Adaro Mineral WORK ORDER

Civil Road & Special Operation (CRSO)

WO No. : 4 /WO-MH /IX/2023

REQUESTING INFORMATION
Name : Galang Fachri P Request Date : 29-Feb-2024
Position : Safety Officer Completion Date :
Departement : HSE Cost Centre :

WORK INFORMATION
Facility /
System /
Location/Area Lampunut Equipment No. :

Detail Description of Work: (attach drawing/sketch/photo if necessary)

Jumlah Sticker:
DT-001 = 3 Sticker 001 = 4 Sticker
DT-002 = 3 Sticker 002 = 2 Sticker
MT-001 = 3 Sticker

RESOURCE INFORMATION

No Equipment/Plant Unit Hour Rate No Manpower Unit Hour Rate

1 Dump Truck 2
2 Mixer Truck 1

APPROVAL INFORMATION
V Approved to proceed Rejected Return to requester to fill up further engineering detail

Galang Fachri P Febryansyah DR

Request Approved Field Supervisor Dept. Head

Port Expansion Project_Work Order Form_R0