HSE DAILY REPORT

RS BUDDHA TZU CHI

JOB NO. DAY DATE WORKING AREA
Senin 24-Feb-20 Lt.1
Rev. 01
HSE ACTIVITIES
No Activities No. Activities
1 Induction 6
2 Survey lokasi 7
3 8
4 9
5 10
MAN POWER & MAN HOURS
TODAY
Overtime Previous
No Classification Working Manpower Overtime Total Cummulative
Manpower Manhour Working Manhour
Hour (Overtime) Manhour Manhour
Hour
Site Management
1 Project Manager
2 Project Coordinator
3 Site Manager
4 Engineer
5 QA / QC Coordinator
6 HSE Coordinator/Officer
7 Accounting Officer
Indirect Labour
1 Fitter
2 Electrical
3 Scaffolder
4 Welder
5 Semi Skill
6 Driver
7 Civil Supervisor
8 Rigging/ Scaffolder Supervisor
9 Mechanics Supervisor
10 Crane Operator
11 Ass Operator Crane
12 Truck, Trailer, Exca, Vibro Opr
13 Safetyman
14 Security
15
Direct Labor
1 Foreman Rigger & Scaffolder
2 Leadhand Civil
3 Skill Civil
3 Rigger
4 Mechanics
5 Carpenter
6 General Worker
Subcontractor
1 Manager
2 Engineer
3 Supervisor
4 Electrician
5 Workers
GRAND TOTAL 0 0 0 0 0 0 0 0 0
HSE PERFORMANCE
LAGGING INDICATOR LEADING INDICATOR
∑ Case Lost Time (Day)
No Remark No Remark Today Previous Total
Today Previous Total Today Previous Total
1 Fatality 0 0 0 0 0 0 1 Induction
2 Lost Time Injury 0 0 0 0 0 0 2 JSA review
3 Medical Treatment 0 0 0 0 0 0 3 Safety Talk
4 First Aid 0 0 0 0 0 0 4 Toolbox Meeting
5 Nearmiss 0 0 0 0 0 0 5 Training Attendance
6 Fire Incident 0 0 0 0 0 0 6 Inspection
7 Equipment Incident 0 0 0 0 0 0 7 IBPR
8 Vehicle Incident 0 0 0 0 0 0 8 HSE Meeting
9 Significant Oil Spill 0 0 0 0 0 0 9 Violation Records
10 Environmental Pollution 0 0 0 0 0 0 WORK PERMIT
RATIO Cold Work
Hot Work
No Remark Today Previous Average
Confined Space
10
1 Incident Frequency Rate Working at height
2 Incident Severity Rate Scaffold
Exavation
Radiography
SAFETY OBSERVATION CARD (SOC CARD) WEATHER RECORD
No Remark Today Previous Total Time Sunny Cloudy Rainy
1 Unsafe Condition Start
2 Unsafe Act 07.00-08.00 v
3 Housekeeping 08.00-09.00 v
GRAND TOTAL 0 09.00-10.00 v
TOPIC OF TBM DISCUSSION 10.00-11.00 v
11.00-12.00 v
12.00-13.00 v
13.00-14.00 v
HAZARD FINDING OR HIGH RISK CONDITION & CORRECTIVE ACTION 14.00-15.00 v
15.00-16.00 v

GRAND TOTAL (Hours) 8

MAIN EQUIPEMENT OPERATING TODAY
No. Vehicle & Equipment Unit Operating Hours
1 Car Station
2 Equipment
TOTAL
Prepared by, Acknowledged by,

HSE Coordinator SITE MANAGER

Date : 24 FEBRUARI 2020 Date : 24 FEBRUARI 2020