fin Innovasi IMN Mitra /Nusantara | (QHSE Form Title» Doc ID FIMN-COM-004 Eft Date: 24 June 2019 Audit Plan Revision _:0 Page: Page | of 2 Planned Audit Date 189 19 February, 2020 an 1. Verify the compliances of QHSE-MS refer to audit criteria Objective of Audit 2. Verify the consistency of QHSE-MS implementation 3. Identification possibility of QHSE-MS improvement 4. Verify manufacturer compliances to the requirement of API Spec 6A 5. Verification of previously intemal and external audit finding (ifany ) ; ‘The audit to be conduct to area of PT. Innovasi Mitra Nusantara and coverage for Scope of Audit 1. All Audit Criteria Clauses 2. All QHSE-MS process ( ISO 9001;14001: 45000 ) that applicable to PT. IMN 3. All manufacturing process that comply with API Spec 6A won T, 180 9001:2015 Aude Citerss 2. 180 14001 :2015 3. ISO 45001 : 2018 4. APL Spec 6A Latest edition - T, Documents! record verification Method of Audit a 3._ Observation of process ‘Auditor Team 1. Ardest 2, Avie 3. Hidayah 7Dedik 4. Ariel 5. Ali 6, Devi ‘Audit Area ‘Audit Area ‘Auditee Engineering Arief! Dedik ‘CNC Manufacturing) Production | Arief/Dedik/ Rifaldi/ Dono Warehouse Arief/Dedik/ Rifaldi/ Dono ‘Maintenance ‘ArieffDedik/ Rifaldi/ Dono Planning ‘Arief/ Devi Purchasing Ardest/ Ali [QC & NDT ‘Ardest/ Avrie! Syaiful Marketing Ardest/ Reni Document Control ‘Ardest/ Reni GA- Training ‘Atdest/ Hidayah HSE Dwi / Avric / Dono ‘Management ‘Axdest/ Reni Planned Opening Meeting | Date : 18" February, 2020 Time : 08.30AM_ ‘Venue : IMN Meeting Room Planned Closing Mecting | Date: 198 February, 2020 Time: 04,00 PM ‘Venue : IMN Meeting RoomInnovasi i Me ‘QHSE Form Title Doc 1D FIMN-COM-004 Eff Date = 24 June 2019 Audit Plan Revision 0 Page Page 2 of 2 ‘Times of Audit 1 Day Schedule, (08.30-09.00 ‘Opening Meeting 18° February, 2020 All Auditor = Introduction scope of audit = Introduction plan of audit MR, Dept Head, all = Introduction ‘methods of audit | personnel 1* Day Schedule, (09.00 - 10.00 Plant Tour (all Innovasi Mitra Nusantara area) 18 February, 2020 All Auditor Point check - Manufacture Flow Storage Material MR, Dept Head, all = Identification =Policy personnel Traceability ~ Segregation Material = __58 & HSE (concern)_- Working Knowledge 1 Day Schedule, 10.00 12.00 18% February, 2020 > Documentation, interview and observation of Ardest Avrie Engineering MR, Dept Head, related Ali Hidayah > Documentation, interview and observation of sonnel Planning 1" Day Schedule, 13.00- 15.00 18% February, 2020 > Documentation, interview and observation of Ali Avric Warehouse MR, Dept Head, related Ardest /Hidayah > Documentation, interview and observation of personnel Maintenance 1" Day Schedule, 15,00- 17.00 18 February, 2020 Avtic / Ali > Documentation, interview and observation of MR, Dept Head, related (ENC Manufacture personnel Ardest > Documentation, interview and observation of HSE 27 Day Schedule, 08.00- 10.00 19 February, 2020 > Documentation, interview and observation of Arief / Devi Purchasing MR, Dept Head, related Dedik > Documentation, interview and observation of personnel Marketing _ 2" Day Schedule, 10.00- 12.00 19® February, 2020 > Documentation, interview and observation of Arie / Devi Qc-NDT MR, Dept Head, related Dedike > Documentation, interview and observation of personnel GA. Training "Day Schedule, 13:00- 15.00 19 February, 2020 > Documentation, interview and observation of Arief / Devi Document Control MR, Dept Head, related Dedik > Documentation, interview and observation of personnel Management (Internal audit, Obj. Target, Management review, ete related to management) 2 Day Schedule, 15.00- 16.00 19 February, 2020 All Auditor > Compile report 2 Day Schedule, 16.00- 17.00 19 February, 2020 All Auditor > Closing Meeting, Finding Review & Timing MR, Dept Head, all closing finding nel Adress: