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ataran- LAPORAN PENYELIDIKAN INSIDEN INCIDENT INVESTIGASI REPOIT TR RERSA TCA ER en PEER PREMATURE LOSS REPORTT ‘OTHER NCDENT TINSIOEN LANNY [Nama Job Ste [Kerbon Plaku Ns insisen INRP Karyawan rane Departemen cA NES yt 9p na ign) a en ‘oor-t100 101-0200 ‘river SRV 01-0808 ‘3 Operator Heavy Equppnent 501-0400 4 Mechaniofechnican 5 Supevisor 6 rat 0690 7 Subcontractor OsT- 0800 701-1100, bation rea Works 201-1300 2 [Mine Area. 1301-1400. 3 [suing kre 401-500 [Sock Room 1501-1800 1601-1700, $7018 1801-1020. 1901-2000. uated Tale, CWA CWS, TZ att 71.90 eep Psa, Crane, Water tuck, Fost 2th 2200 PC, Grader, Guldver, Exeartar Loser mh 7300 Ol Fi [Ala Peraks PompalPunp) Gerest a5 TOR Bot a400 ttaitanomer ‘attr. Gunaan Lebar Kosong ain Dan Lapin Apa Tia encour Poda saat Bopar Ay tH -S ( ¢.0.0) melacuean Peqatanan mency tempat kerja di Joan raya trangad mobic Fortuner LY Ol meyerempet agian belexana, Gerebar arene petcas difarie motor di sant mosuk ditieungan arah HI oy a depan + So m ada Grebar meter far arak berlawanan cdo nbIL AWa- Hioa Bgpae Aji 78.3 metacunan perereman mengaicibatkan Bumper Lecer dan Lamu Depan lei’ pecth a OTT b| Se E a i fleoren | parenommoman TT "1420/0 net ot tant ss Sb 203 aa me Dipindai dengan CamScanner LAPORAN PENYELIDIKAN INSIDEN INCIDENT INVESTIGASI REPORT Halaman-Page 2 [AGENT AGENCY =r wl armero PE DERAIAT RERUSAKAN | —WARTHILANG FERKIRAAN BIAYA a3 Tire Te DEGREE OF MAGE pete aru cos? i i Ales Fartuner ol kederng, = ° 2. 000. 090 + Gen ~ Bale ie a: ITT KOMPONEN IRR ADAY ERA TKERUSARAN Nae OF VTM/ COMPONENT EAN) oun OAM Ly = Bumper Kier Tecet = Braet Tampa Deban ein: Pe ah reumadhan IZONTAK DENGAN PERMUKAAN KERIA ARANG KAGAR,TAIAM, TERSAYAT, OUT DNTACT WH SUREACE COARSE MATERAL HARP, CAUSING CUTS. ETO) ERED DONT TERVAT PRO TERIEDT TANT ERRNO SOR TANG ERS CORR BTER HERTS TORE FROSTED TAC CENGAN STR RAOUS, BNR PACT OAT REBSNOAT Soucrwm cre mourn cess Tome ovate [evar rene mr MCA TNE MTA i. BT AORN ITEKANAN BERLEEIN /BEBAN BERLEBIN/DIGUNAKAN SECARA BERLEBIM (OPAKSARAN LEENIS INSIDEN LAIN YANG TIDAK DISEBUTKAN DT ATAS CI Loree MOEN WISH ARE NOT ONE OF TE ABOVE PLEASE SPECEY) Taman 78 an apo e harus Glanphap sali be SHE Dept Glan 2 Fajr sian Kanon Page 6 20 ope shod be comple & wat othe SHE Dept HO within 2x24 hus ater ne net “SARSIMATA (SKA ADAY DEPARTEMEN KS8LH "MANAGER PROYER EYE WITNESS OF AN, SHE DEPARTHENT KH PROJECT MANAGER eraome arama [hana are revoae [sous]. 05-2020 [son SHR/NMSOYERMA -Rev 2 Di indai dengan CamScanner DENAY INCIDENT LY FOPTUNER Of Dipindai dengan CamScanner Paes IZIN MENGOPERASIKAN ALAT AUTHORIZED BY . Dipindai dengan CamScanner Dipindai dengan CamScanner

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