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    Form Pemeriksaan Alat Berat PPA

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    Kreswanto martha wijaya
    This heavy vehicle safety checklist documents a safety inspection of equipment and physical aspects of heavy vehicles. It includes sections to record vehicle details and operator information as well as checklists to inspect over 30 individual components, systems, and safety equipment. A status of A/TA/B/TB is assigned to each item to indicate presence, condition, and any issues needing attention. Inspectors, preparers, and approvers must sign off on the completed inspection form.

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    Form Pemeriksaan Alat Berat PPA

    Uploaded by

    Kreswanto martha wijaya
    44 views1 page
    This heavy vehicle safety checklist documents a safety inspection of equipment and physical aspects of heavy vehicles. It includes sections to record vehicle details and operator information as well as checklists to inspect over 30 individual components, systems, and safety equipment. A status of A/TA/B/TB is assigned to each item to indicate presence, condition, and any issues needing attention. Inspectors, preparers, and approvers must sign off on the completed inspection form.

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    This heavy vehicle safety checklist documents a safety inspection of equipment and physical aspects of heavy vehicles. It includes sections to record vehicle details and operator information as well as checklists to inspect over 30 individual components, systems, and safety equipment. A status of A/TA/B/TB is assigned to each item to indicate presence, condition, and any issues needing attention. Inspectors, preparers, and approvers must sign off on the completed inspection form.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    44 views1 page

    Form Pemeriksaan Alat Berat PPA

    Uploaded by

    Kreswanto martha wijaya
    This heavy vehicle safety checklist documents a safety inspection of equipment and physical aspects of heavy vehicles. It includes sections to record vehicle details and operator information as well as checklists to inspect over 30 individual components, systems, and safety equipment. A status of A/TA/B/TB is assigned to each item to indicate presence, condition, and any issues needing attention. Inspectors, preparers, and approvers must sign off on the completed inspection form.

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    © All Rights Reserved
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    DAFTAR INSPEKSI PERALATAN DAN FISIK ALAT BERAT

    HEAVY VEHICLE SAFETY CHECKLIST


    1. DATA ALAT BERAT :
    a) Model / Type : _________________________________
    b) Nama Alat Berat : _________________________________
    c) Tanggal Pemeriksaan / Inspeksi : _________________________________
    d) Nama Operator : _________________________________
    e) Surat izin (SIO) : _________________________________
    f) Pengalaman Kerja : _________________________________
    Status Keterangan
    2. PERALATAN /PERLENGKAPAN :
    a) Engine : A/ TA / B / TB
    b) Hydraulic System : A/ TA / B / TB
    c) Hose Hydraulic : A/ TA / B / TB
    d) Hydraulik pump : A/ TA / B / TB
    e) Hydraulik Seal : A/ TA / B / TB
    f) Brake System : A/ TA / B / TB
    g) Parking System : A/ TA / B / TB
    h) Control System : A/ TA / B / TB
    i) Joint : A/ TA / B / TB
    j) Handle Bucket : A/ TA / B / TB
    k) Starting Motor : A/ TA / B / TB
    l) Transmission : A/ TA / B / TB
    m) Steering : A/ TA / B / TB
    n) Operator Seat : A/ TA / B / TB
    o) Lampu2 kerja : A/ TA / B / TB
    p) Operator kabin / Ruang kerja Operator : A/ TA / B / TB
    q) Filter Oli : A/ TA / B / TB
    r) Filter Hydraulic : A/ TA / B / TB
    s) Filter Solar / Fuel : A/ TA / B / TB
    t) Bucket : A/ TA / B / TB
    u) Kaca Spion / Back Mirrow : A/ TA / B / TB
    v) Reward Buzzer : A/ TA / B / TB

    3. ALAT KESELAMATAN :
    a) Safety Helmet Operator : A/ TA / B / TB
    b) Safety Shoes Operator : A/ TA / B / TB
    c) Safety Gloves Operator : A/ TA / B / TB
    d) Masker Operator : A/ TA / B / TB
    e) Ear plug : A/ TA / B / TB
    f) Kotak obat P3K : A/ TA / B / TB
    g) Pemadam api : A/ TA / B / TB
    h) Safety Glasses Operator : A/ TA / B / TB
    i) Safety belt : A/ TA / B / TB

    Dipersiapkan oleh, Diperiksa oleh, Disetujui oleh,

    Keterangan : A= ada TA= tidak ada B= baik TB= tidak ada

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