INTERAKSI PERILAKU

KESELAMATAN BBS Interaction

INTERAKSI PERILAKU KESELAMATAN

BBS Interaction
Tanggal Waktu
: :
Date Time
Nama Pelapor No. ID
: :
Reported By ID No.
Lokasi Proyek
:
Location Project
List Aktifitas
:
Activity List
Jenis Tindakan/Perilaku Yang Direspon
⃞ Aman/ Safe ⃞ Tidak Aman/ Unsafe
Behaviour type you’ve response:
Uraikan Perilaku yang Anda observasi:
Describe the Behaviour you have observed:

Uraikan Respon Anda terhadap perilaku yang diamati:

Describe Your Response:

Nama & No. ID yang diamati: Paraf :

No. ID & Name of Observed: Sign

Perlu Tindakan Lebih Lanjut ? : ⃞ Ya / Yes ⃞ Tidak / No

Need Further Action? (Please Tick)

Jika perlu tindak lanjut, maka observer / pelapor harus menentukan permintaan tindakan perbaikan
If need further action, observer/reporter should set corrective action request

Corrective Action Responsible Person Due Date

Pengawas Paraf
Supervisor : :
Sign

Note: Ketika perlu tindakan lebih lanjut, Pengawas area wajib untuk mereview / memvalidasi table di atas saat proses approval
When further action is needed, the Area Supervisor is obliged to review / validate the above table during the approval process

Once printed this document becomes uncontrolled. Refer to Petrosea Intranet for controlled copy.

Form No. PTP-SHE-FO-G-

Rev No. 3 1 of 2
0011
INTERAKSI PERILAKU
KESELAMATAN BBS Interaction

Once printed this document becomes uncontrolled. Refer to Petrosea Intranet for controlled copy.

Form No. PTP-SHE-FO-G-

Rev No. 3 2 of 2
0011