PRELIMINARY CHECKLIST

1. Company Name : PT MULTICRANE PERKASA

Address : Cengkareng Business City Lot 5 Boutique 29-30
Jl.Atang Sanjaya No.21 Benda
Tangerang – Banten 15125
Phone : 021 29777 8888 / 021 2255 8644
Fax : 021 2255 8644
Email : info@multicraneperkasa.com
Website : www.multicraneperkasa.com
Establish Year : 2012
Company Status : BUMN / Private / PMA
If PMA; From Country . . . . . . . . . . . . . .

2. Contact Persons
No Name Position Email Phone/Mobile
1. Herfian ISO & Business herfian.wijaya@multicraneperkasa.com 082111365601
Wijaya Proccess Spv
2. Nursanti Office & Facility nursanti.akbar@multicraneperkasa.com
Akbar Manager
3.

3. EMPLOYEES

Education Age
No. Function Number
<SLA D3 S1 >S1 <35 ≥35
Organic
1 Board of Director
2 GM
3 Senior Manager
4 Junior Manager
5 Staff (office)
6 Staff (Site)
Unorganic / Contractor
1 ................
2 ................
TOTAL

4. Products/Services
No Product/Services/Activities Remarks
1. Authorized Distributor of Heavy Equpment

5. Any statutory/regulatory must comply with your product/services (if available)

 ..............................
 ..............................
 ..............................
 ..............................

PT Sucofindo Prima Internasional Konsultan

6. Prime Customer/Client
 ..............................
 ..............................
 ..............................
 ..............................

7. Management System already used

No. System Yes/No Remarks

1 QMS ISO 9001 Yes

2 EMS ISO 14001
3 OHSAS 18001
4 SMK3 (PP 50)
5 ....
6

8. Does the company have the following item

*Please select the option below (☒)
Q/H/S/E : Quality/Health/Safety/Environment

Item Q H S E Remarks
Policy ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Objective ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Manual ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Aspect Impact / ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
Hazard Identification ☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Programs ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Procedure ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Work Instruction ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Form-form ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Record implemention ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
system ☐< 50% ☐< 50% ☐< 50% ☐< 50%
☐N/A ☐N/A ☐N/A ☐N/A
Applicable Code/ ☐≥ 50% ☐≥ 50% ☐≥ 50% ☐≥ 50%
Identification/ ☐< 50% ☐< 50% ☐< 50% ☐< 50%
Specification

PT Sucofindo Prima Internasional Konsultan

 Item Q H S E Remarks
☐N/A ☐N/A ☐N/A ☐N/A

9. The planned Scope of Standard/System(s) Implementation and Certification

Head Office/
No Branch/ Unit/Section Location/Address Remarks
Site/Plant

10. Plan of System Development & Certification Target

*Please select the option below (☒)
a. QMS ISO 9001 : ☐ System Development ☐ Certification
b. EMS ISO 14001 : ☐ System Development ☐ Certification
c. OHSAS 18001 : ☐ System Development ☐ Certification
d. SMK3 PP 50 : ☒ System Development ☒ Certification
e. ISO 22000 : ☐ System Development ☐ Certification
f. HACCP : ☐ System Development ☐ Certification
g. ........................ : ☐ System Development ☐ Certification
h. ........................ : ☐ System Development ☐ Certification
i. ........................ : ☐ System Development ☐ Certification

11. Integration system : ☐ Yes ☐ No

12. Time target for certification : ........................
13. The Selected Certification Body : ........................

...........................

(. . . . . . . . . . . . . . . . . . . . . . . . . .) (. . . . . . . . . . . . . . . . . . . . . . . . . .)
Client Consultant/Marketing

Note:
Please attach:
- The company profile
- The organization structure & scope of organization will be developed/implemented
- Picture of the company's business processes in general

PT. SUCOFINDO PRIMA INTERNASIONAL KONSULTAN

Graha Sucofindo Lantai 12
Jl. Raya Pasar Minggu Kav.34 Jakarta 12780
Telp. 7983666 Ext. 1315, 1309 ; info@sprint.co.id
Contact Person

Nama Email Phone Mobile

PT Sucofindo Prima Internasional Konsultan

Rangga Frasdika rangga@sprint.co.id +62 21-798 3666 Ext 1104 0852 9311 7335
Wijanarka wijanarka@sprint.co.id +62 21-798 3666 Ext 1302 0813 8134 1432
Duny Prabawati duny@sprint.co.id +62 21-798 3666 Ext 1105 0821 2718 1713

PT Sucofindo Prima Internasional Konsultan