Contractor HSE Implementation Q2 /2018 (Apr - June 2018)

N Items Description Evidence

o
A. SAFETY CONTROL

Evidence that induction to

1.
workers has been conducted.

2. Evidence that K3 is implemented a. Pedestrian way

in the construction activity :
a. Availbility of pedestrian b. Safety sign
way,
b. safety signs,
c. Personnel Protective
Equipment (PPE)

c. PPE
Fire preventions: a. Fire Extinguisher
a. Evidence of fire
extinguisher is provided
at certain location inside
PP and SS area,
b. Fire training for the
worker,
c. Evacuation route for fire.

b. Fire Training for worker

c. Evacuation Route
 a. N/A for Lifting Equipment

b. HSE Training

Evidence of implementation of
legal regulation & procedure
related with HSE such as:
3.
a. Lifting Equipment,
b. HSE Trainings.
c. Safety campaign

c. Safety Campaign

Evidence of emergency
4. Emergency and rescue drill N/A for period APR – JUN 2018
responce and rescue drill (if any)
B. HYGIENE CONTROL
1. Clinic and Emergency Response Emergency Response Facility is A. Clinic N/A
facility available at site B. Emergency Response Facilty
 Statistic data of worker illness N/A, due to no workers illness
2. N/A
during January – March 2018 during this period

3. Health training and awareness No Health training for this period N/A

4. Charity event (if any) No charity event for this period N/A

C. WASTE CONTROL

Evidence of waste segregation Waste separation by type of

1. by contractor (organic waste, organic, plastic, common metal,
plastic, common metal, etc) disposable domestic.

a. TPS domestic waste (tempat

pembuangan sementara limbah a. TPS inside of Project a. N/A
domestik) is provided inside PP Area b. N/A
2.
and SS area. b. Domestic waste
b. Domestic waste transporting transportation
by third parties
 A. Availabilty of Toilet

Sanitary facilities inside PP and

SS area :
a. Availability of toilet,
septic tank, absorption
3.
well
b. Maintenance of sewage
treatment discharge
water

B. N/A
Evidence and documentation
that hazardous material (HM) N/A
and hazardous waste (HTW) Due to not available hazardous material
produced during construction
activity managed properly
including:
a. HM and HTW temporary
4 storage recent condition
b. HM and HTW symbol
and labelling
c. HM and HTW Spill
prevention availability
d. HTW transporting by
third party

D. AIR POLLUTION CONTROL

1. Evidence on emission and air a. N/A
pollution prevention: b. N/A
a. vehicle that pass c. N/A
emission test, d. Speed Limit Sign
b. wearing earplug and
dust mask on noisy and
dusty worksite,
c. equipment and vehicle
maintenance activity,
 d. speed limit sign,
e. material mobilization
cover by tarpaulin when
pass resident area (if
any),
f. tire wash to vehicle that
exit from site,

e. Material Mobilization covered by Terpaulin

f. N/A

Evidence of cleaning activity on Public road cleaning N/A

2. public road vicinity of the project
(photo, etc.)
a. Area of water spraying by
contractor All project area was covered by asphalt and concrete block
b. Water filling for dust a. N/A
Evidence of dust exposure control b. N/A
3.
control. c. Water tank trucks c. N/A
conducted sparying d. N/A
d. Spot praying to control
dust exposure
E. SURFACE AND SEA WATER POLUTION CONTROL
1. Evidence of mud pollution Control and prevention of mud is
prevention and control: done to keep the construction
a. Mud clean up activity area safe so as not to interfere a. N/A
inside project area with on site development b. N/A
b. Availibity of pressure c. N/A
pump for tire wash
 c. Availability of tire
washing pond
Surface water runoff prevention a. N/A
and control: b. N/A
a. Availibity of sediment
2. settling ponds and
recent condition
b. Drainage maintenance
activities
3. Silt curtain for dredging activities N/A
Dumping activities is following N/A
4.
the regulation on dedicated area
F. OTHERS
Evidence performing repairment
or replacement if damage toward N/A
public facility occur by contractor
activity (if any).
1.
Note: public facility is facility
outside project area which
damage by contractor activities s
Evidence of conservation effort Plantation activities (if any) N/A
2.
as per RKL guideline.
Environmental Emergency Drill N/A N/A
3.
(if any)