SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN

PT. NUOVITO ASIA HOLDINGS

DAFTAR DOKUMEN (Manual Mutu)

No. Nama Dokumen Kepemilikan Jenis Dokumen

1 Manual Mutu Terpadu MR Manual Terpadu
2 Kebijakan dan Komitmen PT. Nuovito Asia Holdings MR Manual Terpadu
3 Ketentuan Penulisan Dokumen MR Manual Terpadu
4 Sistem Pengawasan dan Pengendalian dokumen MR Manual Terpadu

5 HSE Management Plan HSE Manual Terpadu

6 Sasaran dan Program HSE HSE Manual Terpadu
7 Tanggung jawab K3LL HSE Manual Terpadu
8 Manual SMK3 HSE Manual Terpadu
9 Pedoman SOP (SOP Handbook) HSE Manual Terpadu
10

11 Manual Kepegawaian HRD Manual Terpadu

12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
KUMEN No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of

Jenis Dokumen Kode/ Nomor Dokumen Revisi

Manual Terpadu MT/MR-01/III/16
Manual Terpadu MT/MR-02/III/16
Manual Terpadu MT/MR-03/III/16
Manual Terpadu MT/MR-04/III/16

Manual Terpadu MT/HSE-01/III/16

Manual Terpadu MT/HSE-02/III/16
Manual Terpadu MT/HSE-03/III/16
Manual Terpadu MT/HSE-04/III/16
Manual Terpadu MT/HSE-05/III/16

Manual Terpadu MT/HRD-01/III/16

 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN
PT. NUOVITO ASIA HOLDINGS

DAFTAR DOKUMEN (PROSEDUR MUTU HSE)

No. Nama Dokumen Kepemilikan Jenis Dokumen

1 Prosedur Identifikasi Bahaya penilaian dan pengendalian risiko HSE Prosedur Terpadu
2 Prosedur Pelaksanaan pelatihan K3LL HSE Prosedur Terpadu
3 Rencana, Pedoman, Panduan Audit dan Inspeksi K3LL HSE Prosedur Terpadu
4 Pengelolaan limbah dan sampah HSE Prosedur Terpadu
5 Prosedur Izin Kerja HSE Prosedur Terpadu
6 Short Service Employee Program HSE Prosedur Terpadu
7 Prosedur Tanggap darurat HSE Prosedur Terpadu
8 Prosedur Alat Pelindung diri (APD) HSE Prosedur Terpadu
9 Komunikasi dan Konsultasi HSE Prosedur Terpadu
10 Prosedur Ketidaksesuaian Tindakan Koreksi dan Pencegahan HSE Prosedur Terpadu
11 Management Review HSE Prosedur Terpadu
12 Prosedur Pemantauan Implementasi dan Kinerja HSE Prosedur Terpadu
13 Prosedur inspeksi K3LL HSE Prosedur Terpadu
14 Prosedur Audit Internal HSE Prosedur Terpadu
15 Penanganan Insiden, Kecelakaan, dan Penyakit akibat kerja HSE Prosedur Terpadu
16 SDM K3LL HSE Prosedur Terpadu
17 Manual Prosedur Instalasi Operasi dan Pemeliharaan MOSRM HSE Prosedur Terpadu
18 HSE Housekeeping HSE Prosedur Terpadu
19 HSE Induction and sosialization HSE Prosedur Terpadu
20
21 Contractor selection management
22 document and report control
23 Employee EHS handbook
24 HSE Audit review
25 comunication and stakeholder engagement
26 HSE Framework document
27 HSE Planning objectives and targets
28 Incident reporting and investigation
29 leadership and commitment
30 management of change
31 risk assessment and management
32 Standard Operating Procedures
33 Training and Competence
34
35
36
37
38
39
40
41
UMEN No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of

Jenis Dokumen Kode/ Nomor Dokumen Revisi

Prosedur Terpadu PT/HSE-01/IV/16
Prosedur Terpadu PT/HSE-02/IV/16
Prosedur Terpadu PT/HSE-03/IV/16
Prosedur Terpadu PT/HSE-04/IV/16
Prosedur Terpadu PT/HSE-05/IV/16
Prosedur Terpadu PT/HSE-06/IV/16
Prosedur Terpadu PT/HSE-07/IV/16
Prosedur Terpadu PT/HSE-08/IV/16
Prosedur Terpadu PT/HSE-09/IV/16
Prosedur Terpadu PT/HSE-10/IV/16
Prosedur Terpadu PT/HSE-11/IV/16
Prosedur Terpadu PT/HSE-12/IV/16
Prosedur Terpadu PT/HSE-13/IV/16
Prosedur Terpadu PT/HSE-14/IV/16
Prosedur Terpadu PT/HSE-15/IV/16
Prosedur Terpadu PT/HSE-16/IV/16
Prosedur Terpadu PT/HSE-17/IV/16
Prosedur Terpadu PT/HSE-18/IV/16
Prosedur Terpadu PT/HSE-19/IV/16
 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN No.
Date
PT. NUOVITO ASIA HOLDINGS
Rev
DAFTAR DOKUMEN (PROSEDUR MUTU HRD) Page

No. Nama Dokumen Kepemilikan Jenis Dokumen Kode/ No

1 Prosedur Penilaian Kinerja Karyawan HRD Prosedur Terpadu PT/HR
2 Medical Check Up Karyawan HRD Prosedur Terpadu PT/HR
3 Prosedur Operasional Pendidikan dan Pelatihan HRD Prosedur Terpadu PT/HR
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of

Kode/ Nomor Dokumen Revisi

PT/HRD-01/IV/16
PT/HRD-02/IV/16
PT/HRD-03/IV/16
 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN No.
Date
PT. NUOVITO ASIA HOLDINGS
Rev
DAFTAR DOKUMEN (INSTRUKSI KERJA HSE) Page

No. Nama Dokumen Kepemilikan Jenis Dokumen Kode/ No

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of

Kode/ Nomor Dokumen Revisi

 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN
PT. NUOVITO ASIA HOLDINGS

DAFTAR DOKUMEN (INSTRUKSI KERJA HRD)

No. Nama Dokumen Kepemilikan Jenis Dokumen

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of

Kode/ Nomor Dokumen Revisi

 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN
PT. NUOVITO ASIA HOLDINGS

DAFTAR DOKUMEN (FORMULIR MR)

No. Nama Formulir Kepemilikan Jenis Dokumen

1 Daftar Dokumen MR Formulir
2 Pengajuan Revisi dan Pembuangan Dokumen MR Formulir
3 Pengajuan Revisi dan pembuangan Formulir MR Formulir
4 Lembar Distribusi Dokumen MR Formulir
5 Daftar Dokumen Eksternal MR Formulir
6 Berita Acara Pemusnahan Dokumen MR Formulir
7 Pengendalian Dokumen MR Formulir
8 Tanda Terima Dokumen MR Formulir
9 MR Formulir
10 MR Formulir
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev A (0)
Page 1 of

Kode/ Nomor Form Revisi

FM/MT-MR-04/01/III/16
FM/MT-MR-04/02/III/16
FM/MT-MR-04/03/III/16
FM/MT-MR-04/04/III/16
FM/MT-MR-04/05/III/16
FM/MT-MR-04/06/III/16
FM/MT-MR-04/07/III/16
FM/MT-MR-04/08/III/16
FM/MT-MR-04/09/III/16
FM/MT-MR-04/10/III/16
 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN
PT. NUOVITO ASIA HOLDINGS

DAFTAR DOKUMEN (FORMULIR HSE)

No. Nama Formulir Kepemilikan Jenis Dokumen

1 HSE Training Program HSE Formulir
2 HSE Training Matrix HSE Formulir
3 HSE Training Overall HSE Formulir
4 Job Safety Analysis (JSA) HSE Formulir
5 Inspeksi K3LL Warehouse HSE Formulir
6 Inspeksi K3LL Office dan Umum HSE Formulir
7 HSE Induction Form HSE Formulir
8 Protokol Audit Internal HSE Formulir
9 Pelaporan Investigasi Insiden HSE Formulir
10 Tool Box Meeting HSE Formulir
11 Minute Of Meeting K3LL HSE Formulir
12 Non Conformity Report HSE Formulir
13 Identifikasi Bahaya Penilaian dan Pengendalian Risiko HSE Formulir
14 Pelaporan Awal Kecelakaan HSE Formulir
15 Laporan kejadian Hampir Celaka/Nearmiss HSE Formulir
16 Daftar No telp Darurat / penting HSE Formulir
17 Jadwal pelatihan uji coba Tanggap darurat HSE Formulir
18 Latihan Tanggap Darurat HSE Formulir
19 Daftar Tempat Evakuasi HSE Formulir
20 Laporan Keadaan Darurat HSE Formulir
21 Evaluasi Kinerja Tahunan HSE Formulir
22 Anomaly Report HSE Formulir
23 Anomaly Register HSE Formulir
24 Working permit HSE Formulir
25 Emergency Respon Plan (FIRE) HSE Formulir
26 Emergency Respon Plan (SPILL) HSE Formulir
27 Inspection of Vehicle HSE Formulir
28 Berita Acara Serah Terima APD HSE Formulir
29 HSE Formulir
30 HSE Formulir
31 HSE Formulir
32 HSE Formulir
33 HSE Formulir
34 HSE Formulir
35
No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of 2

Kode/ Nomor Form Revisi

FM/PT-HSE-02/01/IV/16
FM/PT-HSE-02/02/IV/16
FM/PT-HSE-02/03/IV/16
FM/HSE-01/V/16
FM/PT-HSE-18/01/V/16
FM/PT-HSE-18/02/V/16
FM/PT-HSE-19/01/V/16

FM/PT-HSE-08/01/IV/16
 SISTEM PENGAWASAN DAN PENGENDALIAN DOKUMEN
PT. NUOVITO ASIA HOLDINGS

DAFTAR DOKUMEN (Formulir HRD)

No. Nama Formulir Kepemilikan Jenis Dokumen

1 Medical Check Up HRD Formulir
2 Penilaian Pegawai HRD Formulir
3 HRD Formulir
4 HRD Formulir
5 HRD Formulir
6 HRD Formulir
7 HRD Formulir
8 HRD Formulir
9 HRD Formulir
10 HRD Formulir
11 HRD Formulir
12 HRD Formulir
13 HRD Formulir
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
No. FM/MT-MR-04/01/III/16
Date 31 Maret 2016
Rev 0
Page 1 of

Kode/ Nomor Form Revisi