Ref. No.

Date : 15-Aug-2019
NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 15-Aug-2019

(Time) 17.00 to 22.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : INDRANADI

5. CELLPHONE NUMBER : +62813-6418-8981

6. LIST OF WORKERS DOING : 1. BUDI IRAWAN (SCAFFOLDER)

OVER TIME (Name & Position)
. 5. MUZONIF (ASS. SCAFFOLDER)
2. SUMARDI (ASS. SCAFFOLDER)
3. WASONO AL IKLAS (SCAFFOLDER)
4. ROHMAN (ASS. SCAFFOLDER)
6. MOH YUSUP (ASS. SCAFFOLDER)
7. IKHAS ABSAR (ASS. SCAFFOLDER)
8. ERY KUSWANTO (ASS. SCAFFOLDER)
9. MUHAMMAD MUHTADI (INSPECTOR)
10. SUPRATO (ASS. SCAFFOLDER)
11. NANANG SETIAWAN (FOREMAN)
12. FANDI ACHMAD (ASS. SCAFFOLDER)
13. SARINTO (ASS. SCAFFOLDER)
14. ADHI BUDIARTO (ASS. SCAFFOLDER)
15. ADE KURNIAWAN (ASS. SCAFFOLDER)
16. BAMBANG SUPENO (SCAFFOLDER)
17. NURUL EGI (ASS. SCAFFOLDER)
18. GRAFIKA (ASS. SCAFFOLDER)
19. AHMAD NOOR ROHIM (ASS. SCAFFOLDER)
20. SUHARY (ASS. SCAFFOLDER)
21. M BAHRUL ULUM (ASS. SCAFFOLDER)
22. A TONY PRAYOGO (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP
M. ARFAH
Position :
1. WORKING DAY, DATE & TIME : (Day) THURSDAY
(Time) 17.00 to
2. WORKING AREA (detailed location) : TOS, LFO TANK, LAYDOWN 3
3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING
4. RESPONSIBLE PERSON : AMON
5. CELLPHONE NUMBER : +62 852-1700-7101
6. LIST OF WORKERS DOING : 1. BAYU HARDIANNTO (FOREMAN)
OVER TIME (Name & Position) 2. SIRIN (ASS. SCAFFOLDER)
3. FAHMI SAHAB (ASS. SCAFFOLDER)
4. EKO WAHYUDI (ASS. SCAFFOLDER)
. 5. M SAMSUDIN (ASS. SCAFFOLDER)
6. ACHMAD SYAIFUDIN (INSPECTOR)
7. SLAMET RIYADI (ASS. SCAFFOLDER)
8. BAGUS PUTRA P (ASS. SCAFFOLDER)
9. NANANG PRASETYO (SCAFFOLDER)
10. SAMSIR (FOREMAN)
11. ANDRIYANI NST (ASS. SCAFFOLDER)
12. NUR HADI (ASS. SCAFFOLDER)
13. BUDI HARSO (ASS. SCAFFOLDER)
14. FARIZ SETIAWAN (ASS. SCAFFOLDER)
15. NASIR (ASS. SCAFFOLDER)
16. M NURZEN (ASS. SCAFFOLDER)
17. BAMBANG H (ASS. SCAFFOLDER)
18. M KHAERIL GHOZALI (ASS. SCAFFOLDER 51. BANI K (ASS. SCAFFOLDER)
19. NURYANTO (ASS. SCAFFOLDER)
20. KARIAJI (FOREMAN)
21. SUBKHAN (ASS. SCAFFOLDER)
22. CHOIRUL IMAM SUBEKTI (ASS. SCAFFOLD55. MADRI (ASS. SCAFFOLDER)
23. FERRY ROHAYAT (ASS. SCAFFOLDER)
24. ERY IRAWAN (FOREMAN)
25. M IKHWAN S (ASS. SCAFFOLDER)
26. DAKIRIN (ASS. SCAFFOLDER)
27. MASDUKI ARIFIN (ASS. SCAFFOLDER)
28. TA'AT PRIYAMOKO (FOREMAN)
29. SALIKIN (ASS. SCAFFOLDER)
30. FERNANDO (ASS. SCAFFOLDER)
31. AINUR ROFIK (FOREMAN)
32. KARNALI (ASS. SCAFFOLDER)
33. DURYANTO (ASS. SCAFFOLDER)
Project Participants
BTG/BOP/CIVIL/SF *)
Heru Tjahjono
Site Coordinator
Note : Valid by Company Stamp
Note: Overtime should be above 6 pm (di atas jam 6 sore)
*)
Strikethrough / cross the un-necessary ones
Date : 15-Aug-2019
Approved by, :
(Project participant)
(Representative)
Position :
(Date) 15-Aug-2019
22.00
34. M MUSYORI (ASS. SCAFFOLDER)
35. KAHARUDIN (ASS. SCAFFOLDER)
36. NUR ROCHIMIN (ASS. SCAFFOLDER)
37. DIAN ALANUARI (ASS. SCAFFOLDER)
38. CASDI (ASS. SCAFFOLDER)
39. SURATMAN (SCAFFOLDER)
40. BUDI RIYADI (ASS. SCAFFOLDER)
41. SUNARDI (FOREMAN)
42. FAKIHUDIN (ASS. SCAFFOLDER)
43. M RISQON (ASS. SCAFFOLDER)
44. M MAKMURRODIN (ASS. SCAFFOLDER)
45. IQBAL HAMZAL F (ASS. SCAFFOLDER)
46. M KHOLISUL R (SCAFFODLER)
47. ACHMAD MUSLIMIN (ASS. SCAFFOLDER)
48. JULY HARI (ASS. SCAFFOLDER)
49. ROMI IRDAL (ASS. SCAFFOLDER)
50. ROHMAT HANDOYO (ASS. SCAFFOLDER)
52. SLAMET AFTHAN B (FOREMAN)
53. AMAT GUNTUR (SCAFFOLDER)
54. M ZAM'AN NASIR (ASS. SCAFFOLDER)
56. DEDE JAELANI (ASS. SCAFFOLDER)
57. SUWARNO (ASS. SCAFFOLDER)
58. ROHMANI (ASS. SCAFFOLDER)
59. ANANDA RISKY (ASS. SCAFFOLDER)
60. ANDRIK SETIAWAN (INSPECTOR)
Nawakara
(Person in Charge)
Position : ______________________
Ref. No. :
Date : 15-Aug-2019
 NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 15-Aug-2019

(Time) 17.00 to 22.00

2. WORKING AREA (detailed location) : PIPE RACK 141 C

3. WORK ACTIVITIES : INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : SUGIANTORO

5. CELLPHONE NUMBER : +62 823-8270-8061

6. LIST OF WORKERS DOING : 1. ABDUL KASIM LESTALUHU (FOREMAN)

OVER TIME (Name & Position)
. 5. IRFAN CHOIRUL A (ASS. SCAFFOLDER)
2. HERI PURNOMO (ASS. SCAFFOLDER)
3. ADIB SUSILO (ASS. SCAFFOLDER)
4. NUR HASIM H (ASS. SCAFFOLDER)
6. ARIYADI RESERTO (ASS. SCAFFOLDER)
7.SABAR ROHMAN (ASS. SCAFFOLDER)
8. RUDIANTO (FOREMAN)
9. AHMAD ZAENI N (ASS. SCAFFOLDER)
10. TEGUH HARIANTO (ASS. SCAFFOLDER)
11. ASIS (ASS. SCAFFOLDER)
12. SUBKHAN (ASS. SCAFFOLDER)
13. KALYUBI (ASS. SCAFFOLDER)
14. NOVAN SANTOSO (ASS. SCAFFOLDER)
15. WAHYU ARIF TIANTO (ASS. SCAFFOLDER)
16. IMRON JAMALUDIN I (ASS. SCAFFOLDER)
17. BASIR (SPV)
18. MOCH MARTONI (FOREMAN)
19. AGUS PURNOMO (ASS. SCAFFOLDER)
20. M ARIF FADJRIN (ASS. SCAFFOLDER)]
21. RIYANTO (ASS. SCAFFOLDER)
22. M ZULFIKAR (ASS. SCAFFOLDER)
23. MUHAMMAD IMRON (ASS. SCAFFOLDER)
24. WAHYUDI (ASS. SCAFFOLDER)
25. IDA BAGUS B (ASS. SCAFFOLDER)
26. MISWANTO (ASS. SCAFFOLDER)
27. IMAM NUR ROFIK (ASS. SCAFFOLDER)
28. DENI ALI RAMBANG (ASS. SCAFFOLDER)
29. ALI SANDRA (ASS. SCAFFOLDER)
30. JUSMADI (ASS. SCAFFOLDER)
31. ASRONI (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 15-Aug-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 15-Aug-2019

(Time) 19.00 to 6.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND MODIFICATION SCAFFOLDING

4. RESPONSIBLE PERSON : ERIK WICAHYONO

5. CELLPHONE NUMBER : +62 822-4876-5802

6. LIST OF WORKERS DOING : 1. SIS AFANDI (SCAFFOLDER)

OVER TIME (Name & Position)
. 5. IWAN SANTOSO (ASS. SCAFFOLDER)
2. HARMOKO (ASS. SCAFFOLDER)
3. JOKO CASMITO (SCAFFOLDER)
4. WILDAN MUKHOLADUN D (SCAFFOLDER)
6. SUSWANTO (ASS. SCAFFOLDER)
7. KHOIRUL JAMAL (ASS. SCAFFOLDER)
8. NICKY DZIA'UL HAKIM (ASS. SCAFFOLDER)
9. AJI MUKTIONO (SCAFFOLDER)
10. M ULIL ABSOR (ASS. SCAFFOLDER)
11. NUR YAENUDIN (ASS. SCAFFOLDER)
12. LIM SWI KING (ASS. SCAFFOLDER)
13. DEDE YUSUP K (ASS. SCAFFOLDER)
14. SUNARDI 1 (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
 Ref. No. :

Date : 1-Aug-2019
NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 1-Aug-2019

(Time) 17.00 to 22.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : INDRANADI

5. CELLPHONE NUMBER : +62813-6418-8981

6. LIST OF WORKERS DOING
OVER TIME (Name & Position)
. 5. SUMARDI (ASS. SCAFFOLDER)
: 1. A. TOHIRIN (FOREMAN) 34. NUR ROCHIMIN (ASS. SCAFFOLDER)
2. RIYANLIE (ASS. SCAFFOLDER) 35. M TAUFIQ (ASS. SCAFFOLDER)
3. ARBIYANTO (ASS. SCAFFOLDER) 36. DIAN ALANNUARI (ASS. SCAFFOLDER)
4. BUDI IRAWAN (ASS. SCAFFOLDER) 37. AINUR ROFIK (FOREMAN)
6. WASONO AL IKLAS (ASS. SCAFFOLDER)
7. ROHMAN (ASS. SCAFFOLDER)
8. MUZONIF (ASS. SCAFFOLDER)
9. DIMAS DIAN SAPUTRA (ASS. SCAFFOLDER)
10. IRFAN BUDI HARJO (ASS. SCAFFOLDER)
11. MOH YUSUP (ASS. SCAFFOLDER)
12. IRKHAS ABSAR F (ASS. SCAFFOLDER)
13. M ANDREAN S (ASS. SCAFFOLDER)
14. NURHADI (ASS. SCAFFOLDER)
15. ERY KUSWANTO (ASS. SCAFFOLDER)
16. MUHAMMAD MUHTADI (INSPECTOR)
17. SLAMET SUKIRJO (ASS. SCAFFOLDER)
18. SUPRATO (ASS. SCAFFOLDER)
19. SUYANTO (ASS. SCAFFOLDER)
20. NANANG SETIAWAN (FOREMAN)
21. FANDI ACHMAD (ASS. SCAFFOLDER)
22. SARINTO (ASS. SCAFFOLDER)
23. ADHI BUDIARTO (ASS. SCAFFOLDER)
24. ADE KURNIAWAN (ASS. SCAFFOLDER)
25. BAMBANG SUPENO (ASS. SCAFFOLDER)
26. TEGUH PRAYITNO (ASS. SCAFFOLDER)
27. ABDUL RAHMAN (ASS. SCAFFOLDER)
28. NURUL EGI (ASS. SCAFFOLDER)
29. GRAFIKA (ASS. SCAFFOLDER)
30. AHMAD NOOR ROHIM (ASS. SCAFFOLDER)
31. MUHAMMAD BAHRUL ULUM (ASS. SCAFFOLDER)
32. AHMAD TONI PRAYOGO (ASS. SCAFFOLDER)
33. SUHARY (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :
 Date : 1-Aug-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 1-Aug-2019

(Time) 17.00 to 22.00

2. WORKING AREA (detailed location) : PIPE RACK 137 A, B

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : SUGIANTORO

5. CELLPHONE NUMBER : +62 823-8270-8061

6. LIST OF WORKERS DOING : 1. ABDUL KASIM LESTALUHU (FOREMAN)

OVER TIME (Name & Position)
. 5. TEGUH PRASETYO (ASS. SCAFFOLDER)
2. HERI PURNOMO (ASS. SCAFFOLDER)
3. HARIS SUSMANTORO (ASS. SCAFFOLDER)
4. A. SURYO PUTRA NEGORO (ASS. SCAFFOLDER)
6. WAHIRMANTO (ASS. SCAFFOLDER)
7. EKO WAHYUDI 2 (ASS. SCAFFOLDER)
8. EKO SULISTYONO (ASS. SCAFFOLDER)
9. ADIB SUSILO (ASS. SCAFFOLDER)
10. NUR HASIM HARJO (ASS. SCAFFOLDER)
11. MADINAR (ASS. SCAFFOLDER)
12. IRFAN CHOIRUL ANAM (ASS. SCAFFOLDER)
13. ARI YADI RESERTO (ASS. SCAFFOLDER)
14. SABAR ROHMAN (ASS. SCAFFOLDER)
15. RUDIANTO (FOREMAN)
16. AHMAD ZAENI NASRULLAH (ASS. SCAFFOLDER)
17. TEGUH HARIYANTO (ASS. SCAFFOLDER)
18. MUHAMMAD RIQY ARAMA (ASS. SCAFFOLDER)
19. NANANG NORISWANTO (ASS. SCAFFOLDER)
20. ASIS (ASS. SCAFFOLDER)
21. SUBKAN (ASS. SCAFFOLDER)
22. KALYUBI (ASS. SCAFFOLDER)
23. AHMAD TURKAMUN (ASS. SCAFFOLDER)
24. NOVAN SANTOSO (ASS. SCAFFOLDER)
25. SIGIT PANCA (ASS. SCAFFOLDER)
26. IMRON JAMALUDIN I (ASS. SCAFFOLDER)
27. WAHYU ARIF TIANTO (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 1-Aug-2019
 NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 1-Aug-2019

(Time) 17.00 to 22.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : AMON

5. CELLPHONE NUMBER : +62 852-1700-7101

6. LIST OF WORKERS DOING : 1. BAYU HARDIANTO (FOREMAN)

OVER TIME (Name & Position)
. 5. M. ILYAS (SCAFFOLDER)
2. SIRIN (ASS. SCAFFOLDER)
3. AGOS N (ASS. SCAFFOLDER)
4. FAHMI SAHAB (ASS. SCAFFOLDER)
6. EKO WAHYUDI 1 (ASS. SCAFFOLDER)
7. M. SAMSUDIN (ASS. SCAFFOLDER)
8. NANDA PRATAMA (SCAFFOLDER)
9. ACHMAD SYAIFUDIN (INSPECTOR)
10. NANANG PRASETYO (SCAFFOLDER)
11. JOYO PAMUNGKAS (SCAFFOLDER)
12. SAMSIR (FOREMAN)
13. KHOIRUL ANAS (ASS. SCAFFOLDER)
14. ANDRIYANI NST (ASS. SCAFFOLDER)
15. M SHOKEH (ASS. SCAFFOLDER)
16. NURHADI B (ASS. SCAFFOLDER)
17. KUSWO MARTONO (ASS. SCAFFOLDER)
18. RIDHO ILLAHI (ASS. SCAFFOLDER)
19. BUDI HARSO (ASS. SCAFFOLDER)
20. WARDOYO (ASS. SCAFFOLDER)
21. BILAL WAHYU (ASS. SCAFFOLDER)
22. NURUDIN KHALIM MULLOH (ASS. SCAFFOLDER)
23. EKO WIDODO (FOREMAN)
24. ARFANI (SCAFFOLDER)
25. SAFIUDIN (ASS. SCAFFOLDER)
26. M. NURZEN (ASS. SCAFFOLDER)
27. AMAT AFROZI (ASS. SCAFFOLDER)
28. IHWAN FAUZI (ASS. SCAFFOLDER)
29. PARIYANTO (ASS. SCAFFOLDER)
30. DJULIANTO (ASS. SCAFFOLDER)
31. BAMBANG HERDIANTO (ASS. SCAFFOLDER)
32. YUSUP BAKHTIAR (ASS. SCAFFOLDER)
33. IAN BAHRUN (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 1-Aug-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 1-Aug-2019

(Time) 17.00 to 22.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : GATOT HERUYANTO

5. CELLPHONE NUMBER : +62 853-3198-5558

6. LIST OF WORKERS DOING
OVER TIME (Name & Position)
. 5. SUNARDI 1 (ASS. SCAFFOLDER)
: 1. ERIK WICAHYONO (FOREMAN) 34. MASDUKI ARIFIN (ASS. SCAFFOLDER)
2. SIS AFANDI (ASS. SCAFFOLDER) 35. M ULIL ABSOR (ASS. SCAFFOLDER)
3. BAGUS A (ASS. SCAFFOLDER) 36. KHOIRUL JAMAL (ASS. SCAFFOLDER)
4. URIP JUMADI (ASS. SCAFFOLDER) 37. SYAIDA AMBYAH (INSPECTOR)
38. TA'AT PRIYAMOKO (FOREMAN)
6. JOKO CASMITO (ASS. SCAFFOLDER) 39. AJI MUKTIONO ( SCAFFOLDER)
7. HARMOKO (ASS. SCAFFOLDER) 40. DEDE YUSUP (ASS. SCAFFOLDER)
8. AGUS SUPRIYANTO (ASS. SCAFFOLDER) 41. SUSWANTO (ASS. SCAFFOLDER)
9. WILDAN MUKHOLADUN D (ASS. SCAFFOLDER) 42. IMRON SUBEKTI (ASS. SCAFFOLDER)
10. SYAMSUDIN (ASS. SCAFFOLDER) 43. NICKY DZIYA'ULHAKIM (ASS. SCAFFOLDER)
11. IWAN SANTOSO (ASS. SCAFFOLDER) 44. WIHARNO (ASS. SCAFFOLDER)
12. WAHYU JULIANTO (ASS. SCAFFOLDER) 45. WAHYONO (ASS. SCAFFOLDER)
13. NURYANTO (ASS. SCAFFOLDER) 46. SALIKIN (ASS. SCAFFOLDER)
14. KARIAJI (FOREMAN) 47. HENI PRIYANTO (ASS. SCAFFOLDER)
15. RIDHO ALBERT NUGROHO (ASS. SCAFFOLDER 48. FAHMI YULIZAR (ASS. SCAFFOLDER)
16. ZIKKI ZULKANAEN (ASS. SCAFFOLDER) 49. FERNANDO (ASS. SCAFFOLDER)
17. FISAL MAULANA (INSPECTOR)
18. SUBHAN (ASS. SCAFFOLDER)
19. CHOIRUL IMAM SUBEKTI (ASS. SCAFFOLDER)
20. UPRIYANTO (ASS. SCAFFOLDER)
21. MUHAMMAD MASRAP (ASS. SCAFFOLDER)
22. FERRY ROHAYAT (ASS. SCAFFOLDER)
23. BAGAS DWI HANDIKA P (ASS. SCAFFOLDER)
24. WARTONO (ASS. SCAFFOLDER)
25. M SABRI (ASS. SCAFFOLDER)
26. RODI (ASS. SCAFFOLDER)
27. ERY IRAWAN (FOREMAN)
28. HARYANTO (ASS. SCAFFOLDER)
29. LIM SWI KING (ASS. SCAFFOLDER)
30. WAHYUDIN (ASS. SCAFFOLDER)
31. M IKWAN SARIFUDIN (ASS. SCAFFOLDER)
32. DAKIRIN (ASS. SCAFFOLDER)
33. NUR YAENUDIN (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 1-Aug-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) THURSDAY (Date) 1-Aug-2019

(Time) 19.00 to 6.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND MODIFICATION SCAFFOLDING

4. RESPONSIBLE PERSON : SLAMET AFTHAN BUDIANTO

5. CELLPHONE NUMBER : +62 813-7848-1827

6. LIST OF WORKERS DOING : 1. ALIP MURTOPO (SCAFFOLDER)

OVER TIME (Name & Position)
. 5. M. ZAM'AN NASIR (ASS. SCAFFOLDER)
2. WAHYU ARIZAL KADAFI (ASS. SCAFFOLDER)
3. AMIRUDIN (ASS. SCAFFOLDER)
4. AMAT GUNTUR ( SCAFFOLDER)
6. ANDIK PUGUH SETI (ASS. SCAFFOLDER)AWAN
7. MADRI (ASS. SCAFFOLDER)
8. YOU NOW BAGUS Y (ASS. SCAFFOLDER)
9. IMRON SUBEKHI (ASS. SCAFFOLDER)
10. DEDE JAELANI (ASS. SCAFFOLDER)
11. SUWARNO (ASS. SCAFFOLDER)
12. ROHMANNI (ASS. SCAFFOLDER)
13. ANANDA RIZKY N (ASS. SCAFFOLDER)
14. EKO SAMSUL ARIFIN (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
 Ref. No. :

Date : 27-Jul-2019
NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 13.00 to 22.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : INDRANADI

5. CELLPHONE NUMBER : +62813-6418-8981

6. LIST OF WORKERS DOING : 1. A. TOHIRIN (FOREMAN)

OVER TIME (Name & Position)
. 5. SUMARDI (ASS. SCAFFOLDER)
2. SUHARY (ASS. SCAFFOLDER)
3. ARBIYANTO (ASS. SCAFFOLDER)
4. BUDI IRAWAN (ASS. SCAFFOLDER)
6. GRAFIKA (ASS. SCAFFOLDER)
7. ROHMAN (ASS. SCAFFOLDER)
8. ABDUL RAHMAN (ASS. SCAFFOLDER)
9. DIMAS DIAN SAPURTRA (ASS. SCAFFOLDER)
10. IRFAN BUDI HARJO (ASS. SCAFFOLDER)
11. AHMAD TONI PRAYOGO (ASS. SCAFFODLER)
12. IRKHAS ABSAR F (ASS. SCAFFOLDER)
13. M. ANDREAN S (ASS. SCAFFOLDER)
14. ADE KURNIAWAN (ASS. SCAFFOLDER)
15. BAMBANG SUPENO ( SCAFFOLDER)
16. MUHAMMAD MUHTADI (INSPECTOR)
17. SARINTO (ASS. SCAFFOLDER)
18. SUPRATO (ASS. SCAFFOLDER)
19. SUYANTO (ASS. SCAFFOLDER)
20. NANANG SETIAWAN (FOREMAN)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :
 Date : 27-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 13.00 to 22.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : SUGIANTORO

5. CELLPHONE NUMBER : +62 823-8270-8061

6. LIST OF WORKERS DOING : 1. ABDUL KASIM LESTALUHU (FOREMAN)

OVER TIME (Name & Position)
. 5. TEGUH PRASETYO (ASS. SCAFFOLDER)
2. HERI PURNOMO (ASS. SCAFFOLDER)
3. AHMAD TURKAMUN (ASS. SCAFFOLDER)
4. A. SURYO PUTRA NEGORO (ASS. SCAFFOLDER)
6. WAHIRMANTO (ASS. SCAFFOLDER)
7. EKO WAHYUDI 2 (ASS. SCAFFOLDER)
8. EKO SULISTYONO (ASS. SCAFFOLDER)
9. ADIB SUSILO (ASS. SCAFFOLDER)
10. NUR HASIM HARJO (ASS. SCAFFOLDER)
11. MADINAR (ASS. SCAFFOLDER)
12. IRFAN CHOIRUL ANAM (ASS. SCAFFOLDER)
13. ARI YADI RESERTO (ASS. SCAFFOLDER)
14. SABAR ROHMAN (ASS. SCAFFOLDER)
15. RUDIANTO (FOREMAN)
16. AHMAD ZAENI NASRULLAH (ASS. SCAFFOLDER)
17. TEGUH HARIYANTO (ASS. SCAFFOLDER)
18. MUHAMMAD RIQY ARAMA (ASS. SCAFFOLDER)
19. NANANG NORISWANTO (ASS. SCAFFOLDER)
20. ASIS (ASS. SCAFFOLDER)
21. KALYUBI (ASS. SCAFFOLDER)
22. SUBKAN (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 27-Jul-2019
 NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 13.00 to 22.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : AMON

5. CELLPHONE NUMBER : +62 852-1700-7101

6. LIST OF WORKERS DOING : 1. BAYU HARDIANTO (FOREMAN)

OVER TIME (Name & Position)
. 5. BAMBANG HERDIANTO (ASS. SCAFFOLDER)
2. SIRIN (ASS. SCAFFOLDER)
3. AGOS N (ASS. SCAFFOLDER)
4. FAHMI SAHAB (ASS. SCAFFOLDER)
6. EKO WAHYUDI 1 (ASS. SCAFFOLDER)
7. AMAT AFROZI (ASS. SCAFFOLDER)
8. NURUDIN KHALIM MULLOH (ASS. SCAFFOLDER)
9. ACHMAD SYAIFUDIN (INSPECTOR)
10. NANANG PRASETYO (SCAFFOLDER)
11. JOYO PAMUNGKAS (SCAFFOLDER)
12. SAMSIR (FOREMAN)
13. M. NURZEN (ASS. SCAFFOLDER)
14. ANDRIYANI NST (ASS. SCAFFOLDER)
15. RODI (ASS. SCAFFOLDER)
16. EKO WIDODO (FOREMAN)
17. KUSWO MARTONO (ASS. SCAFFOLDER)
18. WARDOYO (ASS. SCAFFOLDER)
19. BILAL WAHYU (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 27-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 13.00 to 22.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : GATOT HERUYANTO

5. CELLPHONE NUMBER : +62 853-3198-5558

6. LIST OF WORKERS DOING
OVER TIME (Name & Position)
. 5. SUNARDI 1 (ASS. SCAFFOLDER)
: 1. ERIK WICAHYONO (FOREMAN) 34. MASDUKI ARIFIN (ASS. SCAFFOLDER)
2. AJI MUKTIONO (SCAFFOLDER) 35. WAHYU ARIF TIANTO (ASS. SCAFFODLER)
3. BAGUS A (ASS. SCAFFOLDER) 36. NOVAN SANTOSO (ASS. SCAFFOLDER)
4. URIP JUMADI (ASS. SCAFFOLDER) 37. TA'AT PRIYATMOKO (FOREMAN)
6. JOKO CASMITO (ASS. SCAFFOLDER)
7. HARMOKO (ASS. SCAFFOLDER)
8. AGUS SUPRIYANTO (ASS. SCAFFOLDER)
9. WILDAN MUKHOLADUN D (ASS. SCAFFOLDER)
10. SALIKIN (ASS. SCAFFOLDER)
11. SIGIT PANCA NOVIANTO (ASS. SCAFFOLDER)
12. WAHYU JULIANTO (ASS. SCAFFOLDER)
13. HENI PARYANTO (ASS. SCAFFOLDER)
14. FAHMI YULIZAR (ASS. SCAFFOLDER)
15. FERNANDO (ASS. SCAFFOLDER)
16. FISAL MAULANA (INSPECTOR)
17. WAHYONO (ASS. SCAFFOLDER)
18. SIGID PANCA (ASS. SCAFFOLDER)
18. WARTONO (ASS. SCAFFOLDER)
20. IWAN SANTOSO (ASS. SCAFFOLDER)
21. SYAMSUDIN (ASS. SCAFFOLDER)
22. NURYANTO (ASS. SCAFFOLDER)
23. SYAIDA AMBYAH (INSPECTOR)
24. ERY IRAWAN (FOREMAN)
25. HARYANTO (ASS. SCAFFOLDER)
26. LIM SWI KING (ASS. SCAFFOLDER)
27. DEDE YUSUP K (ASS. SCAFFOLDER)
28. M IKWAN S (ASS. SCAFFOLDER)
29. DAKIRIN (ASS. SCAFFOLDER)
30. GINANJAR GEDE (ASS. SCAFFOLDER)
31. NUR YAENUDIN (ASS. SCAFFOLDER)
32. M ULIL ABSOR (ASS. SCAFFOLDER)
33. KHOIRUL JAMAL (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 27-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 13.00 to 22.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : BASIR

5. CELLPHONE NUMBER : +62823-8933-0440

6. LIST OF WORKERS DOING : 1. MOCH. MARTONI (FOREMAN)

OVER TIME (Name & Position)
. 5. SHOLIKHUL UMAR (ASS. SCAFFOLDER)
2. IKLIL FAUZI (ASS. SCAFFOLDER)
3. M. MEGA DANI (ASS. SCAFFOLDER)
4. ADI SETIAWAN (ASS. SCAFFOLDER)
6. NUR HIDAYAT (ASS. SCAFFOLDER)
7. DENI ALI RAMBANG (ASS. SCAFFOLDER)
8. M. ARIF FADJRIN (ASS. SCAFFOLDER)
9. AGUS PURNOMO (ASS. SCAFFOLDER)
10. AZADIEN ALFAIN ZIDANE (ASS. SCAFFOLDER)
11. IWAN ANDIKA (SCAFFOLDER)
12. RIYANTO (ASS. SCAFFOLDER)
13. SYAIFUL ANWAR (FOREMAN)
14. M. ZULFIKAR (ASS. SCAFFOLDER)
15. GIANTO (ASS. SCAFFOLDER)
16. JUSMADI (ASS. SCAFFOLDER)
17. ALI SANDRA (SCAFFOLDER)
18. OPI (ASS. SCAFFOLDER)
19. IDA BAGUS BAYU DEWAJI (ASS. SCAFFOLDER)
20. WAHYUDI (ASS. SCAFFOLDER)
21. MISWANTO (ASS. SCAFFOLDER)
22. IMAM NUR ROFIK (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 27-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)
 M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 13.00 to 22.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - MAINTANANCE MATERIAL AND DELIVERY MATERIAL TO WORK AREA

- INSTALL AND MODIFICATION SCAFFOLDING

4. RESPONSIBLE PERSON : AINUR ROFIK

5. CELLPHONE NUMBER : +62 831-6400-3083

6. LIST OF WORKERS DOING : 1. MUHAMMAD TAUFIQ (ASS. SCAFFOLDER)

OVER TIME (Name & Position) 2. KARNALI (ASS. SCAFFOLDER)
3. DURYANTO (ASS. SCAFFOLDER)
4. M MUSYORI (ASS. SCAFFOLDER)
. 5. KAHARUDIN (ASS. SCAFFOLDER)
6. NUR ROCHIMIN (ASS. SCAFFOLDER)
7. DIAN ALANUARI (ASS. SCAFFOLDER)
8. SURATMAN (SCAFFOLDER)
9. MAKMURRODIN (INSPECTOR)
10 M RISQON (ASS. SCAFFOLDER)
11. RAHMAD DONI (SPV)
12. FAKIHUDIN (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 27-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)
 M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SATURDAY (Date) 27-Jul-2019

(Time) 19.00 to 6.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND MODIFICATION SCAFFOLDING

4. RESPONSIBLE PERSON : KARIAJI

5. CELLPHONE NUMBER : +62852-6440-9089

6. LIST OF WORKERS DOING : 1. RIDHO ALBERTH NUGROHO (ASS. SCAFFOLDER)

OVER TIME (Name & Position) 2. IMRON JAMALUDIN IMAWAN (ASS. SCAFFOLDER)
3. M SABRI (ASS. SCAFFOLDER)
4. SUBHAN (ASS. SCAFFOLDER)
. 5. CHOIRUL IMAM SUBEKTI (ASS. SCAFFOLDER)
6. UPRIYANTO (ASS. SCAFFOLDER)
7. MUHAMMAD MASRAP (ASS. SCAFFOLDER)
8. FERRY ROHAYAT (ASS. SCAFFOLDER)
9. BAGAS DWI HANDIKA PUTRA (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 27-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)
 Position :
1. WORKING DAY, DATE & TIME
2. WORKING AREA (detailed location)
3. WORK ACTIVITIES
4. RESPONSIBLE PERSON
5. CELLPHONE NUMBER
6. LIST OF WORKERS DOING
OVER TIME (Name & Position)
. 5. ACHMAD MUSLIMIN (ASS. SCAFFOLDER)
Project Participants
BTG/BOP/CIVIL/SF *)
Heru Tjahjono
Site Coordinator
Note : Valid by Company Stamp
Note: Overtime should be above 6 pm (di atas jam 6 sore)
*)
Strikethrough / cross the un-necessary ones
Position :
: (Day) SUNDAY (Date) 27-Jul-2019
(Time) 7.00 to 22.00
: FABRIC FILTER
: -INSTALL AND REMOVE SCAFFOLDING
: RAHMAD DONI
: +62812-6152-6214
: 1. NICOLAUS O (FOREMAN)
2. SAHID FAHMI ZAKA (ASS. SCAFFOLDER)
3. ANDRIK SETIAWAN (INSPECTOR)
4. M. KHOLISUL ROMADHON (SCAFFOLDER)
6. JULI HARRY (ASS. SCAFFOLDER)
7. IFAN FAUZI (ASS. SCAFFOLDER)
8. AMAT MUSLIH (ASS. SCAFFOLDER)
9. ROMI IRDAL (ASS. SCAFFOLDER)
10. ROHMAT HS (ASS. SCAFFOLDER)
11. BANI K (ASS. SCAFFOLDER)
12. JUMAHIL (ASS. SCAFFOLDER)
13. DHAFA PRATAMA P (ASS. SCAFFOLDER)
14. SLAMET AFTHAN BUDIANTO (FOREMAN)
15. ALIP MURTOPO (SCAFFOLDER)
16. WAHYU ARIZAL KADAFI (ASS. SCAFFOLDER)
17. AMIRUDIN (ASS. SCAFFOLDER)
18. AMAT GUNTUR ( SCAFFOLDER)
19. M. ZAM'AN NASIR (ASS. SCAFFOLDER)
20. ANDIK PUGUH SETI (ASS. SCAFFOLDER)AWAN
21. MADRI (ASS. SCAFFOLDER)
22. EKO SAMSUL ARIFIN (ASS. SCAFFOLDER)
23. IMRON SUBEKHI (ASS. SCAFFOLDER)
24. DEDE JAELANI (ASS. SCAFFOLDER)
25. SUWARNO (ASS. SCAFFOLDER)
26. ROHMANNI (ASS. SCAFFOLDER)
27. ANANDA RIZKY N (ASS. SCAFFOLDER)
Nawakara
(Person in Charge)
Position : ______________________
 Ref. No. :

Date : 28-Jul-2019
NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 7.00 to 18.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : INDRANADI

5. CELLPHONE NUMBER : +62813-6418-8981

6. LIST OF WORKERS DOING : 1. A. TOHIRIN (FOREMAN)

OVER TIME (Name & Position)
. 5. SUMARDI (ASS. SCAFFOLDER)
2. MUHAMMAD BAHRULL ULUM (ASS. SCAFFOLDER)
3. ARBIYANTO (ASS. SCAFFOLDER)
4. BUDI IRAWAN (ASS. SCAFFOLDER)
6. MUHAMMAD CHOTIBUL UMAM (ASS. SCAFFOLDER)
7. ROHMAN (ASS. SCAFFOLDER)
8. AHMAD NOOR ROHIM (ASS. SCAFFOLDER)
9. DIMAS DIAN SAPURTRA (ASS. SCAFFOLDER)
10. IRFAN BUDI HARJO (ASS. SCAFFOLDER)
11. AHMAD TONI PRAYOGO (ASS. SCAFFODLER)
12. IRKHAS ABSAR F (ASS. SCAFFOLDER)
13. M. ANDREAN S (ASS. SCAFFOLDER)
14. NURHADI (ASS. SCAFFOLDER)
15. ERY KUSWANTO (ASS. SCAFFOLDER)
16. MUHAMMAD MUHTADI (INSPECTOR)
17. SLAMET SUKIRJO (ASS. SCAFFOLDER)
18. SUPRATO (ASS. SCAFFOLDER)
19. SUYANTO (ASS. SCAFFOLDER)
20. NANANG SETIAWAN (FOREMAN)
21. FANDI ACHMAD (ASS. SCAFFOLDER)
22. SARINTO (ASS. SCAFFOLDER)
23. ADHI BUDIARTO (ASS. SCAFFOLDER)
24. ADE KURNIAWAN (ASS. SCAFFOLDER)
25. BAMBANG SUPENO ( SCAFFOLDER)
26. TEGUH PRAYITNO (SCAFFOLDER)
27. SUHARY (ASS. SCAFFOLDER)
28. NURUL EGI (ASS. SCAFFOLDER)
29. GRAFIKA (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :
 Date : 28-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 7.00 to 18.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : SUGIANTORO

5. CELLPHONE NUMBER : +62 823-8270-8061

6. LIST OF WORKERS DOING : 1. ABDUL KASIM LESTALUHU (FOREMAN)

OVER TIME (Name & Position)
. 5. TEGUH PRASETYO (ASS. SCAFFOLDER)
2. HERI PURNOMO (ASS. SCAFFOLDER)
3. AHMAD TURKAMUN (ASS. SCAFFOLDER)
4. A. SURYO PUTRA NEGORO (ASS. SCAFFOLDER)
6. WAHIRMANTO (ASS. SCAFFOLDER)
7. EKO WAHYUDI 2 (ASS. SCAFFOLDER)
8. EKO SULISTYONO (ASS. SCAFFOLDER)
9. ADIB SUSILO (ASS. SCAFFOLDER)
10. NUR HASIM HARJO (ASS. SCAFFOLDER)
11. MADINAR (ASS. SCAFFOLDER)
12. IRFAN CHOIRUL ANAM (ASS. SCAFFOLDER)
13. ARI YADI RESERTO (ASS. SCAFFOLDER)
14. SABAR ROHMAN (ASS. SCAFFOLDER)
15. RUDIANTO (FOREMAN)
16. AHMAD ZAENI NASRULLAH (ASS. SCAFFOLDER)
17. TEGUH HARIYANTO (ASS. SCAFFOLDER)
18. MUHAMMAD RIQY ARAMA (ASS. SCAFFOLDER)
19. NANANG NORISWANTO (ASS. SCAFFOLDER)
20. ASIS (ASS. SCAFFOLDER)
21. KALYUBI (ASS. SCAFFOLDER)
22. SUBKAN (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 28-Jul-2019
 NOTIFICATION OF OVERTIME/HOLIDAY WORK
Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 7.00 to 18.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : AMON

5. CELLPHONE NUMBER : +62 852-1700-7101

6. LIST OF WORKERS DOING : 1. BAYU HARDIANTO (FOREMAN)

OVER TIME (Name & Position)
. 5. M. ILYAS (SCAFFOLDER)
2. SIRIN (ASS. SCAFFOLDER)
3. AGOS N (ASS. SCAFFOLDER)
4. FAHMI SAHAB (ASS. SCAFFOLDER)
6. EKO WAHYUDI 1 (ASS. SCAFFOLDER)
7. BAMBANG HERDIANTO (ASS. SCAFFOLDER)
8. NURUDIN KHALIM MULLOH (ASS. SCAFFOLDER)
9. ACHMAD SYAIFUDIN (INSPECTOR)
10. NANANG PRASETYO (SCAFFOLDER)
11. JOYO PAMUNGKAS (SCAFFOLDER)
12. SAMSIR (FOREMAN)
13. AMAT AFROZI (ASS. SCAFFOLDER)
14. ANDRIYANI NST (ASS. SCAFFOLDER)
15. M. NURZEN (ASS. SCAFFOLDER)
16. NURHADI (ASS. SCAFFOLDER)
17. KUSWO MARTONO (ASS. SCAFFOLDER)
18. RIDHO ILLAHI (ASS. SCAFFOLDER)
19. BUDI HARSO (ASS. SCAFFOLDER)
20. WARDOYO (ASS. SCAFFOLDER)
21. BILAL WAHYU (ASS. SCAFFOLDER)
22. RODI (ASS. SCAFFOLDER)
23. EKO WIDODO (FOREMAN)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 28-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 7.00 to 18.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : GATOT HERUYANTO

5. CELLPHONE NUMBER : +62 853-3198-5558

6. LIST OF WORKERS DOING
OVER TIME (Name & Position)
. 5. SUNARDI 1 (ASS. SCAFFOLDER)
: 1. ERIK WICAHYONO (FOREMAN) 34. MASDUKI ARIFIN (ASS. SCAFFOLDER)
2. SIS AFANDI (ASS. SCAFFOLDER) 35. WAHYU ARIF TIANTO (ASS. SCAFFODLER)
3. BAGUS A (ASS. SCAFFOLDER) 36. NOVAN SANTOSO (ASS. SCAFFOLDER)
4. URIP JUMADI (ASS. SCAFFOLDER) 37. TA'AT PRIYATMOKO (FOREMAN)
38. AJI MUKTIONO (SCAFFOLDER)
6. JOKO CASMITO (ASS. SCAFFOLDER) 39. DEDE YUSUP K (ASS. SCAFFOLDER)
7. HARMOKO (ASS. SCAFFOLDER) 40. SUSWANTO (ASS. SCAFFOLDER)
8. AGUS SUPRIYANTO (ASS. SCAFFOLDER)
9. WILDAN MUKHOLADUN D (ASS. SCAFFOLDER)
10. SALIKIN (ASS. SCAFFOLDER)
11. SIGIT PANCA NOVIANTO (ASS. SCAFFOLDER)
12. WAHYU JULIANTO (ASS. SCAFFOLDER)
13. HENI PARYANTO (ASS. SCAFFOLDER)
14. FAHMI YULIZAR (ASS. SCAFFOLDER)
15. FERNANDO (ASS. SCAFFOLDER)
16. FISAL MAULANA (INSPECTOR)
17. WAHYONO (ASS. SCAFFOLDER)
18. SIGID PANCA (ASS. SCAFFOLDER)
18. WARTONO (ASS. SCAFFOLDER)
20. IWAN SANTOSO (ASS. SCAFFOLDER)
21. SYAMSUDIN (ASS. SCAFFOLDER)
22. NURYANTO (ASS. SCAFFOLDER)
23. SYAIDA AMBYAH (INSPECTOR)
24. ERY IRAWAN (FOREMAN)
25. HARYANTO (ASS. SCAFFOLDER)
26. LIM SWI KING (ASS. SCAFFOLDER)
27. SUSWANTO (ASS. SCAFFOLDER)
28. M IKWAN S (ASS. SCAFFOLDER)
29. DAKIRIN (ASS. SCAFFOLDER)
30. GINANJAR GEDE (ASS. SCAFFOLDER)
31. NUR YAENUDIN (ASS. SCAFFOLDER)
32. M ULIL ABSOR (ASS. SCAFFOLDER)
33. KHOIRUL JAMAL (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 28-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 7.00 to 18.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - INSTALL AND REMOVE SCAFFOLDING

4. RESPONSIBLE PERSON : BASIR

5. CELLPHONE NUMBER : +62823-8933-0440

6. LIST OF WORKERS DOING : 1. MOCH. MARTONI (FOREMAN)

OVER TIME (Name & Position)
. 5. SHOLIKHUL UMAR (ASS. SCAFFOLDER)
2. IKLIL FAUZI (ASS. SCAFFOLDER)
3. M. MEGA DANI (ASS. SCAFFOLDER)
4. ADI SETIAWAN (ASS. SCAFFOLDER)
6. NUR HIDAYAT (ASS. SCAFFOLDER)
7. ALI SANDRA (SCAFFOLDER)
8. M. ARIF FADJRIN (ASS. SCAFFOLDER)
9. AGUS PURNOMO (ASS. SCAFFOLDER)
10. AZADIEN ALFAIN ZIDANE (ASS. SCAFFOLDER)
11. IWAN ANDIKA (SCAFFOLDER)
12. RIYANTO (ASS. SCAFFOLDER)
13. SYAIFUL ANWAR (FOREMAN)
14. M. ZULFIKAR (ASS. SCAFFOLDER)
15. GIANTO (ASS. SCAFFOLDER)
16. JUSMADI (ASS. SCAFFOLDER)
17. DENI ALI RAMBANG (ASS. SCAFFOLDER)
18. OPI (ASS. SCAFFOLDER)
19. IMAM NUR ROFIK (ASS. SCAFFOLDER)
20. WAHYUDI (ASS. SCAFFOLDER)
21. MISWANTO (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 28-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)
 M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 7.00 to 18.00

2. WORKING AREA (detailed location) : ALL AREA

3. WORK ACTIVITIES : - MAINTANANCE MATERIAL AND DELIVERY MATERIAL TO WORK AREA

- INSTALL AND MODIFICATION SCAFFOLDING

4. RESPONSIBLE PERSON : AINUR ROFIK

5. CELLPHONE NUMBER : +62 831-6400-3083

6. LIST OF WORKERS DOING : 1. MUHAMMAD TAUFIQ (ASS. SCAFFOLDER)

OVER TIME (Name & Position) 2. FAKIHUDIN (ASS. SCAFFOLDER)
3. DURYANTO (ASS. SCAFFOLDER)
4. M MUSYORI (ASS. SCAFFOLDER)
. 5. KAHARUDIN (ASS. SCAFFOLDER)
6. NUR ROCHIMIN (ASS. SCAFFOLDER)
7. DIAN ALANUARI (ASS. SCAFFOLDER)
8. SURATMAN (SCAFFOLDER)
9. MAKMURRODIN (INSPECTOR)
10 M RISQON (ASS. SCAFFOLDER)
11. RAHMAD DONI (SPV)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 28-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)
 M. ARFAH (Representative)

Position : Position :

1. WORKING DAY, DATE & TIME : (Day) SUNDAY (Date) 28-Jul-2019

(Time) 19.00 to 6.00

2. WORKING AREA (detailed location) : FABRIC FILTER 1

3. WORK ACTIVITIES : - INSTALL AND MODIFICATION SCAFFOLDING

4. RESPONSIBLE PERSON : KARIAJI

5. CELLPHONE NUMBER : +62852-6440-9089

6. LIST OF WORKERS DOING : 1. RIDHO ALBERTH NUGROHO (ASS. SCAFFOLDER)

OVER TIME (Name & Position) 2. IMRON JAMALUDIN IMAWAN (ASS. SCAFFOLDER)
3. M SABRI (ASS. SCAFFOLDER)
4. SUBHAN (ASS. SCAFFOLDER)
. 5. CHOIRUL IMAM SUBEKTI (ASS. SCAFFOLDER)
6. UPRIYANTO (ASS. SCAFFOLDER)
7. MUHAMMAD MASRAP (ASS. SCAFFOLDER)
8. FERRY ROHAYAT (ASS. SCAFFOLDER)
9. BAGAS DWI HANDIKA PUTRA (ASS. SCAFFOLDER)

Project Participants Nawakara

BTG/BOP/CIVIL/SF *)

Heru Tjahjono
(Person in Charge)
Site Coordinator Position : ______________________
Note : Valid by Company Stamp

Note: Overtime should be above 6 pm (di atas jam 6 sore)

*)
Strikethrough / cross the un-necessary ones
Ref. No. :

Date : 28-Jul-2019

NOTIFICATION OF OVERTIME/HOLIDAY WORK

Requested by, : PT. SSP Approved by, :
(Project participant)

M. ARFAH (Representative)
 Position :
1. WORKING DAY, DATE & TIME
2. WORKING AREA (detailed location)
3. WORK ACTIVITIES
4. RESPONSIBLE PERSON
5. CELLPHONE NUMBER
6. LIST OF WORKERS DOING
OVER TIME (Name & Position)
. 5. ACHMAD MUSLIMIN (ASS. SCAFFOLDER)
Project Participants
BTG/BOP/CIVIL/SF *)
Heru Tjahjono
Site Coordinator
Note : Valid by Company Stamp
Note: Overtime should be above 6 pm (di atas jam 6 sore)
*)
Strikethrough / cross the un-necessary ones
Position :
: (Day) SUNDAY (Date) 28-Jul-2019
(Time) 7.00 to 18.00
: FABRIC FILTER
: -INSTALL AND REMOVE SCAFFOLDING
: RAHMAD DONI
: +62812-6152-6214
: 1. ANANDA RIZKY N (ASS. SCAFFOLDER)
2. SAHID FAHMI ZAKA (ASS. SCAFFOLDER)
3. ANDRIK SETIAWAN (INSPECTOR)
4. M. KHOLISUL ROMADHON (SCAFFOLDER)
6. JULI HARRY (ASS. SCAFFOLDER)
7. IFAN FAUZI (ASS. SCAFFOLDER)
8. AMAT MUSLIH (ASS. SCAFFOLDER)
9. ROMI IRDAL (ASS. SCAFFOLDER)
10. ROHMAT HS (ASS. SCAFFOLDER)
11. BANI K (ASS. SCAFFOLDER)
12. JUMAHIL (ASS. SCAFFOLDER)
13. DHAFA PRATAMA P (ASS. SCAFFOLDER)
14. SLAMET AFTHAN BUDIANTO (FOREMAN)
15. ALIP MURTOPO (SCAFFOLDER)
16. ROHMANNI (ASS. SCAFFOLDER)
17. AMIRUDIN (ASS. SCAFFOLDER)
18. AMAT GUNTUR ( SCAFFOLDER)
19. M. ZAM'AN NASIR (ASS. SCAFFOLDER)
20. ANDIK PUGUH SETI (ASS. SCAFFOLDER)AWAN
21. MADRI (ASS. SCAFFOLDER)
22. EKO SAMSUL ARIFIN (ASS. SCAFFOLDER)
23. IMRON SUBEKHI (ASS. SCAFFOLDER)
24. DEDE JAELANI (ASS. SCAFFOLDER)
25. SUWARNO (ASS. SCAFFOLDER)
Nawakara
(Person in Charge)
Position : ______________________
SC-WME JOINT OPERATION ( 'SCJO" ) Ref. No. :

Date :

MATERIAL / EQUIPMENT GATE PASS

Requested b: Verified By : _______________________________
(Name of Company/Contractor) (Name of Responsible Main Contractor)

_______________________________
( Name of Responsible Person ) ( Name of Responsible Person )

Position : ______________________ Position : ______________________

METHOD OF REMOVAL FROM PROJECT SITE : Trailer Truck/Truck/Pick Up

Others (specify) : ____________________________________

Driver's Name : _______________________ Vehicle Police No. : ____________________________________

DATE AND ESTIMATED TIME OF REMOVAL FROM PROJECT SITE

Date : _______________________ Time : _________________________________

NOTE : - Regular removal hours on Mondays thru Fridays 08.00 - 17.00 WIB
- Saturdays 08.00 - 12.00 WIB

Quantity
Item No. Description of Materials / Equipment Unit In Word Reason for Removal
In Number
(Say)

Approved by SCJO Aknowledged by PT. Nawakara Perkasa Nusantara (SS-911)

(Name) (Name)
Position : ___________________________
Position : ______________________________________

SCJO Ref.No. : _________________ Date: ______________ Date : ________________Time : ________________

SECURITY CHECK AT MAIN GATE UPON ACTUAL REMOVAL FROM

DOCUMENT DISTRIBUTION
SITE

DATE : _________________ TIME :_____________ 1. ORIGINAL : PT. NPN Office

SIGNATURE : ____________________________________ 2. COPY-1 : SCJO
FULL NAME : ____________________________________ 3. COPY-2 : Contractor

Note: Valid by Company Stamp and Loading Forms