Form Absen

TANGGUH EXPANSION PROJECT
ABSEN PEKERJA
RABU
SENIN (…../.…./..…) SELASA (…../.…./..…) KAMIS (…../.…./..…) JUMAT (…../.…./..…) SABTU (…../.…./..…) MINGGU (…../.…./..…)
(…../.…./..…)
No Nama / Name Position
IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT IN OUT
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Petugas Pengawas/Engineer/Mandor
Task Supervisor / Engineer / Foreman
Nama / Name Jabatan / Designation Tanda tangan / Signature Tanda tangan / Signature Tanda tangan / Signature Tanda tangan / Signature Tanda tangan / Signature Tanda tangan / Signature Tanda tangan / Signature
1
LAPORAN HARIAN PRESTART BRIEFING
FORM DAILY PRESTART BRIEFING
Nama Proyek : TANGGUH EXPANSION PROJECT Number :

Name of Project
Kegiatan / Activity Location : TRAIN 3

Waktu Mulai
Tanggal / Date …../......................../ 20 ...
Start time:
Nomor JSA /
JSA number
☐ Kerja di ketinggian / Working at Height ☐Penggalian / Excavation

Ijin Persyaratan,
jika ada / Permit ☐ Kerja suhu panas(pengelasan, grinda dll) / Hot work ☐ME/ Energized (mechanic/electric)
Requirements, if any
☐ Tempat Terbatas / Confined space
Alat Listrik yang
digunakan, jika
ada Power tools used,
if any
Prosedur kerja
aman Safe Work
Procedures
PPE required for the task/APD yang dibutuhkan untuk bekerja
YES / NO YES / NO YES / NO YES / NO YES / NO
Persyaratan APD Tambahan :

Additional PPE requirements
No of operatives:
Nama / Name Jabatan / Designation Tanda tangan / Sig
1 ARIF FITRANDI SUPERINTENDENT 1

2 HANDY SYAHPUTRA HSSE ENGINEER
3 HARIS RISDIANA SAFETY SUPERVISOR
4 AWALUDDIN Techincian Supervisor
5 DJUWARTO SUPERINTENDENT 2
6 SATRIA ASST. SURVEYOR
7 SHOHIBURRAHMAN QC INSPECTOR TRAIN 3 PROCESS AREA
8 ALIF QC LAB INSPECTOR
9 FREDY NUCHTERINDO QC MATERIAL RECEIVING INSPECTOR
10 IRWAN SAPUTRA LOGISTICS
11 Abdus Salam Rigger
12 Eko Susanto Pile Cutting Worker
13 Suwanto Pile Cutting Worker
14 Sutriono Pile Cutting Worker
15 Hariyono Experienced Concrete Worker
16 Panut Experienced Concrete Worker
17 Purwanto Experienced Rebar Worker
18 Imam Rohmad Experienced Rebar Worker
19 Dwi Nur Cahyono Experienced Rebar Worker
20 Rion Dwi Ardono Experienced Rebar Worker
21 Setiyo Budiono Experienced Rebar Worker
22 Sukirno Experienced Rebar Worker
23 Paryono Experienced Rebar Worker
24 Suwito Experienced Formwork Worker
25 Sutrisno Experienced Formwork Worker
26 Sukarsono Experienced Formwork Worker
27 Nurkolis Experienced Formwork Worker
28 Siswanto Experienced Formwork Worker
29 Pancik Haryono Experienced Formwork Worker
30 Sumaji Embedded Worker
31 Mustaqim Embedded Worker
32 Bunadi Traffic Controller
33 Mahsudi Alhusnani Operator Excavator 320D
34 Ahmad Basroni Operator Excavator 320D
35 M. Garibaldi Operator Dump Truck 22 Ton
36 Dwi Santoso Operator Dump Truck 22 Ton
37 Ahmad Jaelani Operator Dump Truck 22 Ton
38 Deni Listanto Operator Dump Truck 22 Ton
39 Donico Operator Truck Mounted Crane 10 T
40 Saptani Operator Rough Terrain Crane 60 T
41 Rosihun Slinger
42 Syarif Hidayat Rigger
43 Prima Heavy Techincian Techinician
44 Sukron Heavy Equipment Techinician
45
46
47
48
49
50
51
52
53
54
55
56
Nama / Name Jabatan / Designation Tanda tangan / Si
1
2
3
TRAIN 3
ai
Excavation
ed (mechanic/electric)
bekerja
YES / NO
Tanda tangan / Signature

TANGGUH EXPANSION PROJECT
ABSEN PEKERJA
SENIN (…../.…./.. SELASA (…../. RABU KAMIS (…../.…./.. JUMAT (…../.…./.. SABTU (….
…) …./..…) (…../.…./..…) …) …) …)
Nama / Name
P S OT P S OT P S OT P S OT P S OT P
1 Paidi Experienced Civil Worker
2 Joko Experienced Civil Worker
3 Haryono Experienced Civil Worker
4 Haryono Bunder Experienced Civil Worker
5 Panut Experienced Civil Worker
6 Pancik Haryono Experienced Civil Worker
7 Lukito Experienced Civil Worker
8 Boimin Experienced Civil Worker
9 Iwan Experienced Civil Worker
10 Budi Atmojo Experienced Civil Worker
11 Suratman Experienced Civil Worker
12 Sutrisno Experienced Civil Worker
13 Imam Rohmad Experienced Civil Worker
14 Heru irawan Experienced Civil Worker
15
16
17
18
19
20
Nama / Name Jabatan / Designation Tanda tangan / Tanda tangan / Tanda tangan / Tanda tangan / Tanda tangan / Tanda tan
Signature Signature Signature Signature Signature Signatur
1
KETERANGAN :
P = PAGI
S = SIANG
OT = OVERTIME
SABTU (…../.…./.. MINGGU (…../.
…) …./..…)
S OT P S OT
Tanda tangan / Tanda tangan /

Signature Signature

Name of Project

Waktu Mulai
Tanggal / Date …../......................../ 20 ...
Start time:
Nomor JSA /
JSA number

Ijin Persyaratan,
Alat Listrik yang
digunakan, jika
if any
Prosedur kerja
aman Safe Work
Procedures

No of operatives:
1 Arif Fitrandi SUPERINTENDENT 1

2 Bendhova
3 Handy Syahputra HSSE ENGINEER
4 Haris Risdiana SAFETY SUPERVISOR
5 Awaluddin Techincian Supervisor
6 Djuarto SUPERINTENDENT 2
7 Satria ASST. SURVEYOR
8 Shohiburahman QC INSPECTOR TRAIN 3 PROCESS AREA
9 Alif QC LAB INSPECTOR
10 Fredy Nuchterindo QC MATERIAL RECEIVING INSPECTOR
11 Irwan Saputra LOGISTICS
12 Abdus Salam Rigger
42 Rosihun Slinger
46 Marianto
47 Heru Irawan
48 Musiran
49 Dudung
50 Mario
51 Suparmin
52 Bagus Setiyobudi
53 Candra Tri S
54 Marsono
55 Suyono
56 Paidi 2
57 Hardi Slamet
58 Imam Mustarom
59
60

1
2
3
TRAIN 3
ai
Excavation
bekerja
YES / NO

Train 3
No Nama Posisi Status

1 Eko Susanto Pile Cutting Worker of
2 Suwanto Pile Cutting Worker of
3 Sutriono Experience Civil Worker of
5 Purwanto Experienced Rebar Worker of
10 Sukarsono Experienced Formwork Worker of
11 Nurkolis Experienced Formwork Worker of
16 Marianto Carpenter
17 Musiran Carpenter
18 Candra Tri S Rebarman
19 Marsono Carpenter
20 Suyono Carpenter
21 Paidi 1 Carpenter
22 Hardi Slamet Experience Civil Worker
23 Imam Mustarom Experience Civil Worker
24 Warsito Scafolder
25 Harmanto Experience Civil Worker
26 Hartono Experience Civil Worker
27 Dimar Malik Maulana Scafolder
28 Sukarsono Experience Civil Worker
29 Sudarto Rebarman
30 Joni Aan Bugiarto Rebarman
31 Sarmin Rebarman

Name of Project
Kegiatan / Activity Location : LAP. VOLLEY

Waktu Mulai
Tanggal / Date …../......................../ 20 ...
Start time:
Nomor JSA /
JSA number

Ijin Persyaratan,
Alat Listrik yang
digunakan, jika
if any
Prosedur kerja
aman Safe Work
Procedures

No of operatives:
1 GANTA DIPAYASA ENGINEERING MANAGER
2 PUTU WISNU P DEPUTY QA/QC
3 ABD. RAHMAN S QC COORDINATOR
4 BAYU KUMORO PROJECT CONTROL
5 DWIKY BHASKARA PROGRESS CONTROLLER
6 REZA EKA PRADIPTA SITE ENGINEER 1
7 EGI NUAMSYAH KOSASIH QA ENGINEER
8 LEORAT QC SUPERVISOR
9 INDAH HANINDITA ADM QA/QC
10 TRISNAWATI GALLARAN DOC. CONTROL
11 PRIMADITA MANURUNG ADM QA/QC
12 RIANDA ARIFIN DRAFTER
13
14
15
16
17
18
19
20
21
22
23
24
25

1
2
3
LAP. VOLLEY
ai
Excavation
bekerja
YES / NO

TOOLBOX MEETING ABSENCE

Name of Project

Waktu Mulai
Tanggal / Date …../......................../ 20 ...
Start time: 06.30
Nomor JSA /
JSA number

Ijin Persyaratan,
Alat Listrik yang
digunakan, jika
if any
Prosedur kerja
aman Safe Work
Procedures
YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO

No of operatives:
Nama / Name Jabatan / Designation Tanda tangan / Signature
1 IJAN SOPIAN CONSTRUCTION MANAGER
2 ARIF FITRANDI SUPERINTENDENT 1
3 BENDHOVA SITE COORDINATOR
4 SUGENG SUHENDRIK SURVEYOR 1
5 SATRIA ASST. SURVEYOR
6 GANTA DIPAYASA ENGINEERING MANAGER
7 BAYU KUMORO PROJECT CONTROL
8 DWIKY BHASKARA PROGRESS CONTROLLER
9 TRISNA DOC CONTROLLER
10 REZA PRADIPTA SITE ENGINEER 1
11 MUH. SHODIQ GA COORDINATOR
12 RAHMAT FIRDAUS HR OFFICER
13 HARDIANSYAH HSE MANAGER
14 SAMSUL BAHRI HSSE TRAINER
15 HANDY SYAHPUTRA HSSE ENGINEER
16 HARIS RISDIANA SAFETY SUPERVISOR
17 ALDINAUFAL OKTOARINDA ENVIRONMENTAL ENGINEER
18 PUTU WISNU DEPUTY QA/QC MANAGER
19 ABD. RAHMAN S QA/QC COORDINATOR
20 LEORAT QC SUPERVISOR
21 EGI NUAMSYAH QA ENGINEER
22 INDAH HANINDITA QC ADM
23 PRIMADITA MANURUNG QC ADM
24 SHOHIBURRAHMAN QC INSPECTOR TRAIN 3 PROCESS AREA
25 ALIF QC LAB INSPECTOR
26 FREDY QC MATERIAL RECEIVING INSPECTOR
27 AWALUDDIN
28 M. THOYIB SAFETY SUPERVISOR
29 IRWAN LOGISTIC
30 ABDUSSALAM Rigger
34 Boimin Experienced Concrete Worker
42 Iwan Experienced Rebar Worker
48 Joko Experienced Formwork Worker
49 Wakid Experienced Formwork Worker
53 Haryono Experienced Formwork Worker
54 Lukito Experienced Formwork Worker
60 Dudung Sunarya Operator Excavator
67 Rosihun Slinger
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
Nama / Name Jabatan / Designation Tanda tangan / Signature
1
2
3

Name of Project
Kegiatan / Activity Location : PIONEER

Waktu Mulai
Tanggal / Date …../......................../ 20 ...
Start time:
Nomor JSA /
JSA number

Ijin Persyaratan,
Alat Listrik yang
digunakan, jika
if any
Prosedur kerja
aman Safe Work
Procedures

No of operatives:
5 Panut Experienced Civil Worker
11 Suratman Experienced Civil Worker
12 Sutrisno Experienced Civil Worker
14 Heru irawan Experienced Civil Worker
15
16
17
18
19
20
21
22
23
24
25

1
2
3
PIONEER
ai
Excavation
bekerja
YES / NO

FORM ABSENSI PEKERJA
PT. PP (Persero) Tbk
PROYEK TANGGUH EXPANSION LNG GENERAL CIVIL WORK
AREA PIONEER
HARI / TANGGAL :
PAGI SIANG
NO Nama / Name JOB TITLE ACTIVITY
IN OUT SIGN IN OUT SIGN
5 Didik Suyanto Experienced Civil Worker
11 Yatin Experienced Civil Worker
12 Wardoyo Experienced Civil Worker
14 Nuris Sobakh Experienced Civil Worker
15 Agung Sudarwanto Experienced Civil Worker
16 Cipto Suswanto Experienced Civil Worker
17 Dimas Prasetyo Experienced Civil Worker
18 Januri Experienced Civil Worker
19 Naswantoro Experienced Civil Worker
20 Slamet Experienced Civil Worker
21 Suhartono Experienced Civil Worker
22 Suliyanto Experienced Civil Worker
23 Sumarno Experienced Civil Worker
24 Surono Experienced Civil Worker
25 Suwito Experienced Civil Worker
26
27
28
29
30
SUPERVISOR/SAFETY/MANDOR
NO Nama / Name Jabatan / Designation Tanda tangan / Signature Tanda tangan / Signature
1 SUPERVISOR
2 SAFETY
3 MANDOR
OVERTIME
IN OUT SIGN
AREA TRAIN 3
HARI / TANGGAL :
PAGI SIANG
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
SUPERVISOR/SAFETY/MANDOR
NO Nama / Name Jabatan / Designation Tanda tangan / Signature Tanda tangan / Signature
1 SUPERVISOR
2 SAFETY
3 MANDOR
OVERTIME
IN OUT SIGN
AREA TRAIN 3
HARI / TANGGAL :
PAGI SIANG
1 Zumroni Experience Civil Worker
2 Aripin Experience Civil Worker
3 Heri Prasetyo Experience Civil Worker
4 Parni Experience Civil Worker
5 Dimas Prasetyo Flagman
6 Jaimun Experience Civil Worker
7 Warsito Foreman
8 Dwi Candra Kristanu Experience Civil Worker
9 Mardi Skilled Mason
10 Masriki Skilled Mason
11 Zumroni Rebarman
12 Fauzan Experience Civil Worker
13 Munawir Experience Civil Worker
14 Agus Susilo Experience Civil Worker
15 Samiran Experience Civil Worker
16 Darta Experience Civil Worker
17 Radika Experience Civil Worker
18 Herman Experience Civil Worker
19 Muhammad Mursidi Experience Civil Worker
20 Panut Rebarman
21 Sutrisno Rebarman
22 Pancik Hariyono Rebarman
23 Heri Sulistiyono Experience Civil Worker
24 Didik Suyanto Rebarman
25 Wardoyo Rebarman
26 Iwan Rebarman
27 Sujarwo Experience Civil Worker
28 Sarmin Rebarman
29 Candra Tri Ardono Experience Civil Worker
30 Bangkit Prayoga Rebarman
31 Joni Aan Bugiarto Rebarman
32 Saiful Anwar Experience Civil Worker
33 Jofi Danang Dwi Arisanto Experience Civil Worker
34 Genot Heri Kasianto Experience Civil Worker
35 Naswantoro Experience Civil Worker
36 Muselih Skilled Mason
37 Cecep Anggi Experience Civil Worker
38 Burham Experience Civil Worker
39 Agus Experience Civil Worker
40 Hudria Experience Civil Worker
41 Asep Experience Civil Worker
42 Wartim Experience Civil Worker
43 Damin Experience Civil Worker
44 Supanda Experience Civil Worker
45 Hermawan Experience Civil Worker
46 Yani Experience Civil Worker
47 Muhammad Herisan Experience Civil Worker
48 Darmawan Experience Civil Worker
49 Badru Experience Civil Worker
50 Saepul Bargo Experience Civil Worker
51 Amaludin Experience Civil Worker
52 Nurhakim Experience Civil Worker
53 Dede Parhan Experience Civil Worker
NO Nama / Jabatan / Tanda tangan / Signature Tanda tangan / Signature

Name Designation
SUPERVI
1
SOR
2 SAFETY
3 MANDOR
OVERTIME
IN OUT SIGN

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TANGGUH EXPANSION PROJECT

Nama Proyek : TANGGUH EXPANSION PROJECT Number :

Kegiatan / Activity Location : TRAIN 3

☐ Kerja di ketinggian / Working at Height ☐Penggalian / Excavation

PPE required for the task/APD yang dibutuhkan untuk bekerja

YES / NO YES / NO YES / NO YES / NO YES / NO

Persyaratan APD Tambahan :

1 ARIF FITRANDI SUPERINTENDENT 1

Tanda tangan / Signature

Tanda tangan / Tanda tangan /

Nama Proyek : TANGGUH EXPANSION PROJECT Number :

Kegiatan / Activity Location : TRAIN 3

☐ Kerja di ketinggian / Working at Height ☐Penggalian / Excavation

PPE required for the task/APD yang dibutuhkan untuk bekerja

YES / NO YES / NO YES / NO YES / NO YES / NO

Persyaratan APD Tambahan :

1 Arif Fitrandi SUPERINTENDENT 1

Nama / Name Jabatan / Designation Tanda tangan / Si

Tanda tangan / Signature

No Nama Posisi Status

Nama Proyek : TANGGUH EXPANSION PROJECT Number :

Kegiatan / Activity Location : LAP. VOLLEY

☐ Kerja di ketinggian / Working at Height ☐Penggalian / Excavation

PPE required for the task/APD yang dibutuhkan untuk bekerja

YES / NO YES / NO YES / NO YES / NO YES / NO

Persyaratan APD Tambahan :

Nama / Name Jabatan / Designation Tanda tangan / Si

Tanda tangan / Signature

Nama Proyek : TANGGUH EXPANSION PROJECT Number :

Kegiatan / Activity Location : TRAIN 3

☐ Kerja di ketinggian / Working at Height ☐Penggalian / Excavation

YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO

Persyaratan APD Tambahan :

Nama / Name Jabatan / Designation Tanda tangan / Signature

Nama Proyek : TANGGUH EXPANSION PROJECT Number :

Kegiatan / Activity Location : PIONEER

☐ Kerja di ketinggian / Working at Height ☐Penggalian / Excavation

PPE required for the task/APD yang dibutuhkan untuk bekerja

YES / NO YES / NO YES / NO YES / NO YES / NO

Persyaratan APD Tambahan :

Nama / Name Jabatan / Designation Tanda tangan / Si

Tanda tangan / Signature

NO Nama / Jabatan / Tanda tangan / Signature Tanda tangan / Signature

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