RISET

TRAFFIC PENGEMBANGAN
ACCIDENT GREEN PRO
REPORT
PT. ASTRA
PT ASTRA DAIHATSU MOTORDAIHATSU MOTOR - STAMPIN

Page : 1 Revision No. : -

Form No. : Form/Safety Issue Date : 21-May-21
Title of the incident Traffic Accident Team Member Dept.Assembling ( Tertabrak pengendara lain )
Date 24-Aug-21 Time 06:20 Location Jl. Raya Surya Utama (Kawasan Surya Cipta )
Time Category Going Home Going Work Weekend Long Holiday Shutdown Mudik Lebaran

Employment pattern Permanent Employee Contract Employee Temporary Empl. Others ( )

Name RIZKI PUTRA RAMADHAN NPK 70894 Safety DOJO Date 01-Apr-21 Safety Riding Date 03-May-21
Victim's detail Age 19 tahun Sex Male Female Length of experience 4.8 BULAN
Employee Level Team Member Dept./Div. ASSEMBLING Plant V
Vehicle Motorcycle Car Bus Train Bicycle Others

License NG OK SIM STNK Sticker

PPE Not Use OK Helm Not Clicked Helmet

OK Main Lamp Shoes Jacket Gloves

Vehicle NG
Tire Other Signal Lamp Brake Lamp Brake Mirror

Head Face Neck Left Hand Right Hand Body

Site Of Injury
Left Foot Right Foot Luka robek [ lengan siku tangan kiri ]
Severity Death Lost Work Day Scratch-Non LWD RS.Primaya Karawang
Cost Impact -

Description Sketch
<Situation>
Hari / Tgl : Selasa 24 Agustus 2021
Jam :
Tempat Kejadian : Jalur Irigasi Kali malang
Korban : Rizki Putra Ramadan / 70894 Arah ke kawasan PERURI Arah ke kawasan KIM & Surya Cipta
Dept. : Assembling [ Chassis / shift A ]

Kronologi :
- Mr. Rizki going home after Work night shift, together with friend, on motor cycle. from
ADM KAP 07.00 AM,

- When in kalimalang, Rizki overtake another vehicle, but unfortunately fail because of
road condition. [ different road levels )

- Rizki and Friend fall down and left hand hit by truck behind him
Current condition :
- Laceration on left arm
- Broken left arm

<Causes of incident> 4M 1E + 1 Direct Cause

Violation Traffic
Overtaking Hit by Other Vehicle Road Condition Unfit Rider Overspeed
Rules
Direct Cause
Vehicle NG Kondisi jalan berbeda level ketinggian antara lajur kanan & kiri

Main Problem Break The Rule Poor KY Poor Environment Fatigue Tidak menduga bahaya
1.MAN :
- Less alert when driving
- lacks of understanding of the pathsbtaken every time they go to and home from workare dangerous areas that have the potential for accidents to occur.
- lacks of discussion regarding the understanding of safe driving fpr both themselves and other
- Merasa terganggu dalam berkendara apabila di depan menghalangi pandangan, sehingga berkeinginan untuk mendahului nya
2. ENVIROMENT
- Demage roads, different levels between the right and left and sloping road conditions
- Dark area road condition
- Narrow street
<Countermeasures>
NO A. MAN <Due Date> <PIC> <Status>
- Information of traffic accident to all employees ( morning meeting )
> Provide edcation to all employee to increase awarenes of the dangers around us that we do not
predic( others driver, the enviroment,and wild animals) by informing traffic accident that occur KY
> KY interactive Training ( Show video during training how the road condition lead to the factory )

∆
26 Agust - 25 Sept 21 All Member
1

- activity KYT weekly by case Traffic accident materi up to date 26 Agust - 25 Sept 21 Komite safety ∆
- Conduction interview and CNC with victins by the foreman and Supervisor 26 Agust - 25 Sept 21 management Assy ∆
- Discussion with Team member to on good drivinf behavior and make comitment to drive safety. 25 Agust - 25 Sept 21 management Assy ∆
B. ENVIROMENT <Due Date> <PIC> <Status>
2 - Confirmation to MANAGEMENT and the HSE committee for submission of road repairs to the local government HSE & MANAGEMENT ∆
<Management Reflection>

<Yokoten Point>
- Drive Calmly and be patient
- Cultivate a sense of wanting to drive safely and safely both for himself and for others
- Always obey traffic signs and good driving ways
- Always apply as if we are driving unsafe,so always be alert
Karawang, 24 agustus 2021
Verified Approved Checked Prepared

Setelah Laporan Selesai Harap Merubah Risk Management Max. 3x24 Jam.
EHS Dept.Head Sec.Head Saf. Officer
Actual Road Codition Remark

Current condition Road :

- Slit road condition

Current condition Team Member

- Laceration on left arm
- Broken left arm

Continue the KY interactive Activity