MONTHLY REPORT

ENVIRONMENT
PT. SWADAYA CIPTA
PROJECT : JTB UNITIZATION GAS PROJECT

SCOPE OF WORK : HYDRAULIC STRUCTURE

LOCATION : JAMBARAN TIUNG BIRU - BOJONEGORO

PERIOD : 26 Desember 2019 s/d 25 Januari 2020

SUBCONTRACTOR CONTRACTOR
DATE
PREPARED CHECK APPROVED CHECK APPROVED

25-Nov-19
RANGGA ARUM
A. K. MIZAN FIRMAN HARI S.
HAYKAL ALBUNTANA
HSE ENVIRO HSE COORD Site Manager Enviro Staff Enviro Coord.
 ENVIRONMENTAL SOCIALIZATION and TRAINING

REV 0

REPORT PERIOD 26 Desember 2019 s/d 25 Januari 2020

No Activity Location No Actifity Location Remarks

Sosialisasi bahaya hewan melata
1. Sosialisasi house keeping area kerja Pond 2 3 Pond 2
diarea kerja
Sosialisasi menjaga kesehatan dimusim Refresh training pencegahan dan
2. Pond 2 4 Pond 2
penghujan penanganan tumpahan

FOTO KEGIATAN

Sosialisasi house keeping area kerja Sosialisasi menjaga kesehatan dimusim penghujan Sosialisasi bahaya hewan melata diarea kerja Refresh training pencegahan dan penanganan
tumpahan

Attd.List

Sosialisasi house keeping area kerja Sosialisasi menjaga kesehatan dimusim penghujan Sosialisasi bahaya hewan melata diarea kerja Refresh training pencegahan dan penanganan
tumpahan
 ENVIRONMENTAL DOCUMENTASI

REV 0

REPORT PERIOD 26 Desember s/d 25 Januari 2020

FOTO KEGIATAN

Housekeeping area shelter General House keeping House keeping area kerja Pengisian bahan bakar

Penyedotan Tinja Pond 2 Penyedotan Tinja Pond 3 House keeping toilet pengisian air toren

Pengecekan Eyewash Pengisian air toren Pembungan sampah & segregasi Buletin enviro
Pengecekan Eyewash Pengisian air toren Pembungan sampah & segregasi Buletin enviro
 CONSORTI
UM

Aktivitas Pengisian BBM

 ENVIRO MONTHLY REPORT

No Daily Check List Enviro DESCRIPTION OF ACTIVITIES

1 2 3

I Checklist Inspeksi Lingkungan

II Checklist eye wash dan toilet

III Spill Kit

 GPF CONSTRUCTION JTB PROJECT

LIST PERALATAN SPILL KIT

PERUSAHAAN : PT. SWADAYA CIPTA - HS

LOKASI PENEMPATAN : Area Pond 2

No Alat Spill Kit Jumlah Awal Tanggal Penggunaan Jumlah Pengunaan Catatan

Pasir 1 Karung kecil

Majun 1 kg
Sarung Tangan Karet 1 Ea
1 Sekop 1 Ea
Trashbag 2 Ea
Cangkul 1 Ea
Sapu Lidi 1 Ea
 MSDS List REGISTER
JTB PROJECT

No. Type of Chemical Trade Name Producer Name of Sub Contractor Where it is used MSDS Website / Email Controlling
2 Solar Bio Solar PT. Pertamina (Persero) Indonesia PT SWADAYA CIPTA-HS Heavy Equipment, Light Vehicle, Genset MSDS\01. msds-bio-solar.pdf mask, Ruber glove
 Sep-19
KONSUMSI BBM ( HEAVY EQUIPMENT )

26-Dec

27-Dec

28-Dec

29-Dec

30-Dec

31-Dec

10-Jan

11-Jan

12-Jan

13-Jan

14-Jan

15-Jan

16-Jan

17-Jan

18-Jan

19-Jan

20-Jan

21-Jan

22-Jan

23-Jan

24-Jan

25-Jan
1-Jan

2-Jan

3-Jan

4-Jan

5-Jan

6-Jan

7-Jan

8-Jan

9-Jan
No Nama Alat

EXCAVATOR PC 78 60 N/A 60 N/A 60 N/A 0 60 N/A 60 N/A 60 N/A N/A N/A 60 N/A 60 N/A 60 N/A 60 N/A 60 N/A 60 N/A 60 N/A 60 N/A

EXCAVATOR PC 200 100 100 100 100 100 100 0 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100

JUMLAH Total 160 100 160 100 160 100 0 160 100 160 100 160 100 100 100 160 100 160 100 160 100 160 100 160 100 160 100 160 100 160 100
Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter

Heavy Equipment
N/A
R I N C I A N

Jumlah Pemakaian Dalam Satu

Bulan 3740
Liter
Heavy Equipment

KONSUMSI BBM (Light Vehicle)

1 INNOVA 19 19 19 19 19 19 0 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19

2 ELF 19 19 19 19 19 19 0 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19

3 Pick UP 19 19 19 19 19 19 0 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19
JUMLAH Total 57 57 57 57 57 57 0 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57 57
Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter Liter

Jumlah Pemakaian Dalam Satu

Bulan 1653 Liter

Light Vehicle
 Sep-19

26-Dec

27-Dec

28-Dec

29-Dec

30-Dec

31-Dec

10-Jan

11-Jan

12-Jan

13-Jan

14-Jan

15-Jan

16-Jan

17-Jan

18-Jan

19-Jan

20-Jan

21-Jan

22-Jan

23-Jan

24-Jan

25-Jan
1-Jan

2-Jan

3-Jan

4-Jan

5-Jan

6-Jan

7-Jan

8-Jan

9-Jan
Tanggal

PEMAKAIAN AIR (Penyiraman Jalan)

N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Jumlah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³ M³

Jumlah Pemakaian Dalam

Satu Bulan 0
M³

PEMAKAIAN KERTAS
A4 66 60 66 45 66 80 0 66 65 70 30 66 20 60 66 30 66 66 66 70 30 66 70 66 66 80 60 45 66 70 66
KANTOR
A3 8 40 10 15

Jumlah 66 60 74 45 66 80 0 66 65 70 30 66 60 60 66 30 76 66 66 70 45 66 70 66 66 80 60 45 66 70 66

Pemakaian A4 1809 sheets

Satu Bulan A3 73 sheets
 Sep-19

26-Dec

27-Dec

28-Dec

29-Dec

30-Dec

31-Dec

10-Jan

11-Jan

12-Jan

13-Jan

14-Jan

15-Jan

16-Jan

17-Jan

18-Jan

19-Jan

20-Jan

21-Jan

22-Jan

23-Jan

24-Jan

25-Jan
1-Jan

2-Jan

3-Jan

4-Jan

5-Jan

6-Jan

7-Jan

8-Jan

9-Jan
Tanggal

SAMPAH
2 2 2 1 2 2 0 2 2 2 1 2 2 2 2 2 2 1 2 2 2 2 2 2 1 2 2 2 2 2 2
ORGANIC
Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg
6 6 6 3 6 6 0 6 6 6 3 6 6 6 6 6 6 3 6 6 6 6 6 6 3 6 6 6 6 6 6
NON ORGANIC
Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg

HAZARDOUZ
Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg

ORGANIC 56 Kg
Jumlah
Pemakaian NON
Dalam Satu ORGANIC 168 Kg
Bulan
HAZARDOUZ 0 Kg

Limbah B3 Padat dan Cair

B3 CAIR
Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr Ltr

MAJUN
Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg Kg

Pemakaian B3 CAIR 0 Ltr

Dalam Satu
Bulan MAJUN 0 Kg

Sedot Tinja Dan Pemakaian Air Toren

Sedot Tinja 3000 3000
Shelter
Air Toren 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300

Jumlah 300 300 300 300 300 300 300 300 3300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 300 3300 300 300 300 300 300

Pemakaian Sedot Tinja 6000 Ltr

Dalam Satu
Bulan Air Toren 9300 Ltr
 CONSORTI
UM

LIST OF MANIFEST B3 VENDOR

CV KAISAR CV MAHARANI

CV YOGI PUTRA CV DWI JAYA

 CONSORTIUM

RJJ JTB GPF - Dust Control Program

No Month Company Day Water Truck Rates Volume (L) Total Volume (L) Location
1 July SWG 31 3 5 5000 2325000 Jalan (A) Akses Perhutani, plus Pioneer Area
2 SWG 31 2 5 5000 1550000 Jalan (A) Akses Perhutani
August
3 YIN 31 2 6 5000 1860000 Jalan (A) Akses Perhutani
4 SWG 30 2 5 5000 1500000 Jalan (A) Akses Perhutani
5 September YIN 30 2 6 5000 1800000 Jalan (A) Akses Perhutani
6 RJJ 30 1 5 5000 750000 Jalan (A) Akses Perhutani, plus Pioneer Area
7 SWG 31 2 5 5000 1550000 Jalan (A) Akses Perhutani
8 October YIN 31 2 6 5000 1860000 Jalan (A) Akses Perhutani
9 RJJ 31 1 5 5000 775000 Jalan (A) Akses Perhutani, plus Pioneer Area
10 SWG 25 2 5 5000 1250000 Jalan (A) Akses Perhutani
11 November (Hujan) YIN 25 2 6 5000 1500000 Jalan (A) Akses Perhutani
12 RJJ 25 1 5 5000 625000 Jalan (A) Akses Perhutani, plus Pioneer Area
13 SWG 25 2 5 5000 1250000 Jalan (A) Akses Perhutani
14 December 2018 (Hujan) YIN 25 2 6 5000 1500000 Jalan (A) Akses Perhutani
15 RJJ 7 1 5 5000 175000 Jalan (A) Akses Perhutani, plus Pioneer Area
16 SWG 25 1 5 5000 625000 Jalan (A) Akses Perhutani
January 2019 (Hujan)
17 YIN 25 1 6 5000 750000 Jalan (A) Akses Perhutani
18 SWG 25 1 7 5000 875000 Jalan (A) Akses Perhutani
February 2019 (Hujan)
19 YIN 25 1 8 5000 1000000 Jalan (A) Akses Perhutani
20 SWG 31 1 5 5000 775000 Jalan (A) Akses Perhutani
March 2019 (Hujan)
21 YIN 31 1 6 5000 930000 Jalan (A) Akses Perhutani
22 SWG 30 1 5 5000 750000 Jalan (A) Akses Perhutani
April 2019 (Hujan)
23 YIN 30 1 6 5000 900000 Jalan (A) Akses Perhutani
 ENVIRONMENTAL PERFORMANCE

REV 0 REV

CONSORTIUM
MONTH 0

Number of Env. Accident Energy and Natural Resource Consumption Total Waste

Remarks
Oil / chemical spill Fuel LIMBAH B3
No Period Oil/ chemical spill Oil / Chemical Spill Black
Electrical Water Paper Organic Inorganic
10-100 barel <5 Barrel Water
> 100 Barrel Diesel Petrol PADAT CAIR

a2 b c KWH Liter Liter Liiter (reams) Ton Ton Liter Ton Liter

1 January 3,443 7,500 0.036 0.118 6000 Periode 26 Desember - 25 Januari 2020

2 February

3 March

4 April

5 May

6 June

7 July

8 August

9 September

10 October

11 November

12 December 1,950 1,800 0.02 0.050

Sub-total 0.00 0.00 0.00 0.00 5393 0.00 9300.00 0 0.056 0.168 6000 0.000 0.000

Previous Total 0.00 0.00 0.00 0.00 0 0.00 0.00 0 0.000 0.000 0 0.000 0.000

Total 0.00 0.00 0.00 0.00 5393 0.00 9300.00 0 0.056 0.168 6000 0.000 0.000