Document No.

PROJECT SAFETY PLAN

RAPP

10 PIPELINE LANGGAM RAPP DEVELOPMENT PROJECT

PROJECT SAFETY PLAN

No

Issued Date

Document status

Prep by

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Document No.

PROJECT SAFETY PLAN

RAPP

10 PIPELINE LANGGAM RAPP DEVELOPMENT PROJECT

TABLE OF CONTENTS 1. GENERAL 1.1. Scopes 1.2. Abbreviation and Definitions FSHE POLICY 2.1. The Corporate FSHE Policy 2.2. The Project FSHE Policy HAZARD IDENTIFICATION RISK ASSESSMENT AND RISK CONTROL FSHE CODE, LAW AND GOVERNMENT REGULATION PROJECT FSHE OBJECTIVES FSHE PROGRAMS ORGANIZATION AND RESPONSIBILITY OF FSHE TRAINING REQUIREMENTS COMMUNICATION 9.1. Project FSHE Management Meetings 9.2. Site FSHE Meeting

2.

3. 4. 5. 6. 7. 8. 9.

10. CONTROL OF THE FSHE PERFORMANCE 10.1. Procedures 10.2. Work Instruction 10.3. Work Permit 10.4. Material Safety Data Sheets 10.5. Personal Protective Equipment 10.6. Fire Extinguisher 10.7. First Aid Equipment 10.8. Other Requirements. 11. ATTACHMENTS

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1.

GENERAL 1.1. Scopes This Project Safety Plan (PSP) is designed to guide the 10 Pipeline Langgam RAPP Development Project and its Sub-contractor to assure that a Job execution will be conducting in the Project course. The PSP is an internal part of the Project Management System which is designed for the requirements of the Steam Station Control Retrofit Area 1 on Safety, Health and Environment Management System. The PSP is designed to provide a sound basis for communication and the participation of all personnel on the project in the implementation of the Health and Safety of personnel, protection of the environment and prevention of Employer, Contractor and Subcontractor asset loss by identifying the HSE Standard applicable to all phases of the Project. 1.2. Definitions and Abbreviations 1.2.1 Definitions Throughout this PSP and all project safety related document the following terms and definitions shall be applied : INDOGAS : PT. Indogas Contractor : PT. META EPSI. Subcontractor : The party(s) that carry(s) out all equipment, technical document/ drawings and services the duties specified by the Contractor. PSP : Project Safety Plan. Project : Steam Station Control Retrofit Area1. Supplier / Vendor : The party which is supply materials, equipments, technical documents / drawings and services to performs the duties specified by OWNER. 1.2.2 Abbreviations AMDAL ANDAL RA EIA EMS ERP HIRARC ISO MSDS OSH OSHMS : : : : : : : : : : : SEE EIA (Environment Impact Assessment). Environment Impact Assessment. Risk Assessment. Environment Impact Assessment. Environment Management System Emergency Response Plan. Hazard Identification Risk Assessment and Risk Control. International Standard Organization. Material Safety Data Sheet. Occupational Safety and Health Occupational Safety and Health Management
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OSHAS PSP SOP 2. FSHE POLICY 2.1.

: : :

System. Occupational Safety and Health Assessment System. Project Safety Plan Standard Operating Procedure.

THE CORPORATE FSHE POLICY The Contractor FSHE Policy is mentioned on Attachment A.1.

2.2.

THE PROJECT FSHE POLICY The Project FSHE Policy is mentioned on Attachment A.2.

3.

HAZARD IDENTIFICATION RISK ASSESSMENT AND RISK CONTROL The Hazard Identification Risk Assessment and Risk Control (HIRARC) is mentioned on Attachment B.

4.

CODE, LAW AND GOVERNMENT REGULATION Law / UU No. 1 : 1970, regarding the Safety. Regulation of Minister Labor No. 05 : 1996, regarding Health and Safety Management System. Joint Ministerial Decree of Minister of Labor and Minister Public of Work No. 174/MEN.1986, No. 104/KPTS/1986 regarding safety on construction area. Government Regulation of Republic Indonesia No. 18 : 1999, regarding management of toxic and hazardous waste. ISO 9001:2000, Quality Management System. OSHAS 18001 Occupational Health and Safety Management System. Relevant updated Government and/or Authority regulation. Other updated relevant Code, Standard, and Reference on occupational safety and health.

5.

PROJECT FSHE OBJECTIVES The Projects FSHE Objectives are mentioned on Attachment C.

6.

FSHE PROGRAMS The program which is utilized in this PSP are : to identify, to access and to control the hazard and to create safe construction caused by the project activities, which enable continual improvement during performance of the project. The program are implemented by: Management Commitment to Health, Safety and Environmental Protection (see Attachment A). Line Management and Employee responsibility for Health, Safety and Environmental Protection.

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Health, Safety and Environmental Standard that are understood by all workforce. Measurement and Audit of performance. Reporting and recording of all accident, incident and near misses with through investigation and follow up action to prevent recurrence. Appropriate and effective training during project course. Communication through all levels of the organization. Evaluation of Subcontractor's FSHE Policy to comply with FSHE Contractor. Emergency Response Plan.

The Programs is mentioned in on Attachment D. 7. ORGANIZATION AND RESPONSIBILITY FOR FSHE Line management from the General Project Manager through every level of supervision, is responsible and accountable for health, safety and environment management, progress and performance. The organization chart is mentioned on Attachment E. Specific responsibilities of individuals are detailed below: 7.1. Project Manager Responsibilities : Implementation of PSP. Provision of adequate PSP resources to the project. Safety performance of all section associated with their activities in the project. Ensuring that all accident and incident are reported in accordance with Work Accident Procedure. Approval of Subcontractor/Suppliers and Vendors before they are working for the Project. Ensuring Subcontractors/Suppliers address the requirements for compliance with this PSP. The safety performance of Subcontractors/Suppliers if they are competent and adequately trained for their designated task. Activities : Continuous monitoring of PSP performance. Review the PSP performance with FSHE Leader. Regularly inspect the project, workplaces with senior project personnel. Review accident/incident statistic and any relevant PSP reports and implements recommendations. Review training implementation records and requirements. 7.2. Site Manager Responsibilities : FSHE performance of their area of control.
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Compliance Subcontractor / Supplier to the Project FSHE objectives. Provision and maintenance of safe system of works. Implementation of FSHE procedure and programs in their area of control.

Activities : Chairs monthly of the Project FSHE meetings. Review the safety progress with FSHE Coordinator for their area of responsibility. Inspect periodically all workplace. Review accident / incident reports and FSHE performance report, and the implementation of recommendations. Review Subcontractor / Supplier FSHE performance. Promote FSHE tool box meetings and safety meetings. Review environmental protection performance. 7.3. FSHE Coordinator Responsibilities : Implementation of the PSP. Implementation of all FSHE Procedure. Developing and implementing all safety training needed for workforce and Inspection Schedule (patrol safety program). Establishment, periodic drill of project emergency response team. Developing and implementing audit schedule. Conduct accident / incident investigation for any accident / incident occur during project course. Prepare of accident / incident reports and provision of recommendations for remedial act. Resolution of FSHE issues. Generation of FSHE Procedure. Generation of weekly and monthly project FSHE reports. Provision of FSHE advice and recommendations to Line Management. Activities : To coordinate and control the FSHE activities with the personnel within the project site. Active participate in monthly FSHE meetings and weekly SHE joint visit (management tour). To make FSHE Training Plan for workforce. Review periodically project FSHE performance. Participate in accident / incident investigation as necessary. Administer accident / incident reporting system and ensure the distribution of the result / remedial act the relevant department. Ensure the regular emergency response drill are performed to all sites. Provide monthly report & safety inspection check list.
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7.4.

Performing employee of FSHE training needed. Ensure that all workforce at the project sites comply with this FSHE Plan. Participate in project weekly meeting at site. Conduct or coordinate tool box talk or meeting.

Supervisor and FSHE Officer Responsibilities : Coordinating the FSHE activities on the area they are assigned. Ensure that the works are performed in according to PSP and the Procedures. Ensure that appropriate PPE are used by the workers performing the works. Ensure that all safety rules are conducted before any activities are performed. Enforcement of all safety health and environmental rules and regulations. Enforce of statutory regulations. Compliance of Subcontractors / Suppliers to the PSP and Project objectives. Assist investigations of accidents and incidents in their area of control. Conduct toolbox talk / meetings. Activities : To arrange work permit before work is commencing. Participate in FSHE monthly and weekly meetings. Conduct toolbox meetings and safety talk. Assist in FSHE inspection on site. Report and investigate all accident and incident that occur in there area of responsibilities.

7.5.

Safety Man / Safety Inspector Responsibilities : Ensure that work permit on his area of activity is issued. Close check that the activities are performed in accordance with PSP. Ensure that the work are performed in according to the Procedures. Ensure that appropriate PPE are used by all workers performing the works. Ensure that all safety rules are conducted before any activity is performed. Enforcement of all safety health and environmental rules and regulations. Enforce of statutory regulations. Compliance of Subcontractor / Suppliers to the PSP and Project Objectives. Assist investigation of all accident / incident in their area of control. Activities :

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7.6.

To arrange and obtain work permit before work is started. Participate in FSHE monthly meetings. Conduct toolbox meetings and safety talk before new work is performed. Assist in FSHE inspection on site. Perform first aid of any accident / incident that occur in their area of responsibilities Assist investigation of all accident / incident that occur in their area of responsibilities.

Employees Responsibilities Every employee has a responsibility to take reasonable care for the Project Health, Safety and Environment of themselves and or other workers / employees and report all hazard that may be affected by their actions. Employees are responsible for undertaking their activities in strict accordance with the Procedures and work instructions issued to them. They must identifying of any unsafe situation / condition then immediately report to their supervisors, they must active participating in the achievement improvement of a safe working environment.

7.7.

Subcontractors Responsibilities All Subcontractors / Suppliers shall ensure that they are fully understand, implement and conform to the FSHE rules as laid down within contracts, and undertake their activities in accordance with this Project Safety Plan.

8.

TRAINING REQUIREMENTS 8.1. FSHE Induction All project personnel, including Subcontractors / Suppliers, office workers, workshop / fabrication yard or work site shall be attend a general FSHE Induction prior to work in the Project. This is a apart of the general induction designed to discuss the condition of work, scope of works and other relevant information, and will include introduction to the project and the intention of the FSHE Policy. A FSHE Manual which contain a practical guidance of Health, Safety and Environment Procedure and regulation in this project will be given to new employees / workers who has passed the induction to joint the project team in a Project Safety orientation implemented. The main topics of training covered will include, but not be limited, as appropriate: FSHE Policy. Safety responsibilities. Personal Protective Equipment requirements. Environmental concern. Accident and incident report.

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8.2.

Safety meetings and safety talk. Emergency Response Procedure. Safety driving, operating equipment. Etc.

Visitor Induction Short-term visitors to the worksites will be required to attend a short information session covering specific requirements and guidelines for the particular site including PPE and safety requirement. The Induction for visitor will be conducted by FSHE Leader or Safety Officer on site.

8.3.

Training during Project Course (see Training Matrix and Training Programs Attachment F) The Project FSHE Leader will arrange a plan and implementation of various training sessions specific to the job requirements throughout the project. These sessions will include: OHSAS 18001:1999 Awareness Permit to work system. Protection of the environment. Height safety environment. Hazard Identification Risk Assessment and Risk Control (HIRARC). Basic First Aid techniques. Personal Protective Equipment. Emergency Procedure. Induction courses. Work specific safety requirements. Weekly toolbox meetings on safety campaigns and/or current safety topics. Defensive driving. Theory of Fire Fighting

8.4.

Emergency Response Plan Emergency Response Plan shall be established on each site activities. The personnel who will be manage the emergency situation will undergo training periodically. The training shall in accordance with site emergency response plan applicable to each worksite has been established before the activities are performed. Emergency response plan procedure will be prepared separately. The plans will provide details of local arrangements in case of an emergency. Training will be conducted at least once in the project to the each worksite.

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9.

COMMUNICATION Effective communication is essential for the development of a safety performance throughout the project team. Open communication between the workforce and the project management team on FSHE matters is needed. This will be achieved through the socialization of the project FSHE Policy, periodic briefing and safety campaigns to all workforces. 9.1. Project FSHE Meetings Project safety committee will be established at the project office, they will conduct FSHE meetings at least once a month together or separate with Quality Management Review Meeting, it shall be chaired by Construction Manager. In case there is an accident / incident happen in the project area, project safety committee shall summon all team to have a meeting. These meetings shall involve personnel from management, workers and Subcontractors representative. In this meeting project safety committee shall establish a team for accident/incident investigation, this team shall be chaired by FSHE Coordinator. Result of the investigation shall be circulated to notice boards and copied to the relevant Project Manager, FSHE Manager, Subcontractor and Committee Head Office in Jakarta. 9.2. Site FSHE Meetings All sites will be required to conduct weekly site safety meetings. These meeting shall involve Supervisors, Foreman and Subcontractor / Suppliers. Meeting will encourage discussion from all personnel on safety issues affecting their work group, the result of discussion shall be minutes and followed up. Minutes of meeting will be circulated to notice boards, relevant Project Manager, FSHE Coordinator, Subcontractor and Contractor representative, etc.

10. CONTROL OF THE FSHE PERFORMANCE 10.1. Procedures The Corporate FSHE Committee shall be assist QAFSHE Procedures to the Project Management System of PLTU CFSPP 2 x 25 MW to be implemented on the Project Execution. List of QAFSHE Procedures see Attachment G. The procedures for execution of the project shall be provided by Project Management Team. Construction Procedure will be provided by Engineering,
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Inspection and Test Procedures by QAQC, and FSHE Procedure by FSHE Coordinator. All procedures controlled by Document Control. List of Construction and Inspection Procedures see Attachment H. 10.2. Work Instruction Work Instruction shall be provided by engineering. List of Work Instruction see Attachment I. 10.3. Work Permit A Work permit authorizes specific construction, inspection or repair work to be conducted in a restricted area. The work permit also serves as a record of what steps have been taken to ensure safe working conditions in the restricted area. Restricted areas are the project sites areas that require Area Custodian Authorization to enter and to perform work. Work permit shall be issued only by authorized area work permit issuers. Work permit shall be received only by authorized work permit receivers. Work permit issuers and receivers must have a valid work permit certification card. The receivers of work permit must keep his copy the work site for duration of the job. If in emergency condition occurs, affected area work permits are automatically voided. Work permit must closed out by signature of the issuers and receivers upon completion of the work. The work permits will include: Hot Work Permit. Cold Work Permit. Electrical Work Permit. Radiation Source Permit. Movement of Heavy Equipment Permit. Work Permit Form see Attachment J. 10.4. Material Safety Data Sheets (MSDS) A register of all chemical and hazardous materials on site will be maintained with copies of Material Safety Data Sheets, Hazardous materials or chemical being used shall be properly labeled. Contractor shall be responsible for the proper storage, transportation, handling, use and disposal of all hazardous material utilized in or generated by construction activities. The following principle shall be adopted: Minimize the use of hazardous substances and when it is essential to use such materials, keep them secured, segregate and contained location. Minimize airborne concentration by providing closed ventilation system.
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Storage and handling of hazardous material should be done accordance with the guideline given MSDS and applicable local regulation. Container of hazardous liquids shall be stored inside secondary containments to prevent liquid spills contaminating soil and ground water resources in the surrounding areas. Use appropriate PPE. Monitor work involving hazardous substances and personnel exposure to such substances. Ensure that the PPE used, and in particular, the breathing apparatus being used are in proper usable condition.

10.5. Personal Protective Equipment 10.5.1. Minimum PPE Safety shoes in good condition with treads on soles etc. shall be worn at all times on the work site. Safety Helmets shall be worn at all times, except in accommodation or office area. Safety Spectacles shall be worn to personnel performing or in vicinity of task that may present a hazard to the eyes or as required. Safety Gloves shall be worn all the times for rigger on the work site except in office area. Rubbers Gloves shall be worn to personnel performing holiday test. 10.5.2. Clothing The minimum clothing requirement while at work for this project shall be long sleeved or overall except where the work environment requires greater protection such as welding activity need eye, face and hand protection, sandblasting activity need special wardrobe. Work at Heights Any work at height more than two (2) meters above ground or deck level or work directly over water require a safety belt or safety harness, although each specific job should be assessed on own merit, appropriate protective mechanisms shall be implemented. Whenever task are envisaged that may require work at height, the following action be followed: Avoid or minimize the work at height by redesign the work method. Provide a safe platform i.e. scaffolding elevated work platform etc. Prevent falls with guard-rails and mesh etc. Minimize injury with nets, less than two meters below work level. 10.5.4.
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10.5.3.

Hearing Protection
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Hearing protection shall be worn in areas identified as exceeding statutory noise level (>85dB) sound level meter will be provided and for anticipation above mention everybody (employee) shall be use a ear plug. 10.5.5. PPE General Various tasks will require particular attention to PPE other than that already mentioned. Whenever possible materials and procedures will be selected that reduce the necessity for PPE, however, when it is considered that there is no other alternative, than special PPE is required, training in the use and care of that equipment will be an integral part of the task and logged as a requirement in the Job Safety Analysis and incorporated into the installation procedures.

10.6. Fire Extinguisher The Contractor shall provide fire fighting equipment such as fire extinguisher in the site office and potential flammable location / worksite. Fire extinguisher will be inspected periodically. 10.7. First Aid Equipment The Contractor shall provide First Aid Equipment and Facilities in the form of: First aid sets to be taken on site, in vehicles and launches or small craft. For location under the contractor supervision, a sick-bay must be arranged where first aid can be dispensed by a competent and well trained person. Content of first aid sets. Swake bite kit shall be provided of each working group. The equipment recommended for the clinic included: A comprehensive store of common medicine and first aid apparatus (aspirin, disinfectant, gauze, thermometer, etc.). Classification drugs/medicines must be kept in a locked place with an update inventory. Oxygen respiratory (if needed). Stretcher (preferably of the vacuum type or scoop type). Splints (preferably of inflatable type). Sufficient provision of beds, blankets and sheets.

10.7. Other Requirements for Control of The FSHE Performance. 10.7.1. FSHE Inspection For monitoring and control of the FSHE Performance shall be done Weekly FSHE Inspection by Safetyman / Safety Inspector in the each Project Area. The findings will be discussed in the Weekly Safety Meeting. The results of the inspection will be recorded on the actions posted for information.
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FSHE Inspection will include, but not be limited, as appropriate: Personal Protective Equipment implementation. Workshop Inspection. Fire Extinguisher Inspection FSHE Inspection Form see Attachment K. 10.7.2. Accident / Incident Reporting & Investigation a. Major Incident A major incident is any incident that cause loss, or has the potential to cause loss to the project, whether personnel, hardware or productivity. This includes any injury the personnel which incurs lost time or medical treatment, any incident which cause damage to plant or equipment resulting in substantial loss to the project, or any incident which with a minor change circumstance, could have caused injury or damage. b. Minor Incident Minor incident defines an injury or illness, which does not incapacitate a person from working for more than 3 days, including rest days but not including the day of the injury or reporting the illness. c. Accident Investigation The Project Manager will issue a detailed report of the investigation to employer within 7 days of the accident occurring. The result of the accident / incident investigation report shall be announced to all employees / workers by posted it to the public announcement board. The main purposes of the investigation is to ascertain the accident cause, and to establish suitable corrective action, which will then reduce the possibility a similar incident occurring. 10.7.3. FSHE Auditing a. Audits FSHE Audit & Inspection will be undertaken to verify compliance with the FSHE Plan and Project Procedure. A FSHE audit schedule for all project will be prepared and maintained by FSHE Committee Head Office Jakarta. b. Audit Team The audit & inspection will be done by FSHE Committee Team Head Office Jakarta.

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c. Audit Report A complete audit report will be made by FSHE Committee and assist to the Project Manager and his Project Team in rectifying inconsistent or below standard performance, and areas of non compliance with this plan. The audit report will detail action to be addressed, responsibilities, completion dates and follow up action to be performed. 10.7.4. Measurement of Safety Performance a. FSHE Statistic / Performance Measurement of FSHE performance will be made in two areas. Firstly the historical data of injury and incident number and classification, and secondly with more positive FSHE process management of recording those activities each month which contribute to the overall success of the program. b. Accident / Incident Statistic Standard injury / incident number and frequency rates will be recorded for Lost Time Injury, Medical Treatment Injury, First Aid Injury, Reported Incident, and the all Incident Frequency rate. The FSHE Manager will report the statically indicators on a monthly basis. 11. ATTACHMENT Attachment A Attachment B Attachment C Attachment D Attachment E Attachment F Attachment G Attachment H Attachment I Attachment J Attachment K : : : : : : : : : : : CONTRACTOR FSHE Policy. Hazard Identification Risk Assessment & Risk Control (HIRARC). FSHE Objectives. FSHE Programs. FSHE Organization Chart. Training Matrix & Training Programs. List of QAFSHE Procedures. List of Construction & Inspection Procedures. List of Work Instruction. Forms of Work Permit. Forms of FSHE Inspection.

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ATTACHMENT A

FSHE POLICY

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ATTACHMENT B

HAZARD IDENTIFICATION RISK ASSESSMENT AND RISK CONTROL ( H I R A R C)

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ATTACHMENT C

PROJECT FSHE OBJECTIVES

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FSHE OBJECTIVES
No. I ACCIDENT a. b. c. d. e. f. II Fatality Serious Medical Treatment Case First Aid Case Incident Near Miss 0 0 5 15 30 60 DESCRIPTION OVJECTIVES

ILLNESS a. b. c. Fatality Serious Medical Treatment Case 0 0 5

III

OTHERS ACCIDENT a. b. c. d. e. Motor Cycle Vehicle Tool, Equipment Chemical, Oil Fire 0 0 5 0 0

IV.

RECORD DATA a. b. c. d. Total Work Day Total Work Hour Lost Time Total Manpower up dated up dated up dated up dated

V.

Personal Protective Equipment a. Safety Helmet refer to HIRARC

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b. c. d. e. f. g. h. VI.

Safety Shoes Ear Protection Hand Gloves Respiratory Eyes Protector Safety Belt Safety Net

refer to HIRARC refer to HIRARC refer to HIRARC refer to HIRARC refer to HIRARC refer to HIRARC refer to HIRARC

PLANNING 1. TRAINING a. Basic b. Fire Fighting c. HIRARC d. Emergency Response Plan 2. AWARENESS a. Safety Talk Meeting b. Weekly Meeting c. Monthly Meeting d. Poster e. Sign f. Board g. Banner 3. HIRARC Implementation a. HIRARC New b. HIRARC Review 4. 5. Procedure / Work Instruction Review Continual Activities a. Vehicle Inspection Not Applicable
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1 2 1 3

once a week once a week once a month 1 1 1 1

1 2 1

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b. Workshop Inspection a. PPE Inspection

Weekly Everyday

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ATTACHMENT D

FSHE PROGRAMS

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ATTACHMENT E

FSHE ORGANIZATION CHART

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ATTACHMENT F

TRAINING MATRIX & TRAINING PORGRAMS

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ATTACHMENT G

LIST OF QAFSHE PROCEDURES

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ATTACHMENT H

LIST OF CONSTRUCTION AND INSPECTION PROCEDURES

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ATTACHMENT I

LIST OF WORK INSTRUCTION

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ATTACHMENT J

WORK PERMIT FORM

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ATTACHMENT K

FORMS OF FSHE INSPECTION

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PERSONAL PROTECTION EQUIPMENT INSPECTION SHEET

Day / Date Item of Work Location :___________________________ :___________________________ :___________________________

No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Type of Inspection Safety Helmet Safety Shoes Safety Goggles Safety Gloves Safety Belt Safety Ear Plug Safety Body Harness Respiratory Welding Cap Fire Extinguisher First Aid Kit Stretcher Note :

Awareness Condition

PIC

Target

Remarks

Inspected by FSHE Supervisor ______________ Date :

Reviewed by FSHE Coordinator ______________ Date : .

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WORKSHOP INSPECTION SHEET

Day / Date Item of Work Location :___________________________ :___________________________ :___________________________

No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Type of Inspection

Awareness Condition

PIC

Target

Remarks

Note :

Inspected by FSHE Supervisor

Reviewed by FSHE Coordinator

______________ Date :
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______________ Date : .
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FIRE EXTINGUISHER INSPECTION SHEET

Day / Date Item of Work Location :___________________________ :___________________________ :___________________________

No. 1. 2. 3. 4. 5. 6. 7. 8.

Type of Inspection Restraining Wire Pin Pressure Gauge Cartridge Condition Chemical Powder Hose Condition Bottle Condition

Awareness Condition

PIC

Target

Remarks

Registration Number of Fire Extinguisher : 1. 2. 3. 4.

Note : All Fire Extinguisher must have safety tag. Inspected by Reviewed by FSHE Supervisor

FSHE Coordinator

______________ Date :
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