PT.

Krakatau Daya Listrik

Work Order Form Jl. Amerika No. 1, Samangraya
Citangkil - Cilegon - Banten - Indonesia
Work Order : 316000000260

MWO Description : Pengawasan pekerjaan revitalisasi AM Functional : KDL-J-9823-AMQ-000 Tunnel AM12 - AM13 (TC)
Notification : 306000000226 Equipment : 210000007012 Tunnel AM12 - AM13
Notif. Description : Pengawasan pekerjaan revitalisasi AM Technical Object : KES00226 Tunnel
Reported by : IRFAN P Object Part :
Notification Date : 08.06.2022 Damage :
Maintenance Plan : Cause :
Superior Order : Location : KDL-J-9823 150 kV Line System AM12 to AM13
Order Type : 21UP Unscheduled Predictive Plant Section : S04 Dinas T&DS
Order Status : RELEASE Planner Group : 214 PG T&DS
Priority : 2 Very High Main Work Center : HV1-N01 Work Center HV
Release Date : 28.06.2022 Cost Center : 213220 Dinas-Dinas Transmission & Distribution
Start Date : 09.06.2022 Operation Status :
Finish Date : 09.06.2022 Revision :

OPERATION Ext. Service PR Number:

Op No Sub Work-Center C-Key Operation Short Text Num Dur Work Unit Start-Date Start-Time End-Date End-Time
0010 HV1-N01 PM01 Pengawasan pekerjaan 0 0,0 0,0 MHR 09.06.2022 00:47
revitalisasi AM

COMPONENT Reservation Number: 0000212084

Item Material Description Qty UoM Op No S. Loc PR No Recipient Status

TOOLS/SAFETY
No PRT No Description Qty UoM

PENGAMANAN (Perhatikan 5 langkah Keselamatan Kerja dan Gunakan Peralatan Keselamatan Kerja)
Elektrik Mekanik Safety
Langkah Pengamanan : Langkah Pengamanan : Note :

SPV/SPT : TTD SPV: SPV/SPT : TTD SPV: SPV/SPT/K3 Rep : TTD SPV:
Tanggal : Tanggal : Tanggal :
Aman Dikerjakan [_]Y [_]N TTD SPT: Aman Dikerjakan [_]Y [_]N TTD SPT: JSA [_]Y [_]N TTD SPT:
Aman Dioperasikan [_]Y [_]N Aman Dioperasikan [_]Y [_]N LOTO [_]Y [_]N

DILAKSANAKAN OLEH : DISETUJUI OLEH :

Nama Durasi Nama Tanda Tangan Postponed / Cancellation of Order
Operation By (Name) : _________________
SPV PG-M : Reason Type:
Tanggal : [_] Waiting for Material [_] Waiting for Service
Sptd PG-M : [_] Object Running [_] Duplicate WO
Tanggal : [_] Object Breakdown [_] No Fault Found
SPV PG-Eng : [_] Bad Weather [_] Others
Tanggal :
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Comment: