PT.

TAIYO SINAR RAYA TEKNIK

TAIYO SINAR PLANT DIVISION
Cibitung Office Document No. : FM/ PLANT/ 016
Telp. : 021 - 8832 - 0960 Revision : 00
Fax. : 021 - 8832 - 0855 Revised on : 5 Dec 2018

No : 001 / E /AKC/ PL /03/ 2023

To : PT. INDONESIA STEEL TUBE WORKS

CIKARANG
JAWA BARAT

Attn. : Mr. Agung

Mr. Asep S

WORK PERMISSION
ELECTRIC SHUTDOWN WORK
Project : PT. INDONESIA STEEL TUBE WORKS

Location : CIKARANG

Date of Work : Minggu 12 Maret 2023

Time : 06.00 - 17.00 Wib

Work Description : - Modification At LVMDP Existing, Join Busbar

Detail Work's ( Please mark b at coloumn at below )

1. x Used Welding 4. x Used Excavation

2. x Used Cutting/ Heating 5. √ Other's / Installation only

3. √ Used Chemical ( I'e : paint, thinner etc )

Work Area : ELECTRICAL ROOM

Person In Charge : Taiyo Sinar

1. Eri Ahmad 3. Arie Apriansyah
2. Dede Saifudin

Subcontractor :
1. PT. Kamajaya : 4 Persons

Site Location : "See Attached File"

PT. INDONESIA STEEL TUBE WORKS PT. Taiyo Sinar Raya Teknik
Approved By. Approved By. Approved By. Approved By, Checked By, Prepared By,
Plant Head Div. General Manager Section Manager Site Manager

Mr. SHIMONURI /
Mr. AGUNG Mr. ASEP S Mr. JUN SANO Mr. GOLFRID RHS Mr.ARIE APRIYANSAH Mr. ERI AHMAD
Date : Date : Date : Date : Date : Date :
Approved By, Approved By, Checked By, Prepared By,
PT. INDONESIA STEEL TUBE WORKS Plant Div Head Gen. Manager Sec. Manager Site Manager
CIKARANG

Mr. SHIMONURI /
Mr. JUN SANO Mr. GOLFRID RHS Mr. ARIE Mr. Eri Ahmad
APRIANSYAH

ORGANIZATION CHART

Director Hp 0811 8204 287

Mr. N. ARAKI

Gen. Manager Hp 0811 9378 66

Mr. GOLFRID RHS

Dept. Manager Hp 0811 933 790

Mr. Yon S

TAIYO SINAR Sec. Manager Hp 0811 1712 370 /

Mr. SHIMONURI / Hp 081383224655
CIBITUNG Mr. ARIE
APRIANSYAH

TAIYO SINAR Site Manager Hp 081222878735

SITE PROJECT Mr. ERI AHMAD

PT. KAMAJAYA

- Workers 4 Person
Approved By, Approved By, Checked By, Prepared By,
PT. INDONESIA STEEL TUBE WORKS Plant Div Head Gen. Manager Sec. Manager Site Manager
CIKARANG

Mr. SHIMONURI /
Mr. JUN SANO Mr. GOLFRID RHS Mr. ARIE Mr. ERI AHMAD
APRIANSYAH

ORGANIZATION CHART

Plant Div. Head Hp 0811 1803 367

Mr. JUN SANO

Gen. Manager Hp 0811 9378 66

Mr. GOLFRID RHS

Dept. Manager Hp 0811 933 790

Mr. YON S.M

TAIYO SINAR Sec. Manager Hp 0811 1712 370 /

Hp 0813 8322 4655
Mr. SHIMONURI /
CIBITUNG Mr. ARIE APRIANSYAH

TAIYO SINAR Site Manager HP 0812 2288 735

SITE OFFICE Mr. ERI AHMAD

Supervisor
Mr. DEDE SAIFUDIN Hp 0823 3232 0059

- Modification Panel LVMDB (MCCB 800A)

Document No. : FM-213
Revision : 00
Revised on : 01 March 2002
TAIYO SINAR

SHUT- DOWN SCHEDULE

Customer Name: PT. INDONESIA STEEL TUBE WORKS PT. INDONESIA STEEL TUBE WORKS PT. TAIYO SINAR
Project Name : PT. INDONESIA STEEL TUBE WORKS Approved by, Approved by, Approved by, Approved by, Checked by, Prepared By,
Project Code : 202208041 Plant Div Head Gen. Manager Sec. Manager Site Mgr

Mr. SHIMONURI /
Mr. AGUNG Mr. ASEP S Mr. JUN SANO Mr. GOLFRID RHS Mr. ERI AHMAD
Mr.ARIE APRIYANSAH
Date : Date : Date : Date : Date : Date :

DAY / DATE : 12 Maret 2023

TIME : 06.00 - 17.00 Wib

LOCATION : ELECTRICAL ROOM

IN CHARGE :
ATTENDANCE
EQUIPMENT NAME DESCRIPTION
CUSTOMER TAIYO SINAR

LVMDB - Modification - MCCB 800A PT. INDONESIA STEEL TUB PT. TAIYO SINAR
Mr. AGUNG Eri Ahmad
Mr. ASEP S Dede S
Approved By, Approved By, Approved By, Approved By, Checked By, Prepared By,

TAIYO SINAR MAINTENANCE PANEL of ELECTRICAL ROOM PT. TIV KBC PT. TIV KBC Director GeneralManager Section Manager Site Manager

Customer Name : PT. INDONESIA STEEL TUBE WORKS

Mr. SHIMONURI /
Project Name : PT. INDONESIA STEEL TUBE WORKS Mr. AGUNG Mr. ASEP S Mr. JUN SANO Mr. GOLFRID RHS Mr.ARIE Mr. ERI AHMAD
APRIYANSAH

Project Code : 202208041 Date: Date: Date: Date: Date: Date: 12 Maret 2023

Location : Electrical Room

NO. DESCRIPTION LOCATION PERSON INCHARGE ### Remarks

06.00 07.00 08.00 09.00 10.00 11.00 12.00 13.00 14.00 15.00 16.00 17.00

A PREPARATION WORKS
1 Preparation & Tool Box Meeting Out door Electrical room ALL PERSONIL

### 2 Rotary Ceck & Voltage Check Electrical Room TSRT & TIV KBC

### 3 Switch off ACB at LVMDB and & LBS AT OUTGOING 1 MVMDB Electrical Room Mr. S. Anam ( PT. TIV KBC) Power OFF

### 4 Pasang Lotto LBS OUTGOING MVMDB - Electrical TSRT & ISTW

### 5 Preparation for Temporary Genset 50kVA & Temporary Lighting Electrical Room SPV TSRT & PT. KJ

B CONSTRUCTION WORKS
ELECTRICAL ROOM TSRT = 3 Prsn

1 - Remove Cover & Hole Existing for Busbar KAMAJAYA = 4 Prsn PT. KAMAJAYA

2 - Install Support & MCCB New 800A PT. KAMAJAYA

3 - Remove Main Busbar Existing & Install New Support PT. KAMAJAYA

4 - Fabrikasi Busbar New, to Joint LVMDP PT. KAMAJAYA

5 - Install Busbar existing to New Busbar PT. KAMAJAYA

6 - Ceck Tightning & Marking PT. TSRT & PT. KAMAJAYA

7 - Switch ON ACB at LVMDB and & LBS AT OUTGOING 1 MVMDB PT. TIV KBC Power ON

8 - Rotary Ceck PT.TSRT, PT.TIV KBC

9 - Cleaning Area ALL Personil

EMERGENCY CALL FLOW CHART
PT. INDONESIA STEEL TUBE WORKS

TAIYO SINAR
Hp 0811 1559207
SUMMITMAS HEAD OFFICE PRESIDENT DIRECTOR
Telp. ( 021 ) 5253400 Y.MOTOE TSRT PT. INDONESIA STEEL TUBE WORKS
Fax. ( 021 ) 5253089
1st

CIBITUNG OFFICE
Telp. ( 021 ) 88325503 Hp 0811 8204287 HP 0811 941 562
Fax. ( 021 ) 88325504 EXECUTIVE DIRECTOR DIRECTOR
N.ARAKI SURYANTO

EMERGENCY CALL FLOW CHART

Hp 0811 856046
SAFETY & QUALITY MNG DEPT.
BUDI RUDATO
1st 1st 2nd

Hp 08121043365
SAFETY DEPT.
KADEK G
Hp 0811 1712370 Hp 0811 933790
GENERAL MANAGER DEPARTMENT MANAGER
K. SHIMONURI YON SM
1st
LEST THAN 10 MINUTS

Hp 0811 933812
PROJECT MANAGER/SEC MNG 2nd 4th
RONY TEGUH A
1st
Hp 081222878735
SITE MANAGER
TAIYO SINAR - SITE OFFICE ERI AHMAD
INDONESIA STEEL TUBE WORKS
3th PT. INDONESIA STEEL TUBE WORKS , SITE
1st
MANAGER
RESCUE TEAM Covid - 19 HP 082332320059 Mr. AGUNG
SUPERVISOR
NURYATIM
Leader : Parjono TSRT
Ass leader : Eri ahmad TSRT
Evacuation : Dede S TSRT Hp 0813 7545 0202 PT. INDONESIA STEEL TUBE WORKS , SITE
SAFETY/HSE OFFICER MAINTENANCE LEADER
Transportation : ARIS WIJAYA
2nd
Mr. ASEP S
0857 1045 5586

SAFETY
ACCIDENT 1st
TROUBLE

Fire Dept PMI Ambulance HOSPITAL UMUM HOSPITAL COVID PUSKESMAS POLICE

kawasan Deltamas RSUD GRATI RSUD Winongan

Puskesmas Polsek Winongan
Pasuruan 118
021-22158215 416615 )0343( 4508999 )0343( 442723 )0343( 441389 )0343(
4508999 )0343(
PT. TAIYO SINAR RAYA TEKNIK
Working Procedure Check List
No. of WP : 001 / E /AKC/ PL /03/ 2023 Date : 12 Maret 2023
Project Name : PT. ISTW
Project Code : 2022-08-041
Project Location : Cikarang
Submit
No. Description Doc. No
this time
1 Check List Kerja Listrik FM/PLANT/018 ✘

2 Check List Preparation ✘

3 Flow Chart of Shut Down Schedule FM/ PLANT / 010 ✘

4 Method Meeting FM -220 ✘

5 Single Line Diagram ✘

6 Working Prosedur, KY (prediksi bahaya) & Safety Analisa FM/PLANT/004C ✘

7 Risk Assessment FM - 339 ✘

8 Penanggung Jawab Panel FM - 339 ✘

9 Peraturan Megger WI-PL-3-080 ✘

10 Voltage & Rotation Check FM/PLANT/015 ✘

11 Membuang Sisa Tegangan Listrik di Busbar WI-QC-0176-2021 ✘

12 Form Check Sebelum dan Sesudah ✘

13 Peraturan dasar Taiyo Sinar Raya Teknik ✘

General Manager Mr. GOLFRID RHS Sign :

Dep.Manager Mr. YON S MEINEDI Sign :

Ass. Dept Manager Sign :

Section Manager Mr. SHIMONURI/ARIE A Sign :

Site Manager Mr. ERI AHMAD Sign :

Safety Officer MARYAM DIANA Sign :

Supervisor Mr. DEDE S Sign :

Document No. : FM/PLANT/018
Revision : 00
Revised on : 17 Dec 2018

PT. TAIYO SINAR RAYA TEKNIK

CHECK LIST KERJA LISTRIK

Project Name : PT. INDONESIA STEEL TUBE WORKS
Project Location : CIKARANG
Working Procedure No : 001/ISTW/E/PL/III/2023

CHECKED

Working procedure sudah dibuat dan Spv: Dede S

dipahami
SM: Eri Ahmad
SEBELUM KERJA
Working procedure sudah mendapat
Approval dari pimpinan Divisi &
Customer
SM: Eri Ahmad

Sudah dilakukan voltage cek &

SEBELUM POWER OFF rotation cek sebelum power off
Spv: Dede S

Memastikan saat power off dilakukan

SAAT POWER OFF oleh owner
Spv: Dede S

Sudah sesuai dengan rencana kerja &

sudah dilakukan pengecekan (Megering ,
continiuty dll) serta warna cable & vinil
sudah sesuai
Spv: Dede S

SEBELUM POWER ON Sudah dilakukan pengecekan

tightening & marking pada semua
connection
Spv: Dede S

Cleaning semua panel & tutup semua

celah lubang.
Spv: Dede S

Memastikan saat power ON

SAAT POWER ON dilakukan oleh owner
Spv: Dede S

Sudah dilakukan voltage cek &

SETELAH POWER ON rotation cek , serta sudah disetujui
owner
Spv: Dede S

Checked by Prepared by
TSRT TSRT

( SM : Eri Ahmad ) ( SPV : Dede S)

7)Check List Kerja Listrik

PT. TAIYO SINAR RAYA TEKNIK

Preparation Work ( Check List Site Condition )

No. of WP : 001 / E /AKC/ PL /03/ 2023 Date : 12 Maret 2023
Project Name : PT. INDONESIA STEEL TUBE WORKS
Project Code : 2022 08 041
Project Location : Cikarang
No. Description Result Remarks
1 Actual Visual Condition : All Room, All Panel Kotor / Bersih
2 Actual Visual Condition : All Oil Trafo Bocor / Tidak
3 All Temporary Equipment :
Genset+Safety Cone, Lighting, Cable, ELCB Ada/Tidak
Stock Fuel for Genset Ada/Tidak
4 Papan KY sesuai Grup Subcont Ada/Tidak
5 List up Manpower Shutdown+Status Antigen+Vaksin Ada/Tidak
6 List up Equipment & Tools Subcontractor Ada/Tidak
7 List up Measurement Tools by Taiyo Sinar Ada/Tidak
8 Test Pen 20kV, Hand Glove 20kV Ada/Tidak
9 Clamp Pembuang Sisa Tegangan Listrik Ada/Tidak
Document No. : FM/ PLANT / 010
Revision : 01
Revised on : 5 Mar 2021

FLOW CHART OF SHUT DOWN SCHEDULE

Customer Name : PT. INDONESIA STEEL TUBE WORKS
Project Name : PT. INDONESIA STEEL TUBE WORKS
Project Code : 202208041
Works : - Modification At LVMDP Existing, Join Busbar Minggu 12 Maret 2023
PIC / SIGN
NO ITEM TIME FLOW CHART WHO WHAT HOW
(Name / Date)

1. START
PREPARATION WORK

06.00 PT. TAIYO SINAR

PERMIT OF WORKS Eri Ahmad Dede S * PREPARATION * KY Meeting
up to * TOOL BOX MEETING * Working Procedure Meeting
* Check APD
07.00 SUB CON ( ALL )
PREPARATION &
TBM

2
* ROTARY CHECK
* VOLTAGE CHECK
SWICH OFF ACB LVMDB 380 PT. ISTW Mr. Agung * SWITCH OFF LVMDB (ELECTRICAL ROOM) * Switch OFF
SHUTDOWN WORKS

V - Incoming LVMDB

07.00 * Switch OFF

Switch Off LBS Outgoing MVMDB PT. ISTW Mr. Agung * SWITCH OFF MVMDB (ELECT ROOM) - Turn Off & Put Warning Sign
up to & LOTTO

SCOPE OF WORKS :
CONSTRYCTION WORKS

07.00 TSRT Eri Ahmad - Modification PANEL LVMDB Existing

- Fabrikasi Busbar New, to Joint Dede S (MCCB 800A)
LVMDB
- Install Support & MCCB New 800A-
up to
Joint - Remove Main Busbar Existing
& Install New Support
- Fabrikasi Busbar New, to Joint Subcont (Kamajaya)
12.40 LVMDB
- Install Busbar existing to New Busbar
- Ceck Tightning & Marking

` Switch ON LBS
4 (Outgoing MVMDB PT. ISTW Mr. Agung * SWITCH ON LBS Outgoing MVMDB Panel * Switch ON
)
- Take out Warning Sign & LOTTO

13.00
ENERGIZE

up to

SWITCH ON ACB LVMDB

13.10 PT. ISTW Mr. Agung * SWITCH ON LVMDB 200V No.1 - 3 - Outgoing Trafo
TSRT Eri Ahmad and Local Panel -200V * Switch ON
Dede S - Put Warning Sign & LOTTO

5 13.15 PT. ISTW Mr. Agung

PT. TAIYO SINAR
FINAL CHECK

up to ROTATION CHECK/ MCCB TSRT Eri Ahmad * JOINT VOLTAGE CHECK Rotary Check
800A) Dede S

13.30
* Cleaning work area
FINISH STAFF ( ALL ) * CLEANING
Subcont

PT. AQUA GOLDEN MISSISIPI BABAKANPARI PLANT Div. Head General Manager TSRT Site Manager TSRT

Mr. AGUNG Mr. ASEP S Mr. Suryanto K Shimonuri Eri Ahmad

Tgl : Tgl : Tgl : Tgl : Tgl :
TAIYO SINAR TAIYO SINAR

Tanggal : 19 Juni 2022

Nama : Nuryatim
No. Telp : 082332320059
: Tanda Tangan

TAIYO SINAR TAIYO SINAR

Tanggal :19 Juni 2022

Nama : KUSWANDI
No. Telp : 082332320059

: Tanda Tangan
OFF + LOTTO

Install New MCCB 800A

OFF + LOTTO
WORKING PROSEDUR, KY (PREDIKSI BAHAYA) & SAFETY ANALISA
- KHUSUS KERJA LISTRIK - Document No. : FM/PLANT/004C
Revision : 01
Revised On : 3 Dec 2018

Nama Customer PT. INDONESIA STEEL TUBE WORKSNama Pekerjaan 0

Prosedur Kerja
Nama Proyek PT. INDONESIA STEEL TUBE WORKS Approval Eri Ahmad Prepared by Nuryatim Date 12 - Maret 2023
No. Step kerja Alat Kerja & Alat Safety Perkiraan Bahaya dan langkah safetynya Sket / Gambar Kerja Pemeriksa
(Tanggal)
1 - Breafing / TBM TOOLS : 12-Mar-23
- Prearation tools - Kunci-kunci + kunci torque
- Obeng Plus & minus Dede S
- Tang potong & tank kombinasi
- Rotary
- Babby Genset
- Multi tester
- Lamu TL + kael roll (Temporary)
- Hand glove
- APD

Dede S
2 Positioning Tools Kesetrum arus listrik
Hand Tools - Matikan sumber listrik saat sambung kabel lampu
Lotto,Gembok
Voltage Tester

3 Power OFF MV-MDB (By Owner) Kesetrum arus listrik

Pastikan Power OFF - Memastikan power sudah OFF Dede S
- Check dengan alat ukur listrik / Tespen
- Pasang LOTTO pada pusat sumber listrik

4 Tangan terjepit
LVMDB - Pastikan baut2 cover sudah di buka
- Fabrikasi Busbar New, to Joint LVMDB
- Install Support & MCCB New 800A- Joint
- Remove Main Busbar existing & Install New Support
- Fabrikasi Busbar New, to Joint LVMDB - Pastikan pekerja sudah menggunakan APD
- Install Busbar existing to New Busbar ( Hand glove) Dede S
- Ceck Tightning & Marking
- Rotary Ceck Luka tergores
- Pastikan pekerja menggunakan APD
- Pastikan lokasi kerja sudah di beri penerangan
yang cukup

Dede S
5 Tightening & Marking Kepala terbentur
Double Check Tigtening - Pastikan pekerja sudah menggunakan APD
(Safety helmet)
- Pastikan lokasi kerja sudah di beri penerangan
yang cukup Dede S

6 Test function component Kesetrum arus listrik

- Final check - Informasi ke seluruh pekerja koordinasi Modif Panel LVMDB (Add MCCB 800A
- Instal cover panel power sudah di hidupkan
- Ceck Voltage,Rotary Dede S

7 Energize
- Power ON (By Owner)
- Ceck Voltage Aktual

*Note 1 : Working Prosedur harus sosialisasi kepada semua pekerja *Note 2 : Khusus Untuk Pekerjaan Listrik
& lakukan diskusi 2 arah sampai semua mengerti
Nama pekerja Sign Nama pekerja Sign 1. Penanggung Jawab Pekerjaan Listrik : Div Head General Mgr Dept Mgr Assist Dept Mgr Section Mgr Site Manager Safety Supervisor

1 6

2 7 2. Prosedur pekerjaan listrik dibuat oleh :

3 8

4 9 3. Alat listrik & Voltage Detector : J Sano Golfrid RHS Yon SM Shimonuri/Arie S Eri Ahmad Maryam DIana Dede S

5 10 Date : Date : Date : Date : Date : Date : Date : Date :

Document No: FM - 339
Revision : 00
Revised on : 12 Mar. 2008

TAIYO SINAR SAFETY FIRST

PENANGGUNG JAWAB PANEL

Project : PT. INDONESIA STEEL TUBE WORKS

NAMA : DEDE S

SITE MANAGER : ERI AHMAD

NO. HP : 081 222 878735
TANDA TANGAN :
Document No. : FM/PLANT/015
Revision : 00
Revised on : 20 Mar 2018

PT. TAIYO SINAR RAYA TEKNIK

VOLTAGE & ROTATION CHECK

Project Name : PT. INDONESIA STEEL TUBE WORKS
Project Location : CIKARANG
LVMDB :
Transformer :
Area : Elect Room

CHECKED
VOLTAGE ROTATION ( R - S - T )
By Supervisor

BEFORE SHUT DOWN (MAINTENANCE WORKS ) : ___________________ Volt

:________
:________ Name : ………………………………………
Date : ………………………………………

AFTER SHUT DOWN (MAINTENANCE WORKS ) : ___________________ Volt

:________
:________ Name : ………………………………………
Date : ………………………………………

Note : Lakukan phase rotation check sebelum power OFF Checked by Prepared by
& sesaat setelah power ON Customer TSRT

(PIC : Dede S) (SM : Eri Ahmad)