RENCANA OBYEKTIF & PROGRAM QHSE

No Dok : FM.HSE.003;; Tgl Terbit : 27 September 2021

Lokasi :
Tanggal :
Periode :

KPI
Deskripsi Program Tahun
Area Fokus Target 90% Target
No Jadwal Responsibel Personil Ket. Lampiran Bobot
/Personil Actual Pencapaian
Bulan Jan Feb Mar Apr Mei Jun
HSE Objective
Week 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

0%

External Training K3 Jadwal Action By Target Actual Ket.

6.1 6.1 Authorize Gas Test 2 Tahunan SPV Civil 0 0 Lengkap
6.2 Basic Safety Training 2 Tahunan HSE Personnel 0 0 Lengkap
6.3 Scaffolding Inspector 5 Tahunan Scaffolder 0 0 Lengkap
6.4 First Aider 1 Tahunan HSE Personnel 0 0 Lengkap
6.5 Fire Fighter 1 Tahunan HSE Personnel 0 0 Lengkap
6.5 Electrical safety 1 Tahunan Electrician 0 0 Lengkap
 RENCANA OBYEKTIF & PROGRAM QHSE
No Dok : FM.HSE.003; Tgl Terbit : 27 September 2021

Lokasi :Workshop 1
Tanggal :
Periode : Januari - Desember 2021

KPI
No Program Description (Tahun) 90%
Focus Area / Target
Schedule Responsible Person Remarks Attachment Weightage Achivement
Personnel Actual
Month Jan Feb Mar Apr Mei Jun target
1 HSE Objective
Week 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Target
1
Site Manager /

Actual
1.1 No Fatality - 2 All personnel 0 Goal Zero
HSSE Officer
3
4
Target
1

Actual
1.2 No LOPC > 100 Liter - 2 Site Manager On Site 0 During commision, handover
3
4
Target
before the operator
1
Site Manager / HSSE All personnel Additional Fit to work for
Actual

1.3 Fit to Work (OPR Heavy Equipment) wants to work the first 2 100%
day on the site Officer onsite Operator of Heavy equipment
3
4
Target
1
500 hours = 1 NMPI/ Min. 1
Actual

1.4 NMPI Weekly 2 HSSE Officer All personnel 100%

NMPI Reporting per-weeks
3
4
Target
1
Site Manager / HSSE L3 HSSE Manager is the in
Actual

1.5 Serious NMPI - 2 All personnel 0

Officer charge person for lucidity access
3
4
Target
1
Site Manager / HSSE L3 HSSE Manager is the in
Actual

1.6 TRC (Total Recordable Cases) - 2 All personnel 0

Officer charge person for lucidity access
3
4
Target
1
Site Manager / HSSE L3 HSSE Manager is the in
Actual

1.7 LSR Violation - 2 All personnel 0

Officer charge person for lucidity access
3
4
Target
1
Incident Investigation Reports L3 HSSE Manager is the in
Actual

1.8 as agreed 2 HSSE Officer All personnel 0

Quality charge person for lucidity access
3
4
Actual
2 HSE Meeting Schedule Jan Feb Mar Apr Mei Jun Action By Target Remarks

Target
1 Site Manager, Site
Actual

2.1 Safety Talk / Tool Box Meeting Daily 2 Officer, HSSE All personnel 100% Everyday or conditional job
3 Officer
4
Target
1
Shell CM / Meinhardt Shell / Meinhardt
Actual

2.2 Weekly meeting Weekly 2 16 Attendance list

Site Engineer & L3 Coreteam
3
4
Actual
3 HSE Inspection Schedule Jan Feb Mar Apr Mei Jun Action By Target Remarks

Target
1
HSE Personnel / Daily check by Operator and
Actual

3.1 Equipment Inspection Monthly 2 Onsite NA

Operator monthly check by HSSE officer
3
4
Target
1
Actual

3.2 Safety Equipment Inspection Every 2 weeks 2 HSE Personnel Onsite 8 Per 2 weeks
3
4
Target
1
Site Manager / Onsite / All
Actual

3.3 PPE Inspection Daily 2 100% Check everyday (checklist)

HSSE Officer personnel
3
4
Target
1
Shell CM / Meinhardt Shell / Meinhardt
Actual

3.4 Site Patrol with Client Weekly 2 16 Patrol to check site together
CM & L3 Coreteam
3
4
Target
1 Must be tested to min 2 person
Onsite (security
Actual

3.5 Drug and Alcohol Test Weekly 2 HSSE Officer 100% random check and witness by
gate)
3 MHT site supervisor every week
4
Actual
4 HSE Audit Schedule Jan Feb Mar Apr Mei Jun Action By Target Remarks

Target
1 20% 18%
Site Manager / HSSE Site Manager / 2 Audit every month (HSE &
Actual

4.1 Site Internal Audit Every 2 weeks 2 8

Officer HSSE Officer Project)
3
4
Target
1
1 Audit every month (HSE &
4,2 HSSE Audit by HSSE Manger Monthly 2 HSSE Coordinator Project Site 8
Project)
3
4
Target
1
HSSE Audit by L3 Top level
Actual

4.3 Monthly 2 L3 Top Management Project Site 8 HSSE Audit Form

Management
3
4
Target
1
Site Manager / HSSE
Actual

4.4 Talk Not Tick Audit Every 2 weeks 2 Random Worker 100% 2 worker minimal per 2 weeks
Officer
3
4
Actual
5 Internal HSSE Training & Acreditation Schedule Jan Feb Mar Apr Mei Jun Action By Target Remarks

Target
1
Every new worker
Actual

5.1 Worker Induction & Acreditation 2 HSSE Officer All personnel 100% All Personnel of L4
come to site
3
4
Target
1
Will be specified. i.e. fire drill,
Actual

5.2 Safety drill Monthly 2 L3 ERP Team All personnel 4

medivac drill, rescue drill
3
4
Target
1
PTW System, LSR & Golden Rules Site Manager / HSSE
Actual

5.3 Monthly 2 All personnel 4 Attendance list

(Refresh) Officer
3
4
Target
1
Site Manager / HSSE
Actual

5.4 Safety Working Guidelines (Refresh) Monthly 2 All personnel 4 Attendance list
Officer
3
4
Target
1
Site Manager / HSSE
Actual

5.5 PPE Training Monthly 2 All personnel 4 Attendance list

Officer
3
4
Target
1
Site Manager / HSSE
Actual

5.6 Safety Equipment Training Monthly 2 All personnel 4 Attendance list

Officer
 Site Manager / HSSE

Actual
5.6 Safety Equipment Training Monthly All personnel 4 Attendance list
Officer
3
4
Target
1
Site Manager / HSSE

Actual
5.7 High Risk Activity Tracker Traiining Monthly 2 All personnel 4 Attendance list
Officer
3
4
Target
1
Site Manager / HSSE

Actual
5.8 LOTOTO Training Monthly 2 All personnel 4 Attendance list
Officer
3
4
Target
1
Site Manager / HSSE

Actual
5.9 First Aider Monthly 2 All personnel 4 Attendance list
Officer
3
4
Target
1
Site Manager / HSSE

Actual
*5.10 Fire Fighter Monthly 2 All personnel 4 Attendance list
Officer
3
4
Target
1
Site Manager / HSSE
Actual

5.11 Blue Zone Monthly 2 All personnel 4 Attendance list

Officer
3
4
6 External Safety Training Schedule Action By Target Actual Remarks
6.1 Authorize Gas Test 2 Yearly SPV Civil 1 1 Completed
6.2 Basic Safety Training 2 Yearly HSE Personnel 1 1 Completed
6.3 Scaffolding Inspector 5 Yearly Scaffolder 1 1 Completed
6.4 First Aider 1 Yearly HSE Personnel 1 1 Completed
6.5 Fire Fighter 1 Yearly HSE Personnel 1 1 Completed
6.5 Electrical safety 1 Yearly Electrician 1 1 Completed
 RENCANA OBYEKTIF & PROGRAM QHSE
No Dok : FM.HSE.003; Rev.01; Tgl Terbit : 27 September 2021

Lokasi :
Tanggal :
Periode :

No HSE OBJECTIVES ACTION PLAN TARGET WAKTU PIC

Prepared By: Approved By OWNER:

PT. Hydroraya Adhi Perkasa

HSE PT. HAP MANAGEMENT REPRESENTATIVE PT.HAP