PENDAWAI ELEKTRIK PW2 / PW4

1. Butiran
A. Butir- Butir Peribadi

• Nama : ______________________________
• No. K/P : ____________________________
• Tarikh mula melibatkan kerja-kerja elektrik : _______________
B. Butir – Butir Kontraktor Elektrik

• Nama syarikat : ______________________________

• Alamat : _____________________________________
• Kelas pendaftaran dengan ST : ____________________
• Nama orang kompeten : _______________________________
• Nombor kad pengenalan : ________________________________
• Nombor perakuan kekompetenan : _____________________________
C. Butir – Butir Kerja Pendawaian yang Dijalankan

• Nama projek : _____________________________________

• Alamat projek : ___________________________________________
• Tarikh mula projek : ___________________________
• Tarikh siap projek : ________________________
2. Kerja-Kerja Harian
• Tarikh : ________________________
• Pegawai yang menyelia : ________________________________
• Tempat / lokasi : _____________________________
• Aktiviti: _________________________________________
• Cara kerja :-
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 • Langkah – Langkah Keselamatan:-
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• Jenis kerja-pendawaian : __________________________
• Jenis peralatan yang terlibat : _________________________
• Jenis-jenis pengujian yang dijalankan :-
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• Cara mengendalikan / menjalankan ujian di atas :-
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• Analisis :-
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• Gambar / Lampiran (Rujuk belakang) : _______________________________

3. Di akhir tiap-tiap kerja perlu disahkan oleh orang kompeten dan majikan

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Tandatangan Orang Kompeten Tandatangan Majikan

Nama : ………………………........ Nama : ……………….................

No Perakuan : ………………….. Cop Syarikat : ……………………