No.

Dokumen : MBS-HSE-FM-008

Revisi No. :-
HSE PLAN/PROGRAM
SPS Outdoor Cleaning Services
Tanggal Terbit : 01 Agustus 2022
No Kontrak : 4710004439
Halaman Aug, 2022 - Jul, 2023
: 01

2022 2023
No Program Description TARGET PIC Remarks
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
I. LAGGING INDICATOR
A. Total Manpower 1197 1176 1218 1218 1218 1218 1218 1218 1218 1218 1218 1218 14553 Data harian setiap bulan
SM & HSE
B. Total Manhours 9496 9576 9496 9496 9496 9496 9496 9496 9496 9496 9496 9496 114032 dari SM
1 Fatality 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Lost Time Injury (LTI) 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Restricted Work Day Case (RWDC) 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Medical Treatment Case (MTC) 0 0 0 0 0 0 0 0 0 0 0 0 0
5 First Aid Case (FAC) 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Near miss Incident ( NMI) 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Lost Time Injury Frequency (LTIF) 0 0 0 0 0 0 0 0 0 0 0 0 0
HSE
8 Severity Rate (SR) 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Total Recordable Injury (TRIR) 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Material Lost (ML) 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Number of road traffic Accident (or rate/km) 0 0 0 0 0 0 0 0 0 0 0 0 0

12 Motor Vehicle Crash 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Environmental Damage (ED) 0 0 0 0 0 0 0 0 0 0 0 0 0
II. LEADING INDICATOR
1 HSE Induction 1 0 0 0 0 0 0 0 0 0 0 0 1 HSE
2 Medical Check Up 0 0 0 0 0 0 0 0 0 0 0 58 58 HRD, SM & HSE
3 CeRMAT Input 5 5 5 5 5 5 5 5 5 5 5 5 60 SM & HSE All Personnel
4 JRA Review 0 0 0 0 0 1 0 0 0 0 0 0 1 SM & HSE
5 Prejob Meeting 8 8 8 8 8 8 8 8 8 8 8 8 96 SM & HSE
6 HSE Talk/Toolbox Meeting 4 4 4 4 4 4 4 4 4 4 4 4 48 SPV & HSE
7 HSE Meeting 1 1 1 1 1 1 1 1 1 1 1 1 12 SM & HSE
8 HSE Management Visit 0 0 0 0 0 0 0 1 0 0 0 0 1 PM,SM & HSE
9 HSE Reward 0 0 0 0 0 0 0 1 0 0 0 0 1 PM,SM & HSE All Personnel
10 Training
a Basic Fire Fighting 0 0 0 0 0 0 0 0 0 0 0 0 0
b Basic Sea Survival 0 0 0 0 0 0 0 0 0 0 0 0 0
b Basic First Aid Training 0 0 0 0 0 0 0 0 0 0 0 0 0 HSE

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 2022 2023
No Program Description TARGET PIC Remarks
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul HSE
c Gesture & Posture 0 0 0 0 0 0 0 0 0 0 0 0 0
c Devensive Drive Training 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Emergency Drills/excercies 0 0 0 1 0 0 0 0 0 1 0 0 2 Foreman,SM & HSE
12 PPE Inspection 1 1 1 1 1 1 1 1 1 1 1 1 11 Foreman, SM & HSE Harus diketahui PIC PHM
13 Inspection Kotak P3K 1 1 1 1 1 1 1 1 1 1 1 1 11 Foreman, SM & HSE Internal Inspection

14 APAR Inspection Sertification (all area) 1 1 1 1 1 1 1 1 1 1 1 1 11 Foreman, SM & HSE Internal Inspection

15 Mechanical Tolls Inspection 1 1 1 1 1 1 1 1 1 1 1 1 11 Foreman, SM & HSE Internal Inspection

16 Electrical Tols Inspection 0 0 0 0 0 0 0 0 0 0 0 0 0 Foreman, SM & HSE Internal Inspection

17 Ful body harnes inspection & Tangga 0 0 0 0 0 0 0 0 0 0 0 0 0 Foreman, SM & HSE Internal Inspection
Housekeeping Inspection (Office &
18 0 1 0 1 0 1 0 1 0 1 0 0 5 Foreman, SM & HSE Internal Inspection
Workshop)
19 Hygiene Inspection at office 0 0 0 0 1 0 0 0 0 1 0 0 2 SM & HSE Internal Inspection
20 HSE Internal Audit 0 0 0 0 0 1 0 0 0 0 0 0 1 SM & HSE
21 Waste monitoring 1 1 1 1 1 1 1 1 1 1 1 1 11 Foreman, SM & HSE
HSE,PM,SM & Top
22 Review Procedure HSE & Company Policy 0 0 0 0 0 0 0 0 0 1 0 0 1 Management

23 HSE Review Meeting 0 0 1 0 0 1 0 0 1 0 0 0 3 PM,SM & HSE

III. HSE IMPROVEMENT
Pelatihan secara Inhouse Basic First Aid Project Coordinator,
1 0 0 0 0 0 1 0 0 0 0 0 0 1
Untuk Karyawan di kantor Finance, SM & HSE

Pelatihan pemadaman api menggunakan

2 0 0 0 0 0 0 1 0 0 0 0 0 1
APAR sebelum di isi ulang.

Dibuat oleh, Diperiksa Oleh, Diketahui Oleh, Disetujui 0leh,

………………………………. ………………………………. ………………………… Marlan Sihombing

HSE Coordinator Site Manager & Project Manager Manager/Directure SCM/AM-Quality. PHM

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No. Dokumen : MBS-HSE-FM-009
HSE PLAN/PROGRAM
Revisi No. :-
SPS Outdoor Cleaning Services Logo Perusahaan
Tanggal Terbit : 01 Agustus 2022 No Kontrak : 4710004439
Aug, 2022 - Jul, 2023
Halaman : 01

2022 2023 REALIZATION

No Program Description TARGET Remarks
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul QTY %
I. LAGGING INDICATOR
A. Total Manpower 0 0 0 0 0 0 0 0 0 0 0 0 14616 0 0% Data dari SM
B. Total Manhours 0 0 0 0 0 0 0 0 0 0 0 0 120576 0 0% Data dari SM
1 Fatality 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Lost Time Injury (LTI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Restricted Work Day Case (RWDC) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Medical Treatment Case (MTC) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 First Aid Case (FAC) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Near miss Incident ( NMI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Lost Time Injury Frequency (LTIF) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Severity Rate (SR) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Total Recordable Injury (TRIR) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Material Lost (ML) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Number of road traffic Accident (or rate/km) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Motor Vehicle Cash 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Environmental Damage (ED) 0 0 0 0 0 0 0 0 0 0 0 0 0 0
II. LEADING INDICATOR
1 HSE Induction 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%
2 Medical Check Up 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0%
3 CeRMAT Input 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0%
4 JRA Review 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%
5 Prejob Meeting 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0%
6 HSE Talk/Toolbox Meeting 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0%
7 HSE Meeting 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0%
8 HSE Management Visit 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%

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 2022 2023 REALIZATION
No Program Description TARGET Remarks
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul QTY %
9 HSE Reward 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0% All Personnel
10 Training
a Basic Fire Fighting 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!
b Basic Sea Survival 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!
c Basic First Aid Training 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!
d Gesture & Posture 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!
11 Devensive Drive Training 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!
12 Emergency Drills/excercies 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0% Harus diketahui PIC PHM
13 PPE Inspection 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0% Internal Inspection
14 Inspection Kotak P3K 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0% Internal Inspection
15 APAR Inspection Sertification (all area) 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0% Internal Inspection
16 Mechanical Tolls Inspection 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0% Internal Inspection
17 Electrical Tols Inspection 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0! Internal Inspection
18 Ful body harnes inspection & Tangga 0 0 0 0 0 0 0 0 0 0 0 0 0 0 #DIV/0!
19 Housekeeping Inspection (Office & Workshop) 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0% Internal Inspection
20 Hygiene Inspection at office 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0%
21 HSE Internal Audit 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%
22 Waste monitoring 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0%
23 Review Procedure HSE & Company Policy 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%
24 HSE Review Meeting 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0%
III. HSE IMPROVEMENT
Pelatihan secara Inhouse Basic First Aid Untuk
1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%
Karyawan di kantor
Pelatihan pemadaman api menggunakan APAR
2 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0%
sebelum di isi ulang.

Dibuat oleh Team HSE, Diperiksa Oleh, Diketahui Oleh,

………………………… ……………………………….. ………………………………….

HSE Coordinator Site & Project Manager Manager/Directure

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