F-CH-AG-204-004

REV : 00
DATE :2016.07.15

Audit Checklist

PAGE OF : STANDARD AUDIT IS BASED UPON: ISO 14001:2015

AUDITOR: Ahmad Efendi DATE: 17 Februari 2017

Document Description of Audit Point Acc / Rej Comments C.A.R. #

Reference
HSE Does the yiid have a high level conceptual Acc Already have internal external issues, stated NA
Management understanding of the internal and external issues in the HSE management plan that its will be
Plan, other that can affect, either positively or negatively, its reviewed and updated regularly.
related ability to achieve the intended outcomes of its Lampiran 6
document EMS?
HSE Acc Matrix of interested parties and their NA
Has the yiid adequately determined the
Management corresponding needs and expectations,
interested parties and their requirements relevant
Plan, other resulting the compliance obligation
to its EMS? Which of these requirements are
related Lampiran 6
considered as organizations compliance
document
obligations?
HSE Acc Stated in the HSE management plan, NA
Has the yiid determined the boundaries and
Management environmental aspect
applicability of the EMS to establish its scope
Plan, other
related Pada point 4.3 tentang Scope
document
HSE Acc Intended outcome already include the NA
Has the yiid implemented and EMS, including all
Management enhancement of environmental
required processess, in accordance with the
Plan, other performance, fulfillment of compliance
requirements of ISO 14001?
related obligations and achievement of
document environmental objectives.
Environmental risk assessment.
Menunjukan Kinerja K3, Pemenuhan
Perundangan, penilaian RO, dan Pencapaian
tujuan Lingkunagn
Environmental Acc Yes. Already have risk and opportunities NA
Does the yiid maintain documented information
Risk & documentation.
on its risks and opportunities and are the
Opportunities

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 F-CH-AG-204-004
REV : 00
DATE :2016.07.15

Audit Checklist

Document Description of Audit Point Acc / Rej Comments C.A.R. #

Reference
document, Dokumentasi RO
processess needed documented to the extent
record of legal
necessary to be sure they are carried out as
compliance,
planned?
other related
document Acc The environmental risk and opportunities NA
Check the environmental aspect
document and environmental risk
assessment register already consider a life
cycle environment (stated on HSE
management plan), routine, non routine
activities, emergency situation, significant
environmental aspects, communication and
documentation. Refer to risk assessment
procedure (for criteria)
Menujukan RO, dengan kriteruia jenis
kegiatan, terodkumentasi, peraturan
perundangan
HSE Acc List of compliance obligations NA
Does the yiid determine and have access to the
Management
compliance obligation related to its
Plan, other Tunjukan daftar perunundangan
environmental aspects? Maintain the documented
related
information of its compliance obligation?
document
HSE Planning action to address these risks and Acc Already have environmental objective and
Management opportunities, significant environmental aspect, program. The objective already consider the
Plan, other compliance obligations financial, technological options, operational
related and business requirements
document Tunjukan tujuan sasarn program, yang ada
di manual.. manual poin 6.2.2
HSE Does the yiid plan, implement and control any Acc Yiid already doing control to prevent NA
Management processes? Maintain documented information to environmental impacts. Controls including
Plan, other the extent necessary to have confidence that the engineering controls, procedure, work
related processes have been carried out as planned? instruction, describe in the environmental
document risk assessment following the hierarchy

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 F-CH-AG-204-004
REV : 00
DATE :2016.07.15

Audit Checklist

Document Description of Audit Point Acc / Rej Comments C.A.R. #

Reference
(elimination, substitution, engineering
control, administrative, PPE)
Menunjukkan RO dengan menyebutkan
proses pengendendalian , (elimination,
substitution, engineering control,
administrative, PPE)
HSE Acc Already have results of analysis and NA
Has the yiid identified the improvement
Management evaluation of environmental performance,
opportunities and taken necessary actions that
Plan, other compliance, internal audit and management
will better enable the organization to achieve the
related review
intended outcome of its EMS
document Menunjukan analisa , evaluasi kepatuhan
perundangan, audit dan manajemen review
Acc Corrective action has been taken and NA
Check the Nonconformance report
implemented, the MR already review the
effectiveness of any corrective action taken.
Menunjukan CPAR dr hasil external internal
audit.
Acc Identify the improvement from analysis & NA
Continual improvement
evaluation, internal audit in the
management review meeting
Menunjukan Tinjuaan Manajemen.

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