Title Page
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Unit
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Date
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Auditor
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Auditee
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Location
Summary :
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1. Dokumen Engineering (ISO 9001:2008 Klausul 4.2.4)
Kelengkapangan Dokumen
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a. Data Prosedur dan IK update (ISO 9001:2008 Klausul 4.2.4)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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b. Data Bisplan Tahunan Engineering yg sudah diApprove PM Manager (ISO 9001:2008 Klausul 4.2.4)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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c. Odner Master PM Tahnunan & PM bulanan
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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d. Odner BA kerusakan / corrective
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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e. Data Master kunjungan vendor
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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f. Data hasil lab air STP, air PAM, Colling Tower
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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g. Data hasil infrared thermography
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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h. Data cek tegangan tembus trafo (jika ada)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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i. Data cek Ampere Capasitor Bank
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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j. Data hasil general checklist vendor tahunan lift / cek safety device lift
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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k. Data cheklist laporan kunjungan vendor lift bulnanan
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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l.Data billing PLN, PGN, PAM (minimal 3 bulan terakhir)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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m.Data list masa jatuh tempo kalibrasi/Tera meter air dan listrik
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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1. Struktur Organisasi Eng unit update ( ISO 9001:2008 Klausul 5.3)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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2. Rekap data profil detail Utility MEP (Merk, Kapasitas, KW, Ampere)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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3. Kelengkapan As Build Drawing MEP gedung
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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4. Rencana training tahunan, terkait realisasi training/review IK/sosialiasi PM (ISO 9001:2008 Klausul 6.2.2)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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5. Schedule kerja bulanan seluruh team
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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6. Daftar listing perijinan Engineering
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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7. Filling odner tersusun rapi & Label odner,lengkap,update (ISO 9001:2008 Klausul 4.2.4)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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8. Tools opname Engineering
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Preventive Maintenance (ISO 9001:2008 klausul 6.3 6.4)
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1. Jadwal PM Tahunan yg sudah diapprove PM Manager
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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2. Jadwal PM bulanan yg sudah diapprove PM Manager
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Corrective Maintenance (ISO 9001:2008 klausul 6.3 6.4)
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2. WO Corrective asset apabila ada kerusakan
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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3. Berita Acara Terkait kerusakan dan perbaikan Equipment
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
2. Sistem Power Emergency<br>
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1. Oli & filter diganti? Kapan oli & filter genset diganti terakhir kali?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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2. Accu Genset diganti? Kapan terakhir diganti?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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3. Apakah pernah di test Genset dengan actual load beban minimal 30%? (Minimal 1 thn skali)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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4. Apakah ada laporan Cek Infrared Thermography?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
3. Sistem Elektrikal
Panel TM
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1. Kapan terakhir kali dilakukan Maintenance Panel TM ?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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2. Apa saja aktivitas Maintenance yang dilakukannya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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3. Apakah sistem proteksinya pernah tes fungsi? kapan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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4. Bagaimana cara tesnya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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5. Apa saja rekomendasi dari hasil pengetesannya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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6. Apakah ada pengantian spare part? apa saja?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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7. Apakah pernah cek Megger tes kubikal TM? kapan terakhir dilakukan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Trafo
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1. Kapan terakhir kali dilakukan Maintenance Trafo ?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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2. Apa saja aktivitas Maintenance yang dilakukannya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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3. Apakah sistem proteksinya pernah tes fungsi? kapan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
4. Bagaimana cara tesnya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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5. Apa saja rekomendasi dari hasil pengetesannya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
6. Apakah ada pengantian spare part? apa saja?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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7. Cek Tegangan Tembus Trafo, pernah dilakukan? Bagaimana hasilnya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
8. Ada laporan hasil tes DGA dan BDV nya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Panel LV
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1. Kapan terakhir kali dilakukan Maintenance LV ?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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2. Apa saja aktivitas Maintenance yang dilakukannya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
3. Apakah sistem proteksinya pernah tes fungsi? kapan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
4. Bagaimana cara tesnya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
5. Apa saja rekomendasi dari hasil pengetesannya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
6. Apakah ada pengantian spare part? apa saja?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
7. Apakah ada data setting relay proteksi LVMDP seperti batas under, dan over voltage
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
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8. Apakah pernah dites System Proteksinya seperti Under voltage, Over Voltage, Earthfoult
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Panel Distribusi & Panel kontrol asset
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1. Apakah ada stock fuce, mcb,mccb dan breakernya? apakah ada stock part kritikal?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah pernah dites system controlnya seperti control relay pada pompa-pompa?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Capasitor Bank
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1. Apakah ada logsheet rekap data cek Ampere Capasitor bank per phase per stepnya ? (Dicek secara berkala)
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah ada spare part MCCB, breakernya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
undefined
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
Grounding
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1.. Apakah ada data cek Grounding elektrical, Penyalur petir, grounding Lift
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
7. Apakah pernah dicek infrared thermography system electricalnya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
8. Apakah ada laporan infrarednya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
4. Sistem HVAC
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1. Apakah ada IK Perawatan Unit AC splite?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah ada IK Perawatan FCU?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
3. Apakah ada IK perawatan Exhaust Fan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
4. Apakah ada IK perawatan & operasional AC VRV?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
5. Apakah ada IK perawatan dan operasional Chiller? Pompa CWP & CHWP?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
6.Apakah ada hasil cek infrared Thermography untuk panel panelnya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
7. Apakah buat berita acara jika ada breakdown pada system HVAC?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
5. Sistem STP
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1. Apakah ada hasil lab STP air recycle 3 bulan terakhir?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah nilai hasil labnya tidak ada yang melewati standar baku mutu air?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
6. Sistem Transportasi
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1. Tunjukan laporan hasil PM cek bulanan Vendor
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Tunjukan laporan cek Safety Device tahunan / General check list vendor
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
3. Apakah sudah difollow up temuan laporan general checklist list vendornya?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
7. Kalibrasi (ISO 9001:2008 klausul 7.6)
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1. Apakah ada Master List Kalibrasi/TERA?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah ada Sertifikasi TERA kwh meter dan water meter?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
3. Apakah ada rekap Data tambah dan turun daya unit dari tenant?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
4. Bagaimana cara monitoring terhadap alat ukur, kwh meter listrik dan air yg berpotensi bermasalah?
8. Sistem Air Bersih & pompa Fire
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1. Apakah ada IK perawatan pompa, jockey, electric, diesel?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah ada data on/off Setting Pompa Fire pump?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
3. Apakah ada jadwal pengurasan GWT?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
4. Apakah jadwal pengurasan GWT sudah masuk ke jadwal SMMS?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
5. Apakah dilakukan pengurasan GWT secara rutin minimal 6 bulan sekali?
-
6. Apakah ada data hasil lab Air bersih minimal Setahun sekali?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
9. Monitoring Barang gudang Engineering
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1. Apakah ada database sofcopy barang sisa yang disimpan di gudang Engineering?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah pernah dicek stock opname barang Gudang Eng oleh GA / Finance?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
10. Risk Management
-
1. Apakah ada IK / prosedur penanganan jika terjadi banjir diruang pompa fire pump? Apa yg pertama dilakukan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
2. Apakah ada IK /prosedur jika PLN trip/blackout, apa yg pertama dilakukan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
3. Apakah ada IK / Prosedur jika terjebak didalam lift? Apa yg pertama dilakukan?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
4. Apakah ada IK penanganan gondola terjebak ditengah gedung?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
11.Pengelolaan Limbah B3
-
Apakah ada sertifikat perijinan pengelolaannya ?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
Apakah perijinannya masih berlaku/belum jatuh tempo?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
Apakah ada daftar list apa saja yang termasuk kriteria limbah B3?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
-
Apakah ada tempat/ruangan transit pembuangan limbah B3 diunit ini?
- Yes
- No/High Risk (Max 1bln)
- Medium Risk (Max 3 bln)
- No/Low Risk (Max 6 bln)
- Suggestion
- Not Available
12. Siganture
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Auditor (Nama lengkap)
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Auditee (Nama lengkap)
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