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Form Induction Record: No. Dokumen: FIR-WS-17-21 Tgl. Terbit: 22-Aug-17 Revisi: 0: 1 of 1

This document contains an employee induction record and details. It lists the employee's name, ID number, emergency contact, and address. It also outlines 12 induction content topics that were covered, including the company's safety, health, and environment policies, personal protective equipment policies, safe work procedures, emergency response procedures, and more. The employee acknowledges attending the induction course and undertaking to follow the guidelines provided on occupational health, safety, and the environment.

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Fristami Dinul Surya
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269 views2 pages

Form Induction Record: No. Dokumen: FIR-WS-17-21 Tgl. Terbit: 22-Aug-17 Revisi: 0: 1 of 1

This document contains an employee induction record and details. It lists the employee's name, ID number, emergency contact, and address. It also outlines 12 induction content topics that were covered, including the company's safety, health, and environment policies, personal protective equipment policies, safe work procedures, emergency response procedures, and more. The employee acknowledges attending the induction course and undertaking to follow the guidelines provided on occupational health, safety, and the environment.

Uploaded by

Fristami Dinul Surya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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No.

Dokumen : FIR-WS-17-21
Tgl. Terbit : 22-Aug-17
FORM INDUCTION RECORD Revisi : 0
Page : 1 Of 1

DATA PEKERJA / EMPLOYEE DETAILS

No. KTP / SIM / ID Number :

Nama Lengkap / Full Name :

Tempat & Tanggal Lahir / Place & Date Of Birth :

Jabatan / Position :

Alamat / Address :

No. Telephon / Phone Number :

JIKA SAYA DALAM KEADAAN DARURAT HARAP HUBUNGI / EMERGENCY CONTACT PERSONEL

Nama Lengkap / Full Name :

:
Hubungan / Relationship
Alamat / Address :

No. Telephon / Phone Number :

INDUCTION CONTENT / ISI INDUKSI

1 BAMA Safety Health Environment – Policy 7 Control & Job Risk Assessment
BAMA Kebijakan K3LH Kontrol & Taksiran pengendalian Bahaya Pekerjaan

2 BAMA Alcohol & Drugs – Policy 8 Personal Responsibilities of HSE


BAMA Kebijakan Alcohol & Obat-obatan Tanggung jawab pekerja terhadap K3LH

3 BAMA Personal Protective Equipment – Policy 9 Work Permit


BAMA Kebijakan Alat Pelindung Diri Ijin Kerja

4 Working Environment 10 Accident, Incident, Anomaly Report & Record


Lingkungan Kerja Laporan & Pencatatan kecelakaan, kejadian, kondisi tidak aman

5 HSE Committee Meeting & Supervising 11 Emergency Response Procedure & Emergency Team
Rapat & Pengawasan K3LH Prosedur Situasi Darurat& Kelompok Tanggap Darurat

6 Safe Work Procedures 12 Work Hours


Tata cara bekerja yang aman Jam kerja

I hereby acknowledge that I have attended the Induction course on Occupational Health and Safety and Environment under take
to follow the guidelines given and all site rules to the best of my ability. I certify that the information provided is true and correct.
EMPLOYEE SAFETY HEALTH & ENVIRONMENT

(…………………………………………………) (…………………………………………………)

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