Doc.

Rev : KA-HRGA-FORM-002

P2H LIGHT VEHICLE

Tanggal Efektif : 01 Oktober 2021

Rev : 00

Halaman : 1 dari 1

Tanggal / Date : Unit No : MODEL : KM :

KONDISI KONDISI KONDISI

URAIAN (Condition) URAIAN (Condition) URAIAN (Condition)
(Description) BAIK Rusak (Description) BAIK Rusak (Description) BAIK Rusak
(Good) (Bad) (Good) (Bad) (Good) (Bad)
Periksa Kerusakan Badan Mobil Periksa Permukaan Bahan Bakar Tes Semua Lampu
(Check for Body Damage) (Check Fuel Level) (Test All Light)

Periksa Seluruh Roda Periksa Permukaan Oli Mesin Tes Lampu Hazard
(Check All Tyres) (Check Oil Level) (Test Hazards Light)

Periksa Baut Roda Periksa Kebocoran Oli Mesin Tes Lampu Kedip/Rotary
(Check Wheel Nut) (Check Engine Oil Leaks) (Test Flashing Light)

Periksa Ban Serep Periksa Permukaan Oli Steering Tes Klakson

(Check Spare Tyres) (Check Oil Steering Level) (Test Horn)

Periksa Kebersihan Kaca Periksa Permukaan Minyak Rem Tes Fungsi Kemudi
(Check Window Clean) (Check Brake Fluid Level) (Test Steering Wheel)

Periksa Sticker Jadwal Perawatan Periksa Permukaan Air Radiator Tes Fungsi Rem
(Check Schedule Service Sticker) (Check Radiator Water Level) (Test Brake Function)

Periksa Sabuk Keselamatan Periksa Air Pembersih Kaca Tes Fungsi Rem Parkir
(Check Seat Belt) (Check Wiper Water Level) (Test Parking Brake Function)

Periksa Perlengkapan Dongkrak Periksa Semua Lampu Indikator Tes Fungsi Alarm Mundur
(Check Jack & Attachement) (Check All Indicator Light) (Test Reverse Alarm Function)

Periksa Perlengkapan P3K & Alat Pemadam Api Ringan (Check First Periksa kondisi bendera/b.whip Periksa sticker commisioning
Aid Kits & Fire Extinguisher) (Check buggy whip condition) (Check commisioning sticker)

Keterangan
Nama Pengemudi : (Remarks)

Jabatan :

Tanda Tangan :
Ket : Jika ada item kerusakan unit pada bagian (BRAKE, STEERING, SEAT BELT DAN RODA) maka unit tidak boleh dioperasikan dan segera laporkan ke pit kontrol dan pengawas

Doc. Rev : KA-HRGA-FORM-002

P2H LIGHT VEHICLE

Tanggal Efektif : 01 Oktober 2021

Rev : 00

Halaman : 1 dari 1

Tanggal / Date : Unit No : MODEL : KM :

KONDISI KONDISI KONDISI

URAIAN (Condition) URAIAN (Condition) URAIAN (Condition)
(Description) (Description) (Description)
BAIK Rusak BAIK Rusak BAIK Rusak
(Good) (Bad) (Good) (Bad) (Good) (Bad)
Periksa Kerusakan Badan Mobil Periksa Permukaan Bahan Bakar Tes Semua Lampu
(Check for Body Damage) (Check Fuel Level) (Test All Light)

Periksa Seluruh Roda Periksa Permukaan Oli Mesin Tes Lampu Hazard
(Check All Tyres) (Check Oil Level) (Test Hazards Light)

Periksa Baut Roda Periksa Kebocoran Oli Mesin Tes Lampu Kedip/Rotary
(Check Wheel Nut) (Check Engine Oil Leaks) (Test Flashing Light)

Periksa Ban Serep Periksa Permukaan Oli Steering Tes Klakson

(Check Spare Tyres) (Check Oil Steering Level) (Test Horn)

Periksa Kebersihan Kaca Periksa Permukaan Minyak Rem Tes Fungsi Kemudi
(Check Window Clean) (Check Brake Fluid Level) (Test Steering Wheel)

Periksa Sticker Jadwal Perawatan Periksa Permukaan Air Radiator Tes Fungsi Rem
(Check Schedule Service Sticker) (Check Radiator Water Level) (Test Brake Function)

Periksa Sabuk Keselamatan Periksa Air Pembersih Kaca Tes Fungsi Rem Parkir
(Check Seat Belt) (Check Wiper Water Level) (Test Parking Brake Function)

Periksa Perlengkapan Dongkrak Periksa Semua Lampu Indikator Tes Fungsi Alarm Mundur
(Check Jack & Attachement) (Check All Indicator Light) (Test Reverse Alarm Function)

Periksa Perlengkapan P3K & Alat Pemadam Api Ringan (Check First Periksa kondisi bendera/b.whip Periksa sticker commisioning
Aid Kits & Fire Extinguisher) (Check buggy whip condition) (Check commisioning sticker)

Keterangan
Nama Pengemudi : (Remarks)

Jabatan :

Tanda Tangan :
Ket : Jika ada item kerusakan unit pada bagian (BRAKE, STEERING, SEAT BELT DAN RODA) maka unit tidak boleh dioperasikan dan segera laporkan ke pit kontrol dan pengawas