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Pelapor - Diisi jika diperlukan (Filled if required) RSES - CSR
Nama (Name) : Davit Januriyanto l Date / Tanggal :
Bagian (Entity): Operator Perusahaan (Co.): Elnusa Name / Nama :
Signature / Td. Tangan :
Atasan Pelapor (Line Supervisor) : *Internal Deadline (Estimated date for the case to be closed) :
Bagian (Entity): Td. Tangan (Signature): Date: Signature&Name:
CeRMATi sekeliling anda untuk meningkatkan keselamatan. Do CeRMAT in your surrounding to improve safety. Use CR EP HSE 102 as reference to define severity level of the case