No :................../................./......................
HYUNDAII
HYUNDA NKE JO
TG
TGLL CHEC
CHECK
K AL
ALAT
AT CHEC
CHECK
K ( Equi
Equipm
pmen
entt fo
forr Chec
Check
k) DATE
DATE PE
PERI
RIOD
OD : WAKT
WAKTU
U (T
(TIM
IME)
E)
HARIAN BULANAN
TGL BLN THN 1 s/d
( DAILY ) ( MONTHLY )
MINGGUAN TAHUNAN
2 Total :
( WEEKLY ) ( YEARS )
STATUS STATUS
URAIAN PEKERJAAN URAIAN PEKERJAAN
( Description Work ) OK NO ( Description Work ) Ok NO
CATATAN
( ……………………………………………..) 4