PT FAUZAN JAYA MANDIRI

TRAINING RECORD

NO BADGE NAME JOB POSITION LOCATION DRIVING LICENCE PENGAWAS K3 PENGAWAS K3 MANUAL SAFE FIRST AID BASIS FIRE MCU REMARK
MIGAS MIGAS (Exp) HANDLING FIGHTING

1 FJM002 Risaldi Operational Marangkayu A - - Apr-20 May-20 Jun-20

2 FJM003 Maruf Marjuni HSE Officer Marangkayu A Mei -21 Mei-24 Apr-20 May-20 Jun-20
3 FJM004 Normawati Keuangan Marangkayu - - May-20 Apr-20 Jun-20
4 FJM005 Wahyu Sumitra Staff Gudang Marangkayu - - Apr-20 May-20 Jun-20
5 FJM006 Muhammad FikriKordinator Lapangan
Marangkayu A - - May-20 Apr-20 Jun-20
6 FJM007 Saharuddin Staff Gudang Marangkayu - - - - -

Disusun Oleh, Diketahui Oleh,

Maruf Marjuni M Fikri

Safety Officer Koordinator Lapangan
 FIRE EMERGENCY RESPONSE SERVICES
MANPOWER
SC 1800068KT (PERIODE 25 OCTOBER 2018 - 24 APRIL 2019)

NO NAME ID Badge CURRENT JOB POSITION BSS Kelas D Kelas C Kelas B Kelas A

PASIR RIDGE
1 Toga P. Silalahi 01982 Operation Manager Feb-19 Dec-18
2 Zulhaidir 02154 HES Coord Dec-18
3 Natasya Cherish Aurora Admin Yes
4 Ansyar Rachman 03575 Tech Admin
5 M. Nander Kusuma Supervisor FPP Jan-19
6 Sirwanto 02006 Shift Captain
7 Saufil Ahyar 02012 Shift Captain
8 M. Bambang Arifin Shift Captain
9 Ary Rizki Darmawi 00167 Inspector
10 R. Imam Tri Utomo EVT Pump Operator
11 Suheriyanto 02011 EVT Pump Operator
12 M. Yusuf EVT Pump Operator
13 M. Amtsal Ruba'i Mawar 02014 EVT Pump Operator
14 Wisnu Pradana 02021 EVT Pump Operator
15 Agus Susanto 02015 Fireman
16 Suhariyan Fireman
17 Eko Dwi Cahyono 02017 Fireman
18 Berly Nata Kurnia Fireman
19 Herwanto 02019 Fireman
20 Iwan Sukmana Kismat,Amd 02020 Fireman
21 Erry Idfian S 02022 Fireman
22 Rachwan Sopandoyo 02023 Fireman
23 Tonie Adiyanto 02025 Fireman
24 M. Gassing 00124 Fireman
25 Abd. Gafur 02027 Fireman
26 Marsukiyanto Fireman YES YES
27 Rudiansyah Fireman YES YES
28 Suryadi 00166 Dispacther
29 Fachturachmansyah 04014 Dispacther
30 YES
PSB
31 Reno Dustira Prasetiya 02208 Supervisor Oil Spill
32 Susianto 02231 Oil Spill Operator
33 Tumpal Pandiangan 02214 Oil Spill Operator
34 Katimin 02210 Oil Spill Operator
35 Abdi Gumilar 02215 Oil Spill Operator
36 Rendra Ramadiansyah 02211 Oil Spill Operator
37 Abdul Rajjak Gazali 02209 Oil Spill Operator
38 Arry Wicaksono 02226 Oil Spill Operator
39 Diyon Mahardika 05688 Oil Spill Operator
40 Sukardi '02229 Shift Captain
41 Joseph Nita 02216 Shift Captain
42 Andrian Basuki 02224 Shift Captain
43 Ibnu Abbas 02223 Inspector
44 Haidim 02218 EVT Pump Operator YES YES
45 Solihin 02220 EVT Pump Operator
46 Julianto 02225 EVT Pump Operator
47 Cholik Zainuri 02217 Fireman
48 Dedy Agung 02227 Fireman
49 Winardi 02028 Fireman
50 Tahang 02222 Fireman
51 Fathurahman 05759 Fireman
52 Buyung Rahmatullah 02228 Fireman
53 Andi Alfian 05689 Dispatcher
54 Masyudi 05690 Dispatcher
55 YES
NO NAME ID Badge CURRENT JOB POSITION BSS Kelas D Kelas C Kelas B Kelas A

LAWE - LAWE
56 Armansyah 02155 Supervisor FPP Jan-19
57 Sofyansyah 02156 EVT Pump Operator Dec-18
58 Hartanto 02193 EVT Pump Operator Dec-18
59 Susilo Edi Prayitno 02157 EVT Pump Operator Dec-18
60 Djakka Sarwanto 02157 EVT Pump Operator Dec-18
61 Faisal 02159 EVT Pump Operator Dec-18
62 Awang Idwan Ahmadi 02160 EVT Pump Operator Dec-18
63 Jumiyanto 02161 Shift Captain Dec-18
64 Imam Subono 02162 Shift Captain Dec-18
65 Ramli 02163 Shift Captain Dec-18
66 Windu Setiaji 02164 Fireman
67 Mohamad Saeful Mutaqin 02165 Fireman
68 Suradi 02166 Fireman
69 Ahsan Mahmud 02167 Fireman
70 Sigit Tri Nugroho 02168 Fireman
71 Alwi 02169 Fireman
72 Edy Setiawan 02171 Fireman Dec-18
73 Sri Permana Panca Widodo 02172 Fireman
74 Supriyadi 02174 Fireman
75 Badaruddin 02175 Fireman
76 Jasman 02177 Fireman
77 Nurmansyah 02180 Fireman
78 Didi Suryanto 02173 Dispatcher
79 Gunawan Wibisono 02170 Dispatcher
80 Nasrudin 02178 Dispatcher
81 Sofyan Wijaya 01960 Supervisor Inspector YES YES
82 Darmansyah 02179 Inspektor
83 Heyrul Anwar Inspektor
84 Yono Ngasiman Inspektor
85 Syaifudin Inspektor
86 Tommy Dwi Cahyadi Inspektor
NO NAME ID Badge CURRENT JOB POSITION BSS Kelas D Kelas C Kelas B Kelas A

SANTAN
87 Andi Subhan 01928 Supvervisor Oil Spill
88 Mahmud Ishaq 01984 Oil Spill Operator
89 Gaspar Rante 01987 Oil Spill Operator
90 Arman Jaya 01983 Oil Spill Operator
91 Supiansyah 01988 Oil Spill Operator
92 Sufriadi 01985 Oil Spill Operator
93 Mubarak B 01986 Oil Spill Operator
94 Masdar 03914 Oil Spill Operator
95 Ridwan Sholeh 03913 Oil Spill Operator
96 Kahar Sudirman 01929 Supervisor FPP Jan-19
97 Aspar 01939 EVT Pump Operator Dec-18
98 Fajar Subechi 01946 EVT Pump Operator
99 Rahmat Baharuddin 01930 EVT Pump Operator
100 Nasir DL 01944 EVT Pump Operator
101 Syahril 01936 EVT Pump Operator
102 Alfrianus Sandin Paramban 01947 EVT Pump Operator
103 Jusman 01937 Shift Captain STN
104 Nanang HM 01949 Shift Captain STN
105 Azwar Anas L 01945 Shift Captain STN
106 Nasrul 08223 Fireman
107 Jumri 01950 Fireman Dec-18
108 Belgie S 01932 Fireman
109 Edhi Sofyan 01942 Fireman
110 Zainal Thamrin 01940 Fireman
111 Ramli 01941 Fireman
112 Yodi KL 01948 Fireman
113 Jamaluddin 01933 Fireman
114 Usman J 01934 Fireman
115 Ismail 01949 Fireman
116 Anggiat Parsaoran S. 01952 Fireman
117 Sudarwan 05618 Fireman
118 M. Ilyas Dispatcher YES
119 Dispatcher YES
120 Dispatcher YES
121 Andi Sofyan T 01953 Supervisor Inspector Dec-18
122 Alimuddin Jide 01957 Inspektor
123 Sulkifli M 01955 Inspektor
124 Fardi Amin 01935 Inspektor
125 Sumardi Syarief 01958 Inspektor Dec-18 YES YES
126 Syahmil 01943 Inspektor
127 Maskur 01956 Inspektor
 Pengawas
Defensive
Basic Fire

K3 Migas
Training
Fighting
Training Subjects

Auditor
SMK3
Drive
No Function

1 Safety Officer X X X X
2 Supervisor X X
3 Driver X X
4 Operation X

X Mandatory
Optional

Dibuat Oleh,

Safety Officer
 Investigasi

X
Kecelakaan

Supervisor
Mengetahui,
First Aids &

X
X
X
X CPR

Ahli K3
Umum
 FIRE EMERGENCY RESPONSE SERVICES
TRAINING RECORD

EXPIRED FIRE CLASS D EXPIRED FIRE FIRE CLASS C EXPIRED FIRE FIRE CLASS B EXPIRED FIRE FIRE CLASS A EXPIRED FIRE
NO NAME AK3Umum
AK3Umum (3years) CLASS D (3 years) CLASS C (3 years) CLASS B (3 years) CLASS A
REMARK

JOB POSITION LOCATION

13 - 24 March
1 Toga P. Silalahi Operation Manager Pasir Ridge
2017
March 2020 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - 14-Sep-15 Dec-18

13 - 24 March 22-30 Jan

2 Zulhaidir HES Coordinator Lawe Lawe
2017
March 2020 8-Jun-18 Jun-21 8-Mar-18 Mar-21
2015
14-Sep-15 Dec-18

22-30 Jan 30 Nov -5 Dec

3 M. Nander Kusuma Supervisor FPP Pasir Ridge - - -
2015
Jan-19
2015
Jan-19

12-16 Jan 30 Nov -5 Dec

4 Kahar Sudirman Shift Captain STN Santan - - -
2015
Jan-19
2015
Jan-19

22 - 30 Jan 30 Nov -5 Dec

5 Armansyah Supervisor FPP Lawe Lawe - - -
2015
Jan-19
2015
Jan-19

6 Sofyan Wijaya Supervisor Inspector Lawe Lawe - - 6-9 Feb 2017 - -

30 Nov -5 Dec
7 Reno Dustira Prasetya Supervisor OSRT PSB - - - -
2015
Jan-19

22-30 Jan 30 Nov -5 Dec

8 Andi Subhan Supervisor OSRT Santan - - -
2015 2015
Jan-19

9 Ibnu Abbas Inspector PSB PSB - - - 8-Apr-18 Apr-21 -

10 Sukardi Shift Captain PSB - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

11 Joseph Nita EVT Pump Operator PSB - - 8-Apr-18 Apr-21 -

12 Andrian Basuki Shift Captain PSB - - - 8-Apr-18 Apr-21 -

13 Sirwanto Shift Captain Pasir Ridge - - - 8-Apr-18 Apr-21 -

14 M. Bambang Arifin Shift Captain Pasir Ridge - - - 8-Apr-18 Apr-21 -

15 Jumiyanto Shift Captain Lawe Lawe - - - 8-Apr-18 Apr-21 -

16 Imam Subono Shift Captain Lawe Lawe - - - 8-Apr-18 Apr-21 -

17 Ramli Shift Captain Lawe Lawe - - 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

18 Jusman Shift Captain STN Santan - - 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

19 Azwar Anas L Shift Captain STN Santan - - - 8-Apr-18 Apr-21 -

20 Nanang. HM Shift Captain STN Santan - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

21 Darmansyah Inspektor LLW Lawe Lawe - - 8-Mar-18 Mar-21 - -

22 Heyrul Anwar Inspektor YKN Lawe Lawe - - 8-Mar-18 Mar-21 - -

23 Yono Ngasiman Inspektor YKN Lawe Lawe - - 8-Mar-18 Mar-21 - -

24 Syaifudin Inspektor SPG Lawe Lawe - - 8-Mar-18 Mar-21 - -

25 Tommy Dwi Cahyadi Inspektor SPG Lawe Lawe - - 8-Mar-18 Mar-21 - -

26 Alimuddin Jide Inspektor ATK Santan - - 8-Mar-18 Mar-21 - -

27 Sulkifli M Inspektor ATK Santan - - 8-Mar-18 Mar-21 - -

28 Syahmil Inspektor NIB Santan - - 8-Mar-18 Mar-21 - -

29 Andi Sofyan T Inspektor STN Santan - - 8-Mar-18 Mar-21 - -

30 Sumardi Syarief Inspektor STN Santan - - 8-Mar-18 Mar-21 - -

31 Maskur Inspektor NIB Santan - - 8-Mar-18 Mar-21 - -

32 R. Imam Tri Utomo EVT Pump Operator Pasir Ridge - - - 8-Apr-18 Apr-21 -

33 Suheriyanto EVT Pump Operator Pasir Ridge - - - 8-Apr-18 Apr-21 -

21-24 Des
34 Saufil Ahyar EVT Pump Operator Pasir Ridge - -
2013
8-Apr-18 Apr-21 -

21-24 Des
35 M. Yusuf EVT Pump Operator Pasir Ridge - -
2013
8-Apr-18 Apr-21 -

36 M. Amtsal Ruba'i Mawar EVT Pump Operator Pasir Ridge - - 8-Apr-18 Apr-21 -

37 Wisnu Pradana EVT Pump Operator Pasir Ridge - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

12-16 Des
38 Haidim EVT Pump Operator PSB -
2016
- -

39 Solihin EVT Pump Operator PSB - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

40 Julianto EVT Pump Operator PSB - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 8-Apr-18 Apr-21 -

41 Sofyansyah EVT Pump Operator Lawe Lawe - - 8-Apr-18 Apr-21 -

42 Hartanto EVT Pump Operator Lawe Lawe - - 8-Apr-18 Apr-21 -

43 Susilo Edi Prayitno EVT Pump Operator Lawe Lawe - - 8-Apr-18 Apr-21 -

44 Djakka Sarwanto EVT Pump Operator Lawe Lawe - - 8-Apr-18 Apr-21 -

45 Faisal EVT Pump Operator Lawe Lawe - - 8-Apr-18 Apr-21 -

46 Awang Idwan Ahmadi EVT Pump Operator Lawe Lawe - - 8-Apr-18 Apr-21 -

47 Aspar EVT Pump Operator Santan - - 8-Apr-18 Apr-21 -

 EXPIRED FIRE CLASS D EXPIRED FIRE FIRE CLASS C EXPIRED FIRE FIRE CLASS B EXPIRED FIRE FIRE CLASS A EXPIRED FIRE
NO NAME AK3Umum
AK3Umum (3years) CLASS D (3 years) CLASS C (3 years) CLASS B (3 years) CLASS A
REMARK

JOB POSITION LOCATION

48 Fajar Subechi EVT Pump Operator Santan - - 8-Apr-18 Apr-21 -

49 Rahmat Baharuddin EVT Pump Operator Santan - - 8-Apr-18 Apr-21 -

50 Nasir DL EVT Pump Operator Santan - - 8-Apr-18 Apr-21 -

51 Syahril EVT Pump Operator Santan - - 8-Apr-18 Apr-21 -

52 Alfrianus Sandin Paramban EVT Pump Operator Santan - - 8-Apr-18 Apr-21 -

53 Agus Susanto Fireman Pasir Ridge - - 8-Mar-18 Mar-21 - -

54 Suhariyan Fireman Pasir Ridge - - 8-Mar-18 Mar-21 - -

55 Eko Dwi Cahyono Fireman Pasir Ridge - - 8-Mar-18 Mar-21 - -

56 Berly Nata Kurnia Fireman Pasir Ridge - - 8-Mar-18 Mar-21 - -

10 - 13 Juni
57 Herwanto Fireman Pasir Ridge -
2013
8-Mar-18 Mar-21 - -

58 Iwan Sukmana Kismat,Amd Fireman Pasir Ridge - 8-Mar-18 Mar-21 - -

59 Erry Idfian S Fireman Pasir Ridge - 8-Mar-18 Mar-21 - -

60 Rachwan Sopandoyo Fireman Pasir Ridge - 8-Mar-18 Mar-21 - -

61 Tonie Adiyanto Fireman Pasir Ridge - 8-Mar-18 Mar-21 - -

10 - 13 Juni
62 M. Gassing Fireman Pasir Ridge -
2013
8-Mar-18 Mar-21 - -

10 - 13 Juni
63 Abd. Gafur Fireman Pasir Ridge -
2013
8-Mar-18 Mar-21 - -

10 - 13 Juni
64 Winardi Fireman PSB -
2013
8-Mar-18 Mar-21 - -

65 Cholik Zainuri Fireman PSB - 8-Mar-18 Mar-21 - -

66 Dedy Agung Fireman PSB - 8-Mar-18 Mar-21 - -

10 - 13 Juni
67 Tahang Fireman PSB -
2013
8-Mar-18 Mar-21 - -

68 Fathurahman Fireman PSB 8-Jun-18 Jun-21 8-Mar-18 Mar-21

69 Buyung Rahmatullah Fireman PSB - 5-7 Dec 2016 8-Mar-18 Mar-21 - -

70 Windu Setiaji Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

71 Mohamad Saeful Mutaqin Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

72 Suradi Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

73 Ahsan Mahmud Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

74 Sigit Tri Nugroho Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

75 Alwi Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

76 Edy Setiawan Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

77 Sri Permana Panca Widodo Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

78 Nurmansyah Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

79 Jasman Fireman Lawe Lawe - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

80 Supriyadi Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

81 Badaruddin Fireman Lawe Lawe - - 8-Mar-18 Mar-21 - -

82 Fardi Amin Fireman Santan - - 8-Mar-18 Mar-21 - -

83 Jumri Fireman Santan - - 8-Mar-18 Mar-21 - -

84 Belgie S Fireman Santan - - 8-Mar-18 Mar-21 - -

85 Edhi Sofyan Fireman Santan - - 8-Mar-18 Mar-21 - -

86 Zainal Thamrin Fireman Santan - - 8-Mar-18 Mar-21 - -

21-24 Des
87 Ramli Fireman Santan - -
2013
- -

88 Yodi KL Fireman Santan - - 8-Mar-18 Mar-21 - -

89 Jamaluddin Fireman Santan - - 8-Mar-18 Mar-21 - -

19-23 Des
90 Usman J Fireman Santan - -
2016
- -

91 Ismail Fireman Santan - - 8-Mar-18 Mar-21 - -

10 - 13 Juni
92 Anggiat Parsaoran S. Fireman Santan -
2013
8-Mar-18 Mar-21 - -

93 Ary Rizki Dispatcher Pasir Ridge - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

94 Suryadi Dispatcher Pasir Ridge - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

95 Fachturachmansyah Fireman Pasir Ridge - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

96 Gunawan Wibisono Dispatcher Lawe Lawe - - 8-Mar-18 Mar-21 - -

 EXPIRED FIRE CLASS D EXPIRED FIRE FIRE CLASS C EXPIRED FIRE FIRE CLASS B EXPIRED FIRE FIRE CLASS A EXPIRED FIRE
NO NAME AK3Umum
AK3Umum (3years) CLASS D (3 years) CLASS C (3 years) CLASS B (3 years) CLASS A
REMARK

JOB POSITION LOCATION

97 Didi Suryanto Dispatcher Lawe Lawe - - 8-Mar-18 Mar-21 - -

98 Nasrudin Dispatcher Lawe Lawe - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

99 Sudarwan Dispatcher Santan - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

100 Masyudi Dispatcher PSB - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

101 Andi Alfian Dispatcher PSB - 8-Jun-18 Jun-21 8-Mar-18 Mar-21 - -

102 Nasrul Dispatcher Santan - 8-Jun-18 Jun-21 - - -

103 Susianto Oil Spill Operator PSB - - - - -

104 Tumpal Pandiangan Oil Spill Operator PSB - - - - -

105 Katimin Oil Spill Operator PSB - - - - -

106 Abdi Gumilar Oil Spill Operator PSB - - - - -

107 Rendra Ramadiansyah Oil Spill Operator PSB - - - - -

108 Abdul Rajjak Gazali Oil Spill Operator PSB - - - - -

16-19 Des
109 Arry Wicaksono Oil Spill Operator PSB - -
2013
- -

110 Diyon Mahardika Oil Spill Operator PSB - - - -

111 Mahmud Ishaq Oil Spill Operator Santan - - - -

112 Gaspar Rante Oil Spill Operator Santan - - - -

113 Arman Jaya Oil Spill Operator Santan - - - -

114 Supiansyah Oil Spill Operator Santan - - - -

115 Sufriadi Oil Spill Operator Santan - - - -

21-24 Des
116 Mubarak B Oil Spill Operator Santan - -
2013
- -

117 Ridwan Sholeh Oil Spill Operator Santan - - - -

118 Masdar Oil Spill Operator Santan - - - -

119 Cheris Admin Fers Pasir Ridge

120 Ansyar Rachman Tech Admin Pasir Ridge - - - - -

Note :

= Mandatory training