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  • Form Penilaian Praktikum-1

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    Aedhyl
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    This document is a form for evaluating practical work involving working at heights, confined spaces, or hot work. It consists of four phases: planning, permitting, implementing, and closing out. Each phase contains several evaluation criteria related to safety documentation, approvals, planning, use of personal protective equipment, and closing permits. The criteria are scored out of 100 and weighted to calculate an overall score. The planning and permitting phases account for 40% and 25% of the score respectively, while implementing and closing out each make up 25% and 10%.

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    This document is a form for evaluating practical work involving working at heights, confined spaces, or hot work. It consists of four phases: planning, permitting, implementing, and closing out. Each phase contains several evaluation criteria related to safety documentation, approvals, planning, use of personal protective equipment, and closing permits. The criteria are scored out of 100 and weighted to calculate an overall score. The planning and permitting phases account for 40% and 25% of the score respectively, while implementing and closing out each make up 25% and 10%.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    12 views1 page

    Form Penilaian Praktikum-1

    Uploaded by

    Aedhyl
    This document is a form for evaluating practical work involving working at heights, confined spaces, or hot work. It consists of four phases: planning, permitting, implementing, and closing out. Each phase contains several evaluation criteria related to safety documentation, approvals, planning, use of personal protective equipment, and closing permits. The criteria are scored out of 100 and weighted to calculate an overall score. The planning and permitting phases account for 40% and 25% of the score respectively, while implementing and closing out each make up 25% and 10%.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    of 1

    FORMULIR PENILAIAN PRAKTIKUM

    WORKING AT HEIGHT/CONFINED SPACE/HOT WORK

    No. Kegiatan Penilaian (Ya/Tdk) Score Bobot Keterangan


    Phase Perencanaan
    1 Pengisian MKJSA 0-100 0
    2 Pengisian Permit 0-100 0
    3 CMP Form 0-100 0
    0
    4 Kelengkapan berkas Permit 0-100 0

    5 Work Plan (Lift Plan, WAH Plan, 0


    Rescue Plan) 0-100
    40%
    Phase Permitting
    1 Approval PA, AC, PTK 0-100 0
    2 Toolbox meeting 0-100 0
    3 Revalidasi 0-100 0 0
    4 Gas Testing (If needed)/GMP 0-100 0
    5 CMP Form 0-100 0
    25%
    Phase Implementing
    1 Penggunaan PPE 0-100 0
    2 Safeguard 0-100 0
    3 SWA/SSWA 0-100 0 0
    4 OPSI 0-100 0
    5 TKI/MKJSA/GMP 0-100 0
    25%
    Phase Colsing Out
    1 Closing Permit: TTD PA, PTK 0-100 0
    2 Pengisian Lesson Learn 0-100 0
    0
    3 Pengembalian Paket Kerja ke 0-100 0
    Control Room
    10%

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