Amati pekerja
Observed Categories - Kategori yang diamati
Personal Protecti ve Equi pment - APD Tool s, Equipment & Materi al - Alat Kerja, Material Hentikan segera jika ada tindakan tidak
aman
Posi ti on & Acti on of People - Posi si - Tindakan Workpl ace Environment - Lingkungan Kerja Buatlah pekerja nyaman
Procedure - Pros edur
Description of Observation:
WHAT - Apa Yang Terjadi Jelaskan apa yang anda lakukan dan
alasannya, Tanyakan pekerjaan dan urutannya
Sampaikan kepada supervisor yang bertanggung jawab dan tindak Ucapkan terima kasih
lanjuti tindakan perbaikan yang sudah disepakati. Laporkan form yang kepada pekerja
sudah lengkap ke HSE
STEP 2 : ACTION (N/A for Good Practice) Please attach photos etc. if available Action Taken:
Did you Talk with Responsible Person for Yes & acti on taken Yes, but she/he didn’t agree All Action already been taken by Action Taker
Correcti ve Acti on No, I couldn't fi nd No, i t corrected by me
Action Taken / Agreement / Suggestion - Tindakan yang dilakukan / Perjanjian / Saran Saran HSE SI/SV
Closed Open HSE SI/SV already been confirmed that all action "Close"
(1)
Close Date: Confirmed Date:
(2) Action Taken by: Confirmed by:
(3)
(4) ( ) ( )
(5)
Note: Reporter don’t have to fill up the back side of this card - Pengamat tidak harus mengisi lembar sebaliknya (Front) ( Back)
XXXXX Project