HSE DAILY

PROYEK : SKTT LOKASI : Surabaya - Bangkalan TANGGAL : 31 Mei 2022

150 kV Suramadu

CONTRACTOR ACTIVITIES
I. HSE ACTIVITIES
No Activities Today Before Total Remark
1 Orientation/Induction
2 Toolbox Meeting 58
3 Job Safety Analysis 2
4 Permit To Work 12
5 Risk Containment Audit
6 HSE Meeting 3
8 Health Check
9 Inspection
15 Other …………………….
II. PERSONAL PROTECTIVE EQUIPMENT
DIBERIKAN KE PEKERJA
No Kind of PPE Remark
Today Record
1 Safety Shoes √
2 Safety Helmet √
3 Safety Glases √
4 Gloves Catun √
5 Ear plug/Ear muff
6 Rompi Keselamatan √
7 Full Body Harnes Doublel
8 Breathing Apparatus
9 Wearpack
10 Masker √
11 Leather Gloves
12 Rubber Gloves
III. PERFORMANCE REPORT
3.1 Incident Report
No Type of Incident Today Before Total Remark
1 Near Miss -
2 First Aid Case -
3 Medical Treatment -
4 Lost Time Injurie -
5 Fatality -
6 Fire Accident -
7 Traffic Accidennt -
8 Propertiy Damage -
9 Environmental Damage -
3.2 Manhour & Safe Manhour
Today Before Total
No Company Remark
Worker Safe Manhour Safe Safe Manhour
Manhour
1 PLN Pusmanpro 5 40 2824 2864
2 PLN UPP 1 8 664 672

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 HSE DAILY
PROYEK : SKTT LOKASI : Surabaya - Bangkalan TANGGAL : 31 Mei 2022
150 kV Suramadu

3 KSO PT. Sucaco – PT. DGS 22 176 10756 10932

4 PLN UPT 2 16 72 72
5 PLN Tim Audit - - 24 24
6 PLN UIT - - 16 16
7 PLN UIP - - 40 40
8 PU - - 72 72
Grand Total 30 240 14468 14692
3.3 Safe Vehicle Distance (In Kilometer)
No Company Today Before Total Remark
1 KSO (Engkel ) 150 3950 4100
2 PLN Pus (Xenia) 80 2000 2080
3 PLN UPP(Xenia) 70 1770 1840
4 PLN UPT (Mobil) - 76 76
5 PLN UIT (Motor) - 70 70
6 PLN Tim Audit - 80 80
7 PLN UIP - 30 30
8 PU (PPK Suramadu) 65 65
Grand Total 300 8041 8341
IV.
Time Sunny Cloudy Rainy Time Sunny Cloudy Rainy
07.00 – 08.00 15.00 – 16.00 √
08.00 – 09.00 √ 16.00 – 17.00 √
09.00 – 10.00 √ 17.00 – 18.00
10.00 – 11.00 √ 18.00 – 19.00
11.00 – 12.00 √ 19.00 – 20.00
12.00 – 13.00 √ 20.00 – 21.00
13.00 – 14.00 √ 21.00 – 22.00
14.00 – 15.00 √ 22.00 – 23.00

HSE KSO HSE PLN PUSMANPRO HSE PLN UPP

Nama Kartika Dewi Asrori Afandi Ady Suryo Nugroho

TANDA TANGAN

Tanggal
31 Mei 2022 31 Mei 2022 31 Mei 2022