HSE Daily Report

• Date

  Date

• Work Area

  Select

• Prepared by

  Agil Shierany

  Adriansyah

  Ismatullah

Permit

• Permit Number

• Activities

• Area Authority

• Performing Authority

• Supervisor/ Engineer

• Heavy Equipments

• Hand Tools & Equipments

• POB

Finding

Unsafe Action

• Unsafe Action Finding 1

  Yes

  No

  N/A

• Finding Location

• Status

  Open

  Close

• Unsafe Action Finding 2

  Yes

  No

  N/A

• Finding Location

• Status

  Open

  Close

• Unsafe Action Finding 3

  Yes

  No

  N/A

• Finding Location

• Status

  Open

  Close

• Unsafe Action Finding 4

  Yes

  No

  N/A

• Finding Location

• Status

  Open

  Close

• Unsafe Action Finding 5

  Yes

  No

  N/A

• Finding Location

• Status

  Open

  Close

Unsafe Condition

• Unsafe Condition Finding 1

  Yes

  No

  N/A

• Location

• Status

  Open

  Close

• Unsafe Condition Finding 2

  Yes

  No

  N/A

• Location

• Status

  Open

  Close

• Unsafe Condition Finding 3

  Yes

  No

  N/A

• Location

• Status

  Open

  Close

• Unsafe Condition Finding 4

  Yes

  No

  N/A

• Location

• Status

  Open

  Close

• Unsafe Condition Finding 5

  Yes

  No

  N/A

• Location

• Status

  Open

  Close

Closing Finding

Corrective Finding Action

• Corrective Finding Action 1

  Media

• Corrective Finding Action 2

  Media

• Corrective Finding Action 3

  Media

• Corrective Finding Action 4

  Media

• Corrective Finding Action 5

  Media

Corrective Finding Condition

• Corrective Finding Condition 1

  Media

• Corrective Finding Condition 2

  Media

• Corrective Finding Condition 3

  Media

• Corrective Finding Condition 4

  Media

• Corrective Finding Condition 5

  Media