PT PLN (Persero)

UNIT PELAKSANA
PROYEK
JARINGAN ACEH MAN POWER & MAN HOUR REPORT
Jl. Sudirman No. 11
Banda Aceh
Telp. (0651) 7315526

A. INFORMASI PEKERJAAN
1. Tanggal : 8 September s/d 20 Oktober 2019
2. Jenis Pekerjaan : PEKERJAAN SIPIL
3. Lokasi : PLTMG ARUN, DESA MEURIAH PALOH, MUARA SATU, KOTA LHOKSUMAWE,
PROVINSI ACEH
4. Perusahaan Pelaksana Pekerjaan : PT. SIBRAMA SAKTI
5. Pengawas Pekerjaan : HILMAN SURYANDA
6. Pelaksana Pekerjaan : EDWARDO J.A …........................
: AGUS …........................
: SAIPUL …........................
B. PERALATAN KESELAMATAN [] Helm [ ] Earmuf [ ] Pelampung/Life vest
1. Alat Pelindung Diri [] Sepatu Keselamatan [ ] Sarung Tangan Katun [ ] Tabung pernafasan
[] Kacamata [ ] Sarung tangan karet [ ] Full body harness
[] Earplug [ ] Sarung tangan 20kV [ ] Lain-lain :
[] Pemadam Api (APAR dll)

2. Perlengkapan Keselamatan & Darurat [ ] Rambu keselamatan

[ ] LOTO (lock out tag out)
[ ] Radio telekomunikasi
SAFETY MANAGEMENT
Daily Safety Activity & Site Issue
Man Man Hour
Power

Today
Today Regular Overtime Total Last Day Today Until Now

0 8 0 0 0 0 0
Job Safety Analysis & Working
Safety Induction Today Total Today Total
Permit
Risk Assesment / JSA /
New Employer 0 0 0 0
Working Procedure

Special Induction 0 0 Working Permit 0 0

Environment Today Total Accident & Incident Today Total

Waste Maintenance 0 0 Fatality 0 0

Rewards Today Total LTI 0 0

Safety Award 0 0 Medical Treatment 0 0

Corection Order & Warning Today Total First Aid Case 0 0

Letters

Issue CO 0 0 Near Miss 0 0

Warning Letters 0 0 Incident 0 0

Disetujui Oleh: Diperiksa Oleh: Disusun oleh: Sketsa/Gambar Lokasi Kerja :

(MANAGER BAGIAN (PEJABAT PELAKSANA K3L/ (PENGAWAS K3

TEKNIK/PENGAWAS PENGAWAS K3) PERUSAHAAN)
PEKERJAAN)