WEEKLY HSE PERFORMANCE RECORD

Company Name : PT. ILFA Mandiri

Period Report : 14 - 20 November 2016
Project : Arun Decomissioning & Enviromental Project
Bioremediasi Tanah Tercemar Shelter Limbah B3)

Day MON TUE WED THU FRI SAT SUN

Date 14-Nov 15-Nov 16-Nov 17-Nov 18-Nov 19-Nov 20-Nov
Total Staf 0 0 0 0 0 0
Total Non Staf 5 5 5 5 5 0
Total Employees 5 5 5 5 5 0
Over Time Employees 0 0 0 0 0 0
Over Time Man Hour 0 0 0 0 0 0
Total Over Time 0 0 0 0 0 0
Total Man Hours Average 40 40 40 40 40 0
Total Manhours Without Lost Time 40 80 120 160 200 0
Accident
Working Hours Average 8 8 8 8 8
Permit & JSA 1 1 1 2 2 0

Report to be submitted to HSE Mgr/Project Mgr

Work Related Incident/Accident Report
This Week Last Week Cummulative
Fatality 0 0 0
Lost Work day Case(s) 0 0 0
Restricted Work Day Case(s) 0 0 0
Medical Treatment Case(s) 0 0 0
First Aid Case(s) 0 0 0
Near Misses Incident Case(s) 0 0 0
Unsafe Act Case(s) 0 0 0
Unsafe Condition Case(s) 0 0 0
Fire Incident 0 0 0
Oil Spill Case(s) 0 0 0
Hazard Identification Report 0 0 0
Motor Vehicle Crashes 0 0 0
Equipmemt Incident 0 0 0

Orientation/Training and Meeting Program

This Week Last Week Cummulative
Walk Through 0 0 0
Safety Patrol 0 0 0
HSE Meeting 0 0 0
Incident Investigation 0 0 0
HSE Training 0 0 0
Tool Box Meeting 5 0 5
Weekly Meeting 0 0 0
Monthly Meeting 0 0 0
Permit And JSA 8 0 8

Dibuat oleh, Di periksa oleh Disetujui oleh

Muhammad Fajri Said Ridwan Khairuddin Syahiban

HSE PMC Project Coordinator PMC PT. Arun NGL

Summary Weekly Tool Box / General Safety Talk

Company Name : PT. ILFA Mandiri

Period Report : 14 - 20 November 2016
Project : Arun Decomissioning & Enviromental Project
Bioremediasi Tanah Tercemar (Shelter Limbah B3)

Materi Tool Box Lokasi ToolBox Jumlah

No. Hari/Tanggal Pembicara
Meeting Meeting Peserta
Senin, 14 November
1 Prosedur Kerja Shelter Limbah B3 5 Iskandar
2016
Selasa, 15 November
2 Bahaya Bahan Kimia Shelter Limbah B3 5 Saiful bahri
2016

3 Rabu, 16 November 2016 Bahaya Limbah B3 Shelter Limbah B3 5 Iskandar

4 Kamis,17 November 2016 APD Shelter Limbah B3 5 Saiful bahri

5 Jumat, 18 November 2016 General Safety Talk Shelter Limbah B3 5 PT. Arun

6 Sabtu, 19 November 2016 No Tool Box

7 Minggu, 20 November 2016 Libur

HSE ISSUE DESCRIPTION

NO Descreption Pekerjaan LOCATION
1. Perhatian Postur Tubuh saat Mencangkul Shelter LB3
2.
3.

4.

AREA OF CONCERN
NO Descreption LOCATION
1. Pemasangan Patok Kerja Shelter LB3
2. Pemberian Line safety Shelter LB3
3. Loading Heavy Equipment Shelter LB3
4. Pembersihan Permukaan Tanah Shelter LB3

Grafik Manhours
PT. ILFA Mandiri
600

520
500

400

300

200
200

100

0
1

2
 TOTAL
This Week
0
5
5
0
0
0
200
200

40
7
Disetujui oleh

airuddin Syahiban
PT. Arun NGL

Ket
520
2
 WEEKLY HSE PERFORMANCE RECORD

Company Name : PT. ILPA Mandiri

Period Report : 21 - 27 November 2016
Project : Arun Decomissioning & Enviromental Project
Remediasi Tanah Terkontaminasi

Day MON TUE WED THU FRI SAT SUN

Date 21-Nov 22-Nov 23-Nov 24-Nov 25-Nov 26-Nov 27-Nov
Total Staf 0 0 0 0 0 0
Total Non Staf 8 8 8 8 8 0
Total Employees 8 8 8 8 8 0
Over Time Employees 0 0 0 0 0 0
Over Time Man Hour 0 0 0 0 0 0
Total Over Time 0 0 0 0 0 0
Total Man Hours Average 64 64 64 64 64 0
Total Manhours Without Lost Time 264 328 392 456 520 0
Accident
Working Hours Average 8 8 8 8 8
Permit & JSA 1 2 2 2 1 0

Report to be submitted to HSE Mgr/Project Mgr

Work Related Incident/Accident Report
This Week Last Week Cummulative
Fatality 0 0 0
Lost Work day Case(s) 0 0 0
Restricted Work Day Case(s) 0 0 0
Medical Treatment Case(s) 0 0 0
First Aid Case(s) 0 0 0
Near Misses Incident Case(s) 0 0 0
Unsafe Act Case(s) 0 0 0
Unsafe Condition Case(s) 0 0 0
Fire Incident 0 0 0
Oil Spill Case(s) 0 0 0
Hazard Identification Report 0 0 0
Motor Vehicle Crashes 0 0 0
Equipmemt Incident 0 0 0

Orientation/Training and Meeting Program

This Week Last Week Cummulative
Walk Through 0 0 0
Safety Patrol 0 0 0
HSE Meeting 0 0 0
Incident Investigation 0 0 0
HSE Training 0 0 0
Tool Box Meeting 5 5 10
Weekly Meeting 0 0 0
Monthly Meeting 0 0 0
Permit And JSA 8 8 16

Dibuat oleh, Di periksa oleh Disetujui oleh

Muhammad Fajri Said Ridwan Khairuddin Syahiban

HSE PMC Project Coordinator PMC PT. Arun NGL

Summary Weekly Tool Box / General Safety Talk

Company Name : PT. ILPA Mandiri

Period Report : 21 - 27 November 2016
Project : Arun Decomissioning & Enviromental Project
Remediasi Tanah Terkontaminasi

Materi Tool Box Lokasi ToolBox Jumlah

No. Hari/Tanggal Pembicara
Meeting Meeting Peserta
Senin, 21 November
1 Prosedur Kerja Shelter Limbah B3 8 Iskandar
2016
Selasa, 22 November
2 Bahaya Bahan Kimia Shelter Limbah B3 8 Saiful bahri
2016

3 Rabu, 23 November 2016 Bahaya Limbah B3 Shelter Limbah B3 8 Iskandar

Kamis, 24 November
4 APD Shelter Limbah B3 8 Saiful bahri
2016

5 Jumat, 25 November 2016 General Safety Talk Shelter Limbah B3 8 PT. Arun

6 Sabtu, 26 November 2016 No Tool Box

7 Minggu, 27 November 2016 Libur

HSE ISSUE DESCRIPTION

NO Descreption Pekerjaan LOCATION
1. Unsafe Act Saat Menuangkan pasir ke dalam bag di bawah masih terdapat pekerja Shelter LB3
2.
3.

4.

AREA OF CONCERN
NO Descreption LOCATION
1. Pemasangan Patok Kerja Shelter LB3
2. Pemberian Line safety Shelter LB3
3. Loading Heavy Equipment Shelter LB3
4. Pembersihan Permukaan Tanah Shelter LB3

Grafik Manhours
PT. ILFA Mandiri
600

520
500

400

300

200
200

100

0
1

2
 TOTAL
This Week
0
8
8
0
0
0
320
520

40
8
Disetujui oleh

airuddin Syahiban
PT. Arun NGL

Ket
520
2
 WEEKLY HSE PERFORMANCE RECORD

Company Name : PT. ILPA Mandiri

Period Report : 28 November - 04 Desember 2016
Project : Arun Decomissioning & Enviromental Project
Remediasi Tanah Tekontaminasi

Day MON TUE WED THU FRI SAT SUN

Date 28-Nov 29-Nov 30-Nov 1-Dec 2-Dec 3-Dec 4-Dec
Total Staf 0 0 0 0 0 0
Total Non Staf 8 8 8 0 0 0
Total Employees 8 8 8 0 0 0
Over Time Employees 0 0 0 0 0 0
Over Time Man Hour 0 0 0 0 0 0
Total Over Time 0 0 0 0 0 0
Total Man Hours Average 64 64 64 0 0 0
Total Manhours Without Lost Time 584 648 712 712 712 0
Accident
Working Hours Average 8 8 8 8 8
Permit & JSA 1 1 1 0 0 0

Report to be submitted to HSE Mgr/Project Mgr

Work Related Incident/Accident Report
This Week Last Week Cummulative
Fatality 0 0 0
Lost Work day Case(s) 0 0 0
Restricted Work Day Case(s) 0 0 0
Medical Treatment Case(s) 0 0 0
First Aid Case(s) 0 0 0
Near Misses Incident Case(s) 0 0 0
Unsafe Act Case(s) 0 0 0
Unsafe Condition Case(s) 0 0 0
Fire Incident 0 0 0
Oil Spill Case(s) 0 0 0
Hazard Identification Report 0 0 0
Motor Vehicle Crashes 0 0 0
Equipmemt Incident 0 0 0

Orientation/Training and Meeting Program

This Week Last Week Cummulative
Walk Through 0 0 0
Safety Patrol 0 0 0
HSE Meeting 0 0 0
Incident Investigation 0 0 0
HSE Training 0 0 0
Tool Box Meeting 3 10 13
Weekly Meeting 0 0 0
Monthly Meeting 0 0 0
Permit And JSA 3 8 11

Dibuat oleh, Di periksa oleh Disetujui oleh

Muhammad Fajri Said Ridwan Khairuddin Syahiban

HSE PMC Project Coordinator PMC PT. Arun NGL

Summary Weekly Tool Box / General Safety Talk

Company Name : PT. ILPA Mandiri

Period Report : 28 November - 04 Desember 2016
Project : Arun Decomissioning & Enviromental Project
Remediasi Tanah Terkontaminasi

Materi Tool Box Lokasi ToolBox Jumlah

No. Hari/Tanggal Pembicara
Meeting Meeting Peserta
Senin, 28 November
1 Prosedur Kerja Shelter Limbah B3 8 Iskandar
2016
Selasa, 29 November
2 Bahaya Bahan Kimia Shelter Limbah B3 8 Saiful bahri
2016

3 Rabu, 30 November 2016 Bahaya Limbah B3 Shelter Limbah B3 8 Iskandar

4 Kamis, 1 Desember 2016

5 Jumat, 2 Desembe 2016

6 Sabtu, 03 Desember 2016 No Tool Box

7 Minggu, 04 Desember 2016 Libur

HSE ISSUE DESCRIPTION

NO Descreption Pekerjaan LOCATION
1. Perhatikan dalam pengangkutan tanah terjadi blind spot forklif Shelter LB3
2.
3.

4.

AREA OF CONCERN
NO Descreption LOCATION
1. Penggalian Tanah Shelter LB3
2. Standby Shelter LB3
3.
4.

Grafik Manhours
PT. ILFA Mandiri
800
700 712

600
500 520

400
300
200
200
100
0
1

3
 TOTAL
This Week
0
8
8
0
0
0
192
712

40
3
Disetujui oleh

airuddin Syahiban
PT. Arun NGL

Ket
712
3
 WEEKLY HSE PERFORMANCE RECORD

Company Name : PT. ILPA Mandiri

Period Report : 05 - 11 Desember 2016
Project : Arun Decomissioning & Enviromental Project
Remediasi Tanah Tekontaminasi

Day MON TUE WED THU FRI SAT SUN

Date 5-Dec 6-Dec 7-Dec 8-Dec 9-Dec 10-Dec 11-Dec
Total Staf 0 0 0 0 0 0 0
Total Non Staf 6 6 6 6 6 6 6
Total Employees 6 6 6 6 6 6 6
Over Time Employees 0 0 0 0 0 0 0
Over Time Man Hour 0 0 0 0 0 0 0
Total Over Time 0 0 0 0 0 0 0
Total Man Hours Average 48 48 48 48 48 48 48
Total Manhours Without Lost Time 760 808 856 904 952 1000 1048
Accident
Working Hours Average 8 8 8 8 8 8 8
Permit & JSA 1 1 1 1 1 1 2

Report to be submitted to HSE Mgr/Project Mgr

Work Related Incident/Accident Report
This Week Last Week Cummulative
Fatality 0 0 0
Lost Work day Case(s) 0 0 0
Restricted Work Day Case(s) 0 0 0
Medical Treatment Case(s) 0 0 0
First Aid Case(s) 0 0 0
Near Misses Incident Case(s) 0 0 0
Unsafe Act Case(s) 0 0 0
Unsafe Condition Case(s) 0 0 0
Fire Incident 0 0 0
Oil Spill Case(s) 0 0 0
Hazard Identification Report 0 0 0
Motor Vehicle Crashes 0 0 0
Equipmemt Incident 0 0 0

Orientation/Training and Meeting Program

This Week Last Week Cummulative
Walk Through 0 0 0
Safety Patrol 0 0 0
HSE Meeting 0 0 0
Incident Investigation 0 0 0
HSE Training 0 0 0
Tool Box Meeting 3 13 16
Weekly Meeting 0 0 0
Monthly Meeting 0 0 0
Permit And JSA 8 11 19

Dibuat oleh, Di periksa oleh Disetujui oleh

Muhammad Fajri Said Ridwan Khairuddin Syahiban

HSE PMC Project Coordinator PMC PT. Arun NGL

Summary Weekly Tool Box / General Safety Talk

Company Name : PT. ILPA Mandiri

Period Report : 05 - 11 Desember 2016
Project : Arun Decomissioning & Enviromental Project
Remediasi Tanah Terkontaminasi

Materi Tool Box Lokasi ToolBox Jumlah

No. Hari/Tanggal Pembicara
Meeting Meeting Peserta

1 Senin, 05 Desember 2016 Standby Shelter Limbah B3 6

2 Selasa, 06 Desember 2016 Standby Shelter Limbah B3 6

3 Rabu, 07 Desember 2016 Standby Shelter Limbah B3 6

Kamis, 08 Desember
4 General Safety Talk Laydown PT Arun 6 Saiful bahri
2016

5 Jumat, 09 Desembe 2016 Standby Shelter Limbah B3 6 Iskandar

6 Sabtu, 10 Desember 2016 APD Shelter Limbah B3 6 Saiful bahri

7 Minggu, 11 Desember 2016 Kebersihan Shelter Limbah B3 6 Saiful bahri

HSE ISSUE DESCRIPTION

NO Descreption Pekerjaan LOCATION
1. Perhatikan dalam pengangkutan tanah terjadi blind spot forklif Shelter LB3
2.
3.

4.

AREA OF CONCERN
NO Descreption LOCATION
1. Penggalian Tanah Shelter LB3
2. Standby Shelter LB3
3. Loading Tanah
4.

Grafik Manhours
PT. ILFA Mandiri
1200

1048
1000

800
712
600
520
400

200
200

0
1

4
 TOTAL
This Week
0
6
6
0
0
0
336
1048

56
8
Disetujui oleh

airuddin Syahiban
PT. Arun NGL

Ket
1048
4
Data Manhours Mingguan

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
200 520 712 1048

Grafik Man Hours Mingguan

PT Primandru Jaya
1200
1048
1000

800 712

600 520

400
200
200

0
1 2 3 4 5 6 7 8 9 10 11 12 13 14
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W W W W W W W W W e e e e e
W W W W W

Data Man Power Mingguan

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10
5 8 8

Chart Title
9
8 8
8
7
6
5
5
4
3
2
1
0
Week 11 Week 12 Week 13 Week 14

Week 11 Week 12 Week 13 Week 14