cence essg be UPPER CISOKAN PUMPED STORAGE POWER TW PLANT PROJECT ( Panckage 1A & 11) mi GD P suns vera DAILY INSPECTION mort (pw). tocanion TL FCW Wolpe Prntovere: (5 ME] Woy : Description Work i en EHeariow Wet e.lamy Cheating. cat Avy fl FILLIN THE CHECKLIST WITHA MARK (9) IF THE CRITERIA ARE SATISFIED, IF NOT, TUT A MARK (X) AND WRITE THE RESULTS OF THE OBSERVATION IN THE "NOT CONFORMITY FINDINGS” COLUMN AND AGREE FOR FOLLOWING UP. IF THE CRITERIA DOES NOT NFED TO BF APPLIED, WRITE IN THE LOCATION (NA-NOT “APPLICABLE) cour ie. HOUStAttE NS 75 NO fe JS Facies: YES] NO z iron want one jf eset eos Tate nt Stay na via é 3 atardovs materat are not sed | V, [Ring with oe Bord afey Z 4 Aleonstructon wastes ocalaed [tery det, 2 lors Below ie oor S| Devobrace re ereaton 5th rework actives 6 Separate 83 & Non BD waste ares t TERS bo Fre 7 5 [Pahoa roof at worsen F wee © FC materal ermine z sctrmcmnctoterlies [EMERGENCY RESPONSE EQUIPMENT 1 | The abie comes wth nuppart | J] T [eseunion Rome i The power sources equnped wih 7 [Fre exinguser & eee Z sei < 3 [Firs ad kit & checkloe t z |NATERIAL STORAGE Lass ae reed morenente + TJNDOOR (canen ping arian, acess) a 2 TOON (rst en tong | 1 | vue nearectyansey uy) (muucher + [Mew amtepardtorrming | y Vines ie a ein ri a itis IEA LOUPMEST [FACILITIES FOR WORKERS 1 [neseieenesisndoed TZ T [lace 0 defecate defect. Fal for 7; Fo fel slashes or 3908 v Nadine hs [remanent To F Jemergensy Eyewash 2 Toivge ttre z 7 [ Retares Z 7“ in Frople 4 bor enete stererina 2 P Gun 4 | ree | ag — ara 3 [ Rest during bres v1 Garey T [People] [Stare [Finiabed fort rnaed aT Urnate ang cefecte propery |W 5 [nate andatete posery Ty loP-dE~AY| [Don't dink ateoholandérops |» 7 [nines nthe expect way = Mangower tee Z “I reby, view by, Approve By @ Dipindai dengan CamScannerEXCAVATOR CHECKLIST FORM Department OCHS No. Certificate Vz Inspection date 5 fei ZOLY — 0 : Yearmade Wut sito No Description Information —. . roxcno] no | ate T Team ‘WATER, FOE ACU wi FURL TE | > [smn ‘TEMPERATURE, WANONL, BING LOOK 7 orenaronat ne i'l diwecnmon 000 NO AS, LUBRICATION z 000 7 Tascsmwoaay | MaWtutTacrntacrauweTeoes | > 3 [oremaronscxs TW, THECUS LAR WOT FROZEN 7 6 | TRACK CONTROLER (GOOD NO LEAKS / DAMAGE 4 7 | BUCKET TRADING ‘G000 7 Tee TLSCOPE WOH DOESNT ET z | mcarrmouwen | METRE 9 | eucms WOO, COMPLETE TEED 7 1 | vom WORING AND DAMAGE > 7 | rower PROPER FUNCTION | rovanv woe PROPER FUNGTIN 3 @ [racommausen | ounct onaacen > | rasta own 7 15 | SWING ALARM PROPER FUNGTION 4 onclason of aspecion Ress Inspection by: ‘Approved by: Ae > Uh. i (& Driver Operatsr solo wabigle @ Dipindai dengan CamScannerDepartment No.Cenitiate D5 inspection date 15 Ul COTY 0 Brseqzepieery PHM Year made 1 Ure sto S yor Hee Bed Jos No Description Information Lcenaticn Funcno] he eee eee [mare | 1 5 iL WATTA TAN 7 ) |psmuwr Jon tmmaatun, avon, swnvoce ff | OPERATIONAL me 4 wil seadeakers {000 WO ATs, LURRATION 7 000 + [scrsano murs | MOMWINT AND HTANWG CoDRMTWTGOO | — 7 | ovcnatons can (WIL, TH GLASS LAR OTIROZEN v © | reac conmmourn GOOD NO LIAKS / DAMAGE 4 7 | BUCKET TRADING 000 4 + fever wcomnean | CTTUSCOR aUGIT Oot DT UAnace 4 9 | eucers NO WOU. COMPETE TECH Z 10 | vox woneng ANO DAMAGE Y 11 | teavenatann PROPER FUNGTION 7 12 | porary uct PROPCR FUNTION 7 12 | Fine DeINGUISHER OMARGL, DAMAGER 4 14 | rst no commer eo 1 | swe nana PROM FUNCTION 7 ‘Condusion of Inspection Results ie Inspection by : Approved by: Git § 4 sorely Operator Safety Officer Manager _ RST @ Dipindai dengan CamScannerLOADER CHECKLIST FORM Inspection Date Deparment; No. Certificate ‘Sef tay slo Yearmade sito No Description Information Milscoae LAT Tar TCE | > | wsmome (TEMPERATURE, HANOCL, SONG LOCK, OPERATIONAL ac 4 3 | HEAD & TAILUGHT AND eenren een uv InDeATOR 4 | WIND SHIELD CD - | ovcearorscan WL, THE GLASSIS CLEAR NOT FROZEN ¢ 6 | wee 000 No EAS / DAMAGE v 7 | ovrmecn PROPER FUNGTIN — + | evcnrmonmen | TETELESCOPE BuOKEToOESNT OxsT - ance 9 | ovcers NO HOU, COMPETE TEETH 7 pate 10 | ranewwnson [e000 4 11 | worn ROPER FUNGTION 1 | porarruom Portn FUNTION i = 1 | rmcorwavsnen | ounce owactn v 14 | rasta coun VY 15 | aan ROPER FNGTON y Conclusion of inspection Results / Driver / Operator @ Dipindai dengan CamScannerB|@ MIXER TRUCK CHECKLIST ou Company Name :Cpw.V Date of Inspection AS (UC tour” Equipment Make Ute Equipment Model 2 MUkeir-ge © Equipment Number T 894 AG Owned/Hired/Contractor Mixer Truck Inspection Checklist, SN, Details YesNo [Comments T_] Transit Mixer should be physically in good condition 2 ‘No damage in tire (Bolts, Crack, Cuts & Air Pressure, etc.) |Z 3 | Registration Number should be written uy 4 Head and tail light and indicators are in working condition. iv 3_|_ Side mirror should be in good condition Z 6 | Wind Shield/glass should be in proper condition. 2 7 ‘Wiper in should be in proper condition. 'S_|_ Red tniangle/reflective tape should be fixed in front of vehicle. Z ‘9 |_ Rotatory par of secondary engine should be covered with fix guard, 7 10 | Rotating part of gear box should be covered by fixed guard. Zz T_|_Inbuilt ladder should be proper with suitable euard. T2 | Front & reverse hom. 7 T3 | Fire Extinguisher in operator eabin. T4 | Operator have valid and suitable license. TS | First aid kit should be available. 16 | Normal break & emergency (hand) break should be in functional & operator | condition ti . ~10 7 1 8 8 Fit for usage :_ Yes No. - Inspection By Reviewed by: Say, P_JEN ‘Sign with date : urna, @ Dipindai dengan CamScannerDUMP TRUCK CHECKLIST FORM Departemen Opps Nomor D.6U4-UB Tanggal Inspeksi: /J- Mae Lola xn Yearwade =: over lah Kondish Ne Deskripsi . oe Ketoreneet SESUAI | Tidak 1 | mesin OU, AIR, TALIKIPAS, ACCU, WIRING, DLL. |” ANGI > | paNeLinstmumen | OUD TEMPERATUR,TEK.ANGIN, w7 SPEEDOMETER, DLL. KOPLING & 3 PERSNELLING ea 4 [sme BAK alee BAI, PERALATAN GERAKAN TL PENGEREMAN BAK 6 | ampu DEPAN BELAKANG, SIGN DAN REM 4 7 | KLAKSON / KACA SPION | BAIK 8 | oumP( sucKeT) BAIK,TIDAK ADA KEBOCORAN TeLescore | -/| 9. | PERLENGKAPAN KUNCI- KUNCI, BAN SEREP Kesimpulan Hasil Inspeksi Diipspeksi oleh ; Diketahui olet 7 te “79 4 iors (cx Zee) Safety Officer Driver Manager @ Dipindai dengan CamScannerme CD DUMP TRUCK CHECKL! Departemen & KS Nomor Tanggal inspeksi : (S” MEL doly KR Yoar Made Driver Sur yana No Deskripst Keterangan eer sak 1 | MESIN OU, AIR, TAL KIPAS, ACCU, WIRING, DLL. 2 | PANELINSTRUMEN ‘OLI, TEMPERATUR, TEK. ANGIN, SPEEDOMETER, DLL. KOPLING & 3 | peRSNELLING ma 4 [snr BAK AIK, PERALATAN GERAK DAN 2) kere PENGEREMAN BAIK 6 | mpu DEPAN BELAKANG, SIGN DAN REM 7. | KLAKSON / KACA SPION BAIK 8 | DUMP ( BUCKET) BAIK, TIDAK ADA KEBOCORAN TELESCOPE 9) | PERLENGKAPAN KUNCI- KUNCI, BAN SEREP ke INsdstsiist sts Kesimpulan Hasil inspeksi Diketahui oleh : HE | Byay @ Dipindai dengan CamScannerFORM TOOL BOX MEETING @ “ sarcryniast WARITANGGAL Riou Ty RUT PEMBICARA = Mima | MEPL P TOKAST PEK SCM Usep | OPARTEMENT oS Topik Safety yong di dshustan: Pow eee oT ‘hr nee m Ea | Aste ste Dipindai dengan CamScanner @ Dipindai dengan CamScannerBEALE det ahahidn a OM IS/s/ouy aw) “Z Ke na AA LBA RL SHAR IRA te 1 —. MARS MS HRARFENMBRIMNR) [ pe SARER RAS 1. LARA: 2 EAE. : : S-2 — Bedi Whi rE RE — qWdG. vAaT we - 2 ARMAGH: CMM EME OFLU e OMG CMRI, Ce ee MeMh Omkirak OvLe nT OR Bl ONE Ole teak Omran seh SPEAR: OMA Otis ORME OM GR OMMia CAL ORM Hi; ORME OPH /e OPE OesUR OSU, AAEM: OME MM OSX Oe eBEM — OA PNB ONKATADY OFF Ost, 5. 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OMA ARO) G FA EME IM, BET Fe I Ne A ae CARAS RR AT A TIER CSE HEMEW ARYL: BOON EAN M,N OLEH ste 1. 2 3 3 AA |e mavbotial: ot 18 5 Bi, MHS MARES { i | 1 Mfr Sig 7 a Rt [afer s feet ae 4 chil tnt, i s na ' & Yea HY 7 MK OS & bev Q Jane [0 Wun, 4 @ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner@ Dipindai dengan CamScanner