stang Massa
1 Input Power
Tanggal
A ENGGINE
Selenoid
Bulan
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
2 Kabel Elektroda
5 Stang Elektroda
4 Amper Meter
6 Stang Massa
1 Input Power
Tanggal
A ENGGINE
Selenoid
Bulan
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Minyak Pelumas
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
selang Udara
Mata Pisau
ENGGINE
Selenoid
Bulan
A
1
3
2
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Minyak Pelumas
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
selang Udara
Mata Pisau
ENGGINE
Selenoid
Bulan
A
1
3
2
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
3 Minyak Pelumas
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
2 selang Udara
1 Mata Pisau
A ENGGINE
Selenoid
Bulan
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
3 Minyak Pelumas
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
2 selang Udara
1 Mata Pisau
A ENGGINE
Selenoid
Bulan
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
3 Minyak Pelumas
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
2 selang Udara
1 Mata Pisau
A ENGGINE
Selenoid
Bulan
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
3 Minyak Pelumas
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Tanggal
1 Mata Pisau
A ENGGINE
Selenoid
Bulan
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Ampere Meter
Mundur
ELECTRIC SYSTEM
Status :
Water Temperatur
Kopling
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
4 Motor Hydrolic
ý
Seal Cylinder
Tidak (cek ulang)
Maju
Hours Meter
Transmision
Tanggal
Hand Break
Roller
C HYDROLIC
ENGGINE
Fuel Fiter
Van Belt
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Handel
Battery
Stik Oil
Lampu
Break
RPM
Track
D DLL
DLL
10
10
12
11
1
2
3
5
9
1
2
3
2
3
4
5
8
A
6
7
5
1
6
3
B
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
9
8
7
6
5
4
3
2
1
27 28 29 30 31
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Ampere Meter
Mundur
ELECTRIC SYSTEM
Status :
Water Temperatur
Kopling
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
4 Motor Hydrolic
ý
Seal Cylinder
Tidak (cek ulang)
Maju
Hours Meter
Transmision
Tanggal
Hand Break
Roller
C HYDROLIC
ENGGINE
Fuel Fiter
Van Belt
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Handel
Battery
Stik Oil
Lampu
Break
RPM
Track
D DLL
DLL
10
10
12
11
1
2
3
5
9
1
2
3
2
3
4
5
8
A
6
7
5
1
6
3
B
2
8
9
24 25
21 22 23
10 11 12 13 14 15 16 17 18 19 20
9
8
7
6
5
4
3
2
1
27 28 29 30 31
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Ampere Meter
Mundur
ELECTRIC SYSTEM
Status :
Water Temperatur
Kopling
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
4 Motor Hydrolic
ý
Seal Cylinder
Tidak (cek ulang)
Maju
Hours Meter
Transmision
Tanggal
Hand Break
Roller
C HYDROLIC
ENGGINE
Fuel Fiter
Van Belt
Kenalpot
Oil Filter
Radiator
Bulan
Kampas
Kampas
Air Filter
Handel
Battery
Stik Oil
Lampu
Break
RPM
Track
D DLL
DLL
10
10
12
11
1
2
3
5
9
1
2
3
2
3
4
5
8
A
6
7
5
1
6
3
B
2
8
9
24 25
13 14 15 16 17 18 19 20 21 22 23
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Join Kopling
JoinKopling
Kopling
Kampas Kopling
Kampas Kopling
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
House Meter
Motor Stater
Tanggal
Break
C HYDROLIC
ENGGINE
TRANMISI
Box Fuse
Fuel Fiter
Gear Box
Van Belt
Kenalpot
Selenoid
Oil Filter
Radiator
Kampas
Kampas
Bulan
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Break
Hand
Yuke
RPM
Bolt
D
10
5
8
9
1
2
3
4
5
1
2
3
4
1
2
3
4
5
A
6
7
1
B
7
3
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Join Kopling
JoinKopling
Kopling
Kampas Kopling
Kampas Kopling
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
House Meter
Motor Stater
Tanggal
Break
C HYDROLIC
ENGGINE
TRANMISI
Box Fuse
Fuel Fiter
Gear Box
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Kampas
Kampas
Bulan
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Break
Hand
Yuke
RPM
Bolt
D
10
5
8
9
1
2
3
4
5
1
2
3
4
1
2
3
4
5
A
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Join Kopling
JoinKopling
Kopling
Kampas Kopling
Kampas Kopling
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
House Meter
Motor Stater
Tanggal
Break
C HYDROLIC
ENGGINE
TRANMISI
Box Fuse
Fuel Fiter
Gear Box
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Kampas
Kampas
Bulan
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Break
Hand
Yuke
RPM
Bolt
D
10
5
8
9
1
2
3
4
5
1
2
3
4
1
2
3
4
5
A
6
7
5
1
B
3
7
2
8
9
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Altenator
Join Kopling
JoinKopling
Kopling
Kampas Kopling
Kampas Kopling
Injection Pump
House Hydrolic
Tutup Radiator
Pump Hydrolic
Seal Cylinder
House Meter
Motor Stater
Tanggal
Break
C HYDROLIC
ENGGINE
TRANMISI
Box Fuse
Fuel Fiter
Gear Box
Van Belt
Selenoid
Kenalpot
Oil Filter
Radiator
Kampas
Kampas
Bulan
Kampas
Air Filter
Klakson
Battery
Stik Oil
Lampu
Break
Hand
Yuke
RPM
Bolt
D
10
5
8
9
1
2
3
4
5
1
2
3
4
1
2
3
4
5
A
6
7
5
1
B
3
7
2
8
9
24 25
13 14 15 16 17 18 19 20 21 22 23
10 11 12
9
8
7
6
5
4
3
2
1
27 28 29 30 31
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Selenoid
PT Adhi Karya (Persero) Tbk
Divisi Konstruksi III
Status :
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Selenoid
PT Adhi Karya (Persero) Tbk
Divisi Konstruksi III
Status :
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Selenoid
PT Adhi Karya (Persero) Tbk
Divisi Konstruksi III
Status :
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Selenoid
Tahun 2017 PT Adhi Karya (Persero) Tbk
Divisi Konstruksi III
KARTU CEK LIS
ALAT GENSET
Altenator
Kampas Kopling
Kampas Kopling
Kampas Kopling
þ Oke
Injection Pump
Motor Stater
Tanggal
ENGGINE
Fuel Fiter
Selenoid
Kenalpot
Oil Filter
Radiator
Bulan
Air Filter
Battery
Stik Oil
1
2
3
5
A
5
1
B
3
7
2
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
C BAGIAN SCREEN
Kampas Kopling
Kampas Kopling
Kampas Kopling
Dinamo Ampere
Tanggal
Selenoid
Bulan
2
1
4
2
24 25
21 22 23
13 14 15 16 17 18 19 20
10 11 12
9
8
7
6
5
4
3
2
1
30 31
27 28 29
26
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Status :
þ Oke
ý Tidak (cek ulang)
Selenoid
26
27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Tanggal
Status
Bulan
Jenis Alat
Tahun 2017
Tahun 2017
No Kode DK
Type Alat/Mesin
Merk Alat/Mesin
REKOMENDASI
1 Periksa Buka Tutup Pintu Cold Bin
No Seri Alat/Mesin
Kapasitas Alat/Mesin
Peralatan
:
:
:
:
:
:
:
:
Mengetahui
B BAGIAN BELT CONVEYOR
( ................................. )
1 Periksa Bearing Motor Roll
Baik
Bukaka
QHSE
Diperiksa
1
Periksa Switch Breaker
Periksa Swicth ON / OFF
2
( ................................. )
Dinamo Ampere
3 Periksa Contaktor Over Load
Periksa Panel - Panel Control
4
4
Periksa Panel - Panel Control
BAGIAN
BAGIAN DRAYER DRAYER
E
BAGIAN
1 Motor Gear Box dan Rantai Penggerak
DRAYER
BAGIANDrive
Periksa DRAYER Gear dan Ring Gear
2
Periksa
BAGIANThrus DRAYER Rloller Drayer
3
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Periksa
BAGIANRing DRAYER Drayer
4
4
Periksa
BAGIANTermo DRAYER Cople
5
Periksa Oli Motor Gear Box
KARTU CEK LIS
6
Periksa Panel - Panel Control
BAGIAN
BAGIAN DRAYER ELEVATOR
F
Operator
Diperiksa
BAGIANRantai DRAYER Hot Elevator
ALAT ASPALT MIXING PLANT ( AMP )
1 Periksa
( ................................. )
Periksa Oli Motor Gear Box
2
Periksa Panel - Panel Control
Kampas Kopling
BAGIAN
BAGIAN DRAYER
HOT BIN
...........................................................................................................................................................................................................................
G
Cirebon , ...........................2017
Catatan : ..........................................................................................................................................................................................................................
BAGIANScale
1 Periksa DRAYER Timbangan Material
Periksa Panel - Panel Control
Kampas
BAGIAN
BAGIAN Kopling
DRAYER
MIXER
H
BAGIANLanatai
1 Periksa
DRAYER Mixer
Periksa Panel - Panel Control
Periksa
BAGIANOli Motor Gear Box
DRAYER
2
Periksa Panel - Panel Control
Periksa
BAGIAN Gigi
DRAYERPenggerak
3
Periksa Panel - Panel Control
KARTU CEK LIS
ALAT STONE CRUSHER
C BAGIAN SCREEN
Kampas Kopling
Dinamo Ampere
Tanggal
Bulan
2
1
4
2
1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2
0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 2 3 4 5 6 7 8 9
2 2 2 3 3
7 8 9 0 1
2
6
REKOMENDASI
Dengan hasil pengecekan tersebut diatas maka memberikan kesimpulan bahwa alat :Layak / Tidak Layak Pakai
Catatan : ..........................................................................................................................................................................................................................
...........................................................................................................................................................................................................................
Cirebon , ...........................2017
Mengetahui Diperiksa Diperiksa
Periksa
BAGIANGigi DRAYERPenggerak
3
Periksa Panel - Panel Control
Kampas Kopling
BAGIAN
BAGIAN DRAYER
AIR COMPRESOR
I
Periksa Panel - Panel Control
1 Periksa
BAGIAN Oli Pelumas
DRAYER
Periksa Panel - Panel Control
2
3
4
Kampas Kopling
Kampas Kopling
Selenoid
þ Oke
Status :
Status :
Kampas Kopling
Kampas Kopling
þ Oke
ý Tidak (cek ulang)
Selenoid