 |
FORM / FORMULIR |
No. Dokumen |
: |
GSI4-OPR-002B |
|
| Revisi |
: |
0 |
|
| P2H |
Tanggal Efektif |
: |
18-Sep-24 |
|
| DUMP TRUCK |
Halaman |
: |
1 |
|
| |
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| BERIKAN TANDA |
: |
✔ |
JIKA KEADAAN BAIK |
|
|
✖ |
JIKA KEADAAN RUSAK |
|
|
- |
JIKA TIDAK ADA PADA PERALATAN |
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| EQUIP.
NO |
|
|
: |
DT.061 |
|
|
|
|
|
|
|
|
|
|
|
|
|
NAMA |
|
: |
Musmuliadi |
|
|
| DATE |
|
|
|
|
: |
17-Apr-2026 |
|
|
|
|
|
|
|
|
|
|
|
|
|
START HM |
: |
5819.1 |
|
|
| HM NEXT SERVICE |
: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
FINISH HM |
: |
|
|
|
| |
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
DAY SHIFT |
|
✔ |
NIGHT SHIFT |
|
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
Tanda Tangan Operator |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
|
| |
| KENDARAAN BERHENTI / MESIN MATI |
|
MESIN
HIDUP |
|
KENDARAAN
BERGERAK |
|
| MESIN
MATI, PORSNELING NETRAL, REM PARKIR TERPASANG |
|
PORSNELING NETRAL,REM PARKIR
TERPASANG |
|
UNTUK UJI JALAN / GERAK |
|
|
|
| |
|
|
|
|
|
| KELILING, ATAS/BAWAH KENDARAAN |
|
DI DALAM
KABIN |
|
KENDARAAN
DIJALANKAN |
|
| |
|
|
|
|
|
| |
✔ |
✖ |
|
|
✔ |
✖ |
|
|
✔ |
✖ |
|
| 1 |
BAN MUKA / BELAKANG |
✔ |
|
|
FUNGSI
METERAN / INDIKATOR ALARM |
|
1 |
STIR / KEMUDI |
✔ |
|
|
| 2 |
TANGGA / PEGANGAN |
✔ |
|
|
1 |
LEVEL OLI MESIN |
✔ |
|
|
2 |
RETARDER |
|
- |
|
| 3 |
LAMPU MUKA BELAKANG |
✔ |
|
|
2 |
LEVEL OLI TRANSMISI |
✔ |
|
|
3 |
REM KAKI |
✔ |
|
|
| 4 |
SELANG / PIPA HIDROLIK |
✔ |
|
|
3 |
LEVEL OLI HIDROLIK |
✔ |
|
|
4 |
REM PARKIR |
✔ |
|
|
| 5 |
TANGKI HIDROLIK |
✔ |
|
|
4 |
LEVEL BAHAN BAKAR |
✔ |
|
|
5 |
GIGI PERSNELING |
✔ |
|
|
| 6 |
TANGKI UDARA |
✔ |
|
|
5 |
SARINGAN UDARA |
✔ |
|
|
6 |
KLAKSON MUNDUR |
✔ |
|
|
| 7 |
TABUNG ACCUMULATOR |
✔ |
|
|
6 |
TEKANAN ANGIN |
✔ |
|
|
7 |
LAMPU PERINGATAN |
✔ |
|
|
| 8 |
SILINDER PENGIKAT (HOIST) |
✔ |
|
|
7 |
SEAT / TEMPAT DUDUK |
✔ |
|
|
8 |
EMS / CMS |
✔ |
|
|
| 9 |
SILINDER HIDROLIK |
✔ |
|
|
8 |
GAUGE |
✔ |
|
|
9 |
SISTEM HIDROLIK |
✔ |
|
|
| 10 |
PUMP TAKE OFF / PTO |
✔ |
|
|
9 |
KEMUDI / STIR |
✔ |
|
|
10 |
GAUGE |
✔ |
|
|
| 11 |
BATTERY / AKI |
✔ |
|
|
10 |
PENGATUR STIR |
✔ |
|
|
|
|
|
|
|
| 12 |
RUANG MESIN |
✔ |
|
|
11 |
PEDAL REM |
✔ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 13 |
TALI KIPAS (FAN BELTS) |
✔ |
|
|
12 |
PEDAL GAS |
✔ |
|
|
UNTUK SEMUA OPERATOR |
| 14 |
SARINGAN UDARA |
✔ |
|
|
13 |
RETARDER |
|
- |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 15 |
KABIN OPERATOR |
✔ |
|
|
14 |
TUAS GIGI TRANSMISI |
✔ |
|
|
1 |
FORMULIR
INI HARUS DIISI SETELAH PERALATANNYA DIPERIKSA DAN KEMUDIAN DISERAHKAN KEPADA
PENGAWAS SETELAH BEROPERASI |
| 16 |
KIPAS KACA (WIPERS) |
✔ |
|
|
15 |
GAS TANGAN (THROTLLE) |
|
- |
|
|
| 17 |
KACA SPION |
✔ |
|
|
16 |
TUAS REM PARKIR |
✔ |
|
|
|
| 18 |
EMS / CMS (Apabila ada) |
✔ |
|
|
17 |
KLAKSON |
✔ |
|
|
|
| 19 |
HANDEL KONTROL |
✔ |
|
|
18 |
LAMPU MUKA / BELAKANG |
✔ |
|
|
2 |
DENGARKAN
DAN CATAT SUARA YANG TIDAK BAIK DARI MESIN MAUPUN PADA BAGIAN LAIN PERALATAN |
| 20 |
KNALPOT (EXHAUST) |
✔ |
|
|
19 |
LAMPU KABIN |
✔ |
|
|
|
| 21 |
KLAKSON MUNDUR |
✔ |
|
|
20 |
EMS / CMS |
✔ |
|
|
|
| 22 |
LAMPU PUTAR (STROBE) |
✔ |
|
|
21 |
AIR CONDITIONER |
✔ |
|
|
3 |
BUATLAH
WORK ORDER (WO) DAN SEGERA MASUKKAN KE WORKSHOP |
| 23 |
PIN DUMP |
✔ |
|
|
22 |
RADIO KOMUNIKASI |
✔ |
|
|
|
| 24 |
|
|
|
|
23 |
MONITOR |
✔ |
|
|
4 |
JIKA ADA
KERUSAKAN, TULIS DI KOLOM KETERANGAN DAN LAPORKAN KONDISI TEMUAN KE PADA
PENGAWAS |
| PERKAKAS / PERALATAN |
|
24 |
MIC |
✔ |
|
|
|
| 1 |
PEMADAM API |
✔ |
|
|
25 |
KABEL MIC |
✔ |
|
|
|
| 2 |
TALI PENGAMAN (SEAT BELT) |
✔ |
|
|
DI LUAR
KABIN |
|
|
| 3 |
RADIO KOMUNIKASI |
✔ |
|
|
1 |
KEBOCORAN OLI |
✔ |
|
|
DIPERIKSA OLEH PENGAWAS |
|
| 4 |
GANJAL BAN |
✔ |
|
|
2 |
KEBOCORAN AIR |
✔ |
|
|
 |
|
| 5 |
TRICON |
✔ |
|
|
3 |
KEBOCORAN UDARA |
✔ |
|
|
|
| KEBERSIHAN |
|
4 |
BATU DI SELA RODA |
✔ |
|
|
|
| 1 |
KEBERSIHAN EQUIPMENT |
✔ |
|
|
KONDISI EQUIPMENT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 |
SUARA MESIN |
✔ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2 |
SUARA TRANSMISI |
✔ |
|
|
Nama Pengawas & Tanda Tangan |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3 |
SUARA DIFFERENTIAL |
✔ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Keterangan kerusakan : |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| OPERATOR YANG BAIK, SELALU MEMERIKSA DENGAN BENAR PERALATANNYA
SEBELUM DIOPERASIKAN OPERATOR MENGERTI BAHWA KESELAMATAN DIRINYA DAPAT
DITUNJANG PADA KONDISI PERALATAN YANG AKAN DIOPERASIKANNYA |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|