PT.

SERTCO QUALITY

HSE COMMUNICATION
Communication

Internal

Communication Media

Telp

External
Fax

Visit
Jenis Komunikasi

Source of information
Name
:
ID Card
:
Date/Time
:

e-mail

Letter

Other, TV, web dll ________

* Letter, fax, email attachmen when available

Keluhan

Informasi

Saran

Lain-lain, ______________________

DESCRIPTION OF PROBLEM
* Please write media source name on Name Column
________________________
________________________
________________________

Sign

Information/Description:

Made by

Approved by

RESPONSE
NOTE

Respond
No respond needed

Name
Date

Name
Date

PSRI 03F3

Aug 25, 06

LIST OF HSE COMMUNICATION

NO

REQUESTED BY

DESCRIPTION

ACTION

DATE

CPAR

P.I.C

REMARKS

PSRI 03F3
25-Aug-06

R01
Jakarta,

__________________________
HSE Management Representative

PSRI 03F4
1
Aug 25, 06

NOTULEN PERTEMUAN K3 (SAFETY MEETING)

Shift

Tanggal
Nama

Paraf

Makalah Pertemuan disampaikan Oleh

Topik yang didiskusikan

Bahan Pertemuan

Judul Makalah

1. Outline
2. Video
3. Handouts
4. Lain-lain
Hasil Diskusi (Pertanyaan dan Jawaban)

DAFTAR HADIR
NO

NAMA

JABATAN

PARAF

PSRI 03F4
25-Aug-06

R01