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OFFICIAL REPORT OF HSE REPORT

Cut off Date :


Pada hari ini, Rabu telah dilakukan pemeriksaan hasil kerja bersama sebagai berikut :-today, we had joint inspection
for final work official report, as per below :
Name : Company

Divisi : HSE Report

Area : Location/Owner/Project Title

Scope of Work

Report for HSE Include HSE Plan, JSA, PTW Register Permit, Monthly Report, Weekly Repot, Daily report
HSE, SBO, Statistic, Presentasi, Data Inspection, Gatepass In & Out, Letter of insvetsigatio, and manpower

Up to May-2019

Demikian Berita Acara ini kami buat dengan sebenarnya dan kami bersedia menerima sanksi apabila kemudian hari di
temukan adanya kesalahan./This how this official report we made, and we are willing to accept sanctions if founds
errors later.

Checked By, Prepared By,

Name : Name :
Position: Position :

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