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*Note Catatan A : Good (Baik) B : Rejected (Ditolak)
Inspected by HSE Departement Diinspeksi oleh Departemen HSE Acknowledged by Site Manager Diketahui oleh Site M
Name Nama :
Position Jabatan :
Sign Tanda Tangan :
TION CHECKLIST : MOBILE ELEVATING WORK PLATFORM (MEWP)
emeriksaam :
First Monthly
:
perator :
Guardrail (Top-rail, Platform Free From Travelling Functions Warning Lamp and Alarm Leaks (from Hoses,
Mid-rail and Toe Debris and Obstruction (Forward, Reverse, Functions Lampu Remote Control Pipe Connections, Horn Klakson
Board) Pagar Platform Bebas dari Steer) Fungsi Bolak Peringatan dan Fungsi Remote Kontrol Rams and Cylinders)
Pembatas Puing dan Halangan Balik Alarm Kebocoran
nager Diketahui oleh Site Manager
Name Nama :
Sign Tanda Tangan :
Step for Acces and
Entrance Gate
Condition Terdapat Remarks Keterangan
Akses Keluar/Masuk
yang Memadai