NOTIFICATION & WORK ORDER SHEET

Notification No. Subject / Description Of Fault / Broken

Week No. : Equipment No. :

Planned order : Equipment Description. :

Unplanned Order : Location : Interport Business Park Kariangau

Dayshift : Est. Work Duration : hrs Actual Hrs : 0.0

Night Shift : Schedule Start Date :

Work Order No.

Malfunction Start Date : Time In :

Malfunction End Date : Time Out :

Hour Meter : hrs Total Hrs : 0.0

REQUIREMENT LABOR
BADGE NO NAME POSITION BADGE NO NAME POSITION

MATERIAL / SERVICE PART

MPN Manufacture No Part Description Qty Unit Issue Voucher No Reservation No.

Action / Detail of Job / Operation

Notif No. WO :

Performed By Reviewed By Approved By

Insert your Sign Insert your Sign Insert your Sign

Mechanic / Electric Foreman / Supervisor Maint. Superintendent

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 NOTIFICATION & WORKORDER SHEET
QUALITY ASSURANCE CHECKLIST

Notification No.
Schedule Start Date :
Work Order No.
Week No. :
Subject :
Equipment No :

Catatan : Sebagai penjamin kualitasterhadap hasil pekerjaan pada unit / komponent yang tertera dala Jon Sheet Notification Order
yang telah di tanda tangani oleh Supervisor, Foreman pada form Notif ini, dan Superintendent berkewajiban mereview dan
bertangung jawab sepenuhnya terhadap isi dari job sheet form Notification Order tersebut dengan juga memastikan
semua item checklist pada form Notification Order dibawah ini telah di konfirmasi seluruhnya.

Quality Assurance Checklist Item :

1. Pastikan pekerjaan yang tertera pada Notification Order form (tindakkan perbaikan dan perawatan
system/unit) sudah terselesaikan dan system atau unit telah kembali pada speksifikasi asli
maupun kembali berfungsi dengan normal
Ensure job noted dalam Notification Order form (system / unit maintenance and repair action) have
been resolved and the system or unit has returned back to original specification or operation.

2 Pastikan semua item rekomendasi (jika ada) pada activity task dalam form sudah terselesaikan
Ensure all recommendation item (if any) in the activity task of form has been completed

3 Pastikan kualitas & penyelesaian pekerjaan sesuai dengan prosedur kerja yang ada untuk menghindari atau
meminimalisir resiko terjadinya rework atau redo job
Ensure the quality and completion of work are in accordance with the exiting work procedures to avoid and
minimize the risk of job rework or redo.

4 Pastikan semua doument pendukung sudah diselesaikan dan terlampir besama Notification Order jobsheet
form
(Contoh : jika ada Service Package, Inspection Check List, Test Perfoma)
Esnure all supporting documents have been completed and attached with Notification Order form
(Example : Service Package, Inspection Check List, Perfomance Test)

5 Pastikan unit yang telah di selesaikan tindakan perbaikan ataupun perawatannya sudah dalam posisi &
kondisi aman untuk kembali beroperasi
Ensure the unit which has had its repair or maintenance completed to handed back in a safe position and
condition to get back for operation

Superintendent Comment

Superintendent Approval

Insert your Sign

Superintendent Date Signature

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 Backlog Record

Equipment No. : Notif No. : WO No. : Date :

Priority
No Subject Fault Defect Found Action Need To Do Components Part No Part Description Qty Remarks
P1 P2 P3

10

Legends :
P1 :Immediately Action
P2 :Next Week Plan (including preparation tools, parts & PRTS..etc) Inspection by Checked by Aknowledge by
P3 :Next PM_Service Including

Mechanic / Electrician Supervisor Superintendent

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REGULAR SAFETY MECHANICAL INSPECTION
Dump Truck
No OK Not N/A
Task Description / Deskripsi Tugas Remarks / Comments
OK
A. PRE-START SAFETY ACTIVITIES

1 Sistem Pemutus Penguncian

Lock Out System
2 Pagar
Hand Rails
3 Tangga & Tempat Pijakan
Ladders & Steps
4 Sistem Pemadam Otomatis-Bila Ada
Fire Suppression System-If Equipped
5 Spion
Mirror
6 Fire Extinguisher
Tabung Pemadam kebakaran
7
ROPS / FOPS

8 Kondisi Sabuk Pengaman

Safety Belt Condition
9 Lampu Rotari
Rotary Light / Strobe Light
10 Alarm Mundur
Reverse Alarm
11 Klakson
Horn
12 Kursi Operator dan Penyetel
Operator's Seat & Adjustable
13 Tutup Pengaman
Safety Guard - Fan, Belt, Driveshaft, Radiator etc.
14 Tanda/Label Peringatan Tersedia & Jelas
All Warning Tags/Safety Labels Fitted & Clear
15 Kelengkapan Sistem Hidrolik/Angin
Hydraulic/Pneumatic Attachments

B. ENGINE

1 Kebocoran Oli
Oil Leaks
2 Kebocoran Bahan Bakar
Fuel Leaks
3 Kebocoran Air Radiator
Water Leaks
4 Kebocoran Udara
Air Leaks
5 Tegangan Belt
Belt Tension
6 Sambungan2 & Dudukan
Linkages & Mountings
7 Semua Baut Pengikat
All Retaining Bolts
8 Kondisi Semua Hose / Cacat
All Hoses Fuel & Air System For Condition/Chaffing
9 Kondisi Hose Radiator, Kekencangan Klam
Radiator Hoses Condition, Clamps For Tightness
10 Indikator Level Air Radiator
Cooling System Level Indicator
11 Kebocoran Sistem Pemasukkan Udara
Induction System For Leaks, Clamps For Tightness
12 Kebocoran Gas Buang
Exhaust System For Leaks

C. HYDRAULIC

1 Kebocoran Oli (Hidrolik Sistem)

Oil Leaks
2 Selang2, Pipa & Pengikatnya
Hoses, Pipes & Clamps
3 Pengendali, Smbungan dan Dudukan
Controllers, Linkages & Mountings
4
Pin & Bushing

5
Control Valves

6 Kondisi Sinder Hidrolik

Hydraulic Cylinder Rate Condition

a. Retract Cyl RH

b. Retract Cyl LH

D. SUSPENSION & FRAME

1 Cek suspensi dari keretakan/ karat/ kebocoran

Check Suspension from Crack/ Rust/ Leaks
4 Keretakan Pada Rangka Utama
Main Frame For Crack

E. CABIN

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REGULAR SAFETY MECHANICAL INSPECTION
Dump Truck
1 Kaca Depan, Jendela
Windscreen & Window glass
2 Pelapis Karet
Rubber Seal
3 Pintu, Pegangan Tangan , Pengunci & Engsel
Door, Lock, Handle & Hinges
4 Dudukan & Suspensinya
Mounting & Suspension

F. ELECTRICAL INSPECTION

1 Kunci Kontak
Key Switch
2 Tombol Test Indikator
Indicator Test Switch
3 Pengukur Tekanan Angin
System Air Pressure Gauge
4 Pengukur Suhu Kerja Mesin
Engine Coolant Temperature Gauge
5 Pengukur Putaran Mesin
Tachometer
6 Voltmeter
Pengukur Tegangan
7 Lampu Peringatan
Warning Lamp
8 Alaram peringatan
Warning Buzzer/Alarm
9 Tombol-tombol untuk Lampu
Light Switches
10 Semua Lampu Indikator
All Alert Indicator Lights
11 Pengukur Jam Kerja Mesin
SMU / HMU
12 Sekering & Pemutus Arus
Fuses & Circuit Breaker
13 Tuas kontrol Lampu Sein
Directional Turn Signal & Hazard Flasher Control
14 Tuas Kontrol Lampu Dekat/Jauh
High/Low Beam Control
15 Lampu Kabin
Cabin Lamp
16 Lampu Dashboard
Dash Panel Light
17 Lampu Sein Kiri / Kanan
Turn Signal Lamp (LH / RH )
18 Lampu Kerja Depan
Front Floodlights
19 Lampu Kerja Samping
Side Floodlights
20 Lampu Kerja Belakang
Rear Floodlights ( Prime Mover & Lowboy)
21 Lampu Jauh
High Beam Lamp
22 Lampu Mundur
Reverse Lamp
23 Lampu Jalan
Road Lamp
24 Lampu Rotari
Rotary Lamp/Flash Light/ Strobe Light
25
Accessories Lamp

26 Tegangan Keluar Alternator

Alternator Output Voltage
27 Kondisi Alternator, Belt serta Penyetelannya
Alternator, Belt Condition & Adjustment
28 Pemutus Hubungan Battere
Battery Disconnect Switch
29 Kondisi & Beban Kerja Battere
Battery Condition & Load
30 Level Air Battere
Electrolyte Level
31 Kabel & Terminal Battere
Battery Cable and Terminal
32 Kable Massa
Ground Cable
33 Kabel Harness
Cable Harness
34 Kerja/Kondisi Motor Starter
Starter Motor Operation/Condition
35 Solenoid
Solenoid
36 Therminal Cable
Kabel & Terminal ( Cables & Terminals )

G. FINAL DRIVE

1 Kebocoran Oli
Oil Leaks

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REGULAR SAFETY MECHANICAL INSPECTION
Dump Truck
2 Final Drive Hose Line
Jalur hose final drive

H. DUMP

1 Keretakan Dump
Cracked Dump
2 Cylinder angkut dump kondisi
Dump Cylinder Condition

I. ACCESSORIES

1 Radio Komunikasi
2-Way Radio Communication
2 Klackson
Horn
3 Alarm Mundur
Reverse Alarm
4 Unjuk Kerja & Kontrol, Pendingin Udara
Air Conditioning Operation & Control
5 Kondisi Kompressor Pendingin Udara
A/C Compressor Condition
6 Kondisi Belt & Penyetelannya
A/C Compressor Belt Condition & Adjustment
7 Pengering Udara
Air Dryer
8 Periksa dan Service Kondensor
Condensor, Check and Service
9 Periksa & Service Evaporator
Evaporator, Check And Service
10 Tekanan Kerja Refrigerant
Refrigerant Charging Pressure
11 Pipa / Jalur Pendingin Udara
A/C Line/Piping
12 Kipas Blower
Fan Blower
13 Fungsi Kerja Kipas Kaca
Washer Wipers Function
14 Karet / Sirip Kipas Kaca
Wiper Blade

J. OPERATIONAL TEST (Kimper/Simper Required-Pelaksana Harus Memiliki Kimper/Simper)

1 Hidupkan Mesin-Periksa Suara yang Tidak Biasa

Engine Running ( Check For Unusual Noise )
2 Perpindahan Gigi Transmissi
Transmission Shifting
3 Rem Parkir
Parking Brake
4 Sistem Kemudi
Steering System
5 Sistem Hidrolik/Angin
Hydraulic/Pneumatic System

K. ADDITIONAL CHECKS

Inspection by Acknowledged

Mechanic / Electrician Superintendent

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