HSE & OPERATIONAL

INDUCTION FORM
DATE : HOURS :
TANGGAL Jam :
CONDITION AT : INDUCTED BY :
Kondisi pada Induksi Oleh :

SUBJECT
MATERI TRAINING Check MATERI TRAINING
1. 6
2. 7
3. 8
4. 9
5. 10

Num NAME COMPANY POSITION APPROVED SIGNATURE

No Nama Perusahaan Jabatan Tanda Tangan

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

NOTE : Jakarta,.........................................
* Please mark V on the Coloum which as subject Reported By
on the induction

* Assigned on the righ coloumn is Evidence & Commited

would have learned to all socialization of Induction Subject
and rensponsible to implementation
NAMA / Name :
POSITION/Jabatan :
 Check

ATURE