JASA PERANCANGAN PENGADAAN DAN KONTRUKSI

HSE MONTHLY REPORTING FORM

PEMBANGUNAN PIPA GAS GRISSIK - PUSRI

SAFETY PERFORMANCE STASTISTICS - LKT

PERIOD : 28 Juni 2018 - 30 December 2020

Number of Recordable Work Injuries Recordable Workdays Frequencies Severity

Monthly Total Exposure Total Fatal LWDC RWDC MT Total LTI Total Record Lost Restricted LTIFR TRIR SR
No 0f Hours Empolyees Cases Workdays Workdays
2017 (Project Man-Hours) Cumulative
j=(f*10^6)/ k=(g*10^6)/ i=(h*10^6)/
a1 a2 b c d e f=b+c g=d+e+f h i Tot a1 Tot a1 Tot a1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
previous year 2018 3,259 13 0 0 0 0 0 0 0 0 0 0.0000 0
1 January'2019 2,202 84 0 0 0 0 0 0 0 0 0 0.0000 0
2 February'2019 2,447 92 0 0 0 0 0 0 0 0 0 0.0000 0
3 Maret'2019 2,202 114 0 0 0 0 0 0 0 0 0 0.0000 0
4 April'2019 4,802 114 0 0 0 0 0 0 0 0 0 0.0000 0
5 Mei'2019 4,802 114 0 0 0 0 0 0 0 0 0 0.0000 0
6 Juni'2019 4,802 114 0 0 0 0 0 0 0 0 0 0.0000 0
7 Juli'2019 4,802 114 0 0 0 0 0 0 0 0 0 0.0000 0
8 Agustus'2019 41,836 353 0 0 0 0 0 0 0 0 0 0.0000 0
9 September'2019 239,644 737 0 0 0 0 0 0 0 0 0 0.0000 0
10 Oktober'2019 239,644 737 0 0 0 0 0 0 0 0 0 0.0000 0
11 November'2019 239,644 737 0 0 0 0 0 0 0 0 0 0.0000 0
12 Desember'2019 239,644 737 0 0 0 0 0 0 0 0 0 0.0000 0
previous year 2019 1,026,471 197 0 0 0 0 0 0 0 0 0 0.0000 0
1 January' 2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
2 February'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
3 Maret'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
4 April'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
5 Mei'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
6 Juni'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
7 Juli'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
8 Agustus'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
9 September'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
10 Oktober'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
11 November'2020 42,289 197 0 0 0 0 0 0 0 0 0 0.0000 0
12 Desember'2020 31,500 126 0 0 0 0 0 0 0 0 0 0.0000 0

TOTAL 1,526,409 737 0 0 0 0 0 0 0 0 0 0.0000 0

LWDC : Lost Work Days Cases
RWDC : Restricted Work Days Cases 2017 - 2018 Accident Summary
MT : Medical Treatment 1. Accident Frequency Rates = 0 / million manhours (ANSI Z. 16.1)
LTI : Lost Time Injury 2. Accident Severity Rates =0 (ANSI Z 16.1)
LTIR : Lost Time Injury Rate 3. Incident Rate = 0/ Total Exposure Hours (OSHA STANDARD)
FR : Frequency Rate
SR : Saverity Rate

Prepared by,

Chief HSE