HSE OPP Website

Form - PBBG

dEPARTEMEN HSE

OPP-F-SHE-02 Formulir Distribusi Kebijakan MK3L

OPP-F-SHE-03A Formulir Identifikasi Bahaya, Penilaian dan Penetapan Pengendalian Risiko

OPP-F-SHE-03B Formulir Job Safety Analysis

OPP-F-SHE-03C Formulir Health Risk Assesment (HRA)

OPP-F-SHE-04A Formulir Identifikasi Aspek Dampak Lingkungan

OPP-F-SHE-04B Formulir Identifikasi Risiko Peluang (Berdasarkan Pihak Berkepentingan)

OPP-F-SHE-04C Formulir Identifikasi Risiko Peluang (Berdasarkan Issu)

OPP-F-SHE-05A Formulir Identifikasi Risiko dan Tindakan untuk Mengatasi Risiko dan Peluang (Mutu)

OPP-F-SHE-06A Formulir Laporan Evaluasi Peraturan Perundangan

OPP-F-SHE-06B Formulir Daftar Perijinan dan Persyaratan Lain

OPP-F-SHE-07A Formulir Tujuan Sasaran Program

OPP-F-SHE-08C Formulir PICA

OPP-F-SHE-09A Formulir Check List Audit Internal

OPP-F-SHE-09B Formulir Agenda Audit Internal

OPP-F-SHE-09C Formulir Rekap Ketidaksesuaian Audit Intenal

OPP-F-SHE-09D Formulir Permintaan Tindakan Perbaikan

OPP-F-SHE-10A Formulir Program rapat tinjauan manajemen

OPP-F-SHE-10B Formulir Notulen Rapat Tinjauan Manajemen

OPP-F-SHE-10C Formulir Catatan Status Tinjauan Manajemen

OPP-F-SHE-11A Formulir Berita Acara Pemusnahan Dokumen

OPP-F-SHE-11B Formulir Penarikan Dokumen

OPP-F-SHE-11C Formulir Usulan Pembuatan dan Revisi Dokumen

OPP-F-SHE-11D Formulir Daftar Induk Dokumen

OPP-F-SHE-11E Formulir Daftar Dokumen Eksternal

OPP-F-SHE-11F Formulir Monitoring Review Dokumen

OPP-F-SHE-12A Formulir Daftar Induk Catatan

OPP-F-SHE-13A Formulir daftar hadir safety talk/P5M

OPP-F-SHE-13B Formulir Hazard Report

OPP-F-SHE-13C Formulir pelaporan tindakan tidak aman/Kartu Terimakasih

OPP-F-SHE-13D Formulir Papan Informasi K3PLM

OPP-F-SHE-15A Formulir Daftar Hadir Pertemuan

OPP-F-SHE-15B Formulir Notulen Rapat KKP/P2K3

OPP-F-SHE-15C Formulir Minute Of Meeting (MOM)

OPP-F-SHE-16A Formulir Daftar Hadir

OPP-F-SHE-16B Formulir Induksi Tamu

OPP-F-SHE-18A Formulir Permintaan APD

OPP-F-SHE-18B Formulir Penerimaan dan Pengembalian APD

OPP-F-SHE-18C Formulir Laporan Pemakaian APD

OPP-F-SHE-18D Formulir Inspeksi Bulanan APD

OPP-F-SHE-18E Formulir Berita Acara Kehilangan/ Kerusakan APD

OPP-F-SHE-19A Formulir Ijin Kerja di Ketinggian

OPP-F-SHE-19B Formulir Ijin Kerja Panas

OPP-F-SHE-19C Formulir ijin Kerja Dekat Air

OPP-F-SHE-19D Formulir Ijin Penggalian Tanah

OPP-F-SHE-19E Formulir Ijin Kerja Listrik

OPP-F-SHE-19F Formulir Ijin Kerja di Area Longsor

OPP-F-SHE-19G Formulir Ijin Kerja di Ruang Terbatas

OPP-F-SHE-19H Formulir Evaluasi Izin Kerja Khusus

OPP-F-SHE-20A Formulir OTT Mengoperasikan Dump Truck

OPP-F-SHE-20B Formulir OTT Mengoperasikan LV

OPP-F-SHE-20C Formulir OTT Mengoperasikan Bulldozer

OPP-F-SHE-20D Formulir OTT Mengoperasikan Excavator

OPP-F-SHE-20E Formulir OTT Mengoperasikan Fuel Truck

OPP-F-SHE-20F Formulir OTT Mengoperasikan Motor Grader

OPP-F-SHE-20G Formulir OTT Mengoperasikan Compactor

OPP-F-SHE-20H Formulir OTT Mengoperasikan Water Truck

OPP-F-SHE-20I Formulir OTT Mengoperasikan Pekerjaan Survey

OPP-F-SHE-20J Formulir OTT Mengoperasikan Haul Truck

OPP-F-SHE-20K Formulir OTT Mengoperasikan Repair Tyre

OPP-F-SHE-20L Formulir OTT Mengoperasikan Perkakas dan Peralatan Bertenaga

OPP-F-SHE-20M Formulir OTT Membongkar pasang komponen unit

OPP-F-SHE-20N Formulir OTT Mengoperasikan Komputer

OPP-F-SHE-20O Formulir OTT Mengoperasikan Drilling Machine

OPP-F-SHE-20P Formulir OTT Pengisian Bahan Bakar

OPP-F-SHE-20Q Formulir OTT Perbaikan dan Perawatan Bulldozer

OPP-F-SHE-20R Formulir OTT Perbaikan dan Perawatan Excavator

OPP-F-SHE-20S Formulir OTT Perbaikan dan Perawatan Dump Truck

OPP-F-SHE-20T Formulir OTT Perbaikan dan Perawatan Motor Grader

OPP-F-SHE-20U Formulir OTT Pekerjaan Greasing

OPP-F-SHE-20V Formulir OTT Pekerjaan Pemindahan Tower Lamp

OPP-F-SHE-20W Formulir OTT Pekerjaan Press Filter

OPP-F-SHE-20X Formulir OTT Pekerjaan Pemasangan atau Pelepasan Teeth Bucket

OPP-F-SHE-20Y Formulir OTT Pekerjaan Pemasangan atau Pelepasan Tyre

OPP-F-SHE-20Z Formulir OTT Pekerjaan Pemasangan dan Pelepasan Rambu - Rambu

OPP-F-SHE-20AA Formulir Izin Menumpang Unit

OPP-F-SHE-21A Formulir Inspeksi Area Mine Haul Road

OPP-F-SHE-21B Formulir Inspeksi Workshop

OPP-F-SHE-21C Formulir Inspeksi Mess

OPP-F-SHE-21D Formulir Inspeksi Office

OPP-F-SHE-21E Formulir Inspeksi Fuel Storage

OPP-F-SHE-21F Formulir Inspeksi Warehouse

OPP-F-SHE-21G Formulir Inspeksi Gudang Peledak

OPP-F-SHE-21H Formulir Inspeksi Alarm Emergency dan Smoke Detektor

OPP-F-SHE-21I Formulir Inspeksi Eyewash

OPP-F-SHE-21J Formulir Inspeksi Gerindra

OPP-F-SHE-21K Formulir Inspeksi Welding

OPP-F-SHE-21L Formulir Inspeksi Kabel

OPP-F-SHE-21M Formulir Inspeksi Catering

OPP-F-SHE-21N Formulir Inspeksi TPS LB3

OPP-F-SHE-21O Formulir Inspeksi APAR

OPP-F-SHE-21P Formulir Inspeksi peralatan/Instalasi listrik

OPP-F-SHE-21Q Formulir Inspeksi Compressor

OPP-F-SHE-21R Formulir Inspeksi Kepatuhan

OPP-F-SHE-21S Formulir Inspeksi Hydrant

OPP-F-SHE-21T Formulir Inspeksi Pemantauan Daerah Basah

OPP-F-SHE-21U Formulir Inspeksi Kecepatan (Speed Gun)

OPP-F-SHE-21V Formulir Jadwal Inspeksi KO

OPP-F-SHE-21W Formulir Inspeksi Area Disposal

OPP-F-SHE-21X Formulir Inspeksi Area Front Loading OB

OPP-F-SHE-21Y Formulir Inspeksi Area Front Loading Coal

OPP-F-SHE-21Z Formulir Inspeksi Area Dewatering

OPP-F-SHE-21AA Formulir Inspeksi Smoke Detector

OPP-F-SHE-21AB Formulir Inspeksi Spill Kit

OPP-F-SHE-21AC Formulir Inspeksi Area CSA

OPP-F-SHE-21AD Formulir Inspeksi Area Pit Stop

OPP-F-SHE-22A Formulir KPI

OPP-F-SHE-23B Formulir Laporan Bulanan Lingkungan

OPP-F-SHE-24A Formulir Penyelidikan Kecelakaan dan Insiden

OPP-F-SHE-24B Formulir Keterangan Korban dan Saksi Kecelakaan

OPP-F-SHE-24C Formulir Absen Pasca Accident

OPP-F-SHE-24D Formulir Berita Acara

OPP-F-SHE-24E Formulir Surat Keterangan Penahanan Mine Permit

OPP-F-SHE-25A Formulir Struktur ERT

OPP-F-SHE-25B Formulir Nomor Telepon Keadaan Darurat

OPP-F-SHE-25C Formulir Program Kerja ERT

OPP-F-SHE-25D Formulir Laporan Simulasi Emergency Respons

OPP-F-SHE-27A Formulir Daftar Alat Pemadam Api Ringan (APAR)

OPP-F-SHE-27B Formulir Pemindahan/Penggantian Alat Pemadam Api Ringan (APAR)

OPP-F-SHE-27C Formulir Data Pemasangan Sistem Alarm

OPP-F-SHE-28A Formulir Standar Isi Kotak/Kantong P3K

OPP-F-SHE-28B Formulir Pemakaian Isi Kotak/Kantong P3K

OPP-F-SHE-28C Formulir Lembar Pemakaian Isi Kotak/Kantong P3K

OPP-F-SHE-28D Formulir Log Book Kunjungan Balai K3

OPP-F-SHE-28E Formulir Lembar Periksa Fasilitas Balai K3

OPP-F-SHE-28F Formulir Lembar Periksa Peralatan Emergency Rescue

OPP-F-SHE-28G Formulir Daftar Jenis Obat P3K

OPP-F-SHE-28H Formulir Inspeksi First Aid Box (P3K) Tipe B

OPP-F-SHE-28I Formulir Inspeksi AED

OPP-F-SHE-28J Formulir Inspeksi Responder Bag

OPP-F-SHE-28K Formulir Registrasi Kotak P3K

OPP-F-SHE-29A Formulir Survei Ergonomi

OPP-F-SHE-29B Formulir Checklist Bugar/ Kesiapan Kondisi Kesehatan

OPP-F-SHE-29C Formulir Pemeriksaan Fatigue

OPP-F-SHE-29D Formulir Wakeup Call

OPP-F-SHE-29E Formulir Pemeriksaan Kesehatan Awal Shif

OPP-F-SHE-29F Formulir Pemulangan Karyawan Fatigue

OPP-F-SHE-29G Formulir Identifikasi Faktor Kelelahan

OPP-F-SHE-30A Formulir List Pemeriksaan MCU

OPP-F-SHE-30B Formulir Penilaian Vendor MCU

OPP-F-SHE-30C Formulir Rekapitulasi MCU

OPP-F-SHE-30D Formulir Tindaklanjut MCU

OPP-F-SHE-30E Formulir Struktur Organisasi Pos Kesehatan

OPP-F-SHE-30F Formulir Pemeriksaan Kesehatan Program PASTI

OPP-F-SHE-30G Formulir Pernyataan Komitmen Program Wellness

OPP-F-SHE-30I Formulir Permintaan Pemeriksaan Penunjang

OPP-F-SHE-30J Formulir Permintaan Pemeriksaan Laboratorium

OPP-F-SHE-30K Formulir Pemeriksaan Khusus MCU

OPP-F-SHE-31A Formulir Berobat

OPP-F-SHE-32A Formulir Perhitungan AKG

OPP-F-SHE-32B Formulir Rekapitulasi AKG

OPP-F-SHE-33 Formulir Struktur Organisasi P2HIV AIDS

OPP-F-SHE-35A Formulir Work Order Penyediaan Rambu

OPP-F-SHE-36A Formulir Distribusi LOTO

OPP-F-SHE-36B Formulir Pelepasan LOTO

OPP-F-SHE-39A Formulir Persetujuan atas perubahan design, metode atau proses

OPP-F-SHE-40A Formulir Daftar Alat/Peralatan Subkontraktor

OPP-F-SHE-40B Formulir Monitoring Laporan Bulanan Mitra Kerja

OPP-F-SHE-40C Formulir Kuisioner CMS Out Of Mining Area

OPP-F-SHE-41A Formulir P2H Light Vehicle (LV)

OPP-F-SHE-41B Formulir P2H BUS

OPP-F-SHE-41C Formulir P2H Crane Truck

OPP-F-SHE-41D Formulir P2H Bulldozer

OPP-F-SHE-41E Formulir P2H Heavy Dump Truck

OPP-F-SHE-41F Formulir P2H Excavator

OPP-F-SHE-41G Formulir P2H Fuel Truck

OPP-F-SHE-41H Formulir P2H Motor Grader

OPP-F-SHE-41I Formulir P2H Compactor

OPP-F-SHE-41J Formulir P2H Water Truck DT

OPP-F-SHE-41K Formulir P2H Drilling Machine

OPP-F-SHE-41L Formulir P2H Dump Truck

OPP-F-SHE-41M Formulir P2H Pompa

OPP-F-SHE-41N Formulir P2H Genset

OPP-F-SHE-41O Formulir P2H Lube Truck

OPP-F-SHE-41P Formulir P2H Tower Lamp

OPP-F-SHE-41Q Formulir P2H Forklift

OPP-F-SHE-41R Formulir P2H Telehandler

OPP-F-SHE-41S Formulir P2H Water Truck HD

OPP-F-SHE-41T Formulir P2H Tyre Truck

OPP-F-SHE-41U Formulir P2H Chainsaw

OPP-F-SHE-41V Formulir P2H Rotarysaw

OPP-F-SHE-41W Formulir P2H Chipping Hammer

OPP-F-SHE-41X Formulir P2H Engine Pump

OPP-F-SHE-41Y Formulir P2H Alat Ekstrikasi

OPP-F-SHE-41Z Formulir P2H HPU (Hydraulic Pumping Unit)

OPP-F-SHE-41AA Formulir P2H Pompa Booster dan Slurry Tank

OPP-F-SHE-41AB Formulir P2H Compressor

OPP-F-SHE-43A Formulir Laporan Keselamatan Operasi

OPP-F-SHE-44A Formulir Jadwal Pengukuran Lingkungan Kerja

OPP-F-SHE-44B Formulir Evaluasi Hasil Pengukuran Lingkungan Kerja

OPP-F-SHE-44C Formulir Jadwal Kalibrasi Alat Ukur

OPP-F-SHE-44D Formulir Pengukuran Suhu

OPP-F-SHE-44E Formulir Pengukuran Pencahayaan

OPP-F-SHE-45A Formulir Log Book Limbah B3

OPP-F-SHE-45B Formulir Berita Acara Serah Terima LB3

OPP-F-SHE-45C Formulir Monitoring Pihak Pengangkut LB3

OPP-F-SHE-47A Formulir Pemeriksaan Oil Trap

OPP-F-SHE-51A Formulir Inspeksi Tata Graha

OPP-F-SHE-57A Golden Rule PT. OPP

OPP-F-SHE-57B Formulir Surat Peryataan Disiplin Karyawan

OPP-F-SHE-58A Formulir Laporan Kegiatan Training Internal

OPP-F-SHE-64 Formulir Struktur Organisasi P2 Covid-19

OPP-F-SHE-66A Formulir Pembatasan Kendaraan

OPP-F-SHE-67A Formulir Diagnosis PAK

OPP-F-SHE-68 Formulir Survei Keluhan Gangguan Otot Rangka (Gotrak)

OPP-F-SHE-69 Formulir Pemeriksaan Oil TrapFormulir NAPZA

OPP-F-SHE-73A Formulir Evaluasi Pemantauan dan Pengukuran Kinerja TSP K3PLM

OPP-F-SHE-73B Formulir Evaluasi Pemantauan dan Pengukuran Lingkungan Kerja

OPP-F-SHE-73C Formulir Evaluasi Pemantauan dan Pengukuran Kinerja Pengelolaan Kesehatan Kerja

OPP-F-SHE-73D Formulir Evaluasi Pemantauan dan Pengukuran Kinerja Keselamatan Operasi

OPP-F-SHE-74A Formulir Pemeriksaan dan Pengujian Dump Truck dan Sejenisnya

OPP-F-SHE-74B Formulir Pemeriksaan dan Pengujian Excavator

OPP-F-SHE-74C Formulir Pemeriksaan dan Pengujian Bulldozer

OPP-F-SHE-74D Formulir Liquid Penetrant Test Report

OPP-F-SHE-74E Formulir Magnetic Particle Test Report

OPP-F-SHE-74F Formulir Pemeriksaan Self Loader Mixer

OPP-F-SHE-76A Formulir Liquid Leak Testing Report

dEPARTEMEN HCGS

OPP-F-HCGS-02 Formulir Job Description

OPP-F-HCGS-03 Formulir Permintaan Tenaga Kerja

OPP-F-HCGS-04 Formulir Biodata Calon Karyawan

OPP-F-HCGS-05 Formulir Report Of Daily Recruitment

OPP-F-HCGS-06 Formulir Penilaian Interview Calon Karyawan

OPP-F-HCGS-07 Formulir Pernyataan Seleksi Calon Karyawan

OPP-F-HCGS-08 Formulir Offering Letter

OPP-F-HCGS-09 Formulir Pengantar Medical Check Up

OPP-F-HCGS-10 Formulir Kontrak Kerja

OPP-F-HCGS-11 Formulir Induksi Karyawan Datang Cuti/Karyawan Baru

OPP-F-HCGS-12 Formulir Serah Terima Karyawan

OPP-F-HCGS-15 Formulir Cuti Karyawan

OPP-F-HCGS-16 Formulir Izin Meninggalkan Job Site

OPP-F-HCGS-17 Formulir Coaching & Counseling

OPP-F-HCGS-18 Formulir Surat Teguran & Surat Peringatan

OPP-F-HCGS-19 Formulir Penilaian Kinerja Karyawan

OPP-F-HCGS-20 Formulir Employee Contract Report

OPP-F-HCGS-21 Formulir Pemberitahuan Putus Kontrak

OPP-F-HCGS-22 Formulir Pemberitahuan PKWT Perpanjangan

OPP-F-HCGS-23 Formulir Pemberitahuan Jeda Karyawan

OPP-F-HCGS-24 Formulir Rekomendasi Usulan Permanen

OPP-F-HCGS-25 Formulir Exit Interview

OPP-F-HCGS-26 Formulir Clearence Sheet

OPP-F-HCGS-27 Formulir Exit Clearence

OPP-F-HCGS-28 Formulir Rencana Kebutuhan Pelatihan

OPP-F-HCGS-29 Formulir Jadwal Pelatihan

OPP-F-HCGS-30 Formulir Daftar Hadir Pelatihan

OPP-F-HCGS-31 Formulir Hasil Evaluasi Pelatihan

OPP-F-HCGS-32 Formulir Matriks Pelatihan Khusus

OPP-F-HCGS-33 Formulir Matrik Kompetensi

OPP-F-HCGS-34 Formulir Evaluasi Efektifitas Training

OPP-F-HCGS-35 Formulir Rekapitulasi Evaluasi Efektifitas Training

OPP-F-HCGS-36 Formulir Surat Tugas Dinas

OPP-F-HCGS-37 Formulir Ikatan Dinas Training

OPP-F-HCGS-38 Formulir Deklarasi Perjalanan Dinas

OPP-F-HCGS-39 Formulir Kesimpulan Pelaksanaan Training

OPP-F-HCGS-40 Formulir Monitoring Pelaksanaan Training

OPP-F-HCGS-47 Formulir Laporan Lembur Karyawan

OPP-F-HCGS-48 Formulir Surat Perintah Lembur

OPP-F-HCGS-49 Formulir Absensi Manual Thl

OPP-F-HCGS-50 Formulir Persetujuan Pemotongan

OPP-F-HCGS-51 Formulir Medical Voucher Claim

OPP-F-HCGS-52 Formulir Serah Terima Pekerjaan (STP)

OPP-F-HCGS-53 Formulir Surat Perintah Kerja (SPK)

OPP-F-HCGS-54 Formulir Rencana Kebutuhan Barang

OPP-F-HCGS-55 Formulir Permohonan Biaya

OPP-F-HCGS-56 Formulir Rencana Anggaran Biaya

OPP-F-HCGS-57 Formulir Permintaan Pengadaan Software/ Hardware

OPP-F-HCGS-58 Formulir Job Pending

OPP-F-HCGS-60 Formulir Permintaan Pekerjaan

OPP-F-HCGS-65 Formulir Schedule Perawatan LV

OPP-F-HCGS-66 Formulir Checklist Barang Inventory GA

OPP-F-HCGS-67 Formulir Checklist Kamar Mandi / Toilet

OPP-F-HCGS-68 Formulir Schedule Housekeeping

OPP-F-HCGS-76 Formulur Pengecekan (Pemeliharaan) Air Conditioner

OPP-F-HCGS-77 Formulir Tanda Terima Dokumen & Barang

OPP-F-HCGS-79 Formulir Form Tanda Terima Dokumen Barang

OPP-F-HCGS-84 Formulir Risalah Perundingan Bipartit

dEPARTEMEN oPERATION

OPP-F-OPR-04A Formulir Checklist Inspeksi Area Pit (Front Loading)

OPP-F-OPR-04B Formulir Inspeksi Inspeksi Disposal

OPP-F-OPR-04D Formulir Perintah Kerja Harian

OPP-F-OPR-05A Formulir Observasi Jam Kritis Kepada Operator

OPP-F-OPR-05B Formulir Formulir Petunjuk Pertanyaan perator Yang Izin Fatigue

OPP-F-OPR-05C Formulir Checklist Speak Up (Check Point)

OPP-F-OPR-06A Formulir Inspeksi Penempatan Barang

OPP-F-OPR-06B Formulir Inspeksi Triwulan Loker Handphone

dEPARTEMEN Finance

OPP-F-FNC-01 Formulir Invoice

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