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    Form Bbs Card Safety

    Uploaded by

    Benny Adityaning Bntoro
    The document appears to be an observation report card used by a company to document potential safety risks and incidents in the workplace. It includes sections to describe details of behaviors, conditions, or incidents observed; potential risks; causes of unsafe behaviors; suggestions to prevent recurrences; and sections for signatures and dates. The card is repeated three times, with each copy intended to document a separate incident or observation.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd

    Form Bbs Card Safety

    Uploaded by

    Benny Adityaning Bntoro
    1K views2 pages
    The document appears to be an observation report card used by a company to document potential safety risks and incidents in the workplace. It includes sections to describe details of behaviors, conditions, or incidents observed; potential risks; causes of unsafe behaviors; suggestions to prevent recurrences; and sections for signatures and dates. The card is repeated three times, with each copy intended to document a separate incident or observation.

    Original Description:

    Formulir bbs card untuk peningkatan safety awareness

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    © © All Rights Reserved

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    The document appears to be an observation report card used by a company to document potential safety risks and incidents in the workplace. It includes sections to describe details of behaviors, conditions, or incidents observed; potential risks; causes of unsafe behaviors; suggestions to prevent recurrences; and sections for signatures and dates. The card is repeated three times, with each copy intended to document a separate incident or observation.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    1K views2 pages

    Form Bbs Card Safety

    Uploaded by

    Benny Adityaning Bntoro
    The document appears to be an observation report card used by a company to document potential safety risks and incidents in the workplace. It includes sections to describe details of behaviors, conditions, or incidents observed; potential risks; causes of unsafe behaviors; suggestions to prevent recurrences; and sections for signatures and dates. The card is repeated three times, with each copy intended to document a separate incident or observation.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
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    KARTU LAPORAN OBSERVASI BBS

    KARTU LAPORAN OBSERVASI BBS

    KARTU LAPORAN OBSERVASI BBS

    (BBS OBSERVATION REPORT CARD)

    (BBS OBSERVATION REPORT CARD)

    (BBS OBSERVATION REPORT CARD)

    Rincian dari Tindakan / Kondisi / Insiden yang diamati


    (Detail of Behavior / Condition / Incident observed)
    Detail Issue :

    Rincian dari Tindakan / Kondisi / Insiden yang diamati


    (Detail of Behavior / Condition / Incident observed)
    Detail Issue :

    Rincian dari Tindakan / Kondisi / Insiden yang diamati


    (Detail of Behavior / Condition / Incident observed)
    Detail Issue :

    Apa potensi resikonya?


    What is the potensional RISK?

    Apa potensi resikonya?


    What is the potensional RISK?

    Apa potensi resikonya?


    What is the potensional RISK?

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Terjepit / terkait sesuatu

    Lain-lain :

    Terjepit / terkait sesuatu

    Lain-lain :

    Terjepit / terkait sesuatu

    Lain-lain :

    (Caught in / between)

    (Others)

    (Caught in / between)

    (Others)

    (Caught in / between)

    (Others)

    Rincian Tindakan Perbaikan Langsung


    Describe immediate action taken

    Rincian Tindakan Perbaikan Langsung


    Describe immediate action taken

    Rincian Tindakan Perbaikan Langsung


    Describe immediate action taken

    Nama / Name

    Nama / Name

    Nama / Name

    Jabatan / Position

    Jabatan / Position

    Jabatan / Position

    Divisi / Division

    Divisi / Division

    Divisi / Division

    Atasan langsung / Direct Supervisor

    Atasan langsung / Direct Supervisor

    Atasan langsung / Direct Supervisor

    Tanda tangan / Signature

    Tanda tangan / Signature

    Tanda tangan / Signature

    Tanggal / Date

    Tanggal / Date

    Tanggal / Date

    logo perusahaan

    KARTU LAPORAN OBSERVASI BBS


    (BBS OBSERVATION REPORT CARD)

    logo perusahaan

    KARTU LAPORAN OBSERVASI BBS


    (BBS OBSERVATION REPORT CARD)

    logo perusahaan

    KARTU LAPORAN OBSERVASI BBS


    (BBS OBSERVATION REPORT CARD)

    Rincian dari Tindakan / Kondisi / Insiden yang diamati


    (Detail of Behavior / Condition / Incident observed)
    Detail Issue :

    Rincian dari Tindakan / Kondisi / Insiden yang diamati


    (Detail of Behavior / Condition / Incident observed)
    Detail Issue :

    Rincian dari Tindakan / Kondisi / Insiden yang diamati


    (Detail of Behavior / Condition / Incident observed)
    Detail Issue :

    Apa penyebab perilaku tidak aman?


    What is the cause(s) of unsafe behavior?

    Apa potensi resikonya?


    What is the potensional RISK?

    Apa potensi resikonya?


    What is the potensional RISK?

    Peralatan / fasilitas tidak memadai


    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong / teriris / tertusuk


    (cut by / punctured)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Terjepit / terkait sesuatu


    (Caught in / between)

    Lain-lain :
    (Others)

    Terjepit / terkait sesuatu


    (Caught in / between)

    Lain-lain :
    (Others)

    Terjepit / terkait sesuatu


    (Caught in / between)

    Lain-lain :
    (Others)

    Apa potensi resikonya?


    What is the potensional RISK?

    Apa potensi resikonya?


    What is the potensional RISK?

    Apa potensi resikonya?


    What is the potensional RISK?

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Pencemaran Lingkungan
    (Enviromental Pollution)

    Terbakar / kebakaran
    (Fire)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Terpeleset / terguling / terjatuh


    (Slip / trip / fall)

    Jatuh dari ketinggian/tertimpa barang


    (Fall from height)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Menabrak/ditabrak sesuatu
    (Striking against / struck by)

    Kontak listrik / kimia / kuman


    (Electricity / chemical / germ exposed)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong / teriris / tertusuk


    (cut by / punctured)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Sakit pinggang/punggung
    (Muskeleoskeletal disorder)

    Terpotong/teriris/tertusuk
    (cut by / punctured)

    Terjepit / terkait sesuatu


    (Caught in / between)

    Lain-lain :
    (Others)

    Terjepit / terkait sesuatu


    (Caught in / between)

    Lain-lain :
    (Others)

    Terjepit / terkait sesuatu


    (Caught in / between)

    Lain-lain :
    (Others)

    Saran / solusi agar perilaku beresiko / tidak aman tidak terulang

    Saran / solusi agar perilaku beresiko / tidak aman tidak terulang

    Saran / solusi agar perilaku beresiko / tidak aman tidak terulang

    Suggestions / solutions in order to conduct risk / unsafe behavior do not recur

    Suggestions / solutions in order to conduct risk / unsafe behavior do not recur

    Suggestions / solutions in order to conduct risk / unsafe behavior do not recur

    Nama / Name
    Jabatan / Position
    Divisi / Division
    Atasan langsung / Direct Supervisor

    Nama / Name
    Jabatan / Position
    Divisi / Division
    Atasan langsung / Direct Supervisor

    Nama / Name
    Jabatan / Position
    Divisi / Division
    Atasan langsung / Direct Supervisor

    Tanda tangan / Signature

    Tanda tangan / Signature

    Tanda tangan / Signature

    Tanggal / Date

    Tanggal / Date

    Tanggal / Date

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