@ © PLcipeBagunNusntne PT CIPTA BANGUN NUSANTARA. PRE-USE INSPECTION CHECK LIST | Franeeal] el IAONT tad uN LIGHT VEHICLE SRNER ‘| pesers A INERK TYPE oyora Hallux PLAT NO. Bm 8493 DE PROYEK Sorik Marapi Geothermal DIPERIKSA - MEKANIK PARAF [CuENT PT. SGP - ORKA. No URAIAN eias KETERANGAN OK Net OK 1_| Slee Pengingin Mesin ir Rasitor) - 2_[Oimesin | Fier udera z | Keonais an [ 5 _| Tetanen Udara Ban | But Roda ~ 7_| ABatere : 8 _| Miyak Ren 2 9 [ Minvak Power Steering = 10 | Fingsi Storing = 11_| Kea (Depen, Semping, Belakang) zi T2_| Kaca spon - 13 _| Fugsi Stk Kesslanaten zi 14 | Kandi Kabin(Kedersinan) 2 5 _| Kenai Masin : 16_| Fargsi Penal hstamen z 17_| Fubgs! arson & Backup Alem 2 ‘@_| FungsiPengereman - 9 | Fungsi Kopina, Stlan Pal Koping z 20_| Fuhgsi Rem Parke 7 21_| Lato hata: Belakang z 22_| Larou iat Depan 2 2 | varpu Rem 7 24” [ Tathou Emergency & 25 | tarpou Utama Depan 7 25 _| Petenglapen Kesdlarratan Keja a ae 27 _| Tatung Pemacam Kebakaran ¥ 28 _| Segiga Pengaman dan PK z 2_| Grasse (Peumasan) 7 tNepe:nenel 7 Houeekespirg e 3_| RMDRIEN 97036 — 47050 CATATAN Mengetanu, HSE Offcer SuperusarGi wv PT CIPTA BANGUN NUSANTARA moeageewnivante | BRE-USE INSPECTION CHECK LIST JTANGGAL 2 OU2017 \ [UNIT LIGHT VEHICLE Davee Para: As IMERK /TYPE Rojore Haux [PLAT NO) Bm 49> 0¢ |PROYEK ‘Sorik Marapi Geothermal DIPERIKSA - MEXANIK PARAF CLIENT PT. SMGP -ORKA ‘STATUS _ ; NO URAIAN x Wt OK KETERANGAN +_| sistem Pencingn wesin( ar Rear) : 2 | Oimesin 3 | Filter Udera: : 4 | Kong an = | Tekanan Udara Ban : 8 _| Bout Rode z 7_| Arsaere z i 8 | Minyak Rem = 9 | Ninyek Power Stezrng fe 10 | Fings Serna E 41 _| Kaca ( Depan, Samping, Selakang ) © [ “2 _| Kea Spon Z 13 _| Fungsi Sabuk Keselamatan ae 14 _| Kondisi Kabin | Kebersihan ) F 15 | Kondis asin ‘i 16 _| Flrgei Perel netomen es 17 _| Fungsisletson & Bacup Alem 5 18 _| Fungsi Pengereman 19 | FurgsiKeping Stlan Pedal Koping : 20_| Furst Rem Perkir 21 _| Letrpu insite Belakang 722_| Lelrpuindtator Depan 23 [vatou Ren 24 | Tatu Emergency | arou viens Deoan : | Petiengiagen Koslaraton Kea ical 27 | Tabung Peradam Kebekaran e 23_| Segiiga Pergaman dan Pak 7 _| Grease (Petumasan) el ~Nepenenel z 30_| Falsokaaping a 3 [ RADRIEN Q149 — or298 CATATAN Mengetahui, HSE Officer Supervisor@ ML Optafergunusamar, PT CIPTA BANGUN NUSANTARA PRE-USE INSPECTION CHECK LIST TANGGAL, "78 gl2017 r luni LIGHT VEHICLE onner tally | pave fhe MERK TYPE Tojore _wewox PLATNO Bm 6193 De |PROYEK Sorik Marapi Geothermal DIPERIKSA - MEKANIK PARAF CLIENT PT. SMGP - ORKA NO URAIAN Saas KETERANGAN OK Not OK 1_| Sigiem Pendingin Mesin ( Air Radiator ) 2_[ offen 3_| Filter Udara | Kec Ben &_| Teheran Wier Ban 6 | eau Rida 7_| Ait Batere 8 _| Minyak Rem a 9 | MiveKPover Seong z 10_| Figs! sieng 1 | a Dean, Sangig Baatana) 12_| Kaca Spion 13 __| Fungsi Sabuk Keselamaten ¥ 14] Karas Kabin (Kobe) : 18_| KondisiMesin ¥ @_| Fangs Pent rane T7_| Fungi Matson & ackup Alam 48_| Fungsi Pengereman 18 | Fuhgsi Koning, Stelan Pasa Koping 7_| Fung Ren Peale | vatou hotter Baatang 7 @_| terou haat: Depan 7 @_| Lamou Rem 24 _| Lamu Emergency 25 _| Lerou Vana Donen 25 _| Petenghapen Kesearaton Kea 7 21_| Tebung enacar Kebakran B_| SegiigaPergaman dan PIK ~ | Griese (Peumaten) : = Nepa-ner : @_| Foleckeoring 7 31 | MMDRIVEN 97708 934QQ CATATAN Mangels HSE Omer Superior