You are on page 1of 2

Doc.

No : KAP/HSE/FORM/09
QUALITY, HEALTH, SAFETY &
ENVIRONMENTAL MANAGEMENT Revision : A
SYSTEM – FORMS
Date : 20 Desember 2017

DAFTAR OBSERVASI K3LL


HSE OBSERVATION REGISTER

DEPARTMENT/LOCATION: MONTH :

STATUS:
DATE OBSERVATION NOTE CORRECTIVE ACTION
LOCATION CHECK (V) OUT-STANDING/
(Catatan dari Observasi) (Tindakan Perbaikan)
CLOSED

UNSAFE COND.
UNSAFE PROC.
UNSAFE ACT

SAFE COND.

SAFE PROC.
SAFE ACT

TOTAL
Doc. No : KAP/HSE/FORM/09
QUALITY, HEALTH, SAFETY &
ENVIRONMENTAL MANAGEMENT Revision : A
SYSTEM – FORMS
Date : 20 Desember 2017

HSE Officer :

You might also like