APPLICATION FOR STAFF EMPLOYMENT

Position Applied for : Earth Work Supervisor

Name : Gunawan Hady S Sex : Male / Female

Place & Date of Birth : Religion : Moslem

Balikpapan,08 Mei 1971 Marital Status : Married / Single / Other

Current Address : Jl. Gurinda- 4 RT. 42 No. 40C Number of Children : 3
Gg.Melati, Balikpapan Utara ( 76125 ).
ID Card (KTP) No : 647103.080571.0003

Valid Until : 08-05-2019

Phone No. : +6281347308430 Issued in : 15-04-2014

E-mail Address : guns.arika71@gmail.com

FORMAL EDUCATION
Name of School / Universities / Remarks
From To Location
Diploma (Major & GPA)
1987 1990 SMA Negeri- 5 Samarinda      
                             
                             
                             

NON-FORMAL EDUCATION
(Including training, seminar, course – that are most relevant to the position that you are applying for)
Date Name of Training / Course Institution
1999 Digitizing Topo Map ITB ( VICO )
1999 Road and Drilling Location Survey Work MBT & PU ( VICO )
2003 Oil Spill Response VISION ( VICO )
2006 Advance Fire Fighting and Breathing Apparatus HSE ( VICO )
2009 Invironmental Risk Assessment & Task Risk Assessment HSE ( VICO )
2011 Supervisor Development Program BaliLC ( VICO )

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FORM No. PTP-HR-FO-G-0545 Rev No. 2 1 of 4
APPLICATION FOR STAFF EMPLOYMENT

EMPLOYMENT RECORD
(Start with current or last employment and choose the most relevant to the position applied for)
Company name : PT.Jonathan AB. Length of service :
From _____2013________to _____2017________
Entry position : Supervisor Road and Location Last position : Supervisor Road and Location
Directly report to : Superintendent and Manager Numbers of subordinate (if any) : __150_ person(s)
Job Description of your Last Position :
Mengontrol pekerjaan beberapa Kontraktor dalam pembukaan lokasi,mulai Land Clearing, Cutt-Fill, Levelling
and Compacted,sesuai standart/SOP dari Perusahaan dan Design Gambar. Jumlah alat berat yg di
gunakan, jumlah Personil dan Safety.

Reason for leaving the company : Contract Completed.

Company name : PT.Radiant Utama Interinsco & Length of service :

PT. Ceria Utama. From ___2007________to _____2013_______
Entry position : Foreman Last position : Foreman
Directly report to : Supervisor Numbers of subordinate (if any) : _50_ person(s)
Job Description of your Last Position :
Mengawasi pekerjaan Operator untuk bekerja Aman,Sesuai arahan dan sesuai keperluan dilokasi/Gambar.
Jumlah alat berat yg di gunakan, jumlah Personil dan Safety.

Reason for leaving the company : Contract Completed.

Company name : PT. Perdana Karya Length of service :

From ___2002________to _____2007_______
Entry position : HSE Inspector Last position : HSE Inspector
Directly report to : HSE Supt. Numbers of subordinate (if any) : __15___ person(s)
Job Description of your Last Position :
Menginspeksi Unit bersama Tim,Sebelum Alat berat digunakan untuk mendapatkan
Sticker,memastikan unit aman dan Layak di Operasikan.
Memberikan Pengarahan/Induksi kepada Operator atau crew yang terlibat dilokasi kerja.

Reason for leaving the company : Contract Completed.

PERSONAL REFERENCES
( Give names of person of responsibility who have known you for at least 3 years minimum 2 persons )

Name Company Relationship Phone Number

Angga Pradipta VICO Engineer Supv. 085216030555

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FORM No. PTP-HR-FO-G-0545 Rev No. 2 2 of 4
APPLICATION FOR STAFF EMPLOYMENT

Vicky Rinaldo VICO Superintendent 08129433472

ORGANISATION CHART OF COMPANY MOST RELEVANT TO POSITION APPLIED FOR
( State name of company and indicate where you fit in the organization )

PT.Virginia Indonesia Company/ VICO Indonesia adalah Perusahaan Explorasi Pengeboran/Drilling Oil and
Gas yang beroperasi di Darat/ On Shore di Daerah Kutai Kertanegara, Kalimantan Timur.

FOREIGN LANGUAGES
( Please state with Good / Fair / Poor )

Language Speaking Reading Writing

English Basic Basic Basic

                       
                       

COMPUTER PROFICIENCY
Depth
Type Program / Language
(Basic, Intermediate, Advance)

Microsoft Office Word, Exel, Power Point and Internet Intermediate

                 
                 

GOALS / CAREER OBJECTIVES

1). Memajukan, Menjaga Asset dan Nama baik Perusahaan.
2). Menjaga Kekompakan antar Karyawan untuk mencapai hasil yang lebih baik.
3). Memastikan pekerjaan dikerjakan dengan Aman, Tepat waktu dan Sesuai Standart Perusahaan.

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FORM No. PTP-HR-FO-G-0545 Rev No. 2 3 of 4
APPLICATION FOR STAFF EMPLOYMENT

WORK INTEREST
Other Benefit
Current Salary :
Rp.14.000.000,- (current / previous      
(gross)
company) :

Expected Salary : Expected benefit

Rp.15.000.000,-      
(gross) from Petrosea :

Please state why you

When are
believe you are
Karena sesuai dengan Pengalaman Kerja you
suitable for the Anytime
yang dimiliki. available for
position you are
working :
applying:

Other position for which you are considered to be qualified : Earth Work Supervisor

Employment Status Expectation : Permanent / Contract / Internship ( please mark as appropriate )

Are you willing to be assigned outside the city? Yes / No ( please mark as appropriate )
Why?

Karena Saya sangat menginginkan pekerjaan ini.

Have you ever applied to Petrosea YES / NO ( please mark as appropriate )

before? If YES, when was that? ______________________________

Have you ever worked with Petrosea YES / NO ( please mark as appropriate )
before? If YES, when was that? ______________________________

Do you have friends / acquaintances / YES / NO ( please mark as appropriate )

relatives who work in Petrosea If YES, please mention the name(s) here :
currently? __________________________________________________

Date : 22 Maret 2018

The facts stated in this application for  Gunawan Hady S.
employment are true and complete to
the best of my knowledge and belief.
I understand that false information in
this application shall be considered
sufficient for dismissal from
employment.
Applicant’s Signature

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FORM No. PTP-HR-FO-G-0545 Rev No. 2 4 of 4