Weekly Report HSE PT.CSI_Week 38_17-23 September 2025.pdf

Report HSE

1. Weekly Meeting HSE 38
17 –23 September 2025
HEALTH AND SAFETY ENVIRONMENT
SAFETY
SURVEYOR
HSE
PT. COTEC SURVEY INDONESIA
Growth For Excellent Services

2. No Form : 07
Nama Form : CSI-HSE
Revisi : 23 September 2025
Tgl Efektif :
SCOPE OF SERVICE
SITE
WEEK
Pekerja
Lokal
Pekerja non
Lokal
Pekerja
Asing
Total Hour
Pekerja
Lokal
Pekerja non
Lokal
Pekerja
Asing
Total Hour
MANAJEMEN 0 1 0 60 MANAJEMEN 0 0 0 0
PROFESIONAL 0 0 0 0 PROFESIONAL 0 0 0 0
TEKNISI 2 0 0 120 TEKNISI 0 0 0 0
ADMINISTRASI 1 0 0 60 ADMINISTRASI 0 0 0 0
TERAMPIL/SKILL 0 18 0 1080TERAMPIL/SKILL 0 6 0 420
TIDAK ADA SKILL 40 0 0 2400TIDAK ADA SKILL 0 7 0 490
Total 43 19 0 3720Total 0 13 0 910
75 People 71 People
4630 Hour 4 People
ESDM MINING SERVICE
LICENSE
- Waisumo, PT STS
17 - 23 September 2025
B. NUMBER & WORKING HOUR OF EMPLOYEES / JUMLAH & JAM KERJA KARYAWAN
FORMULIR / FORM
LAPORAN WEEKLY KONTRAKTOR (HSE)
CONTRACTOR'S HSE WEEKLY REPORT
A. GENERAL INFORMATION / INFORMASI UMUM
NAME OF CONTRACTOR PT COTEC SURVEY INDONESIA
NAME OF
LEADER /
PJO
M Resal Taufan
Survey Indonesia
B1. Contractor B2. Sub-Contractor
Total Karyawan (B1 + B2) Karyawan Pria
Total Jam Kerja (B1 + B2) Karyawan Wanita

3. No
1
2
3
4
5
6
7
8
9 Safe Day / Hari Kerja Aman / Jam kerja aman 7 114.258
Property Damage / Kerusakan Peralatan 0 0
Near Miss / Near Hit (Including Potential SPI -
Serious Potential Incident)
0 0
Environmental Incident (Number of incident &
Quantity of spill - liter)
0 0
0
First Aid (FA) - Level 1 0 0
Loss Time Injury (LTI) 0 0
Restricted Work Case (RWC) 0 0
C. DATA INCIDENT
Category / Kategori Threshold / Target Achievement / Pencapaian
Fatality 0 0
Medical Treatment Case (MTC) 0

4. No
No. of Activity /
Jumlah
Pelaksanaan
1 13
2 1
3 182
4 6
5 0
6 0
7 1
8 0
9 0
10 0
11 0
12 0
13 0
14 1
15 1
16 1
17 0
D. OHS LEADING INDICATOR / INDIKATOR PROSES K3
Activity / Aktifitas Remarks / Keterangan
Tool Box Meeting/P5M/Health Talk Sample House and Preparation Area
General Safety Talk Pentingnya Komunikasi
Mine Permit
Visitor PT CSI (Operation Officer) masih dalam proses
pembuatan
Training
Inspeksi Lapangan Inspeksi Sample House, Preparasi
Commissioning
Kimper
Pemasangan Sign
Safety Campaign
JSEA
HSE Meeting Coordination Safety Meeting Contractor
Induction 1 Visitor PT. CSI (Operation Officer)
Take 5
Sosialisasi Kebijakan
Praduga Lima
Fatigue Test Fatigue & Alcohol Test (Crew Preparasi)
P2H/Prestart Check
Oven, Jaw Crusher, DoubleRoll, Pilvrerizing Mills &
Compressor, LV

5. NO
1
2
3
4
5
6
E. RENCANA KEGIATAN MINGGU DEPAN
KEGIATAN PLAN KETERANGAN
Induction Continue Continue
Alcohol & Fatigue Test (bersama Medic PT. STS) Continue Continue
Safety Talk Rutin CSI Senin Continue
P5M Selasa-Minggu Continue
Inspeksi ID/Card & APD Continue Continue
Inspeksi Area Kerja CSI Continue Continue

6. SAMPLE HOUSE PREPARASI
DOKUMENTASI PELAKSANAAN KEGIATAN
General Safety Talk & P5M
General Safety Talk

7. KEGIATAN PengambilanSample (SAMPLING)

8. KEGIATAN PENGERJAAN SAMPLE BASAH & KERING

9. KEGIATAN ALCOHOL & FATIGUE TEST

10. DOKUMENTASI FORM P2H PERALATAN
Light Vehicle PeralatanKerja

11. DOKUMENTASI DAFTAR HADIR TOOLBOX MEETING/PERTEMUAN KESELAMATAN

12. PICA-PREPARASI & LAB

14. 7Tidak terdapat sign dilarang merokok pada area
penyimpanan barang di preparasi basah
Muh Fajrin Hidayat
Dibuatkan sign dilarang merokok pada
area penyimpanan barang di preparasi
basah
21-Sep-25 Closed QHSE 26-Aug-25
8Tidak dibuatkan plang pembatas pada area
reminder material serta tidak di pasangi sign "awas
ada pipa"
Muh Fajrin Hidayat
Dibuatkan plang, baricade pipa serta
sign "awas ada pipa" guna memberikan
informasi ketika ada proses
pengangkutan reminder material dan
tidak merusak pipa air yang mengarah
ke office dan lab PT. CSI
21-Sep-25 Closed Preparasi, QHSE 26-Aug-25
9Tidak adanya update checklist inspeksi pada APAR
di area preparasi basah
Muh Fajrin Hidayat
Buatkan checklist inspeksi APAR
21-Sep-25 Closed QHSE 26-Aug-25
10Terdapat keran air yang bocor pada area belakang
lab-office yang menyebabkan air terus menetes
Muh Fajrin Hidayat
Dilakukan pergantian keran air yang
bocor
21-Sep-25 Closed Maintenance 12-Sep-25
11Ditemukan tuas kompressor yang bocor yang
menyebabkan angin keluar tanpa di gunakan
Muh Fajrin Hidayat
Lakukan pergantian tuas kompressor
yang mengalami kebocoran (air duster
gun)
21-Sep-25 Closed Maintenance 27-Aug-25
12Pada area preparasi kering (final) terdapat bekas
lumpur yang belum di bersihkan / housekeeping
Muh Fajrin Hidayat
Lakukan housekeeping area preparasi
kering (final)
21-Sep-25 Closed Preparasi 22-Aug-25

15. TERIMA KASIH