PT.

TARUMA

HSE DAILY ACTIVITY REPORT

Project Day / Date

Client Contractor
Number of Manpower and Manhours Record
Management & Staff Non-Staff
I Personnel Number Personnel Number
Mandays Mandays
Manhours Manhours
Work Permit Record
Types of Work Permit
A. General Work Permit E. Excavation Work Permit
B. Hot Work Permit F. Motorized Equipment Entry Permit
C. Confined Space Entry Permit G. Rigging / Lifting Permit
D. High energy Lectrical Work Permit H. Radiographic Testing Permit
Number of Number of Issued Work Permit
No Work Location Supervisor
II Personnel A B C D E F G H
1
2

Total
Pre-Job Safety Briefing Record
No Work Location Given By Briefing Topics
1
III

Heavy Equipment and Motor Vehicle Record

Heavy Equipment : Heavy Transportation : Light Vehicle :
IV Crane, Dozer, Backhoe, Grader, Pile, etc. Dumptruck, trailer truck, etc. Minibus, pick-up, etc.
Equipment Number Heavy Vehicles Number Light Vehicles Number
Equipment Hours Heavy Vehicles Hours Light Vehicles Hours
Plan Critical Task For Day Tomorrow

Short Description of Incident Occurred (if any)

N/A
VI

Prepared by, Aknowledged by,

HSE Officer Project Manager/SM