You are on page 1of 1

INSPEKSI ALAT PELINDUNG DIRI

NAMA PEKERJAAN :
LOKASI KERJA :
TANGGAL INSPEKSI :
G : Good F : Fair P : Poor
SAFETY WELDING SAFETY SAFETY SAFETY FULL BODY EAR
NO NAMA JOB APRON WEARPACK MASKER
HELMET HELMET GLOVES SHOES GLASSES HARNESS PLUG

1
2

10

Contractor
Inspected by Date : Name : Signature :

Position :

PT. INTER MITRA SEJATI

You might also like