SMS Rev.02

SAFETY
MANAGEMENT
SYSTEM (SMS)
MANUAL
Rev. No. 02
Date : July 2015
PT. MATTHEW AIR NUSANTARA

APL Tower-Central Park, 28th Floor. Podomoro City
JL. Letjend. S. Parman Kav. 28 Grogol Petamburan
Jakarta Barat 11470
INDONESIA
Telp. 021 2929 8888
Fax. 021 2929 8878
SAFETY MANAGEMENT SYSTEM MANUAL

Chapter 1. General
TABLE OF CONTENT
Chapter SUBJECT
PAGE
1.
GENERAL
11
FOREWORD
12
1.1.
INTRODUCTION
14
1.2.
SAFETY MANAGEMENT PLAN
15
1.3.
MANUAL CONTROL SYSTEM
16
1.3.1. Policy
16
1.3.2. Page Control System
16
MANUAL REVISION AND DISTRIBUTION PROCEDURE
18
1.4.1. Revision Procedures
18
1.4.2. Record of Revisions
19
1.4.3. Distribution List
19
1.4.
Date
: March 8, 2015
Revision : 02
1-1

Chapter 1. General
CHAPTER 1
GENERAL
Date
: August, 2011
Revision : 00
1-2

Chapter 1. General
FOREWORD
Safety is a primary importance in our operations. Each of us has the responsibility to

make the safety of ourselves and our co-workers a primary concern. This objective is
fundamental to our well being as well as to the efficient operation of our business.
This manual is intended to assist us in performing our work safely. With few exceptions,
every safety rule or practice in this manual has evolved from experience and knowledge
gained over many years.
Yet, as helpful as they are, safety rules alone cannot prevent accidents. The
indispensable ingredients of a sage working environment are: MANAGEMENT
COMMITMENT, A KNOWLEDGEABLE SUPERVISORY STAFF, AND INVOLVED
SAFETY LEADER and a CONSCIENTIOUS WORK FORCE, where each individual is
an essential part of the planning and efficient operation of every job.
MATTHEW AIR NUSANTARA management recognizes its responsibility to provide
healthful and safe working conditions, safe-working rules based upon experience and
safety knowledge, and competent work direction.
Every employee has the responsibility to prevent accidents and injuries by observing
established working rules, following the directions of supervisors, practicing the
principals taught in safety training, and providing ideas on how our safety efforts might
be further strengthened.
MATTHEW AIR NUSANTARA and its employees have the responsibility to comply with
all government, state and local regulations related to safety and health programs. An
effective safety program extends beyond normal working hours and accordingly, safety
in employees' and their families; off-the-job activities are encouraged.
Date
: August, 2011
Revision : 00
1-3

Chapter 1. General
1.1.
INTRODUCTION
The Safety Management System (SMS) Manual has been developed to direct all
personnel in the safe operations of the PT. Matthew Air Nusantara and defines
the policy that governs the operation of the organization.
PT. Matthew Air Nusantara Safety Management System is issued by Safety
Department. This manual is distributed for internal other department related to
operational safety.
The purpose of this manual is to lay down the Operation Procedure Guide for the
Safety Personnel for conducting his/ her duties and as reference to other
department concerning the Safety.
This Manual is guidance only as a quick reference guide; the detail procedure
might be laid down on different manual.
Refer to provision of the Civil Aviation Safety Regulation (CASR) 135 Subparts D.
Flight Safety Program; AC 120-92 Amdt. 1. Safety Management System; ICAO
Doc. 9859 Amdt. 2. Safety Management Manual, an air carrier shall develop and
maintain a continuing basis, a Flight Safety Program, that is appropriate to the
scope and size of its operation and has a high capability to detect, analyze and
mitigate any risks which may pose a threat to the safety of the air carriers
operations.
To improve on existing levels of aviation safety in the light of the continuing
growth of the industry, additional measures are needed; one such measure is to
implement Safety Management System. Such a system is as important to
business survival as a financial management system and the implementation of a
Safety Management System should lead to achievement of one of civil aviations
key business goal; enhanced safety performance aiming at best practice and
moving beyond mere compliance with regulatory requirement.
PT. Matthew Air Nusantara Safety Management System is an encompassing
program designed to identify all possible hazards within the airline and its
operations, and to seek and apply solutions to reduce risks to people and
property.
Date
: July 24, 2013
Revision : 01
1-4

Chapter 1. General
The Safety Management System is regulatory approved document and its

contents are not supersede any required mandated by the Director General of
Civil Aviation (DGCA) of Republic of Indonesia, nor does it supersede or amend
any aircraft manufactures type specific documentation or any approved
document.
It is systematic in that safety management activities are carried out in accordance
with a pre-determined plan, and applied in a consistent manner throughout the
organization. It is proactive by taking an approach that emphasizes prevention,
through hazards identification and risk control and mitigation measures, before
events that affect safety occur. It is also explicit, in that all safety management
activities are documented, visible and performed as an essential component of
management activities. People, procedures, practices and technology needed to
monitor and improve the safety of the aviation transportation system.
The Safety Personnel are obliged to be familiar with its contents. It is the
responsibility of each holder of this Manual to keep it up to date. Amendments
shall be studied immediately on receipt, and inserted at first opportunity.
1.2.
SAFETY MANAGEMENT PLAN

Safety holds the key to this organizations future and affects everything we do.
This SMS Manual defines the organizations Safety Management Plan. The
Safety Management Plan is the tool used to define how SMS supports the PT.
Matthew Air Nusantara Commercial Flight Operating Procedures. Organization
management is committed to the SMS, and is required to give leadership to the
program and demonstrate through everyday actions, the commitment to safety
and its priority in the achievements of the organization.
The processes in place include the active involvement of all managers and
supervisors, who, through planning and review, must continue to drive efforts for
continuing improvement in safety and safety performance. The term Safety
Management should be taken to mean safety, health, and environmental
management. The key focus is the safe operations of airworthy aircraft.
Safety audits are essential components of the Safety Management Plan. They
review systems, identify safety issues, prioritize safety issues, must involve all
personnel, and enhance the safety of operations.
Date
: July 24, 2013
Revision : 01
1-5

Chapter 1. General
1.3.
MANUAL CONTROL SYSTEM

1.3.1 Policy
Manuals are distributed on a required basis to the PT. Matthew Air
Nusantara Office and DGCA office, and should be used accordingly.
1. The manuals are not transferable. Holder shall retain the manuals
originally issued regardless of change of station or location.
2. Upon termination of employment, the manuals shall be returned to
CASO.
3. Text within a section (subject matter) should not be taken out of
context. The reader should read the entire section for a complete
understanding of the policies and procedures regarding a specific
subject. If question arise, contact the CASO for clarification. A written
response shall be made to clarify the matter in question.
1.3.2 Page Control System

1. Record of Revision
Designed to quickly identify the current revision status of the manual.
2. List of Effective Pages
Designed to provide a summary listing of all applicable pages and the
revision date for the entire manual.
3. Page Format
Page format includes: Top of the Page and Bottom of the Page. Top
of the Page contents Company Logos, Manuals Name, and Chapters
Name and Number. Bottom of the Page contents Page Number,
Manual Revisions Number and Date of Issued.
Date
: August, 2011
Revision : 00
1-6

Chapter 1. General
Top of the Page

Chapter 1. General
Bottom of Page
Date
: April01, 2014
Revision
: 01
5
1 of 1
Note : 1. Company logo

2. Manuals name
3. Number of chapter
4. Chapter title
5. Revision number
6. Date of issued
7. Page number
Date
: March 8, 2015
Revision : 02
1-7

Chapter 1. General
1.4.
MANUAL REVISION AND DISTRIBUTION PROCEDURE

1.4.1.
Revision Procedures
1. Revision to the Safety Management System is the responsibility of
CASO. The revisions are made on an as needed or as required basis
to correct, add to, and/or more clearly define policies, procedures,
methods, and techniques and to reflect new or revised procedures.
2. Whenever revisions are made, Safety Department shall route them to
the holders of manuals. The responsibility for inserting revisions is
the direct responsibility of the manual holder.
3. On occasion, minor revisions to pages will be necessary to correct
spelling, add or delete a word, or number. The corrections may be
made in pen and ink. Such changes will be annotated in pen above
the word, or number or as directed on Revision Transmittal Sheet
and a single line drawn through the word or number changed or
delete. Pen and ink changes will be incorporated in the next revision
of the manual.
4. A vertical bar will be placed on the left hand margin of each page to
indicate changes.
5. If the only change was to the page number a vertical bar will be
placed in the left hand margin next to the revision number.
6. CASO will review the Safety Management System at least every 2
(two) years. These reviews will either confirm that the manual still
current and valid for the Air Operator Certificate use, or will be
identified needed change.
7. This manual and revision there to will be approved by the CASO, and
forward to DGCA for acceptance. Upon acceptance by DGCA,
sufficient copies will be made and distributed the revision page to
each manual holder.
8. A list of effective pages will be issued with each revision so each
manual can be checked and kept current.
Date
: July 24, 2013
Revision : 01
1-8

Chapter 1. General
1.4.2.
Record of Revisions
Keep the Safety Management System
revisions immediately
up to date
by inserting
Revisions for the Safety Management System will be distributed with

transmittal form containing instructions for inserting and/ or removal of
pages.
The transmittal form are numbered consecutively and upon receipt and
filling, the date of insertion and the name of the person filling it shall be
entered to the corresponding number in the record of revision page.
The list of effective pages will be included in order to continuously check at
any time whether the Safety Management System updated. The list of
effective pages will be revised upon revision with each page.
1.4.3.
Distribution List
The Safety Management System shall be distributed to all personnel
involved and responsible for Safety activities as the Controlled Copy. Other
personnel may obtain copy of this Safety Management System from CASO
but will not receive the revisions. Uncontrolled Copy stamp will be provided
in the selected pages manual copy.
CASO will distribute this Safety Management System to the listed functions
below:
Date
: July 24, 2013
Revision : 01
1-9

Chapter 1. General
LIST OF SAFETY MANAGEMENT SYSTEM HOLDERS:
Control No.
Master
Date
: July 24, 2013
Revision : 01
Safety Management System Holder

CASO
1.
Director
2.
Indonesian DGCA
3.
Operation Department
4.
Maintenance Department
5.
FLOPS Kubang-Pekanbaru
6.
FLOPS Balikpapan
1 - 10

Chapter 2. Regulatory Requirement
TABLE OF CONTENT
Chapter SUBJECT
PAGE
2.
SMS REGULATORY REQUIREMENT
21
2.1. GENERAL
23
2.2. SAFETY MANAGEMENT REGULATION
23
2.3. ICAO REQUIREMENTS
24
2.4. STATE SAFETY PERFORMANCE
25
2.5. MATTHEW AIR NUSANTARA SMS REGULATORY
27
REQUIREMENT
Date
: March 8, 2015
Revision : 02
2-1

CHAPTER 2
REGULATORY REQUIREMENT
Date
: August, 2011
Revision : 00
2-2

2.1.
GENERAL
DGCA issue AC 120-92 Amdt 1, with effect from1 September 2009 and Aviation
Act No.1 2009 at 1 January 2009, for all Indonesia AOC holders are mandated to
initiate the implementation of an integrated Safety Management System. Such as
System should include:
1. A Safety Policy and Objectives. This section will explain about management
commitment and responsibility; safety accountabilities of manager.
2. Safety Risk Management that describes are how to identified of hazard, and
processing of risk assessment and mitigation.
3. To evaluate and analysis of safety performances and indicators are needed a
tools of safety assurance, that consist of safety performance monitoring and
measurement, management of change, and continuous improvement and
audit.
4. Safety Promotion are prepare personnel training to ensure their competency
to perform their duties, and safety communication that ensure all staff
members are aware of the SMS.
5. Documentation of all SMS components, procedures and activities including
their relevant integration,
6. Periodic review or audit of the safety management system which measuring
of gap analysis.
7. An emergency respond plan
2.2.
SAFETY MANAGEMENT REGULATION

The purposes Safety management System is to provide instruction and guidance
information to safety personnel on performing his/her duties and activities
according provision of Civil Aviation Safety Regulation (CASR) 135 Amdt. 8
subpart D. Flight Safety Program, AC 120-01, and AC 120-92.
Date
: July 24, 2013
Revision : 01
2-3

This manual is made with refer to:
a. ICAO DOC 9859 Amdt. 2. Safety Management Manual,
b. IATA Safety Management System,
c.
2.3.
DGCA AC 120-92 Amdt. 1 Safety Management System.
ICAO REQUIREMENTS
Safety has always been the overriding consideration in all aviation activities. This
is reflected in the aims and objectives of ICAO as stated in Article 44 of the
Convention on International Civil Aviation (Doc 7300), commonly known as the
Chicago Convention, which charges ICAO with ensuring the safe and orderly
growth of international civil aviation throughout the world.
In establishing States requirements for the management of safety, ICAO
differentiates between safety programmed and safety management systems
(SMS) as follows:
1. A safety program is an integrated set of regulations and activities aimed at
improving safety.
2. A safety management system (SMS) is an organized approach to managing
safety, including the necessary organizational structures, accountabilities,
policies and procedures.
ICAOs Standards and Recommended Practices (ISARPs) (see the following
Annexes to the Convention on International Civil Aviation:
1. Annex 6 - Operation of Aircraft, Part I - International Commercial Air
Transport - Aero plane, and Part III - International Operations - Helicopters;
2. Annex 11 - Air Traffic Services;
3. and Annex 14 - Aerodromes) require that States establish a safety program
to achieve an acceptable level of safety in aviation operations. The
acceptable level of safety shall be established by the State(s) concerned.
While the concept of safety programs and SMS is restricted to Annexes 6, 11
and 14 at present, it is possible that the concept will be expanded to include
additional operational Annexes in the future.
Date
: July 24, 2013
Revision : 01
2-4

A safety program will be broad in scope, including many safety activities aimed at
fulfilling the programs objectives. A States safety program embraces those
regulations and directives for the conduct of safe operations from the perspective
of aircraft operators and those providing air traffic services (ATS), aerodromes
and aircraft maintenance. The safety program may include provisions for such
diverse activities as incident reporting, safety investigations, safety audits and
safety promotion. To implement such safety activities in an integrated manner
requires a coherent SMS.
Therefore, in accordance with the provisions of Annexes 6, 11 and 14, States
shall require that individual operators, maintenance organizations, ATS providers
and certified aerodrome operators implement SMS accepted by the State. As a
minimum, such SMS shall:
1. Identify safety hazards;
2. Ensure that remedial actions necessary to mitigate the risks/hazards are
implemented;
3. Provide for continuous monitoring and regular assessment of the safety level
achieved.
An organizations SMS accepted by the State shall also clearly define lines of
safety accountability, including a direct accountability for safety on the part of
senior management.
ICAO provides specialized guidance material, including this manual on safety
management, for the fulfillment of the SARPs. This manual includes a conceptual
framework for managing safety and establishing an SMS as well as some of the
systemic processes and activities used to meet the objectives of a States safety
program.
2.4.
STATE SAFETY PERFORMANCE

ICAOs Universal Safety Oversight Audit Program has identified fundamental
weaknesses in the safety program of many States, resulting in significant
differences in safety standards around the globe. Notwithstanding the obligations
of Contracting States to fulfill the requirements of ICAO SARPs, States should be
Date
: August, 2011
Revision : 00
2-5

concerned with the safety performance of their national aviation system. The
following are some indicators that a States safety program may be deficient:
1. Inadequate governing legislation and regulations (incomplete, out of date,
etc.);
2. Potential conflicts of interest (regulator versus service provider, educator
versus enforcer, regulator investigating occurrences involving failures by the
regulator;
3. Inadequate civil aviation infrastructure and systems (navigation and
communication aids, aerodromes, airspace management, etc.);
4. Inadequate (incomplete, out-of-date, inconsistent) fulfillment of regulatory
functions such as licensing, surveillance and enforcement (due to resource
limitations, political situation, state of national emergency, etc.);
5. Inadequate resources and organization for the magnitude and complexity of
regulatory requirements (shortages in trained and competent personnel,
administrative capacity, information technology, etc.);
6. Instability and uncertainty within the CAA compromising quality and
timeliness of regulatory performance (staff morale, political interference,
resource limitations, etc.);
7. Absence of formal safety programs (voluntary incident reporting program,
regulatory safety audits, etc.); and
8. Stagnation in safety thinking (rising occurrence rates, weak national safety
culture, reluctance to embrace proven best practices, etc.).
On the other hand, having the following elements in a States safety program
suggests that the program is providing a sound basis for preserving the desired
margins of safety:
1. The administrative machinery for coordinating and integrating all aspects of
the States safety program into a coherent whole;
Date
: August, 2011
Revision : 00
2-6

2. Performance monitoring for all State safety functions (licensing, certification,

enforcement, etc.);
3. Provision of State hazard identification programs (mandatory occurrence
reporting, voluntary (non-punitive) incident reporting, service difficulty
reporting, etc.);
4. Competent accident and incident investigation capabilities (independent from
regulatory authority);
5. Risk-based resource allocations for all regulatory functions (proactively
targeting regulatory attention on known areas of high risk);
6. Active and passive safety promotion programs to assist operators and to
make safety information broadly accessible (including safety databases, trend
analysis, monitoring of best industry practices, etc.);
7. National safety monitoring programs (trend monitoring and analysis, safety
inspections, incident investigations and safety surveillance); and
8. Regular regulatory safety audits to ensure compliance by all operators and
service providers.
2.5.
PT. MATTHEW AIR NUSANTARA SMS REGULATORY REQUIREMENT

PT. Matthew Air Nusantara Safety Management System regulatory requirement
follow and elaborate on current DGCA SMS Regulations for necessary reference
and awareness by all PT. Matthew Air Nusantara Personnel.
Safety Management System Manual is relevant and have correlation to other
safety related requirements or standard such as Company Operation Manual,
Emergency Response Procedure, Dangerous Goods Manual, Aircraft Operator
Security Program, etc.
Date
: July 24, 2013
Revision : 01
2-7

Chapter 3. Scope of Safety Management System
TABLE OF CONTENT
Chapter SUBJECT
PAGE
3.
SCOPE OF SAFETY MANAGEMENT SYSTEM
31
3.1.
GENERAL
32
3.2.
OPERATION OF WORK SCOPE
33
3.3.
NATURE OF ORGANIZATION IN AVIATION

BUSINESS
33
3.4.
EQUIPMENT AND FACILITIES IN

IMPLEMENTATION OF SMS
34
3.5.
SMS OPERATIONS AND / OR ADMINISTRATION
34
3.6.
ELEMENTS OF SAFETY MANAGEMENT SYSTEM
35
3.6.1.
Safety Policy
36
3.6.2.
Safety Objective and Goals
37
Date
3.6.3. Roles and Responsibilities
37
3.6.4. Non-Punitive Reporting Policy
37
3.6.5. Safety Reporting
38
3.6.6.
38
3.6.7. Performance Indicators
38
3.6.8. Safety Investigations
38
3.6.9. Staff Training
39
3.6.10. SMS Audit
39
3.6.11. SMS Data and Record Management
39
3.6.12. Management of Change
39
3.6.13. Emergency Response Plan
3 10
: March 8, 2015
Revision : 02
Hazard Identification, Risk Assessment, and

Determining Control (HIRADC)
3-1

CHAPTER 3
SCOPE OF SAFETY MANAGEMENT
SYSTEM
Date
: August, 2011
Revision : 00
3-2

3.1.
GENERAL
PT. Matthew Air Nusantara Safety Management System manual is intended to
support safety system and safety risk management throughout the DGCA
regulations. This manual provides best practices in safety operation system and
management.
When these regulations or procedures exist, this manual will indicate the
reference and direct the reader to the document. This manual is also intended to
provide guidance to personnel of PT. Matthew Air Nusantara and contractors
who support PT. Matthew Air Nusantara by providing systems and/or analysis.
This manual does not supersede the specific contract, but can be referenced in
the statement of work or other documents as a guide.
3.2.
OPERATION WORK SCOPE

Operating under Indonesian CASR Part-135, PT. Matthew Air Nusantara is a
Non Schedule Charter with business address at
APL Tower-Central Park
th
28 Floor, JL. Letjend. S. Parman Kav. 28. Jakarta Barat 11470, and the home
base at Komplek Panca Surya Garden. Jl. Raya Kubang, Siak Hulu, Kampar
Riau.
The regulations will be applied to the following department / area performing
activities and contract companies.
Operational area including safety and security aspect of:
a. Operations Department, and
b. Maintenance Department.
3.3.
NATURE OF THE ORGANIZATION IN AVIATION BUSINESS

A Safety Management System is a businesslike approach to safety. It is a
systematic, explicit and comprehensive process for managing safety risks. As
with all management systems, a Safety Management System provides for goal
setting, planning, and measuring performance.
A Safety Management System is woven into the fabric of our organisation. It
becomes part of our culture, the way we do our jobs.
Date
: July 24, 2013
Revision : 01
3-3

3.3.
EQUIPMENT AND FACILITIES IN IMPLEMENTATION OF SMS

The intent of any Safety Management System is to produce a culture of safety
awareness is a proactive approach for identifying, managing and controlling
risks.
The result is a team working cooperatively and proactively to seek and detect
hazards and risks, to adequately put in place adequate countermeasures to
assure safety.
To achieve this goal:
1. We must establish a solid foundation for safety efforts,
2. We must care about the safety of our customers and personnel,
3. We must believe that every person in the organization can and has a duty to
prevent accidents.
4. We will integrate safety awareness into everyday activities.
A Safety Management System describes an approach to managing safety and
risk. It represents the most current techniques in accident prevention and
recognizes that many accidents and incidents are the result of a complex but
unintended interaction of multiple factors.
It is our effort in the organization to implement just culture report in the day to day
activities and operations.
3.5.
SMS OPERATIONS AND/OR ADMINISTRATION

Management critically depends upon information to make decisions and lead.
Managers and staff should be able to access and use safety information relating
to our company's own performance. Therefore, a Safety Management System
has to be initiated and utilized to collect and analyze safety data. This includes:
1. Safety goals and evaluation of progress toward these goals, Safety
Performance Indicators.
2. Records of accidents and incidents including internal I external investigation
findings and corrective actions,
3. Safety concerns raised by employees including analysis and resultant action,
Date
: August, 2011
Revision : 00
3-4

4. Results of safety reviews and audits and, when appropriate, corrective action,
5. Records of all safety initiatives or interventions.
3.6.
ELEMENTS OF SMS
3.6.1.
Safety Policy
The Accountable Manager shall have ultimate responsibility for the

implementation and maintenance of the SMS. He or she should have full
control of human/ financial resources and have final authority over
operations under the certificate of approval. He or she should have final
responsibility for all aviation safety issues.
The senior management has to show its commitment by developing a
safety policy, communicating the policy to its staff and establishing safety
objectives and goals for the organization.
The written safety policy is a concrete expression of the managements
philosophy and commitment to safety. It should clearly encapsulate the
senior managements commitment to improving aviation safety as their
top priority. It should be a straightforward statement that includes the
following points:
a) Senior management commitment and intentions with regard to
safety;
b) The organizations safety management principles;
c) Establishment of safety as a core value;
d) Responsibility for the safety program;
e) Non-Punitive Reporting policy (Just culture).
This safety policy should bear visible endorsement by the Accountable
Manager and all members of the organizations senior management
team, and communicated to all levels within the organization.
Date
: March 08, 2015
Revision : 02
3-5

3.6.2.
Safety Objective and Goals

Describe the safety objectives and the safety performance goals of the
organization. The safety objectives would be a short statement that
describes in broad terms what you hope to achieve. In some cases this
statement may be incorporated into the Safety Policy Statement.
Performance goals are specific and measurable goals that allow to
measure the degree of success of PT. Matthew Air Nusantara SMS.
3.6.3.
Roles and Responsibility

The Accountable Manager is responsible for ensuring that the safety
management system is properly implemented and performing to
requirements in all areas of the organization.
To ensure safety management system is properly implemented then it
need determine safety authorities, responsibilities and accountabilities of
personnel at all levels of the organization are defined and documented.
If define and documented of safety personnel authorities, responsibilities
and
accountabilities,
hereinafter
safety
personnel
will give
communication with aim all personnel are understand their authorities,
responsibilities and accountabilities in regards to all safety management
processes, decision and actions.
3.6.4.
Non-Punitive Reporting Policy

Describe the system or policy under which employees are encouraged to
report errors, safety deficiencies, hazards, accidents, and incidents.
There is a policy in place that encourages employees to report errors,
safety deficiencies, hazards or occurrences.
PT. Matthew Air Nusantara will guarantee to all personnel that submit
report regarding errors, safety deficiencies, hazards or occurrences
which non-punitive disciplinary action.
Date
: March 08, 2015
Revision : 02
3-6

3.6.5.
Safety Reporting
A reporting system should include both reactive (accident/incident
reports) and proactive/ predictive (hazard reports) data. Describe how
PT. Matthew Air Nusantara reporting system is designed and how it
works. Factors to consider include: report format, confidentiality, data
collection and analysis and subsequent dissemination of information on
corrective actions, preventive measures and recovery controls.
3.6.6.
Hazard Identification, Risk Assessment, and Determining Control

(HIRADC)
Describe PT. Matthew Air Nusantara hazard identification system and
related schemes and how such data are collated. Describe it process for
any categorization of hazards/risks and their subsequent prioritization for
a documented safety assessment. And then describe how safety
assessment process is conducted and how preventive action plans are
implemented.
3.6.7.
Performance Indicator
There is a formal process to develop and maintain a set of safety
performance indicators for trend, target (desired level) as well as
minimum acceptable (alert) level monitoring.
Periodic planned reviews of company safety performance indicators
including an examination of the companys Safety Management System
to ensure its continuing suitability, adequacy and effectiveness.
3.6.8.
Safety Investigations
Describe how accidents/incidents are investigated. Explain how the
contributing factors to an accident/incident are determined and how
corrective action is recommended to prevent reoccurrence. Describe how
such corrective/preventive actions are reviewed for updating any existing
safety assessment or the need to initiate a safety assessment for newly
uncovered hazards/risks.
Date
: March 08, 2015
Revision : 02
3-7

3.6.9.
Staff Training
Describe the type of SMS and other safety related training that staff
receives and the process for assuring the effectiveness of the training.
Describe how such training procedures are documented. Describe the
safety communication processes/ channels within the organization.
3.6.10. SMS Audit

Regular audit/reviews of company safety performance indicators,
including an internal assessment/ audit of the companys Safety
Management System to ensure its continuing suitability, adequacy and
effectiveness.
Describe any other programs contributing to continuous improvement of
the organizations SMS and safety performance eg safety surveys, ISO
systems, etc.
3.6.11. SMS Data and Record Management
The organization has a records system that ensures the generation and
retention of all records necessary to document and support the SMS.
Records kept include surveillance report, audit report, hazard reports,
risk assessments reports, Safety Committee Meeting record, safety
performance monitoring charts, SMS audit reports, SMS training records.
3.6.12. Management of Change
There is procedure for performing safety assessment prior to introduction
of new equipment or processes which may have safety implications
before they are commissioned.
PT. Matthew Air Nusantara using SWOT analysis to describe any
changes in an organization, operations, and maintenances aspect which
is related to safety concern.
SWOT analysis will be translated using HIRADC analysis to determine
the level of risk and corrective action.
Date
: March 08, 2015
Revision : 02
3-8

3.6.13. Emergency Response Plan

Describe the organizations intentions and commitment to dealing with
emergency situations and their corresponding recovery controls. Outline
the roles and responsibilities of key personnel.
PT. Matthew Air Nusantara has an emergency plan that outlines roles
and responsibilities in the event of a major incident, crisis or accident.
There is a notification process that includes an emergency call list and an
internal mobilization process. The organization has arrangements with
other agencies for aid and the provision of emergency services as
applicable.
Date
: March 08, 2015
Revision : 02
3-9

Chapter 4. SAFETY POLICY
TABLE OF CONTENT
Chapter SUBJECT
PAGE
4.
43
Date
SAFETY POLICY
: March 8, 2015
Revision : 02
4-1

CHAPTER 4
SAFETY POLICY
Date
: August, 2011
Revision : 00
10 - 2

SAFETY POLICY
SAFETY IS OUR BASIC CORPORATE VALUE BECAUSE WE CARE DEEPLY ABOUT
OUR CUSTOMERS AND FELLOW EMPLOYEES
As the Director of PT. MATTHEW AIR NUSANTARA, I would like to affirm my total
commitment to prevent any incident or accident happening in this company as a primary
goal, and will give my full support to all programs which will help the company realize this
goal
Our commitments are:
a. To maintain a reputable position within the airline industry through a continued
investment effort in safety training, safety systems and technology as well as aviation
security.
b. To support all efficient methods for managing and communicating safety, security and
regulation compliance.
c. To assure regular safety internal audits are conducted and review our safety policy
periodically.
d. To assure every employee participated in the safety internal audit process, including but
not limited to third parties, suppliers, and ground handling agents.
All managers, irrespective of level, must ensure employees receive sufficient knowledge
and skills to perform their safety duties in accordance with standards.
Every employee is personally responsible for performance of their duties, with the primary
concern being the safety of our customers, their own safety, the safety of their fellow
employees, and the property and equipment entrusted to their care.
We ensure the company will not initiate disciplinary action against any employee for
reporting a safety hazard or concern to any management level.
Failure by any employee to comply with any part of this policy will result in appropriate
disciplinary action.
Through the dedication of all, we will uphold our safety at all times.
Date
: July 24, 2013
Revision : 01
4-3

Chapter 5. Safety Objective and Goals
TABLE OF CONTENT
Chapter SUBJECT
PAGE
5.
SAFETY OBJECTIVE AND GOALS
52
5.1.
MANAGEMENT PLAN
53
5.2.
MANAGEMENT COMMITMENT
54
5.2.1 General
54
5.2.2 What Resources Are Required
55
5.2.3 Checklist for Measurements of Management

Commitment
56
SAFETY MANAGEMENT SYSTEM REVIEW
56
5.3.
Date
: March 8, 2015
Revision : 02
5-1

CHAPTER 5
SAFETY OBJECTIVE AND GOALS
Date
: August, 2011
Revision : 00
5-2

5.1.
MANAGEMENT PLAN
The responsibility for safety at PT. Matthew Air Nusantara rests with the Director
of the company. This responsibility is being discharged through the development
of a Flight Safety Program which will be managed by the Company Aviation
Safety Officer (CASO). The CASO has therefore, been given the responsibility
and authority to develop, integrate and co-ordinate the program on behalf of the
Director.
The CASO will report to the Director and will have direct access to any
managers, Chiefs, supervisor or other employee of the company, in regards to
flight and ground safety issues. The CASO has also been authorized to deal
directly with DGCA or other organizations in so far as the best interest of the
companys Safety Management System is being served.
All company employees must be familiar with the elements of the Safety
Management System Manual and pursuant to the program, will receive training
commensurate to their position and responsibilities. A copy of the training record
contained in Chapter 12, will be entered in the training record of each person
required to receive training.
This Safety Management System Manual contains a detailed description of the
Flight Safety Program and will be kept up to date and amended by the CASO.
The objectives and goals of the Safety Management System Manual are to
prevent losses resulting from incidents or accidents. The following are the
objectives and goals of the program:
PT. Matthew Air Nusantara Safety Objectives
1. To identify and eliminate hazardous conditions;
2. To provide safety-related educational material to all personnel;
3. To provide a safe, healthy work environment for all personnel;
4. To prevent and reduce aircraft accidents and incidents and to prevent
resulting losses;
5. To incorporate awareness, compliance, inspection, investigation and
education by providing programs delivered to employees;
Date
: August, 2011
Revision : 00
5-3

6. To prevent damage and injury to non-company property and personnel

resulting from our operations.
PT. Matthew Air Nusantara Safety Goals

1. Increase the number of hazard reports received by 10% over the previous
year;
2. Investigate all hazardous events within 3 days of the occurrence;
3. Reduce days lost of injury by 25% over the previous year;
4. Assist in developing Standard Operating Procedures (SOPs), where
applicable;
5. Review, with safety in mind, all proposed new equipment acquisitions,
facilities, operations and procedures;
6. Improve the effectiveness of the safety management system through a yearly
safety assessment that reviews all aspects of the SMS;
7. Reduce annual premature parts costs by 20% over the previous year.
5.2.
MANAGEMENT COMMITMENT
5.2.1. General
While safety management requires the involvement of all staff, to ensure
that Safety Management System to be effective, PT. Matthew Air
Nusantara management is committed to the Safety Management System.
PT. Matthew Air Nusantara management will:
Date
Demonstrate commitment to safety and the Safety Management

Systems.
Set the safety standards and policies for the operation.
Encourage participation in safety management.
Allocate sufficient resources to the Safety Management Systems.
Facilitate the flow of safety information.
: July 24, 2013
Revision : 01
5-4

5.2.2. What Resources Are Required?

Good safety management is a state of mind, not an expensive add-on. It's
about the mindset of everyone involved, rather than money.
During the planning the implementation of the Safety Management
System, we look at the resources available and those that we need to
provide. Resources required may include (but are not limited to):
Time-for
meetings,
communication.
Safety information.
Expertise.
Customized training.
information
gathering,
planning
Contingency plans for hazardous situations and events.
and
Often time, is the largest resource, particularly at the start of the process
of implementing a Safety Management System.
Meetings will be required to establish roles and responsibilities. Time must
also be taken to communicate the intention of the safety management
system to all employees. The time spent communicating policy and goals
to staff will pay dividends in gaining commitment.
We demonstrate management commitment to safety by providing
available resources like safety-related literature, courses, seminars and
crew resource management training.
One of the most important resources we need to devote to the operation
of our Safety Management System is expertise. PT. Matthew Air
Nusantara will need to involve people from across our operation with the
expertise to address safety related issues. Technical training may be
required.
All staff should be trained to understand the purpose of our Safety
Management System and their role in applying it to the way we do
business.
Date
: August, 2011
Revision : 00
5-5

Significant resources - in time and expertise - will be needed to plan
contingencies for hazardous situations and events.
Once hazards start to be identified, senior management is prepared to
commit resources to address those hazards. If hazards are not properly
addressed, enthusiasm for the Safety Management System will quickly
wane.
5.2.3. Checklist for Measurements of Management Commitment.
Management is involved in - and committed to - the Safety Management
System.
Management has approved the organizations safety policy and
operating safety standards.
The safety policy and standards are communicated to all staff, with
visible endorsement by senior management.
Appropriate resources are allocated to support the Safety Management
System.
Management has established an appropriate reporting chain for safety
issues.
Management actively
Management System.
5.3.
encourages
participation
in
the
Safety
SAFETY MANAGEMENT SYSTEM REVIEW

To provide an ongoing leadership reinforcement of Safety Management Systems,
a half-year report is made to the Director by the CASO, Operations Manager, and
Maintenance Manager.
This provides the Director with the current status of discrepancies deficiencies
the company, a brief on the activities undertaken during the previous year, safety
training program status and any other safety related topics. This is an essential
step in the maintenance and continual improvement of the Safety Management
System. Feedback occurs via periodic meetings with the bases, via telephone,
via other means of communications (fax, e-mail, or letter), and interval time at
Date
: August, 2011
Revision : 00
5-6

least three-monthly Safety Action Group Meetings. Safety Action Group Meeting
consists of all personnel PT. Matthew Air Nusantara that aim to review safety
occurrences which before or after has been done.
The Director and Senior Management shall carry a format review of the Safety
Committee Meeting out once per year. This is accomplished by means of a
Management Review Meeting, chaired by the Director.
The purpose of this meeting is to assess the effectiveness and suitability of the
safety management system by examination of the safety performance of the
company, contractual status, results of audits, and considerations arising from
Safety Action Group Meetings as well as three-monthly bases, and can be done
any time a relating to aviation safety. Any trends emerging from any of these
factors will be used to determine whether any changes in procedures, method, or
philosophy are considered necessary to meet present and future needs. Thus,
ensuring that the aims of the overall business plan are progressing as required
and will be achieved.
Minutes of the Safety Committee Meeting will be taken and a closing summary
used to highlight any areas of concern along with instructions to the Department
Heads as to the action required.
Date
: July 24, 2013
Revision : 01
5-7

Chapter 6. Roles and Responsibilities
TABLE OF CONTENT
Chapter SUBJECT
PAGE
6.
ROLES AND RESPONSIBILITIES
62
6.1.
GENERAL
63
6.2.
FUNCTIONS AND RESPONSIBILITIES
64
6.2.1 Specific Management Responsibilities
64
6.2.2 Department Managers Responsibilities
65
6.2.3 Individual Responsibilities
66
SAFETY MANAGER (CASO)
66
6.3.
6.3.1 Training of the Company Aviation Safety Officer

6.3.2 CASO Responsibilities
6.3.3 Flight Safety Officer & Ground Safety Officer
(Base Safety Representatives
6.4.
Date
SMS ORGANIZATION DIAGRAM
: March 8, 2015
Revision : 02
5-1

CHAPTER 6
ROLES AND RESPONSIBILITIES
Date
: August, 2011
Revision : 00
5-2

6.1.
GENERAL
Roles, Responsibilities, and Relationships: The 3 RS of Safety
Management. It shows the relationship between the productive processes of the
aviation service provider as well as the joint protective processes of the regulator
(DGCA). As before, it is important to recognize that the two aviation service
provider systems shown (Protection and Production) are functional rather than
departmental or organizational depictions. One of the principal roles of the
oversight is to promulgate risk controls in the form of regulations, standards, and
policies. It follows that regulatory compliance, in a manner that accomplishes the
regulations safety objectives, is also part of the aviation service providers role in
safety management.
6.2.
FUNCTIONS AND RESPONSIBILITIES

6.2.1. Specific Management Responsibilities
1. To display the Company Policy Statement on Safety, Health,
Environment (SHE) in a prominent place in each work location.
2. To develop and implement programs and procedures to ensure
compliance with all relevant health and safety legislation and standards
particular to the appropriate area of operations.
3. To ensure that all health and safety factors are fully taken into account
when new or changed methods, processes, harmful substances, or
premises are being planned.
4. To provide training for supervisory staff in the correct accident
prevention techniques
6. To provide proper instructions and training in health and safety for new
employees and for employees redeployed into new jobs.
6. To take the necessary precautions, so far as is reasonably practical, to
protect contractors and visitors whilst on Company premises.
Date
: August, 2011
Revision : 00
5-3

7. To fully investigate all accidents reported, as required by the company

procedures, and ensure that the appropriate corrective action has been
taken.
8. To encourage the involvement of all employees in achieving a safe and
healthy workplace.
9. To provide and maintain at plant, machinery and mobile equipment to
a high standard of repair, and to ensure an inspection and audit
program is strictly adhered.
10. To provide safe systems of work and safe work procedures to protect
the health of all persons.
11. To provide adequate first aid facilities and a rehabilitation program to
encourage the early return of employees suffering from work related
injuries and illnesses.
12. To set the example for compliance with the safety policy and maintain
a continued involvement, interest and enthusiasm in the health and
safety program.
6.2.2. Department Managers Responsibilities
As a part of the Management Team, Department Managers shall:
Date
1.
Be responsible for the safe work practices and procedures for the
employees and their own safety.
2.
Encourage proper attitudes and the active involvement of all

employees in achieving a safe and healthy workplace.
3.
Arrange periodic meetings with employees to discuss health and

safety issues.
4.
Induct and train new employees and re-deployed employees so that

they can carry out their duties in a safe and healthy manner.
5.
Maintain plant and equipment in a safe condition and ensure it

complies with the established standards.
6.
Ensure periodic site inspections are conducted to identify potential

and existing hazards.
: August, 2011
Revision : 00
5-4

7.
Encourage the reporting of all hazards, incidents, accidents, and

injuries. Investigate all reported events and complete the appropriate
forms.
8.
Ensure that employees are instructed in the use of appropriate

Personal Protective Equipment (PPE), and know its limitations and
how to maintain it.
9.
Assist in the rehabilitation of any employee who has suffered a work

related injury or illness.
10. Ensure that visitors coming on-site observe the company's safety
policy and procedures.
11. Provide adequate first aid facilities and where necessary, qualified
first aid personnel.
12. By effort and example secure complete compliance of the Company
Policy Statement on Safety, Health & Environment and keep
management informed on all matters relating to health and safety via
Safety Meetings and checklists. Where more urgent safety matters
arise, Department Managers shall directly communicate with the
Company Aviation Safety Officer (CASO).
13. Forward initial copies of all occurrence reports and occupational
injury reports to respective customers and further, provide those
customers with copies of those reports once they have been closed
out.
6.2.3. Individual Responsibilities
All employees have a responsibility for their own health and safety and the
health and safety of others.
6.3.
SAFETY MANAGER (CASO)

The Director, together with the Safety Manager, Operation Manager,
Maintenance Manager, appoints the Company Aviation Safety Program and chair
the Company Aviation Safety Committee.
Date
: August, 2011
Revision : 00
5-5

The CASO shall be responsible to and shall report to the Director, however shall
at times have direct access to the Managing Director.
The Company Aviation Safety Officer (CASO) shall be provided with:
1) Working space that provides privacy and a distraction free environment,
2) Communication equipment and facsimile,
3) Access to all computers and database for the purpose of documenting and
tracking safety related concerns, and
4) Access to all required safety related information, documents and educational
tools.
6.3.1 Training of the Company Aviation Safety Officer

The CASO shall be trained in the following safety related areas:
Date
1)
Flight safety philosophy and company culture;
2)
Human factors and pilot decision making;
3)
Accident prevention;
4)
CASO duties and responsibilities and advisory role to management;
5)
Risk analysis and management;
6)
Accident and incident prevention any investigation;
7)
Conduct of aviation safety survey;
8)
Developing an Emergency Response Plan;
9)
Accident/Incident investigation.
: August, 2011
Revision : 00
5-6

6.3.2 CASO Responsibilities:

1)
Monitoring and advising on all air operator flight safety activities

which may have an impact on aviation safety;
2)
Establishing a reporting system which provides for a timely and free;
3)
Conducting Safety Surveys;
4)
Soliciting and processing safety improvement suggestions;
5)
Developing and maintaining a safety awareness program;
6)
Monitoring industry safety concerns which may have an impact on air

operations;
7)
Maintaining close liaison with helicopter manufacture;
8)
Maintaining close liaison with any Government Safety Directorate

and the National Transportation Safety Board;
9)
Maintaining close liaison with industry safety associations;
10) Developing and maintaining the air carrier emergency response plan;
11) Identifying safety deficiencies and making suggestions for corrective
action;
12) Investigating and reporting on incidents/accidents and making
recommendations to preclude a recurrence;
13) Developing and maintaining a safety data base to monitor and
analyze trends;
14) Making recommendations to the air operator senior management on
matters pertaining to safety;
15) Monitoring the response and measuring the results of safety
initiatives;
Date
: August, 2011
Revision : 00
5-7

16) Ensuring that all occurrences are reported to the appropriate agency;
17) Resolving any findings which may be identified during safety or
regulatory audits or other inspections conducted by the DGCA
personnel;
18) The development, maintenance and modifications of safety brief
videos, briefing cards, safety posters, and the safety publications.
19) Compilation of statistical information regarding Occupational and
flight safety, and the liaison with Department Managers regarding
those figures. Statistical information to include:
a. Accident Frequency Rate
b. Lost Time Injury Frequency Rate
c.
Hazard Occurrence Rate.
6.3.3. Flight Safety Officer & Ground Safety Officer

(Base Safety Representatives)
At all fixed company bases, the Base Manager or Pilot-In-Charge or
Contract Representative is appointed as Base Safety Representative.
Whilst their on-base duties and day-to-day Health & Safety portfolio shall
be reported to the Operations Manager, who has overall responsibility for
base operational matters, they have a direct responsibility to the CASO for
all relevant health & safety issues.
Specifically, their responsibilities shall include:
Date
1)
Conducting the Base Safety Induction for new staff or newly

assigned staff to that base.
2)
Conducting (or initiating other base personnel to conduct) the

periodic Base Safety Inspection.
3)
Conducting (or initiating other base personnel to conduct) the Base

Safety Meeting.
: August, 2011
Revision : 00
5-8

4)
Upkeep of Safety Notification / Bulletin Boards.
5)
The dissemination of safety references and material.
6)
Conducting injury / incident investigations, as directed
7)
By effort and example, secure complete compliance of the

Company's Health and Safety policy, and keep senior management
informed on all matters relating to Health and Safety.
8)
Co-ordinate all matters relating to Safety Survival Equipment.
9)
Assist in monitoring the location of Safety Survival equipment.
10) Conduct quarterly Safety Survival Equipment inventory check.
6.4.
SMS ORGANIZATION DIAGRAM
DIRECTOR
CASO
OPERATION
MANAGER
MAINTENANCE
MANAGER
CHIEF INSPECTOR
SAFETY
COMMITEE
Date
: August, 2011
Revision : 00
5-9

Chapter 7. Non-Punitive Reporting Policy
TABLE OF CONTENT
Chapter SUBJECT
PAGE
7.
NON-PUNITIVE REPORTING POLICY
72
7.1.
GENERAL
73
7.2.
EMPLOYEE POLICY
74
7.3.
NON PUNITIVE REPORTING
74
7.4.
NON PUNITIVE REPORTING POLICY
75
Date
: March 8, 2015
Revision : 02
7-1

CHAPTER 7
NON-PUNITIVE REPORTING POLICY
Date
: August, 2011
Revision : 00
7-2

7.1.
GENERAL
A policy describing under what circumstances an employee would be disciplined
should be clearly laid out and communicated to all staff. CASO communicates
this policy to their staff by having it printed on the hazard reporting forms. In order
to encourage a Safety reporting culture in a company there should really be only
three reasons to discipline an employee.
It is important that the role of each person be clearly defined. Every staff member
has a responsibility to watch out for hazards, for the conditions conducive to
human error or for procedures not tolerant of human error. All have a
responsibility to report hazards and incidents so that steps can be taken to
minimize or eliminate the hazard and so that others can learn from it and avoid
the same situation. It is important that staff members who report hazards are
seen as a positive influence on the organization. It must become praiseworthy to
report if something is not working properly.
Handling of all received forms is about the same as how it s done to all reports,
using Operational Hazard Report as the basic reference to handling reports that
already being well practiced in Quality Department and Safety Department.
7.2.
EMPLOYEE POLICY
Effective safety management System program extends beyond normal working
hours and accordingly, safety in employees and their families; off-the-job
activities are encouraged.
Employees must:
1. Every employee has the responsibility to prevent accidents and injuries by
observing established working rules, following the directions of supervisors,
practicing the principals taught in safety training.
2. Providing ideas on how our safety efforts might be further strengthened.
3. employees have the responsibility to comply with government regulations
related to safety programs
Date
: August, 2011
Revision : 00
7-3

4. Inform the company of any shortcomings with respect to safety or
deficiencies, hazard, accidents and incidents.
5. Prohibited for illegal activity, Criminal intent,
6. take reasonable care of their own safety;
7. take reasonable care of the safety of others who may be affected by their acts
8. co-operate with the company so far as is necessary to enable the companys
duties to be complied with;
9. Not interfere with, or misuse anything provided in the interests of safety.
7.3.
NON PUNITIVE REPORTING

Non-punitive reporting systems are based on confidentiality. Before employees
will freely report incidents, they must receive a commitment from the regulatory
authority or from top management that reported information would not be used
punitively against them. The person reporting the incident (or unsafe condition)
must be confident that anything said will be kept in confidence. In some States,
Access to Information laws make it increasingly difficult to guarantee
confidentiality. Where this happens, reported information will tend to be reduced
to the minimum to meet mandatory reporting requirements.
Date
: August, 2011
Revision : 00
7-4

7.4.
Date
NON PUNITIVE REPORTING POLICY

1.
PT. MATTHEW AIR NUSANTARA is committed to the safest flight operating

standards possible. To achieve this, it is imperative that we have uninhibited
reporting of all incidents and occurrences which may compromise the safe
conduct of our operations. To this end, every employee is responsible for
communicating any information that may affect the integrity of flight safety. Such
communication must be completely free of any form of reprisal.
2.
PT. MATTHEW AIR NUSANTARA will not take disciplinary action against any
employee who discloses an incident or occurrence involving flight safety. This
policy shall not apply to information received by the Company from a source
other than the employee, or which involves an illegal act, or a deliberate or willful
disregard of promulgated regulations or procedures.
3.
The primary responsibility for flight safety rests with line managers, however,
flight safety is everyones concern.
4.
Our method of collecting, recording and disseminating information obtained from

Air Safety Reports has been developed to protect, to the extent permissible by
law, the identity of any employee who provides flight safety information.
5.
I urge all staff to use our flight safety program to help PT. MATTHEW AIR
NUSANTARA become a leader in providing our customers and employees with
the highest level of flight safety.
: July 24, 2013
Revision : 01
7-5

Chapter 8. Safety Reporting
TABLE OF CONTENT
Chapter SUBJECT
PAGE
8.
SAFETY REPORTING
82
8.1.
GENERAL
83
8.2.
PRINCIPLES FOR EFFECTIVE INCIDENT

REPORTING SYSTEMS
83
8.3.
ACCIDENT / INCIDENT REPORTS
83
8.4.
HAZARD REPORTS
84
8.4.1. Investigation of Accidents / Incidents Hazards
84
8.4.2. Trend monitoring
85
8.4.3 Information feedback to employees
85
8.5.
VALUE OF SAFETY REPORTING SYSTEMS
85
8.6.
TYPES OF INCIDENT REPORTING SYSTEMS
86
8.7.
MANDATORY INCIDENT REPORTING SYSTEMS
86
8.8.
CONFIDENTIAL REPORTING SYSTEMS
87
8.9.
REPORT TRUST
87
8.10.
PT. MATTHEW AIR NUSANTARA INCIDENT

REPORTING SYSTEMS
88
8.11.
IMPLEMENTATION OF INCIDENT REPORTING

SYSTEMS
88
8.12.
REPORTING METHOD AND FORMAT
88
8.13.
PRINCIPLE OF PT. MATTHEW AIR NUSANTARA

REPORTING SYSTEMS
89
8.14
THE FEATURES OF PT. MATTHEW AIR

NUSANTARA REPORTING SYSTEM
8 11
8.15.
COMPANY REPORTING SYSTEMS
8 11
8.16.
PT. MATTHEW AIR NUSANTARA REPORT

CHECKLIST
8 12
Date
: August, 2011
Revision : 00
8-1

Chapter 8
SAFETY REPORTING
Date
: August, 2011
Revision : 00
8-2

8.1.
GENERAL
PT. Matthew Air Nusantara Safety Management Systems involve the reactive
and proactive identification of safety hazards. Accident investigations reveal a
great deal about safety hazards; but fortunately, aviation accidents are rare
events. They are, however, generally investigated more thoroughly than
incidents. When safety initiatives rely exclusively on accident data, the
limitations of not having many case samples apply. As a result, the wrong
conclusions may be drawn or inappropriate corrective actions taken.
Report is any hazard that has the potential to cause damage or injury or that
threatens the organizations viability should be reported. Hazards and incidents
should be reported if it is believed that:
a) Something can be done to improve safety;
b) Other aviation personnel could learn from the report; or
c) The system and its inherent defenses did not work as advertised.
A reporting system is a formal means of collecting, recording, acting on and
providing feedback to staff about hazards and risks to our operation.
Reported risks are those that have been identified and can be managed.
Unreported hazards and risks are difficult to identify and therefore to fix.
8.2.
PRINCIPLES FOR EFFECTIVE INCIDENT REPORTING SYSTEMS

People are understood reluctant to report their mistakes to the organization that
employs them or to the government department that regulates them. Too often
following an occurrence, investigators learn that many people were aware of the
unsafe conditions before the event. For whatever reasons, however, they did
not report the perceived hazards, perhaps because of:
a) Embarrassment in front of their peers;
b) Self-incrimination, especially if they were responsible for creating the unsafe
condition;
c) Retaliation from their employer for having spoken out; or
d) Sanction (such as enforcement action) by the regulatory authority.
8.3.
ACCIDENT / INCIDENT REPORTS

All accidents and reportable incidents as defined by the KNKT/NTSC will be
recorded on the form. Employees shall use this form to report all occurrences.
Even if an occurrence does not meet the KNKT/NTSC definition of an accident
Date
: August, 2011
Revision : 00
8-3

or a reportable incident it shall be reported to the CASO. Copies of the
completed form will be passed immediately to the Director and the appropriate
Manager. The CASO will forward reports of all accidents and reportable
incidents to the KNKT/NTSC and DGCA.
A REPORTABLE AVIATION ACCIDENT means an accident resulting directly
from the operation of an aircraft, where:
1) A person sustains a serious injury or is killed as a result of:
Being on board the aircraft;
Coming into contact with any part of the aircraft or its contents; or
Being directly exposed to the jet blast or rotor downwash of the aircraft.
2) The aircraft sustains damage or failure that adversely affects the structural
strength, performance or flight characteristics of the aircraft and that
requires major repair or replacement of any affected component part; or
3) The aircraft is missing or inaccessible.
8.4.
HAZARD REPORTS
The PT. Matthew Air Nusantara Hazard reporting system provides a means for
individuals to report potential hazards to the CASO. PT. Matthew Air Nusantara
Hazard Report forms are located on all Aviation Safety notice boards, at
dispatch, and from the CASO.
At the originators request, Hazard Reports may be confidential. The Hazard
Report could be submitted anonymously or, at the request of the originator, the
identity of the originator will be protected.
The completed Hazard Reports should be mailed, faxed or handed to the
CASO. Hazard Report forms can be placed in the Aviation safety suggestion
box. Where possible, the CASO will provide timely feedback to the originator.
All employees are encouraged to report anything that they perceive as a hazard
or a threat to safety. The company has an obligation to provide a safe working
environment for employees and customers. The identification and correction of
hazards is an important part of this obligation.
8.4.1 Investigation of Accidents / Incidents Hazards
The CASO or any other employee assigned by the Director will
investigate all accidents, incidents and hazards. In the case of accidents
and incidents reported to the NTSC, a company representative may be
appointed as an observer to the NTSC investigation. Investigations will
be conducted to determine the cause of an occurrence and will not be
Date
: August, 2011
Revision : 00
8-4

used for disciplinary action. The Safety Committee will review each
occurrence or hazard and implement or recommend corrective actions to
prevent a recurrence.
The meeting of the Safety Committee is a good means of advising
management on safety issues, however, the quarterly meetings may not
allow timely action on critical events. In the case of urgent items a
special Safety Committee meeting will be called or the CASO will meet
with the appropriate manager or Director to brief on the problem and to
recommend corrective actions.
8.4.2. Trend monitoring
The CASO will maintain a database of all company accidents, incidents
and hazards to permit trend monitoring to take place. These trends will
be reviewed at every Safety Committee meeting. In addition, the CASO
will collect and monitor national and international accident / incident data
on similar aircraft involved in similar operations.
8.4.3. Information feedback to employees
All Safety decisions and corrective actions will be published for
employees to read (usually in the form of minutes of the Safety
Committee meetings). In the case of Hazard Reports, the CASO will
make an effort to provide feedback to the originator.
A six months summary of company accidents, incidents and hazards and
any corrective actions will be prepared by the CASO. A copy of the
summary will be posted on each Safety notice board and distributed to
each manager.
8.5.
VALUE OF SAFETY REPORTING SYSTEMS

1. Recognizing that knowledge derived from incidents can provide significant
insights into safety hazards, several types of incident reporting systems
have been developed. Some safety databases contain a large quantity of
detailed information. The systems containing the information obtained from
accident and incident investigations and safety databases can be grouped
under the general term Safety Data Collection and Processing Systems
(SDCPS). SDCPS refers to processing and reporting systems, databases,
schemes for exchange of information, and recorded information and include
records pertaining to accident and incident investigations, mandatory
incident reporting systems, voluntary incident reporting systems, and selfdisclosure reporting systems (including automatic data capture systems and
Date
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manual data capture systems). Although incidents may not be investigated
in any depth, the anecdotal information they provide can offer meaningful
insight into the perceptions and reactions of pilots, cabin crew, Aircraft
Maintenance Engineers, and aerodrome personnel.
2. Safety reporting systems should not just be restricted to incidents but should
include provision for the reporting of hazards, i.e. unsafe conditions that
have not yet caused an incident. For example, some organizations have
programmers for reporting conditions deemed unsatisfactory from the
perspective of experienced personnel (Unsatisfactory Condition Reports for
potential technical faults). In some States, Service Difficulty Reporting (SDR)
systems are effective in identifying airworthiness hazards. Aggregating data
from such hazard and incident reports provides a rich source of experience
to support other safety management activities.
3. Data from incident reporting systems can facilitate an understanding of the
causes of hazards, help to define intervention strategies and help to verify
the effectiveness of interventions. Depending on the depth to which they are
investigated, incidents can provide a unique means of obtaining first-hand
evidence on the factors associated with mishaps from the participants.
Reporters can describe the relationships between stimuli and their actions.
They may provide their interpretation of the effects of various factors
affecting their performance, such as fatigue, interpersonal interactions and
distractions. Furthermore, many
8.6.
TYPES OF INCIDENT REPORTING SYSTEMS

In general, an incident involves an unsafe, or potentially unsafe, occurrence or
condition that does not involve serious personal injury or significant property
damage, i.e. it does not meet the criteria for an accident. When an incident
occurs, the individual(s) involved may or may not be required to submit a report.
The reporting requirements vary with the laws of the State where the incident
occurred. Even if not required by law, PT. Matthew Air Nusantara may require
reporting of the occurrence to the organization.
8.7.
MANDATORY INCIDENT REPORTING SYSTEMS

1. In a mandatory system, people are required to report certain types of
incidents. This necessitates detailed regulations outlining who shall report
and what shall be reported. The number of variables in aviation operations is
so great that it is difficult to provide a comprehensive list of items or
conditions which should be reported. For example, the loss of a single
hydraulic system on an aircraft with only one such system is critical, while on
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a type with three or four systems, it may not be. A relatively minor problem
in one set of circumstances can in different circumstances result in a
hazardous situation. However, the rule should be: If in doubt - report it.
2. Since mandatory systems deal mainly with hardware matters, they tend to
collect more information on technical failures than on the human
performance aspects. To help overcome this problem, States with welldeveloped mandatory reporting systems are introducing voluntary incident
reporting systems aimed at acquiring more information on the Human
Factors aspects of occurrences.
8.8.
CONFIDENTIAL REPORTING SYSTEMS

Confidential reporting systems aim to protect the identity of the reporter. This is
one way of ensuring that voluntary reporting systems are non-punitive.
Confidentiality is usually achieved by de-identification, often by not recording
any identifying information of the occurrence. One such system returns to the
user the identifying part of the reporting form and no record is kept of these
details. Confidential incident reporting systems facilitate the disclosure of
human errors, without fear of retribution or embarrassment, and enable others
to learn from previous mistakes.
8.9.
REPORT TRUST
1. Persons reporting incidents must trust that the receiving organization, PT.
Matthew Air Nusantara will not use the information against them in any way.
Without such confidence, people will be reluctant to report their mistakes or
other hazards they have noticed.
2. Trust begins with the design and implementation of the reporting system.
Employee input into the development of a reporting system is therefore vital.
A positive safety culture in the organization generates the kind of trust
necessary for a successful incident reporting system. Specifically, the
culture must be error-tolerant and just. In addition, incident reporting
systems need to be perceived as being fair in how they treat unintentional
errors or mistakes. (Most people do not expect an incident reporting system
to exempt criminal acts or deliberate violations from prosecution or
disciplinary action.) Some States consider such a process to be an example
of a just culture.
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8.10. PT. MATTHEW AIR NUSANTARA INCIDENT REPORTING SYSTEMS

The types of serious incidents of interest include:
a. multiple system failures;
b. fires or smoke on board an aircraft;
c. terrain and obstacle clearance incidents;
d. flight control and stability problems;
e. take-off and landing incidents;
f. flight crew incapacitation;
g. Near collisions and other serious air traffic incidents.
8.11. IMPLEMENTATION OF INCIDENT REPORTING SYSTEMS
If implemented in a non-punitive work environment, an incident reporting
system can go a long way towards creating a positive safety culture. Depending
on the size of the organization, the most expedient method for incident and
hazard reporting is to use existing paperwork such as safety reports and
maintenance reports. However, as the volume of reports increases, some sort
of computerized system will be required to handle the task.
In short, if in doubt as to an events safety significance, it should be reported.
(Those incidents and accidents that are required to be reported in accordance
with State laws or regulations governing accident or incident reporting should
also be included in an operators reporting database.)
8.12. REPORTING METHOD AND FORMAT

The method and format chosen for a reporting system matters little as long as it
encourages personnel to report all hazards and incidents. The reporting
process should be as simple as possible and well documented, including details
as to what, where and when to report.
In designing reporting forms, the layout should facilitate the submission of
information. Sufficient space should be provided to encourage reporters to
identify suggested corrective actions. Listed below are some other factors to be
considered in designing a system and reporting forms:
a. Operational personnel are generally not prolific writers; therefore, the form
should be kept as short as possible.
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b. Reporters are not safety analysts; therefore, the questions should be written
in simple, everyday language.
c. Non-directive questions should be used instead of leading questions. (Nondirective questions include: What happened? Why? How was it fixed? And
What should be done?)
d. Prompts may be required for the reporter to think about system failures (for
example: How close were they to an accident?) and to consider their error
management strategies.
e. Focus should be on the detection and recovery from an unsafe situation or
condition.
f. Reporters should be encouraged to consider the wider safety lessons
inherent in the report, for example, how the organization and the aviation
system could benefit from it.
8.13. PRINCIPLE OF PT. MATTHEW AIR NUSANTARA REPORTING SYSTEMS
Care needs to be taken when using data from voluntary incident reports. When
drawing conclusions based on such data, analysts should consider the following
limitations:
a. Information not validated. In some States, voluntary confidential reports can
be fully investigated and information from other sources brought to bear on
the incident. However, the confidentiality provisions of smaller program
(such as company reporting systems) make it difficult to adequately follow
up on a report without compromising the identity of the reporter. Thus, much
of the reported information cannot be substantiated.
b. Reporter biases. Two factors may bias voluntary incident data: who reports
and what gets reported. Some of the factors contributing to the subjective
nature of voluntary incident reports are listed below:
1) Reporters must be familiar with the reporting system and have access to
reporting forms or phone numbers.
2) Reporters motivation to report may vary due to the following factors:
-
Level of commitment to safety;
Awareness of the reporting system;
- Perception
implications);
of
the
associated
risks
(local
versus
systemic
3) Different occupational groups see things differently, both in terms of

interpreting the same event and in terms of deciding what is important.
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4) Reporters must be aware of an incident to submit a report. Errors that go
undetected are not reported.
c) Report forms. Typically, incident reporting forms induce bias (including bias
against reporting at all), for example:
1) A report form must be sufficiently short and easy to use so that
operational personnel are encouraged to use it; thus, the number of
questions must be limited.
2) Completely open questions (i.e. narratives only) can fail to elicit useful
data.
3) Questions can guide the reporter, but they can also distort perceptions
by leading the reporter to biased conclusions.
4) The range of possible events is so broad that a standard structured form
cannot capture all information. (Therefore, analysts may have to contact
the reporter to gain specific information.)
d) Incident reporting databases. Information must be categorized in
accordance with a predetermined structure of keywords or definitions for
entry into the database for later retrieval. Typically, this introduces bias into
the databases, compromising their utility, for example:
1) Unlike objective physical flight parameters, descriptions of events and
any causal attributions are more subjective.
2) Categorization requires a system of predetermined keywords or
definitions, therefore biasing the database, for example:
a) Reports are analyzed to fit the keywords. Details that do not fit are
ignored.
b) It is impossible to create an exhaustive list of keywords for classifying
information.
c) Keywords are either present or not present, providing a poor
approximation of the real world.
d) Information is retrieved according to how it is stored; hence
categorization determines the output parameters. For example, if
there is no keyword called technical failure, then technical failure
will never be found to be the cause of incidents from that database.
e) The categorization system creates a self-fulfilling prophecy. For
example, many incident reporting systems bias the keyword
categorization towards CRM. Consequently, CRM is often cited as
both the cause of the problem and its cure (more CRM training will
redress the perceived CRM deficiency).
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e) Relative frequency of occurrence. Since voluntary incident reporting
systems do not receive information of the type needed to compute useful
rate figures, any attempt to put the incident in the perspective of a frequency
of occurrence vis--vis other occurrences will be an educated guess at best.
For valid frequency comparisons, three types of data are required: the
number of persons actually experiencing similar incidents (not just the
reported incidents), the size of the population at risk of similar occurrences,
and a measurement of the time period under consideration.
f) Trend analysis. Meaningful trend analysis of the more subjective parameters
recorded in incident reporting databases have not been particularly
successful. Some of the reasons for this are listed below:
1) Difficulties in using structured information;
2) Limitations in capturing the context of the incident through keywords;
3) Inadequate levels of detail and accuracy of recorded data;
4) Poor inter-reliability of one report against another;
5) Difficulties in merging data from different databases; and
6) Difficulties in formulating meaningful queries for the database.
8.14
THE FEATURES OF PT. MATTHEW AIR NUSANTARA REPORTING

SYSTEM
The key features of the reporting system are:
1. Identifying what is relevant.
2. Collecting current and applicable information.
3. A procedure for receiving and auctioning reports.
4. A reliable method of accurately recording, storing, retrieving and maintaining
safety reports.
5. A procedure for distributing relevant or appropriate information to staff (and
possibly contractors).
6. Able to be audited.
8.15. COMPANY REPORTING SYSTEMS
1. Hazards can be reported by staff, management, customers or passengers

and external contractors.
2. Any hazard which has the potential to cause damage or injury or which
threatens business viability, should be reported.
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For example:
a) High workload during passenger boarding.
b) Poor communication with Air Traffic Services.
c) Flight crew stress.
d) Failure to follow standard procedures.
e) Information overload from NOTAMs.
f) In-flight turbulence.
g) Unsafe ground traffic movements.
h) Etc.
Methods of uncovering hazards can range from informal interviews with staff
about safety, to computer-based hazard and incident reporting systems.
Staff should feel willing to use the hazard reporting system and trained to
access the forms. The forms may be paper or electronic.
They may be kept in a file with a summary sheet, or entered onto a
database or other tracking system.
All information should be accepted with the aim of fixing problems - not
punishing people.
8.16.
PT. MATTHEW AIR NUSANTARA REPORT CHECKLIST

a) All reports are recorded and investigated.
b) A combination of formal and informal reporting processes is in place.
c) Staffs are aware they will not be penalized for submitting a report.
d) Confidentiality is protected.
e) Staffs who report hazards are given feedback.
f) After investigations, recommendations are made available to all staff
g) A system is in place to allow CASO to monitor the status of each Workplace
failures included job instability from two regional commuter companies
merging, different corporate cultures, high employee turnover and low
morale.
Human failures included the decision of the crew not to de-ice or conduct a
walk-around, failure of the cabin crew to communicate and ground-handler
reticence.
Failures on the part of the operator included:
Date
Lack of a process to report risks and errors.
Inadequate standardized manuals and procedures.
Poor guidelines on deicing procedures.
Inadequate crew coordination.
: August, 2011
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8 - 12

Chapter 9. HIRA Determining Control
TABLE OF CONTENT
Chapter SUBJECT
PAGE
9.
HIRA DETERMINING CONTROL
92
9.1.
PURPOSE
93
9.2.
SCOPE
93
9.3.
DEFINITIONS
94
9.4.
REQUIREMENTS
95
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CHAPTER 9
HAZARD IDENTIFICATION, RISK
ASSESSMENT AND DETERMINING
CONTROL (HIRADC)
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9-2

9.1.
PURPOSE
The purpose of this procedure is to identify and manage the risk resulting from
PT. Matthew Air Nusantara activities in the area of occupational safety and
health.
9.2.
SCOPE
This procedure applies to all the activities created by PT. Matthew Air Nusantara
at designated site.
9.3.
DEFINITIONS
CASO
Abbreviation of Company Aviation Safety Officer.
Consequence
The degree of injuries to personnel, damage to equipment or structures, loss of
material, or reduction of ability to perform a prescribed function arising from an
outcome. Consequences have a magnitude.
Hazard
Source, situation, or act with a potential for harm in terms of human injury or ill
health or a combination of these.
Hazard Identification
Process of recognizing that a hazard exists and defining its characteristics.
Involves recognizing things, which may cause injury or harm to the health or a
person, for instance flammable material, ignition sources or unguarded
machinery.
HIRADC
Abbreviation of Hazard Identification, Risk Assessment and Determining Control.
HOD
Head of Department at PT. Matthew Air Nusantara.
Non Routine
Any ad-hoc, emergency, non-scheduled activities.
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Occupational, Health and Safety (OH&S)
Condition and factors that affect, or could affect the health and safety of
employees or other workers (temporary workers, contractor personnel) visitors,
or any other person in the workplace.
Outcome
A potential end point of an accident scenario which can be assigned a
consequence severity.
Risk
The combination of the predicted frequency and severity of the consequences of
hazard(s) taking into account all of the potential outcomes.
Risk Assessment
Process of evaluating the risk arising from the hazards, taking into account the
adequacy of any existing controls, and deciding whether or not the risk is
acceptable.
Risk Controls (Barriers and Mitigation)
A system, activity, action or procedure that is put in place to reduce the risks
associated with a hazard. Mitigation may include:
elimination of the hazard (preferred),
reduction in the frequency of the hazard (barriers),
reduction in the likelihood of the outcomes of the hazard (outcome mitigation),
reduction of the severity of the outcomes of the hazard (consequence
mitigation).
Risk Management
The total procedure associated with identifying a hazard, assessing the risk,
putting in place control measure, and reviewing the outcomes.
Routine
Activities, which were planned.
Safety Event
A failure condition, causal factor, threat or precursor event which in isolation or in
combination with other safety events could result in an undesirable event.
Undesirable Event
A stage in the escalation of an accident scenario where the accident will occur,
unless an active recovery measure is available and is successfully used.
Workplace
Any physical location in which work related activities are performed under the
control of the organization.
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9-4

9.4.
REQUIREMENTS
9.4.1. The procedure(s) for hazard identification and risk assessment shall take
into account:
a. routine and non-routine activities;
b. activities of all persons having access to the workplace (including
contractors and visitors);
c. human behavior, capabilities and other human factors;
d. identified hazards originating outside the workplace capable of
adversely affecting the health and safety of persons under the control of
the PT. Matthew Air Nusantara within the workplace;
e. hazards created in the vicinity of the workplace by work-related
activities under the control of the PT. Matthew Air Nusantara;
f. infrastructure, equipment and materials at the workplace, whether
provided by the PT. Matthew Air Nusantara or others;
g. changes or proposed changes in the PT. Matthew Air Nusantara, its
activities, or materials;
h. modifications to the safety management system, including temporary
changes, and their impacts on operations, processes, and activities;
i. any applicable legal obligations relating to risk assessment and
implementation of necessary controls;
j. the design of work areas, processes, installations, machinery/
equipment, operating procedures and work PT. Matthew Air Nusantara,
including their adaptation to human capabilities.
9.4.2. The PT. Matthew Air Nusantaras methodology for hazard identification
and risk assessment shall:
a. be defined with respect to its scope, nature and timing to ensure it is
proactive rather than reactive; and
b. provide for the identification, prioritization and documentation of risks,
and the application of controls, as appropriate.
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9.4.3. For the management of change, the HOD shall identify the OH&S hazards
and OH&S risks associated with changes in his/her respective areas, the
OH&S management system, or its activities, prior to the introduction of
such changes.
9.4.4. HIRADC related to occupational safety and health shall be conducted in
accordance with these Hazard Identification Risk Assessment and
Determining Control steps:
1). Identification
a. Identify the main activities of the service or department by referring
to work place inspection, flow charts, surveillance, audit, Standard
Operating Procedures Work Instructions, incident record or other
documentation, as appropriate and record those activities
identified in the HIRADC Form.
b. Use either one or combination of the following methods to identify
the safety and health hazards.
Workplace Inspection;
Discussions and interview;
Accident statistics or reports;
Internal or external audits.
c. Classify the safety and health hazards identified into the following
categories:
Physical - mechanical hazards from tools and equipment,
height, electrical, manual handling, slippery floor, radiation,
confined space, etc.;
Chemical - hazards from use of chemicals, which includes
detergent, lubricants, mineral oil, paints, bitumen, mercury,
solvents, etc.;
Psychological/Physiological- stress from work, monotonous
work, workplace violence etc.;
Ergonomics Awkward posture, repetitive motion, manual
handling, etc.;
Biological Pathogen, bacteria, viruses, mold, fungi, etc.
d. Identify the probable potential effects of those hazards in the
respective hazard and effect columns in the HIRADC Form.
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2). Risk Assessment Procedure
Determine the frequency of the activity being conducted at the
workplace by referring to frequency matrix as shown below:
a. frequency of activity matrix
Frequency of Activity (F)
1
Yearly
1 to 10 times in a year
Monthly
1 to 3 times in a month
Weekly
1 to 3 times in a week
Daily
1 to 5 times in a day
Hourly
Once or more in an hour, or > 5 times in a day
b. Establish the severity of the safety and health hazard(s) identified

by referring to severity matrix as depicted below:
Description
of Severity
5
Category of
Severity
Catastrophic
Huge Damage
Critical Injury
4
Major Damage/ Loss
Major Injury
3
Moderate Damage/
Loss
Date
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Rating
Multiple fatalities
Huge financial loss greater than USD
100,000
Single fatality or permanent total
disability (e.g: lost an eye, lost of limb
(s), or ill health causing irreversibly
health effects (e.g: cancer, total lost of
hearing)
Major financial loss greater than USD
50,000 but less than or equal to USD
100,000
Major injury (e.g: loss of consciousness,
lost of finger (s) or toe (s), broken limb (s)
or ill health (including occupational
poisoning or disease- Third Schedule, or
hospitalized,
disabling
injury
but
recoverable, and/or causing away from
work more than 4 calendar days.
Medium financial loss greater than USD
10,000 but less than or equal to USD
50,000
9-7

Minor Injury
2
Minor Damage
Negligible
1
No damage
Minor cut, laceration or health effect:

ailment (minor infection), or requiring
outpatient medical treatment or affecting
work performance such as restriction to
activities, and/or causing away from work
=< 4 calendar days
Low financial loss/property damage less
than or equal to USD 10,000
No or slight injuries, or no health effect, or
requiring only first aid, and/or not affecting
work performance.
No property damage / financial loss
c. Determine the likelihood of an incident based on incident report

statistics and professional judgment having regard to existing
control measures available. The rating for likelihood of an event
can be obtained by referring to likelihood matrix as shown below:
Rating
Category of
Likelihood
Percentage basis
(estimation)
Very Unlikely
Unlikely
Likely
Most Likely
Certain
The probability to happen is

extremely small (<1%)
Could happen, however very
rare (1% to 9%)
Chances to happen is relatively
high (10% to 59%)
Can happen frequently (60% to
94%)
Expected to happen (95% to
100%)
Number of
Occurrence (actual)
No case so far
One case within 5 to 10
years
One case in 1 to 5 years
One case within 6
months to 1 year
One case in less than
6 months
d. Obtain risk rating by multiplying the frequency of activity with

severity and likelihood for each of the hazards associated to the
activities or processes identified.
=
{} {} {} =
e. Determine the significance level from the points obtained above
with the higher points ranked above lower points, hence, priorities
for reducing those risks are given to those activities, which have
higher points through recommendations having regard to the time
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frame for action(s) to be taken and also consider both long term
and short term solutions including their economic viability.
f.
The relative risk value can be used to prioritize necessary actions

to effectively manage work place hazards. The following table
determines priority based on the following ranges:
Risk Category-guide for Further Action Plan
Risk
Rating
Any Legal to
Comply?
1-9
10-25
Risk
Category
Risk Level
Action and Time Scale
Very Low
Risk to be eliminated or lower

when possible using the
Hierarchy of Control
Low
Moderate
46-85
Action (need
comply with
legal
requirements)
High
85
Action Plan
(with permit)
Critical
NO
26-45
Action
required
within a
reasonable
timeframe
(2-4
weeks)
eliminating
or
minimising the risk using the
Hierarchy of Controls.
Action required this week to
eliminate or minimise the risk
using
the
Hierarchy
of
Controls
Action needed quickly (within
1-2 days). The task should not
proceed unless the risk is
assessed and control options
selected
based
on
the
Hierarchy of Controls.
STOP: Unacceptable under
the existing circumstances. Do
not permit any operation until
sufficient control measures
have been implemented to
reduce risk to an acceptable
level.
3). Controlling Risks

Once a risk rating is determined, each hazard must have its existing
risk control measures evaluated using the Evaluation of Control
Effectiveness Table. This allows for determination of any additional
requirement necessary.
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Evaluation of Control Effectiveness Table
Well Designed Control?
Effectively Implemented
Needs improvement
Deficient
Adequate
Marginal
Strong
Effective
4). Determining Control

PT. Matthew Air Nusantara shall ensure that the
assessments are considered when determining
determining controls, or considering changes to
consideration shall be given to reducing the risks
following hierarchy:
results of these
controls. When
existing controls,
according to the
Having identified the hazards, assessed their risks and reviewed the
existing controls, all hazards must be managed before people are hurt,
become ill or there is damage to plant, property or the environment.
The management of risks in the workplace requires eliminating risks
so far as reasonably practicable in the first instance. Where elimination
is not possible, then risks should be minimized, so far as reasonably
practicable.
All hazards that have been assessed should be dealt with in order of
priority. The most effective control option/s should be selected to
eliminate or minimize risks. The Hierarchy of Controls (see diagram
below) ranks control options from highest level of protection and
reliability to lowest. This should be used to determine the most
effective control/s.
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Hierarchy of Controls
Hierarchy/ Methods of Control
Types of Control
Elimination
The most effective control measures eliminate

the hazard and associated risks. This can be
achieved through removing the hazard or
selecting alternate products or equipment to
eliminate the risk. If a hazard cannot be
eliminated then risks can be minimized by lower
control measures
Substitution
Substitute a substance, method or material to

reduce the risk or the hazard.
Separate the hazard from the workplace or
people.
Modify of equipment (tools) which prevent direct
contact
Isolation
Engineering Control
Administrative Control
PPE
Develop work methods or procedures to reduce

the conditions of risk, for example:
a. Written Safe Operating Procedures
b. Job rotation to restrict hours worked on
difficult jobs.
c. Staff trained in the correct operating
procedures.
Offer the lowest level of protection and should
only be used as a last resort to deal with the
hazard, where the hazard cannot be removed or
reduced by any other means.
HIRADC form can be found in the appendix page b-3 of this manual.
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Chapter 10. PERFORMANCE INDICATOR
TABLE OF CONTENT
Chapter SUBJECT
PAGE
10.
PERFORMANCE INDICATOR
10 2
10.1.
GENERAL
10 3
10.2.
PT. MAN SAFETY GROUP
10 3
10.3.
SAFETY GROUP AGENDA
10 4
10.4.
SAFETY GROUP FREQUENCY MEETING
10 4
10.5.
PT. MAN SAFETY PERFORMANCE INDICATOR
10 5
10.6.
PT. MAN POSITIVE SAFETY CULTURE
10 5
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CHAPTER 10
PERFORMANCE INDICATOR
Date
: August, 2011
Revision : 00
10 - 2

10.1.
GENERAL
The person responsible for the safety management system has to be confident that
the system is working and that it is effective. If done correctly, the self assessment
or internal audit will show whether or not the system works, provided there is
adequate documentation. It is a review of the achievement of the specific safety
goals you have set, the success of the corrective action plans and the risk
reduction strategies implemented that will show whether or not your system is
effective. This review will include whether or not the safety objectives in the SMS
policy and the safety performance goals need to be revised.
10.2.
PT. MATTHEW AIR NUSANTARA SAFETY GROUP

PT. MATTHEW AIR NUSANTARA make the Safety group that CASO is assisted by
a safety group or committee, the Safety group can:
1.
Act as a source of expertise and advice.
2.
Review the progress of incidents/accidents, and the actions taken.
3.
Review the status of hazard/risk reports, and review the actions taken.
4.
Make safety recommendations to address hazards.
5.
Review internal audit reports.
6.
Review and approve audit response and actions taken.
7.
Encourage lateral thinking and creative solutions.
8.
Help identify hazards and defenses.
9.
Prepare and submit reports to the Board of Directors for review.
The size and nature of PT. MATTHEW AIR NUSANTARA operation require the
makeup of the safety group,
The group must include:
1. CASO.
2. A representative from Board of Directors who has the authority to approve safety
recommendations.
Date
: August, 2011
Revision : 00
10 - 3

It should also include at least one representative from each functional area.
For example:
1. Flying operations.
2. Maintenance.
3. Dispatchers
4. Loadmasters
5. Check-in and Ramp.
CASO, a senior manager or any other member of the safety group may chair the
meetings. The role of chairperson can be rotated.
10.3.
SAFETY GROUP AGENDA

1. Review outstanding issues from previous meetings.
2. Review safety action plans.
3. Review accident investigation reports.
4. Review the effectiveness of previous safety recommendations.
5. Notify members of Safety Group activities.
6. Assess and resolve identified hazards.
7. Review internal and external (clients) safety audits and action plans.
8. Monitor and promote safety involvement.
9. Carry out risk assessment on any new equipment, routes or procedures.
10. Plan and organize staff training.
11. Plan for the impact on safety of operational changes.
10.4.
SAFETY GROUP FREQUENCY MEETING

The frequency of committee meetings will be determined by the requirement of each
location of the organization and the volume and severity of identified hazards.
Some Safety groups will meet on a weekly basis, while others may only need to
meet once every two months. Meetings should take place at least every three
months.
Date
: August, 2011
Revision : 00
10 - 4

An extraordinary meeting of the safety group should be called if a serious safety
issue requires urgent resolution. Alternatively, CASO may advise management of
time critical problems and solutions.
10.5.
MATTHEW AIR NUSANTARA SAFETY PERFORMANCE INDICATOR

(a) A safety policy;
(b) A process for planning and measuring safety performance;
(c) A process for identifying hazards and evaluating and managing risks;
(d) A process for ensuring that personnel are trained and competent to perform their
duties;
(e) A process for proactive internal reporting and analysis of hazards, incidents and
accidents, and for taking corrective measures to prevent their recurrence;
(f) Documentation of all the safety management system processes, and a process
for ensuring that personnel are aware of their responsibilities in regards to them;
(g) A process for conducting reviews or audits of the safety management system
processes, on a periodic basis and for cause; and
(h) Any additional safety management system requirements that are prescribed
under the Part of the CASR under which the operations certificate is issued;
10.6.
MATTHEW AIR NUSANTARA POSITIVE SAFETY CULTURE

The commitment of PT. MATTHEW AIR NUSANTARA top management towards
safety, safety practices and safety oversight will determine how business is
conducted from a safety standpoint. The safety culture of the company underpins the
entire safety achievement of the company and is crucial to its success. The ideal
safety culture is one that is supportive of the staff and systems of work, recognizes
that errors will be made and that it is not apportionment of blame that will resolve the
problems. Therefore, the supportive culture will encourage open reporting, seek to
learn from its failures and be just in dealing with those involved. Punitive action must
not follow automatically from the open acknowledgement of human error. However, it
must be made clear that indemnity will not be guaranteed where there has been
gross negligence. The front line defense is that operating staff must not accept
unsafe behavior from their peers.
Date
: August, 2011
Revision : 00
10 - 5

Chapter 11. SAFETY INVESTIGATION
TABLE OF CONTENT
Chapter SUBJECT
PAGE
11.
42
Date
SAFETY INVESTIGATION
: March 8, 2015
Revision : 02
11 - 1

CHAPTER 11
SAFETY INVESTIGATION
Date
: August, 2011
Revision : 00
11 - 2

11.1. GENERAL
Investigation is a process conducted for the purpose of accident prevention
which includes the gathering and analysis of information, the drawing of
conclusions, including the determination of causes and, when appropriate, the
making of safety recommendations.
Effective safety management systems depend on the investigation and analysis
of safety issues. The safety value of an accident, a hazard or an incident is
largely proportional to the quality of the investigative effort.
11.2. ACCIDENT AND INCIDENT INVESTIGATION

By definition, accidents result in damage and/or injury. If we concentrate on
investigating only the results of accidents, not the hazards or risks that cause
them, we are being reactive. Reactive investigations are rather inefficient from a
safety perspective in that latent unsafe conditions posing significant safety risks
may be overlooked.
The focus of an accident investigation should therefore be directed towards
effective risk control. With the investigation directed away from the chase for the
guilty party and towards effective risk mitigation, cooperation will be fostered
among those involved in the accident, facilitating the discovery of the underlying
causes. The short-term expediency of finding someone to blame is detrimental to
the long-term goal of preventing future accidents.
The term serious incident is used for those incidents which good fortune
prevented from becoming accidents, for example, a near collision with another
aircraft or with the ground. Due to the seriousness of such incidents, they should
be thoroughly investigated. Some States treat these serious incidents as if they
had been accidents. This type of full-scale incident investigation has the
advantage of providing hazard information to the same standard as that of an
accident investigation.
For every accident or serious incident, there will likely be hundreds of minor
occurrences, many of which have the potential to become an accident. It is
important that all reported hazards and incidents be reviewed and a decision
taken on which ones should be investigated and how thoroughly.
Date
: August, 2011
Revision : 00
11 - 3

For in-house investigations, the investigating team may require the assistance of
specialists, depending on the nature of the occurrence being investigated, for
example:
a) Cabin safety specialists for in-flight turbulence encounters, smoke or fumes in
the cabin, galley fire, etc.;
b) Experts in air traffic services for loss of separation, near collisions, frequency
congestion, etc.;
c) Maintenance engineers for incidents involving material or system failures,
smoke or fire, etc.; and
d) Experts able to provide airport management advice for incidents involving
foreign object damage (FOD), snow and ice control, airfield maintenance,
vehicle operations, etc.
11.3. INCIDENT MANAGEMENT
All company personnel may report to the CASO any unsafe either through
personal or direct telephone communication. The following elements shall from
the basis of incident management:
1) Decision - the CASO shall foster and promote situation awareness in all areas
of the company;
2) Reporting - a fast, user-friendly system of reporting any unsafe conditions
under which anonymity will be ensured if requested. The incident may be
reported directly by telephone to CASO;
3) Investigation - the CASO will ensure prompt, discreet, documented analyzed
investigation;
4) Action - the CASO has a mandated priority of alerting Flight Operations
Management of all unsafe condition affecting flight operations;
5) Feedback - the CASO shall ensure that the originator and other persons with
the need to know are kept informed. The feedback shall also be provided by
TALK BACK reports, which be released and distributed by CASO from time
to time.
Date
: August, 2011
Revision : 00
11 - 4

11.4. SCOPE OF SAFETY INVESTIGATIONS
How far should an investigation look into minor incidents and hazard reports?
The extent of the investigation should depend on the actual or potential
consequences of the occurrence or hazard. Hazard or incident reports that
indicate high-risk potential should be investigated in greater depth than those
with low-risk potential.
The depth of the investigation should be that which is required to clearly identify
and validate the underlying hazards. Understanding why something happened
requires a broad appreciation of the context for the occurrence. To develop this
understanding of the unsafe conditions, the investigator should take a systems
approach, Resources are normally limited, thus the effort expended should be
proportional to the perceived benefit in terms of potential for identifying systemic
hazards and risks to the organization.
Although the investigation should focus on the factors that are most likely to have
influenced actions, the dividing line between relevance and irrelevance is often
blurred. Data that initially may seem to be unrelated to the investigation could
later prove to be relevant once relationships between different elements of the
occurrence are better understood.
11.5. INFORMATION SOURCES FOR INVESTIGATION

Information relevant to a safety investigation can be acquired from a variety of
sources, including:
1. Physical examination of the equipment used during the safety event. This
may include examining the front-line equipment used, its components, and
the workstations and equipment used by supporting personnel (e.g. ATC,
maintenance and servicing personnel).
2. Documentation spanning a broad spectrum of the operation, for example:
a) Maintenance records and logs;
b) Personal records/logbooks;
c) Certificates and licenses;
d) In-house personnel and training records and work schedules;
Date
: August, 2011
Revision : 00
11 - 5

e) Operators manuals and SOPs;
f) Training manuals and syllabi;
g) Manufacturers data and manuals;
h) Regulatory authority records;
i) Weather forecasts, records and briefing material; and
j) Flight planning documents.
3. Recordings (flight recorders, ATC radar and voice tapes, etc.). These may
provide useful information for determining the sequence of events. In addition
to traditional flight data recordings, maintenance recorders in new generation
aircraft are a potential additional source of information.
4. Interviews conducted with individuals directly or indirectly involved in the
safety event. These can provide a principal source of information for any
investigation. In the absence of measurable data, interviews may be the only
source of information.
5. Direct observation of actions performed by operating or maintenance
personnel in their work environment. This can reveal information about
potential unsafe conditions. However, the persons being observed must be
aware of the purpose of the observations.
6. Simulations. These permit reconstruction of an occurrence and can facilitate a
better understanding of the sequence of events that led up to the occurrence,
and the manner in which personnel responded to the event. Computer
simulations can be used to reconstruct events using data from on-board
recorders, ATC tapes, radar recordings and other physical evidence.
7. Specialist advice. Investigators cannot be experts in every field related to the
operational environment. It is important that they realize their limitations.
When necessary, they must be willing to consult with other professionals
during an investigation.
8. Safety databases. Useful supporting information may come from
accident/incident databases, in-house hazard and incident reporting systems,
confidential reporting programs, systems for monitoring line operations (e.g.
flight data analysis, LOSA and NOSS programs), manufacturers databases,
etc.
Date
: August, 2011
Revision : 00
11 - 6

11.6. INTERVIEWS
Information acquired through interviews can help clarify the context for unsafe
acts and conditions. It can be used to confirm, clarify or supplement information
learned from other sources. Interviews can help to determine what happened.
More importantly, interviews are often the only way to answer the important why
questions which, in turn, can facilitate appropriate and effective safety
recommendations.
In preparation for an interview, the interviewer must expect that individuals will
perceive and recall things differently. The details of a system defect reported by
operational personnel may differ from those observed by maintenance personnel
during a service check. Supervisors and management may perceive issues
differently than line personnel. The interviewer must accept all views as worthy of
further exploration. However, even qualified, experienced and well-intentioned
witnesses could be mistaken in their recollection of events. In fact, it may be
grounds to suspect the validity of the information being received if during
interviews of a number of people concerning the same event, the interviewees
are not presenting different perspectives.
The effective interviewer adapts to these differing views, remaining objective and
avoiding making an early evaluation of the content of the interview. An interview
is a dynamic situation, and the skilled interviewer knows when to continue a line
of questioning and when to back off.
To achieve the best results, interviewers will likely employ a process as follows:
a) Carefully preparing and planning for the interview;
b) Conducting the interview in accordance with a logical, well-planned structure;
c) Assessing the information gathered in the context of all other known
information.
The skilled interviewer does not overly rely on a single witness even the
testimony of an expert. Rather, information from as many sources as practical
needs to be integrated to form an accurate perception of the situation.
Date
: August, 2011
Revision : 00
11 - 7

11.7. INVESTIGATION METHODOLOGY
The field phase of an investigation is used to identify and validate perceived
safety hazards. Competent safety analysis is required to assess the risks, and
effective communications are required to control the risks. In other words,
effective safety management requires an integrated approach to safety
investigations.
Some occurrences and hazards originate from material failures or occur in
unique environmental conditions. However, the majority of unsafe conditions are
generated through human errors. When considering human error, an
understanding of the conditions that may have affected human performance or
decision-making is required. These unsafe conditions may be indicative of
systemic hazards that put the entire aviation system at risk. Consistent with the
systems approach to safety, an integrated approach to safety investigations
considers all aspects that may have contributed to unsafe behavior or created
unsafe conditions.
Effective investigations do not follow a simple step-by-step process that starts at
the beginning and proceeds directly through each phase to completion. Rather,
they follow an iterative process that may require going back and repeating steps
as new data are acquired and/or as conclusions are reached.
11.8. SAFETY RECOMMENDATIONS
When an investigation identifies hazards or unmitigated risks, safety action is
required. The need for action must be communicated by means of safety
recommendations to those with the authority to expend the necessary resources.
Failure to make appropriate safety recommendations may leave the risk
unattended. For those formulating safety recommendations, the following
considerations may apply:
a) Action agency. Who can best take the necessary corrective action? Who has
the necessary authority and resources to intervene? Ideally, problems should
be addressed at the lowest possible level of authority, such as the
departmental or company level as opposed to the national or regulatory level.
However, if several organizations are exposed to the same unsafe
conditions, extending the recommended action may be warranted. State and
Date
: August, 2011
Revision : 00
11 - 8

international authorities or multinational manufacturers may best be able to
initiate the necessary safety action.
b) What versus how. Safety recommendations should clearly articulate what
should be done, not how to do it. The focus is on communicating the nature of
the risks requiring control measures. Detailed safety recommendations which
spell out exactly how the problem should be fixed, should be avoided. The
responsible manager should be in a better position to judge the specifics of
the most appropriate action for the current operating conditions. The
effectiveness of any recommendation will be measured in terms of the extent
to which the risks have been reduced, rather than strict adherence to the
wording in the recommendation.
c) General versus specific wording. Since the purpose of the safety
recommendation is to convince others of an unsafe condition putting some or
all of the system at risk, specific language should be used in summarizing the
scope and consequences of the identified risks. On the other hand, since the
recommendation should specify what is to be done (not how to do it), concise
wording is preferable.
d) Recipients perspective. In recommending safety action, the following
considerations pertain to the recipients perspective:
1) The safety recommendation is addressed to the most appropriate action
authority (i.e. the one having the jurisdiction and authority to effect the
necessary change).
2) There are no surprises (i.e. there has been prior dialogue concerning the
nature of the assessed risks).
3) It articulates what should be done, while leaving the action authority with
the latitude to determine how best to meet that objective.
Formal safety recommendations warrant written communications. This ensures
that the recommendations are not misunderstood and provides the necessary
baseline for evaluating the effectiveness of implementation.
Date
: August, 2011
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11 - 9

11.9. INTERVIEWING TECHNIQUES

Additional guidance for conducting effective interviews is listed below:
a) The interviewers role is to obtain information from the interviewee that is as
accurate, complete and detailed as possible.
b) Interviews, particularly those involving human performance factors, must go
beyond the what and when of the occurrence; they must also attempt to
find out how and why it occurred.
c) The success of the interview will closely relate to personal preparation. Tailor
the preparations to the interview.
d) In the follow-up to an incident or safety event, interviews should be conducted
as soon as practicable. If an immediate interview is impracticable, request a
written statement to ensure information is recorded while fresh in the
interviewees mind.
e) The success of the interview will depend on the timing and the structure of the
questions. Begin the interview with a free-recall question, letting the
individual talk about what he or she knows of the occurrence or subject
matter. As the interview progresses, use a mixture of other types of
questions, for example:
1. Open-ended or trailing-off questions. This type of question evokes rapid
and accurate descriptions of the events, and leads to more participation by
the interviewee (for example, You said earlier that your training was ?).
2. Specific questions. This type of question is necessary to obtain detailed
information and may also prompt the person to recollect further details.
3. Closed questions. This type of question produces yes or no answers
(providing little insight beyond the response).
4. Indirect questions. This type of question might be useful in delicate
situations (for example, You mentioned that the first officer was uneasy
about flying that approach. Why?).
f) When asking a question, avoid leading questions, i.e. any question that
contains the answer. Instead, use neutral sentences.
g) Do not accept any information gained in an interview at face value. Use it to
confirm, clarify or supplement information from other sources.
Date
: August, 2011
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11 - 10

h) In some circumstances, there may be many witnesses to be interviewed. The
resultant (often conflicting) information must be summarized, sorted and
compiled in a useful format.
i) Good interviews require good listening skills.
j) Each interview should be documented for future reference. Records may
consist of transcripts, interview summaries, notes and/or tape recordings.
Date
: August, 2011
Revision : 00
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Chapter 12. STAFF TRAINING
TABLE OF CONTENT
Chapter SUBJECT
PAGE
12.
STAFF TRAINING
12 2
12.1.
GENERAL
12 3
12.2.
SMS AWARENESS TRAINING
12 4
12.3.
AUDIT AND INVESTIGATION TRAINING
12 4
12.4.
HIRA TRAINING
12 5
12.5.
PT. MAN TRAINING
12 5
12.6.
INITIAL SAFETY TRAINING FOR ALL STAFF
12 6
12.7.
SAFETY TRAINING FOR MANAGEMENT
12 7
12.8.
SAFETY TRAINING FOR OPERATIONAL

PERSONNEL
12 7
12.9.
TRAINING FOR CASO
12 7
Date
12.10. TRAINING EVALUATION
12 8
12.11. CERTIFICATE OF TRAINING
12 8
12.12. REQUIREMENTS OF SAFETY OFFICER
12 9
: March 8, 2015
Revision : 02
12 - 1

CHAPTER 12
STAFF TRAINING
Date
: August, 2011
Revision : 00
12 - 2

12.1.
GENERAL
The organizations safety culture is linked to the success of its safety management
training program. All personnel must understand the organizations safety
philosophy, policies, procedures and practices, and they must understand their roles
and responsibilities within that safety management framework. Safety training should
begin with the initial indoctrination of employees and continue throughout their
employment. Specific safety management training should be provided for staffs who
occupy positions with particular safety responsibilities. The training programmed
should ensure that the safety policy and principles of the organization are
understood and adhered to by all staff, and that all staffs are aware of the safety
responsibilities of their positions.
Induction training should be conducted by CASO and customized to suit staff
members' areas of specialty. It should include information about the Safety
Management System, CASO, Safety group or committee and the responsibilities of
all employees to participate in the Safety Management System. Records of
participation should be maintained.
When we introduce new technology or equipment, or make changes to our
operations, training should be provided. There are also regulatory requirements for
specific training and checks, and ongoing technical training for PT. MATTHEW AIR
NUSANTARA employees.
As described above, it is important that all employees be familiar with the Safety
Management System. All employees will be given an initial awareness-training
course that will cover the following subjects.
Description of the Safety Management System,
Commitment of senior management,
Roles and responsibilities of staff and management,
Description, role and responsibility of the CASO / Safety Officer. Roles,
responsibility, and lines of communication within the company as it relates to the
Safety Management System.
The occurrence reporting and notification system,
The audit role within a Safety Management System,
The safety culture and a just reporting system,
Investigation of occurrences and safety related incidents,
The risk management process.
Date
: August, 2011
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12 - 3

In addition to the initial training, all employees will be required to attend an annual
recurrent Safety Management System training course in the above subjects.
All Safety Management System awareness training will be documented and updated
for each employee and these records will be maintained for three years.
12.2.
SAFETY MANAGEMENT SYSTEM AWARENESS TRAINING
Every new employee within PT. MATTHEW AIR NUSANTARA will be given Safety
Management System awareness training as part of their indoctrination. This
indoctrination will include all items required under Paragraph above as well as a
review of the Safety Management Manual, a review of the company Air Safety
Incident report (ASIR) and Safety Hazard Observation reporting forms and a review
of all management personnel including the name and introduction of the Safety
Manager / Officer.
All Safety Management System indoctrination training will be documented and kept
for a minimum of three years.
12.3.
AUDIT AND INVESTIGATION TRAINING
It is vitally important that

abreast of current trends
Each person within the
undertake a course of
commencing assignments
Date
our employees receive the best training possible to stay

and procedures in the areas of auditing and investigation.
organization tasked with auditing or investigations will
specific training in auditing and investigations prior to
in these areas. The training must include:
Planning an audit,
evaluate the audit,
Conducting audits / investigations in a way that is non punitive, and identifies

successes as well as deficiencies,
Preparing an audit / investigation report and present the report to the responsible
manager who has the authority to act on the findings, causes and associated
agreed actions.
: August, 2011
Revision : 00
preparing
an
audit
checklist,
conduct,
report, and
12 - 4

12.4.
HIRA TRAINING
Department heads directly related to maintaining the AOC or Safety Management
System shall undergo HIRA management training. The training will focus on:
12.5.
How to determine the "Safety Hazard" and "Safety Risk",
Develop and utilize effective

prioritize, and manage hazards,
Learn
to
develop an effective change
incorporates tools for HIRA. (Refer Chapter 9)
risk
management
tools. Learn to identify,
management
strategy
that
PT. MATTHEW AIR NUSANTARA TRAINING
PT. MATTHEW AIR NUSANTARA Safety Management System training will include:
a) Initial training; and
b) Recurrent training.
Employees shall receive training commensurate with their:
a) Level of responsibility; and
b) Impact on the safety of the organizations product or service.
To ensure training currency, periodically:
a) Reviewed; and
b) updated.
Safety Lessons Learned
a) PT. MATTHEW AIR NUSANTARA develops safety lessons learned.
b) Lessons learned information used to promote continuous improvement of safety.
c) The organizations PT. MATTHEW AIR NUSANTARA communicate information
on safety lessons learned.
Date
: August, 2011
Revision : 00
12 - 5

12.6.
INITIAL SAFETY TRAINING FOR ALL STAFF

Existing employees and new staff must be trained in the operation of the Safety
Management System, and encouraged to adopt the safety practices of our
organization. Customizing training allows PT. MATTHEW AIR NUSANTARA to
impress our operational practices of safe behavior, risk management decisionmaking and quality control processes on all staff.
One of the functions of safety management training is to create awareness of the
objectives of the SMS of the organization and the importance of developing a safety
culture. All staff should receive a basic introductory course covering:
a.
Basic principles of safety management;
b.
Corporate safety philosophy, safety policies and safety standards (including

corporate approach to disciplinary action versus safety issues, integrated nature
of safety management, risk management decision-making, safety culture, etc.);
c.
Importance of complying with the safety policy and with the procedures that form
part of the SMS;
d.
Organization, roles and responsibilities of staff in relation to safety;
e.
Corporate safety record, including areas of systemic weakness;
f.
Corporate safety goals and objectives;
g.
Corporate safety management programs (e.g. incident reporting systems, LOSA

and NOSS);
h.
Requirement for ongoing internal assessment of organizational

performance (e.g. employee surveys, safety audits and assessments);
i.
Reporting accidents, incidents and perceived hazards;
j.
Lines of communication for safety matters;
k.
Feedback and
information;
l.
Safety awards programmers (if applicable);
communication
methods
for
safety
the dissemination of safety
m. Safety audits; and

n. Safety promotion and information dissemination.
Date
: August, 2011
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12 - 6

12.7.
SAFETY TRAINING FOR MANAGEMENT

It is essential that the management team understand the principles on which the
SMS is based. Training should ensure that managers and supervisors are familiar
with the principles of the SMS and their responsibilities and accountabilities for
safety. It may also be of value to provide managers with training that addresses the
legal issues involved, for example, their legal liabilities.
12.8.
SAFETY TRAINING FOR OPERATIONAL PERSONNEL

In addition to the corporate indoctrination outlined above, personnel engaged directly
in flight operations (flight crew, Engineer, Ground Handling, etc.) will require more
specific safety training with respect to:
12.9.
a.
Procedures for reporting accidents and incidents;
b.
Unique hazards facing operational personnel;
c.
Procedures for hazard reporting;
d.
Specific safety initiatives
e.
Safety committee(s);
f.
Seasonal safety hazards and procedures (winter operations, etc.); and
g.
Emergency procedures.
TRAINING FOR CASO

The person selected as the CASO needs to be familiar with most aspects of the
organization, its activities and personnel. These requirements may be met in-house
or from external courses, however, much of the CASOs knowledge will be acquired
by self-education.
Areas where CASO may require formal training include:
a.
Familiarization with different fleets, types of operations, routes, etc.;
b.
Understanding the role of human performance in accident causation and

prevention;
c.
Operation of SMS;
d. Accident and incident investigation;

e. Crisis management and emergency response planning;
Date
: August, 2011
Revision : 00
12 - 7

f.
Safety promotion;
g. Communication skills;
h. Computer skills such
management; and
as
word-processing,
spreadsheets
and
database
i.
Specialized training or familiarization (such as CRM, FDA, LOSA and NOSS).
j.
Flight safety philosophy and company culture
k. Human factors and pilot decision making

l.
Accident prevention
m. CASO duties and responsibilities and advisory role to management

n. Risk analysis and management
o. Accident and incident prevention any investigation
p. Conduct of aviation safety survey
q. Developing an Emergency Response Plan
12.10. TRAINING EVALUATION
Evaluation of the training effectiveness can include review of staff abilities,
knowledge of processes and practices used in the workplace and any specific
competencies that are required in our operation.
a) Staffs understand how the Safety Management System operates.
b) Staffs are aware of the role they play in the Safety Management System.
c) Staffs understand that the aim of the Safety Management System.
d) Improve safety - not to attribute blame.
e) All personnel attend induction and ongoing safety related training.
12.11. CERTIFICATE OF TRAINING
Each employee, that is a trained person, shall be in possession of a Certificate of
training issued to him or her. It shall be produced on the request of a CASO. The
CASO shall ensure that a copy of each certificate of training is retrained for two
years after the expiry date of the certificate.
Date
: August, 2011
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12 - 8

12.12. REQUIREMENT OF SAFETY OFFICERS
Safety Officer is PT. MATTHEW AIR NUSANTARAs ground and/or flight employee
that is trained to be a Safety Officer.
Individual skill, knowledge and experience in the area of flight and/ or technical
operations are the primary concerns for selecting Safety Officer. Other factors and
qualifications will support this requirement; such as: English language skill, previous
rank, previous safety related job experience, formal education, etc.
Aspect
Requirements
- Good working records; grade; attitude; integrity.

- Good analyzing/ evaluating skill; leadership; team-work;
General
- Comprehensive description
listening/understanding skill.
in
verbal
and
written;
- English language skill, written and spoken.

- Safety related job experience.
- Other formal education may be beneficial.
- General airline managements
- Related airline flight and/ or technical operations.
Knowledge
- Related aviation rules and regulations.

- Related aviation technology.
- Basic auditing procedures and technique.
- 5 years as flight crew, or
- 5 years as maintenance engineer or line maintenance
Experience
engineer, or
- 5 years as on security related tasks, or
- 5 years as ground handling officer (passenger, baggage,
ramp and cargo handling).
Date
: August, 2011
Revision : 00
12 - 9

Chapter 13. SMS AUDIT
TABLE OF CONTENT
Chapter SUBJECT
PAGE
13.
SMS AUDIT
13 2
13.1.
GENERAL
13 3
13.2.
SAFETY AUDIT
13 4
13.3.
PT. MAN AUDIT ACTIVITIES
13 5
13.3.1. Pre-Audit Activities
13 5
13.3.2. Physical Audit
13 6
13.3.3. Post Audit
13 7
13.3.4. Audit Follow-up and Corrective Action
13 7
THE SAFETY AUDIT TEAM
13 8
13.4.1. The Role of The Audit Team Leader
13 8
13.4.2. The Role of the Auditors
13 9
13.4.3. Audit Procedures
13 9
13.4.4. Audit Interviews
13 9
13.4.5. Corrective Action Plan
13 10
13.5.
AUDIT PROGRAM
13 10
13.6.
STEPS IN THE AUDIT PROCESS
13 12
13.7.
AUDIT FINDING
13 12
13.8.
AUDIT RESULT
13 13
13.9.
AUDIT RESULT REPORT
13 14
13.9.1. Audit Report
13 14
13.9.2. Preparing the Executive Summary
13 15
13.4.
Date
: March 8, 2015
Revision : 02
13 - 1

CHAPTER 13
SMS AUDIT
Date
: August, 2011
Revision : 00
13 - 2

13.1.
GENERAL
An audit is a methodical, planned review of our routine operational functions. Internal

safety audits should be carried out as a routine part of our safety program. Every
part of the working system is critically examined to identify strengths, weaknesses or
areas of risk. A safety audit compares stated objectives and operating procedures
with actual work practices.
All audit procedures should be well documented so that any deficiencies can be
easily identified. The audit records and results need to be accurate, complete,
reliable and readily accessible for comparison or trend analysis.
Any safety audit should include the activities of external contractors that influence
the safety of our operation (e.g. maintenance contractors, staff accepting cargo on
behalf of the operator, and aerodrome operators).
A documented activity performed to verify by examination or evaluation of objective
evidence, the adequacy of and compliance with the established quality assurance
and related safety management systems. An audit does not include surveillance or
inspection activities performed for the purpose of control or product acceptance
Safety audits are one of the principal methods for fulfilling the safety performance
monitoring functions. They are a core activity of any safety management system
(SMS). Safety audits may be performed by an external audit authority, such as the
State regulatory authority, or they may be carried out internally as part of an SMS.
This chapter focuses on the internal safety auditing programme.
Internal safety audits can be carried out by staff from within the area being looked at.
Using staff from other areas of our operation is beneficial, it may yield different
results as they are less familiar with the intricacies of the daily tasks or working
environment. Large clients companies conduct periodic audits to PT. MATTHEW
AIR NUSANTARA and the aircraft being used. The standard being used is
Indonesian DGCAs CASR.
Depending on the nature and size of the organization, audits may be carried out at
regular intervals (bi-monthly) or prior to and following any changes to the operation.
They should occur at least twice a year and should be part of the annual assessment
plan for all functional areas. The audit may involve interviews with key staff,
correlation of policies and work practices and observation of the working
environment.
Date
: August, 2011
Revision : 00
13 - 3

13.2.
SAFETY AUDITS
PT. MATTHEW AIR NUSANTARA Safety audits are used to ensure that:
a. The structure of the SMS is sound in terms of appropriate levels of staff;
compliance with approved procedures and instructions; and a satisfactory level of
competency and training to operate equipment and facilities and to maintain their
levels of performance;
b) Equipment performance is adequate for the safety levels of the service provided;
c) Effective arrangements exist for promoting safety, monitoring safety performance
and processing safety issues; and
d) Adequate arrangements exist to handle foreseeable emergencies.
PT. MATTHEW AIR NUSANTARA Safety audits go beyond just checking

compliance with regulatory requirements and conformance with the organizations
standards. The audit team should assess whether the procedures in use are
appropriate and whether there are any work practices that could have unforeseen
safety consequences. The safety audit programmed should be based on the
following principles:
a. The auditor should make all relevant documentation available to the auditors and
arrange for staff to be available for interview as required.
b. Facts should be examined in an objective manner.
c. A written audit report describing the findings and recommendations should be
presented to the unit or section within a specified period.
d. The staff of the unit or section, as well as the management, should be provided
with feedback concerning the findings of the audit.
e. Positive feedback should be provided by highlighting in the report the good points
observed during the audit.
f.
While deficiencies must be identified, negative criticism should be avoided as

much as possible.
The need to develop a plan to resolve deficiencies should be required.
Date
: August, 2011
Revision : 00
13 - 4

Following an audit, a monitoring mechanism may be implemented to verify the

effectiveness of any necessary corrective actions. Follow-up audits should
concentrate on aspects of the operations where the need for corrective action was
identified. Audits to follow up previous safety audits where corrective action was
proposed or because an undesirable trend in safety performance was identified
cannot always be scheduled in advance. The overall annual audit programmed
should make allowance for such unscheduled audits.
13.3.
PT. MATTHEW AIR NUSANTARA AUDIT ACTIVITIES

The 4 basic activities during an audit:
a. Pre-audit;
b. Physical audit;
c. Post audit;
d. Corrective Action and Audit follow-up.
Personnel involved in Audit are:

a. CASO.
b. Representative of the safety group.
c. An external safety consultant (if any)
d. Quality Section.
13.3.1
Pre-audit Activity
Among the initial steps in planning an audit will be to verify the feasibility of
the proposed schedule and to identify the information that will be needed
before commencement of the audit. It will also be necessary to specify the
criteria against which the audit will be conducted and to develop a detailed
audit plan together with checklists to be used during the audit.
The checklists consist of a comprehensive series of questions grouped
under topic headings, which are used to ensure that all relevant topics are
Date
: August, 2011
Revision : 00
13 - 5

covered. For the purposes of a safety audit, the checklists should address
the following areas in an organization:
a)
National safety regulatory requirements;
b)
Organizational safety policies and standards;
c)
Structure of safety accountabilities;
d)
Documentation, such as: safety management manual and operational

documentation (including its local instructions);
e) Safety culture (reactive or proactive);
13.3.2.
f)
Hazard identification and risk management processes;
g)
Safety oversight capabilities (monitoring, inspections, audits, etc.); and
h)
Provisions for assuring safety performance of contractors.
Physical Audit
Operational areas that may be audited include (but are not limited to):
1.
Maintenance arrangements.
2.
Physical work environment.
3.
Equipment safety.
4.
Safe systems of work.
5.
Emergency procedures.
One traps when auditing is to limit the audit to the contents of our checklist.
This can be avoided if audit documents are regularly updated and revised.
Staff doing the audit should be competent and familiar with the areas they
are auditing.
A report of the audit findings is generally written and should be given to the
President Director and key managers for action. Recommended actions
may be phased according to the degree of risk that they pose and the
relative cost of eliminating or controlling the hazards.
It is necessary to continually update our knowledge of our operations and
check to see if our operation is meeting its own safety standards. Are staffs
reporting hazards? If not, why? A safety assessment should be conducted
at least annually. CASO and the quality/inspection department (if
Date
: August, 2011
Revision : 00
13 - 6

applicable) are responsible for planning and conducting regular safety
audits/ assessments.
13.3.3.
Post Audit
Post Audit includes Audit reports, the audit report should be an objective
presentation of the results of the safety audit. As soon as possible after
completion of the audit, an interim audit report should be forwarded to the
manager of the Department / unit / section for review and comments. Any
comments received should be taken into consideration in the preparation of
the final report, which constitutes the official report of the audit.
The key principles to be observed in the development of the audit report
are:
13.3.4.
a.
Consistency of observations and recommendations in the closing

meeting, interim audit report and final audit report;
b.
Conclusions substantiated with references;
c.
Observations and recommendations stated clearly and concisely;
d.
Avoidance of generalities and vague observations;
e.
Objective presentation of the observations;
f.
Use of widely accepted aviation terminology, avoiding acronyms and

jargon; and
g.
Avoidance of criticism of individuals or positions.
Audit Follow Up and Corrective Action

Many aviation organizations have been certified under the International
Organization for Standardization (ISO) standards for products and services
(usually the ISO 9000 series of standards relating to quality management).
As part of the ISO certification process, organizations are subjected to
stringent initial and ongoing quality audits conducted by an independent
auditing organization.
Audit follow-up involves the management of change. Upon receipt of the
final audit report, management must ensure that progress is made to
reduce or eliminate the attendant risks. The primary purpose of an audit
follow-up is to verify the effective implementation of the corrective action
Date
: August, 2011
Revision : 00
13 - 7

plan. Follow-up is also required to ensure that any action taken pursuant to
the audit does not in any way degrade safety. In other words, new hazards
with potentially higher risks must not be allowed to enter the system as a
consequence of the audit.
Failure by the auditor to follow up on lapses in implementing necessary
(and agreed) safety actions will compromise the validity of the entire safety
audit process. Follow-up action may be effected through monitoring the
status of implementation of accepted corrective action plans or through
follow-up audit visits. Where a follow-up visit has been made, a further
report of this visit should be prepared. This report should clearly indicate
the current status of the implementation of the agreed corrective actions. If
any non-compliance, deficiency or safety shortcoming remains unresolved,
the audit team leader should highlight this in the follow-up report.
13.4.
a.
The Company Inspector must continue to monitor the Units short and
long term responses to the audit non conformance findings;
b.
The Company
surveillance.
must
regulate
the
Unit
maintaining
constant
THE SAFETY AUDIT TEAM

Safety audits may be undertaken by a single individual or a team, depending on the
scale of the audit. Depending on the size of the organization and the availability of
resources, experienced and trained individuals within the organization may perform
safety audits or they may assist external auditors. The staff selected to conduct an
audit should have practical experience in disciplines relevant to the area to be
audited, a good knowledge of the relevant regulatory requirements and the
organizations SMS, and they should have been trained in auditing procedures and
techniques. An audit team comprises an audit team leader and one or more auditors.
Those chosen to undertake an audit must be credible to those being audited. In
short, they must be qualified and trained for the audit function in the appropriate
areas of expertise.
13.4.1
The role of the audit team leader

An audit team leader should be appointed if more than one auditor is
involved. The audit team leader is responsible for the overall conduct of the
Date
: August, 2011
Revision : 00
13 - 8

audit. In addition, the audit team leader undertakes some of the general
tasks of an auditor. The audit team leader must be an effective
communicator and must be able to earn the trust of the organization being
audited.
13.4.2.
The role of the auditors

The tasks to be undertaken by each audit team member will be assigned
by the audit team leader. These tasks may include conducting interviews
with staff of the unit or section being audited, reviewing documentation,
observing operations and writing material for the audit report.
13.4.3.
Audit procedures
The techniques for gathering the information on which the audit teams
assessment will be made include:
a)
Review of documentation;
b)
Interviews with staff; and
c)
Observations by the audit team.
The audit team should work systematically through the items on the
relevant checklist. Observations should be noted on standardized
observation sheets.
If a particular area of concern is identified during the audit, this should be
the subject of a more thorough investigation. However, the auditor must
keep in mind the need to complete the rest of the audit as planned and
therefore must avoid spending an excessive amount of time exploring a
single issue and so risk missing other problems.
13.4.4.
Audit interviews
The principal way in which auditors obtain information is by asking
questions. This method provides additional information to that available in
written material. It also gives the staff involved an opportunity to explain the
system and work practices. Face-to-face discussions also permit the
auditors to make an assessment of the level of understanding as well as
the degree of commitment of the staff of the unit or section to safety
management. The persons to be interviewed should be drawn from a
Date
: August, 2011
Revision : 00
13 - 9

range of management, supervisory and operational positions. The purpose
of audit interviews is to elicit information, not to enter into discussions.
Audit observations
Once the audit activities are completed, the audit team should review all
audit observations and compare them against the relevant regulations and
procedures in order to confirm the correctness of observations noted as
nonconformities, deficiencies or safety shortcomings.
An assessment should be made of the seriousness with respect to all items
noted as nonconformities, deficiencies or safety shortcomings.
It should be borne in mind that the audit should not focus only on negative
findings. An important objective of the safety audit is also to highlight good
practice within the area being audited.
13.4.5.
Corrective action plan

At the completion of an audit, planned remedial actions should be
documented for all identified areas of safety concern. The management of
the unit or section has the responsibility for developing a corrective action
plan setting out the action(s) to be taken to resolve identified deficiencies
or safety shortcomings within the agreed time period.
When completed, the corrective action plan should be forwarded to the
audit team leader. The final audit report will include this corrective action
plan and detail any follow-up audit action proposed. The manager of the
area being audited is responsible for ensuring the timely implementation of
the appropriate corrective actions.
13.5.
AUDIT PROGRAM
PT. MATTHEW AIR NUSANTARA Audit Program means to ensure that a
satisfactory level of aviation safety is maintained, and that the Regulations upon
which the Companys AOC and Operations Specification were issued are being
complied with.
Date
: August, 2011
Revision : 00
13 - 10

AUDIT OUTPUTS
a. Audit Report;
b. Observations;
c. Parallel Report.
PT. MATTHEW AIR NUSANTARA AUDIT TEAM
a. Audit Manager (AM),
b. Team Member (Auditor);
d. Others ( Observers).
Audit Manager (AM) consists of:

a. The person responsible for authorizing and overseeing an internal audit;
b. Usually CASO
Team Members (Auditor) consist of;
a. Supports, briefs and assists the Audit Manager
b. Coordinates the activities of the audit team members assigned to his area of
responsibility;
c. Conducts the audit field work;
d. Documents findings;
e. Briefs Team Leader of all findings;
f.
Follows company procedures for immediate threats to safety;
Observers consist of:

a. Accompany the audit team during the audit;
b. Do not participate in the physical inspection unless specifically directed to do so;
c. Not necessarily on every audit.
Auditor must:
a. Respected by company personnel;
b. Sound knowledge of Regulations;
Date
: August, 2011
Revision : 00
13 - 11

c. Good listening skills and Good analytic abilities;
d. Confident in own abilities;
e. Zero tolerance for unsafe operations.
13.6.
STEPS IN THE AUDIT PROCESS
Audit Manager (AM):

a. Sets the Audit Schedule;
b. Delegates his Authority;
d. Schedules the release of the Audit Member.
e. Selects the team;
f.
Communicates internally and externally
g. Prepares the audit plan;

h. Establishes contact with the Auditee;
i.
Sets the audit date(s);
j.
Initiates the Audit Plan;
k. Reviews outputs from the audit;

l.
Formulates the Audit Report and Parallel Findings;
m. Presents report(s) to the Convening Authority;

n. Ensures that the Audit Report is forwarded to the Auditee;
o. Schedules the release of the audit team;
j.
13.7.
Monitors the follow up activity.
AUDIT FINDINGS
AUDIT FINDING means the determination of non-conformance of a product,

process, practice or procedure or a characteristic thereof to a regulation or standard.
Date
: August, 2011
Revision : 00
13 - 12

Steps in Conducting A Physical Inspection

a. Review standards;
b. Obtain checklists;
c. Review and test.
The audit findings may fall into three categories:
a) Serious discrepancies of non-compliance warranting action to suspend a licence,
certificate or approval;
b) Any discrepancy or non-compliance that must be rectified within an agreed time
limit; and
c) Observations on issues that are likely to impact on safety or become a regulatory
issue before the next audit.
13.8.
AUDIT RESULT
The audit result needs to be reported to the appropriate authority in order to be

responded correctly and timely.
Team auditor coordinated by Audit Manager, he is responsible for:
1. Preparing, submitting audit reports to President Director.
2. Preparing, submitting preliminary audit finding, observation to auditee during
closing meeting.
For executive summary, the Audit Manager and other members shall be responsible
to assist in preparing the reports.
The relevant audit results that may be of important safety information & education to
the other relevant area need to be disseminated to share safety awareness amongst
personnel of the organization.
Date
: August, 2011
Revision : 00
13 - 13

13.9.
AUDIT RESULT REPORT
13.9.1.
Audit Report
Audit Manager and Auditor shall:
1. Review, evaluation and verification of audit execution result:
a) Define audit finding:
1) Sort-out results that are positively non-compliance/ nonconformance with the established standards and that corrective
action is (are) required.
2) Group the findings based on the aspect of audit scope (ex:
organization; manual management; qualification; etc).
3) Classify whether it is a major finding (non-compliance) or a minor
4) Finding (not fully conformance).
b) Define observations (recommendation):
1) Sort-out result that are clearly not non-compliance but may in the
future be of potential hazards to the operations if not being
corrected.
2) Group the observations based on the aspect of audit scope (ex:
organization; manual management; qualification; etc).
c) Define Parallel findings:
1) Similar to the observations, but having a root-cause that may
embarrass higher level of management (ex: authority, board of
Management, etc).
2) Not to be delivered to the auditee being audited.
d) Analyze and determine area of deficient that may be of potential
hazards to the company operations so that operation risk could also
be determined whether or not it is acceptable.
e) Provide commendation
recommendations.
for
area
that
are
outstanding
and
2. Prepare reports for audit execution closing meeting:

Provide report and recommendation on closing meeting
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: August, 2011
Revision : 00
13 - 14

3. At home base and maximum 15 days after completing the audit process
(audit closing date):
a) Prepare the audit finding, observation, parallel report form,
b) Prepare the Audit Final Report as general conclusion of that
particular station/ area/ department to present the big picture of its
safety performance,
13.9.2.
Preparing an Executive Summary

Audit Manager shall:
Evaluate all station/ area/ department audit final reports including
verification on the finding, observation and parallel reports when necessary.
Summarize a report that able to present:
a. The area of deficient,
b. The area of potential hazards & risk to the entire operations including,
c. Safety tendency, and
d. Recommendation of necessary corrective action so as to be able brings
the condition to an acceptable risk.
Date
: August, 2011
Revision : 00
13 - 15

Chapter 14. DATA AND RECORD MANAGEMENT
TABLE OF CONTENT
Chapter SUBJECT
PAGE
14.
DATA AND RECORD MANAGEMENT
14 2
14.1.
GENERAL
14 3
14.2.
PT. MATTHEW AIR NUSANTARA RECORD SYSTEM
14 4
14.3.
SMS DATA
14 5
Date
: March 8, 2015
Revision : 02
14 - 1

CHAPTER 14
DATA AND RECORD MANAGEMENT
Date
: August, 2011
Revision : 00
14 - 2

14.1.
GENERAL
PT. MATTHEW AIR NUSANTARA Aviation Safety Reporting System (ASRS) data
are used to:
a) Identify systemic hazards in the national aviation system for remedial action by
appropriate authorities;
b) Support policy formulation and planning in the national aviation system;
c) Support research and studies in aviation, including Human Factors safety
research; and
d) Provide information to promote accident prevention.
The PT. MATTHEW AIR NUSANTARA organization establishes and maintains
information to describe:
1) Safety policies;
2) Safety objectives;
3) SMS requirements;
4) safety-related procedures and processes;
5) Responsibilities and authorities for safety-related procedures and processes;
6) Interaction/interfaces between safety-related procedures and processes; and
7) SMS outputs.
PT. MATTHEW AIR NUSANTARA record Documentation shall be:
a) Legible;
b) Dated (with dates of revisions);
c) Readily identifiable;
d) Maintained in an orderly manner; and
e) Retained for a specified period as determined by the organization
The organization shall establish and maintain procedures
documents required by this Standard to ensure that:
for
controlling all
a) They can be located;

b) They are periodically: reviewed, revised as necessary, and approved for
adequacy by authorized personnel;
Date
: August, 2011
Revision : 00
14 - 3

c) The current versions of relevant documents are available at all locations where
operations essential to the effective functioning of the SMS are performed; and
d) Obsolete documents are promptly removed from all points of use or otherwise
assured against unintended use.
14.2.
PT. MATTHEW AIR NUSANTARA RECORD SYSTEM

PT. MATTHEW AIR NUSANTARA has the record system that ensures the
generation and retention of all records necessary to document and support the SMS
that are:
1.
Identifying what is relevant.
2. Collecting current and applicable information.

3. A procedure for receiving and auctioning reports.
4. A reliable method of accurately recording, storing, retrieving and maintaining
safety reports.
5. A procedure for distributing relevant or appropriate information to staff (and
possibly contractors).
6. Able to be audited.
Records Management
For SMS records, the organization shall establish and maintain procedures for their:
a) Identification;
b) Maintenance; and
c) Disposition.
SMS records management shall be:
a) Legible;
b) Identifiable; and
c) Traceable to the activity involved.
SMS records shall be maintained in such a way that they are:
a) Readily retrievable; and
b) Protected against: damage, deterioration, or loss.
Date
: August, 2011
Revision : 00
14 - 4

14.3.
SMS DATA
Safety Management System has to be initiated and utilized to collect and analyze
safety data. PT. MATTHEW AIR NUSANTARA SMS data includes:
a) Safety Policy and Safety Objectives and evaluation of progress towards these
objectives,
b) Develop Safety Goals and Safety Performance Indicators (SPIs),
c) Collection of data relating to accident and incidents including internal/external
investigations, findings, casual factors and corrective actions,
d) Safety concerns raised by staff including analysis and resultant actions,
e) Results of safety reviews and audits and when appropriate, any corrective
actions,
f)
Records of any safety initiatives or interventions,
g) Safety Performance Monitoring Charts

h) SMS Audit Reports
i)
SMS Training Records
j)
Risk Assessment Reports
k) List of hazard and risk
Date
: August, 2011
Revision : 00
14 - 5

TABLE OF CONTENT
Chapter SUBJECT
PAGE
4.
43
Date
SAFETY POLICY
: March 8, 2015
Revision : 02
4-1

CHAPTER 4
SAFETY POLICY
Date
: August, 2011
Revision : 00
10 - 2

Date
: July 24, 2013
Revision : 01
4-3

JAKARTA
: APL Tower-Central Park 28th Floor, Podomoro City. JL. Letjen S. Parman - Jakarta 11470
Telp: (021) 2929 8888, Fax: (021) 2929 8878

PEKANBARU : Surya Dumai Group Building, 5th Floor, JL. Jend. Sudirman No. 395,
Pekanbaru 28116, Telp: (0761) 32888, Fax: (0761) 32700

Chapter 16 EMERGENCY RESPONSE PLAN
CHAPTER 16
EMERGENCY RESPONSE PLAN
Revision No.
: 00
Date of Issued
: August 2011
Page 16 - 0

JAKARTA
Telp: (021) 2929 8888, Fax: (021) 2929 8878


16.1.
GENERAL
The purpose of this Emergency Response Plan (ERP) is to provide official guide
regarding the proper procedure and practice to be followed in conducting
emergency situation under Air Operator Certificate issued by Directorate General
Civil Aviation in Compliance with Civil Aviation Safety Regulation CASR Part 135.
It will be their responsibility of Managing Director, Safety Manager (CASO) and
Operation Manager to assure Flight Operation Officers, all chiefs, and Board of
Member are formally trained, keep current and familiar with the content of this
manual.
All work performed at this air operation certification including outlying station will
perform in accordance with the policies.
16.2. ORGANIZATION of EMERGENCY

This manual is responsibled by Operational Control Center and Safety Manager as
Coordinator of Crisis Center.
a. ERP is to be used by the company as a basic guidelines required for the
handling of every crisis situation such as Incident, Accident, Hijack, Bom
Threat, Sabotage and others that might endanger the safety, security of flights
or activities.
b. Some of incident does not required to active all members in this case. The
members activated is let under Safety Manager discretions.
c. ERP cannot possibly cover all contingencies so that development of initiative by
all the work unit involved is still needed depend on and conditions.
Organization structure of emergency crisis center team will be explain in the
Appendix 1.
16.3. TYPE of EMERGENCY
In this manual, emergencies are classified as limited and major, to reflect the level
or risk or harm and type of response required.
1.
Objective
The objectives of the policies and procedures in this manual are provided to:
Ensure the company has sound response plans that can be rapidly
implemented;
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: 00
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: August 2011
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JAKARTA
Telp: (021) 2929 8888, Fax: (021) 2929 8878


Ensure the preservation of life, property and environment remains apriority
at all time;
Advise those involved in implementing the Companys response plan of:
o The roles and tasks that they may be required to undertake;
o The role that emergency services authorities (for example, Police, Fire,
Ambulance) may play in an emergency; and
o The actions local airport authorities may request from the Company in
the event that their aerodrome emergency plan is activated;
Ensure actions taken to respond to an emergency are documented;
Ensure investigations are initiated in a timely and effective manner following
the emergency period;
Aid compliance with safety and reporting legislation; and
Identify resource and training requirements.
2.
Key Emergency Response Steps

Although emergencies may differ in type and severity, there are key steps that
must be followed:
Assess the emergency, including threats;
If an emergency is declared, select and implement the appropriate response
and:
o Manage human and physical resources;
o Support emergency services and other authorities; and
o Control the integrity of communication and the access to information by
the public and/or media;
Provide post-emergency support (for example, travel, accommodation,

welfare) to those affected;
Initiate investigations or inquiries following an emergency; and
Resume essential services and normal operations following an emergency.
Revision No.
: 00
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: August 2011
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JAKARTA
Telp: (021) 2929 8888, Fax: (021) 2929 8878


16.4. EMERGENCY CONTACT

In an emergency, quick and efficient communication is the key to a successful
response. The following list of emergency contact contains telephone mobile
number persons and parties who are most likely to be involved.
Emergency Contact List at Base Operation Kubang, Pekanbaru
EMERGENCY SERVICES
MATTHEW AIR MANAGEMENTS
Head Quarter of The Indonesian Armed Force

(+62) 21-3810678
National Transport Safety Committee
(+62) 21-3811308
(+62) 21-3517606
National
Search
(BASARNAS)
+(62) 21-5502111
(+62) 761-674821
and
Rescue
Directorate General Civil Aviation (DGCA)

(+62) 21-3506664
(+62) 21-350665
Fire Fighting / Pemadam Kebakaran
(+62) 761-113
Ambulance
(+62) 761-118
PLN
(+62) 761-123
RSUD
(+62) 761-36118
POLDA Riau
(+62) 761-24424
POLTABES Pekanbaru
(+62) 761-21110
POLSEK Pekanbaru Kota
(+62) 761-21807
Polisi Piket
0761-110
Revision No.
: 00
Date of Issued
: August 2011
Agency
Managing Director
(+62) 21-2929 8888 ext 80200
(+62) 812 1311 1952
CASO/Safety Manager
(+62) 21-2929 8888 ext 80204
(+62) 813 7887 8788
Operation Manager
(+62) 21-2929 8888 ext 80207
(+62) 812 8311 1541
Technical Manager
(+62) 21-2929 8888 ext 80205
(+62) 815 6027 074
Chief Pilot
(+62) 21-2929 8888 ext. 80203
(+62) 813 1619 1991
Chief Inspector
(+62) 21-2929 8888
(+62) 853 5504 4429
Flops Pekanbaru
(+62) 761-7073007
Head Office
(+62) 21-2929 8888
Fax : (+62) 21-2929 8878
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Emergency Contact List at Balikpapan Station, East Kalimantan

EMERGENCY SERVICES
MATTHEW AIR MANAGEMENTS
Head Quarter of The Indonesian Armed Force

(+62) 21-3810678
National Transport Safety Committee
(+62) 21-3811308
(+62) 21-3517606
National
Search
(BASARNAS)
+(62) 21-5502111
(+62) 761-674821
and
Rescue
Agency
Directorate General Civil Aviation (DGCA)

(+62) 21-3506664
(+62) 21-350665
POLDA Kaltim
Telp : +62 542 422386
POLRES Balikpapan
Telp : +62 542 730787
POLSEK Bandara Sepinggan

Telp : +62 542 422376
+62 542 414110
Angkasa Pura I Bandara Sepinggan

Telp : +62 542 766886
Fax : +62 542 766832
Rumah Sakit Pertamina Balikpapan

Telp : +62 542 734020
+62 542 7036982
+62 542 7054888
Managing Director
(+62) 21-2929 8888 ext 80200
(+62) 812 1311 1952
CASO/Safety Manager
(+62) 21-2929 8888 ext 80204
(+62) 813 7887 8788
Operation Manager
(+62) 21-2929 8888 ext 80207
(+62) 812 8311 1541
Technical Manager
(+62) 21-2929 8888 ext 80205
(+62) 815 6027 074
Chief Pilot
(+62) 21-2929 8888 ext. 80203
(+62) 813 1619 1991
Chief Inspector
(+62) 21-2929 8888
(+62) 853 5504 4429
Flops Pekanbaru
(+62) 761-7073007
Head Office
(+62) 21-2929 8888
Fax : (+62) 21-2929 8878
RSUD Dr. Kanujoso Djatiwibowo Balikpapan

Telp : +62 542 873901
+62 542 874155
+62 542 874350
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16.5.
HANDLING AN EMERGENCY
The company Emergency Response Plans are found under separate cover
however they form part of COM. Emergency Response Plans have been
developed, published and distributed in a manual, for all operations where PT.
MATTHEW AIR NUSANTARA will be solely responsible for completing all tasks
identified. The task identified in both manuals is identical with the only difference
being the agency responsible for completing the task.
In brief, these manuals include the following elements:
a. Company policy,
b. Mobilization and agencies notifications,
c. Casualty and next kin notification and coordination,
d. Accident investigation on behalf of the company,
e. Company terms of response to the accident site,
f.
Preservation of evidence,
g. Media relation,
h. Claim and insurance procedure,
i.
Aircraft wreckage removal, and
j.
Emergency response training.
16.5.1
HANDLING OF LIMITED EMERGENCY
A limited emergency is generally confined to one location. By definition, a limited

emergency can be adequately controlled with available, local resources and under
the direction of the airport/ agency/ facility manager. If responded to correctly, a
limited emergency is unlikely to harm Company operations or reputation. If a limited
emergency cannot be controlled, it may escalate to a major emergency and
response procedures will be adjusted accordingly.
1.
Type of Limited Emergencies

Some types of Limeted Emergency that may be encountered are :
Minor fire
Hazardous material spill or toxic emission
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Motor vehicle/ GSE accident
Security breach
Failure of critical equipment
Power failure
Loss of information technology facilities
First aid or medical occurrence.
2.
Key Limited Emergency Response Steps

Limited emergencies may differ in severity and response procedures must be
appropriate to the situation. However, there are key steps that should be
followed, regardless of the limited emergency type. These are listed below:
1. Sound the alarm Notify anyone in the near vicinity by shouting. This
by shouting
will draw their attention to the danger and they may
also help you with the following steps.
2. Notify your Chief/
Manager
Notify your chief/ manager as early as practicable.
3. Evacuate
Follow the Evacuation Procedures in this section.
if necessary
4. Contact the
Safety Manager
3.
Advise the Safety Manager of the emergency

location and details so that s/he can assess if
further action is required.
Telephone : (+62) 21-2929 8888 ext. 80204
Mobile
: (+62) 813 7887 8788
Minor Fire Response

Fires have the potential to escalate rapidly. For example, it can take as little as
five minutes in an office environment from initial ignition to being overcome.
The procedure for responding to a minor fire is listed below.
1. Shout
FIRE
FIRE Advise others nearby of the danger by shouting.
2. Get fire fighting Attempt to get to the nearest fire fighting equipment.
equipment
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3. Select
extinguisher
Select a suitable extinguisher (where available) as

listed on the extinguisher guide on the following
page.
4. If safe to do so, Return to fight the fire if safe to do so. The

fight the fire
extinguisher will last between 30 seconds to 1
minute, so a fire must be small and manageable to
attempt to fight it. To fight the fire, use the acronym
PASS:
5. Evacuate if
necessary
Pull the pin out of the extinguisher, the pin

locks the handle, and prevents accidental
release;
Aim the retardant at the base of the fire;
Squeeze the handle with a gentle motion. The

handle needs to be pressed for a test spray
before you approach the fire;
Sweep the nozzle backwards and forwards

across the base of the flame, this increases the
spread of retardant.
Follow the Evacuation Procedures in this manual,

remembering to remain calm, use stairs, assist
others
IF THE FIRE CANNOT BE EXTINGUISHED

6. Contact
Emergency
Services
Contact emergency services

Fire Fighting: 113 (Pekanbaru Base)
Other telephone numbers are listed
Emergency Contact
(see Subpart 16.4.Emergency Contact)
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on
the
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7. Evacuate
4.
Follow the Evacuation Procedure in this manual,

remembering to remain calm, use stairs, assist
others and follow warden directions
Hazardous Material Spill Response

A hazardous material is any substance that has the potential to cause
injury/illness on contact, and have lasting effects on the body. The response to
controlling a hazardous material spill depends on the type of substance, and a
response for handling one substance may not be appropriate for handling
another.
A). Important Sources of Information
Employees who are likely to handle hazardous materials are to consult the
following documents for comprehensive handling and emergency response
instructions:
Dangerous Goods Manual; and
Material Safety Data Sheets (MSDS)
For substances that are commonly used in the workplace. Supervisors and
managers are responsible for keeping sufficient stocks of the forms and
ensuring that the forms are accessible by employees at all times.
B). Spill Response Procedure.
Although the response to a hazardous material spill may vary, there are
common steps that must be followed. These are outlined below.
1. Evacuate if
necessary
Revision No.
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: August 2011
If the substance is airborne and its effects are

hazardous or unknown, evacuate immediately,
according to the Evacuation Procedures in this
manual and Heliport Manual. As a safety
precaution, all nonessential staff should evacuate
while the spill is controlled. The engineer and
dedicated person in the heliport shall eliminate
hazardous with fire extinguisher facility in the
heliport.
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2. Advise Fire
Services
Contact the local Aviation Fire Department (PKPPK) and provide them with the Dangerous Good
Manual reference, and other relevant details.
Contact telephone numbers are contained in the
Emergency Procedures Quick Reference.
3. Advise Safety
Manager
The Safety Manager MUST be advised.

Telephone : (+62) 21-2929 8888 ext. 80205
Mobile
: (+62) 813 7887 8788
4. Control the
spill
according to
DG directives
Contain spill-use sandbags, pads or similar tools to

stop the substance entering the drainage system.
Dilute spill use agent nominated on MSDS to
dilute, or if unavailable, use water. If substance is
acidic, smother using a spray nozzle or similar.
5. Await Fire
Chief All Clear
When the area is safe, the Fire Chief will give the all
clear to return to the work area.
C). Motor Vehicle / Ground Support Equipment Accident

1. Address
injuries if
applicable
If personnel have been injured as a result of the

accident, priority should be given to their treatment.
Follow the Workplace Injury and Illness Procedures
in this manual.
2. Advise Chief/
Manager
Advise any accident immediately to your Chief or

Manager.
3. Advise Safety
Manager
The Safety Manager MUST be advised.

Telephone : (+62) 21-2929 8888 ext. 80205
Mobile
: (+62) 813 7887 8788
4. Apply Do Not
Operate Tag
If there is any damage that may affect the

serviceability and/ or operation of the vehicle/ GSE,
a DANGER DO NOT OPERATE TAG must be
applied.
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5. Report
accident
Report the accident in Safety Department Data.
6. Await report
before further
use
The vehicle/ GSE must NOT be used until it is

reported as serviceable and tag removed.
D). Security Breach Response

Security breaches may arise in a number of different situations including:
The presence of a person airside without appropriate identification; and
The presence of a suspicious or prohibited item in the workplace.
1. Advise Chief/
Manager
Advise any accident immediately to your Chief or

Manager.
2. Advise Safety
Manager
The Safety Manager MUST be advised so that the

breach may be assessed for risk of threat.
Telephone : (+62) 21-2929 8888 ext. 80205
Mobile
: (+62) 813 7887 8788
If necessary, the Safety Manager will implement
additional security breach responses as contained
in Matthew Air Aircraft Operator Security
Program (Program Keamanan Angkutan Udara)
3. Report breach
Report the breach in Safety Department Data
E. Work Place Injury and Illness

If an employee, contractor, customer or visitor is injured or becomes ill
while working at, or attending Company facilities, the response will depend
on the severity of the incident.
1. First Aid Kit
First aid kits are provided in each Company facility for the treatment of
injuries or illness in the first instance. The green and white first aid
symbol identifies the location of each kit. They are located as follows:
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Head Office PT. Matthew Air Nusantara

Heliport PT. Matthew Air Nusantara Kubang
2. Injury and Illnes Response

1. Contact Chief/
Manager
The injured or ill person contacts a Safety

Officer in person or by telephone so an
assessment of the injury or illness can be made
and appropriate care provided.
2. Advise Safety
Manager
The Safety Officer will advise the employees

supervisor/manager of the outcome of the
treatment of the employees injury or illness.
For example, that the employee has been taken
to hospital. If the person injured is a
nonemployee (eg passenger, contractor), the
Facility Manager that the person was liaising
with will be notified.
3. Obtain witness
statements
If an incident involves a non employee contact

details and statements from any person who
witnessed the event must be sought
6. Complete
Injury/ Illness
Form
Complete the Injury/ Illness Form and submit it

to the Safety Manager (see appendix part 10.2 )
7. Report injury or
illness in SMS
Data Base
The persons supervisor/manager or Company

contact is responsible for submitting an Safety
Department Data.
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IF FURTHER MEDICAL CARE IS REQUIRED

8.
Advise
medical care
provider of
injury / illness
Injured or ill person shall report to a medical

care provider. If the injury or illness was
sustained during, or a result of performing work
duties, the practitioner must be advised
accordingly.
9.
Follow
medical
practitioners
directions
The medical practitioner will organize care as

appropriate and issue a medical certificate
accordingly.
10. Return to
work as
directed
Return to work may only occur when a medical

clearance is provided. The injured/ill worker
shall not return to the workplace before the
return date stated on his/her medical certificate
unless an agreement has been made to return
to work on light or modified duties.
3. Reporting Injury and Illness

Any injury or illness sustained while working at, or attending Company
facilities, must be reported.
a)
Injury / Illness Form

The Injury/ Illness Form must be completed. The information is
particularly important for insurance and legal purposes, including
Workers Compensation.
The form requires that the following details be completed:
Details of the injured/ ill person;
Accident/ incident details;
Injury/ illness details;
First aid given and by whom; and
Confirmation of details by the persons supervisor/manager.
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16.5.2
HANDLING OF MAJOR EMERGENCY

For a major emergency to be declared, a thorough assessment of the
situation and associated risk must be first conducted.
A major emergency may be a result of:
An limited emergency that could not be adequately controlled and has
since escalated;
An aircraft accident;
A threat to safety that has been assessed as genuine.
Assessment of emergencies is primarily the responsibility of the
Emergency Assessment Team. However, the success of their assessment
relies on the quick and accurate provision of information from employees,
supervisors and managers about the situation.
a) All Staff
Employees must report to their chief / manager.
Chiefs / managers must notify their immediate manager and the
Compliance Manager as soon as possible.
The Safety Manager will notify
Assessment Team if appropriate.
members
of the Emergency
b) Emergency Assessment Team

The Emergency Assessment Team (EAT) are responsible for:
Systematically assessing all details of the occurrence, incident or
accident.
Where a threat has been made, the EAT will conduct Positive
Target Identification as outlined in the Threat Assessment section
of this manual.
Assessing potential/ actual severity and impact on:
Preservation of life;
Business operation; and
Implementing emergency response procedures if appropriate.
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c. EAT Members
The EAT must consist of no less than three of the following people:
o Managing Director (MD)
o Safety Manager
o Operations Manager
o Technical Manager
o Chief Pilot
o Chief Inspector
d. Major Emergency Declared

If the EAT declare an emergency, the most senior member of the EAT
will:
Notify appropriate airport authorities, NTSC, DGCA, Police and AP II/
I, Shareholders, PEMDA, of the EAT assessment.
Inform other members of the EAT if applicable.
Activate the Emergency Response Plan (as detailed in this manual)
including establishment of:
The Emergency Control Team; and
The Emergency Control Centre, if required.
Advise agency managers where applicable.
Prepare internal staff advice including reminders about company
policy for communication with the public and media.
Ensure normal Company operations are maintained where possible.
e. Major Emergency Not Declared
If the EAT do not declare an emergency, the most senior EAT member
will :
Notify appropriate airport authorities, DGCA, Police and AP II/I of the
EAT assessment.
Where assessment has involved a threat and Positive Target
Identification has resulted in the threat determined as a hoax,
these authorities must also be advised.
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Prepare internal staff advice including reminders about Company
policy for communication with the public and media.
Ensure debriefing and/or counseling is offered to staff or other
persons who may have been affected
Ensure normal company operations are maintained where possible.
16.6
EMERGENCY CONTROL CENTRE

Management of the companys response to the emergency, liaison with authorities
and use of resources will be conducted at a single location the Emergency
Control Centre (ECC). Under the direction of the Emergency Coordinator, the ECC
will be set up in the meeting room of Matthew Air Head Offices.
Details regarding the ECC set up are provided in this manual in the Emergency
Control Centre section of this manual. The Emergency Coordinator will ensure that
all staff and relevant parties are advised of the alternative location. Details
regarding the roles and responsibilities of the Emergency Control Team are
provided in the Emergency Control Team section of this manual.
16.7. EMERGENCY CONTROL TEAM RESPONSIBILITIES

Matthew Air ECT is responsible for the actions listed below. Details of each
responsibility are detailed in the following sections.
Control the flow of incoming and outgoing information about the
emergency. This includes issuing regular press releases and internal advice to
staff, including staff guidelines for communicating with public and media.
Record the minute-by-minute emergency response actions taken by the
Company.
Provide accurate passenger, crew and cargo manifests to the Police
Coordinator. This may also include providing technical and safety advice about
aircraft involved. If the emergency is at SSQ II, this may be done via SSQ II
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Safety One who is responsible for taking initial command of the Forward
Command Post and briefing Police on their arrival.
Facilitate separation of passengers from crew.
Operate reception areas, and provide interpreters if required, for:
o
Slightly injured or uninjured passengers involved in the emergency;
Slightly injured or uninjured air crew involved in the emergency; and
Relatives and friends of passengers and/ or crew involved.
Provide staff for bearing stretchers (preferably first-aiders) and pushing

wheelchairs as directed.
Provide support to SSQ II Emergency Operations Centre if activated.
Secure Company buildings from unwanted interference if necessary.
Provide transport and/ or accommodation of uninjured where necessary.
Arrange personal toiletry items and clothing in conjunction with Red Cross
for uninjured where necessary.
Provide debriefing and post-trauma services to Riau Airlines staff.
Remove aircraft and debris when released by police and aviation authorities
from the incident/ accident site.
16.7.1 Staffing
The ECT requires individual staff to fulfill the following roles:
Emergency Coordinator
Emergency Coordinator Assistant
Emergency Communications Officer
Emergency Incident Recorder
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Media Liaison Officer
Emergency Support Management Team.
In addition, the Emergency Coordinator will nominate staff to the following
roles:
Passenger Reception Area Coordinator and assistants
Crew Reception Area Coordinator and assistants
Relatives and Friends Reception Coordinator and assistants
Assistants to carry stretchers (preferably first aiders) and push
wheelchairs as required The specific duties each role are contained in
the Emergency Control Team section of this manual.
16.7.2
Facilities
The ECT is to be located in the Emergency Control Centre where possible.
Facilities and resources are detailed in the Emergency Control Centre
section of this manual.
Facilities for each potential ECC location are indicated in the table below,
bearing in mind that the boardroom is the preferred location.
Boardroom
Training Room
White Board
Fax Machine
In and Out phone line
Television
Airfield diagram / Map
Network Connection
Projector (In-Focus)
Portable ECC Kit
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Portable ECC Kit.

QTY
Item Description
Stationery
4
Different colored whiteboard markers
Whiteboard eraser
Packet of pens
Ream of blank paper
10
Post it pads
Stapler
Box Staples
Copy Emergency Response Manual
Airfield diagram / Map
Digital 24 hours clocks with signage

showing local time and GMT
Copy of all staff telephone
List Emergency contact numbers
References
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Lay Out of Emergency Control Center Matthew Air Nusantara
16.8
THREAT ASSESSMENT
A threat is one possible cause of an emergency and there are specific procedures
for handling threat information. When a threat is received, it must be assessed
quickly and efficiently to determine if it represents a genuine emergency.
16.8.1
Aviation Security Program Requirements

The procedures for receiving and responding to most threats are governed
by Matthew Air Aircraft Operator Security Program (AOSP). The threats
covered in the AOSP are:
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Bomb threats;
Suspicious articles;
Suspicious substances;
Threats to act, or acts of unlawful interference; and
Hijack or unlawful seizure of aircraft.
16.8.2
Assessment by Emergency Assessment Team

Matthew Air has nominated senior staff to assess all emergencies,
including threats. Any assessment requires a minimum of three staff
forming the Emergency Assessment Team (EAT).
a)
Positive Ta rget Identification (PTI)

Assessment of threats requires the use of Positive Target Identification
(PTI). PTI is the process of considering whether the threat is targetspecific, and whether it is therefore genuine or hoax. For example,
where Company aircraft are involved, the PTI process may consider
the:
Aircraft Register
Departure time; or
Actual location at the time of the threat.
b) PTI Outcomes
If a threat is assessed as specific, it is considered genuine, and
appropriate emergency response procedures will be implemented. If a
threat is not considered specific or genuine, then no emergency will be
declared. Regardless of the outcome, a report must be submitted into
Safety Management System Data Base.
16.8.3
Genuine Threat Response

If a threat is assessed as genuine (and therefore declared as an
emergency), the Emergency Assessment Team will initiate appropriate
Emergency Response Procedures. Details are contained further in this
manual.
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16.9
THREAT PROCEDURES
Threats to harm Company staff or property may be received in a number of ways.
The procedures for responding to the most common types of threats are provided
in this section. The flow chart below provides an overview of the Companys
response to a threat.
Threat Incident Report
received.
Safety Manager notified.
Major Emergency?
Conference Call any 3 of:

Managing Director
Safety Manager
OPS Manager
TEC Manager
Limited Emergency.
16.5.1
Yes
Emergency Assessment
Team (EAT) convened to
assess the threat
16.8.2
Emergency
Declared
Activate the Emergency

Control Center Emergency
Control Team assembled
No
Yes
Is the threat
genuine?
Emergency Not
Declared
No
Appropriate companies, staff

and authorities notified.
16.6/ 16.7
Appropriate companies, staff

and authorities notified.
16.7
Appropriate emergency
response procedures
implemented.
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16.10.
DETERMINATION OF AN EMERGENCY
An emergency exists when:
a.
A mechanical condition exist that impairs, or is anticipated to impair the ability

to control the aircraft,
b.
The communication or navigation equipment of the aircraft or ground stations

is impaired to the point that orientation of the flight or approach capacity is
very difficult or impossible,
c.
A flight is overdue at destination

communication cannot be established,
d.
An arrival report has not been received by OCS after the reasonable period
following scheduled arrival and OCS cannot ascertain the flights safe arrival
by other means,
e.
A distress massage is received from the aircraft, information is received

indicating that the company aircraft has encountered or declared an
emergency situation,
f.
Weather condition at destination and all other available alternates deteriorate

below authorized minimums,
g.
Fuel onboard the aircraft is insufficient to reach the scheduled destination or

available alternates with the required reserve,
h.
It is suspected that an explosive device has been placed aboard a company

aircraft,
i.
A company aircraft has been diverted from its prescribed route or destination
without advising ATC of the reason for the diversion, or if it becomes known
that a person onboard the aircraft is causing an illegal diversion or has
commanded the aircraft,
j.
Any other circumstance or combination thereof, which, in the opinion of the

pilot-in-Command or other authorized personnel, causes a situation that is
potentially dangerous to an aircraft or its occupants.
for
more
than
30 minutes
and
16.11. DECLARATION OF AN EMERGENCY

An emergency should be declared when any of the above conditions exists, or at
any time when the Pilot-in-Command deems that an emergency condition exists.
An emergency may be declared by:
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a.
The Pilot-in-Command,
b.
The Operations Manager,
c.
The Chief Pilot,
d.
The Flight Dispatcher on-duty, when the approval of any of the above
individuals is not available.
When an emergency is declared, the Pilot-in-Command should ensure that the

ground agencies are made aware of:
16.12.
a.
The number of person onboard,
b.
The amount of fuel remaining in kgs / Lbs,
c.
The Presence, identify and location of dangerous goods on board, and
d.
Any specialized assistance required i.e. ambulance, priority to land, tow

vehicles, etc.
RESPONSIBILITIES AND PROCEDURES DURING AN EMERGENCY

When an emergency has been declared, the Operation manager, or other person
to whom they delegate the authority, shall coordinate all company activities
associated with the situation until the emergency no longer exist. Such
coordination shall be in accordance with the Emergency Response Plan where
applicable.
During an emergency, the person directing these activities shall keep a
chronological log events causing and pertaining to the emergency, and any action
taken.
During or after an emergency, only the Managing Director, the Operation
Manager or the Public Relation Officer is authorized to make any statement or
release any information to the media, public, or any other person not directly
involved. Any release must be coordinated with the Managing Director or his
delegate.
The Operation Manager shall submit required reports to the National Transport
Safety Committee (NTSC) and DGCA or his delegate as directed in this manual.
The following procedures are intended to provide crewmembers some insight in
the actions taken by the ground organization.
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16.12.1 Company Uncertainty Phase

a.
Contact ATC and ensure that the rescue coordination center and
communication stations are notified.
b.
Endeavor to advise the aircraft, by blind or normal transmission that

the uncertainty phase has been declared, and supply pertinent advice
and information regarding weather, rerouting, actions to be taken etc.
c.
Determine present and next positions of the aircraft and the fuel
endurance limit.
d.
Maintain liaison with all agencies, which may render assistance.
e.
Notify all concerned when the uncertainty phase is cancelled or

declare the company ALERT PHASE if the emergency continues.
16.12.2 Company Alert Phase

a.
Inform ATC, rescue coordination center and communications station

of the changed situation.
b.
Ensure that ATC and rescue coordination centers have the following
information at their disposal:
1)
flight plan
2)
particulars of last position report
3)
endurance of time at last position
4)
number of persons on board
5)
any other pertinent information
c.
Endeavor to advice the aircraft by blind or normal transmission that

the alert phase has been declared, and supply pertinent advice and
information regarding weather, rerouting, actions taken etc.
d.
Maintain liaison with all agencies, which may render assistance.
e.
Notify all concerned when the alert phase is cancelled or declare the
company DISTRESS PHASE if circumstances so require.
16.12.3 Company Distress Phase

a.
Inform ATC, rescue coordination center and communications station

of the changed situation.
b.
Inform PT. MATTHEW AIR NUSANTARA flight watch.
c.
Request possible assistance of other aircraft in vicinity.
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16.13.
d.
If applicable arrange for crash equipment to standby at the airport

where the aircraft is expected to land.
e.
Continue to coordinate all emergency activities.
f.
Notify all concerned when the distress phase is cancelled.
TERMINATION OF AN EMERGENCY
The emergency shall be cancelled when the emergency situation no longer exist.
The person directing company activities during the emergency will advise all
appropriate management staff, operations personnel, and other persons or
agencies, which were advised, have involved with the emergency.
Certain situations do not warrant of an emergency from an operational standpoint;
however is it important tat ATC be made aware of the situational that may disrupt
normal flow of air traffic or otherwise impact other operations.
The Pilot-in-Command should also consider requesting Emergency Response
Service (ERS) to mobilize into position a state of alert during any landing that in
conducted with non-standard aircraft configuration or questionable system
integrity. Then, should a situation accord on landing that subsequently
necessitates declaration of an emergency, ERS will be on site immediately.
16.14.
PT. MATTHEW AIR NUSANTARA RESPONSIBILITIES

The aircraft operators ERP should be coordinated with the aerodrome emergency
plan (AEP) so that the operators personnel know what responsibilities the airport
will assume and what response is required by the operator.
As part of their emergency response planning, aircraft operators in conjunction
with the airport operator are expected to:
a.
Provide training to prepare personnel for emergencies;
b.
Make arrangements to handle incoming telephone queries concerning the

emergency;
c.
Designate a suitable holding area for uninjured passengers and miters and
greeters;
d.
Provide a description of duties for company personnel (e.g. person in

command, and receptionists for receiving passengers in holding areas);
e.
Gather essential information on passengers and coordinate fulfillment of their

needs;
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f.
Develop arrangements with other operators and agencies for the provision of
mutual support during the emergency; and
g.
Prepare and maintain an emergency kit containing:

1.
Necessary administrative supplies (forms, paper, name tags, computers,

etc.); and
2.
Critical telephone numbers (of doctors, local hotels, linguists, caterers,

airline transport companies, etc.).
In the event of an aircraft accident at or near the airport, an aircraft operator will
be expected to take certain actions, for example:
a.
Report to airport command post to coordinate the aircraft operators activities;
b.
Assist in the location and recovery of any flight recorders;
c.
Assist investigators with the identification of aircraft components and ensure

that hazardous components are made safe;
d.
Provide information regarding passengers, flight crew and the existence of

any dangerous goods on board;
e.
Transport uninjured persons to the designated holding area;
f.
Make arrangements for any uninjured persons who may intend to continue
their journey or who need accommodation or other assistance;
g.
Release information to the media in coordination with the airport public

information officer and police; and
h.
Remove the aircraft

investigation authority.
and/or
wreckage upon the authorization of the
Although the information in this paragraph is oriented towards an aircraft accident,

some of the concepts also apply to emergency response planning by aerodrome
operators and ATS providers.
16.15. PT. MATTHEW AIR NUSANTARA ERP TRAINING AND EXERCISES
An ERP is a written indication of intent. Hopefully, much of an ERP will never be
tested under actual conditions. Training is required to ensure that the intentions in
the ERP are backed by operational capabilities. Since training has a short shelf
life, regular drills and exercises are advisable.
16.15.1
Senior Management
The Managing Director will participate and/or observe local field and
desktop exercises to practice and evaluate Company procedures.
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All feedback and discussion points raised at the exercise debrief session
will be considered by Senior Management and any relevant aspects of
this manual may be subject to review at this time.
If hosting an exercise, the Company will solicit external critique of
procedures to ensure assessment of procedures is objective.
16.15.2
Matthew Air Managers and Chiefs

Matthew Air managers and chiefs, must read and familiarize themselves
with the contents of this procedures; and ensure personnel under their
supervision are proficient in emergency response duties as required in
this manual.
16.15.3
Emergency Assessment and Control Team

All members of the Emergency Assessment Team (EAT), Emergency
Control Team (ECT) will receive regular training in Emergency
Assessment Process, Emergency Response Procedures and set up of
the Emergency Control Centre.
16.15.4
Evaluation of Emergency Response Plan

a)
Senior Management
The Managing Director is responsible for conducting a formal review
of this manual every two years.
b)
16.15.5
SHE&S Manager
The SHE&S Manager is responsible for the preparation, maintenance
and review of this manual. This includes liaison with relevant airport
authorities, security and emergency services, and participation in
exercises to verify the manual procedures.
Evacuation Training
a)
Emergency Awareness Sessions.

Emergency Awareness Sessions provide a basic overview of
company emergency and evacuation procedures. The sessions also
identify current Facility and Area Wardens.
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Any person who is expected to have a regular presence in
Company facilities will undertake an Emergency Awareness
Session. This includes casual and contract staff and work
experience students.
Where a new employee undertakes induction, the Emergency
Awareness Session will be conducted as part of the process.
One refresher Emergency Awareness Session will be conducted by
the HSE Officer every 24 months and all staff are required to attend.
b)
Facility and Area Warden Training.

The Safety Officer will organize and/ or deliver training to staff
required to fulfill either a Facility or Area Warden role. Training will
ensure that Wardens are proficient in any tasks they may be required
to perform, including:
clearing buildings;
directing staff;
using alarm systems;
fire fighting;
providing first aid; and
taking account of staff.
In some cases, formal training will be provided by qualified, industry

professionals.
c)
Evacuation Drill
The Operation Manager will conduct evacuation drills for each facility
every 24 months. If convenient and appropriate, associated
emergency services may be invited to participate. Following each
drill, a debriefing session will be held for Area and Facility Wardens to
identify areas where further training or improvement may be required.
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INTENTIONALLY PAGE BLANK
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Appendix A - ORGANIZATION
Appendix A
ORGANIZATION
Revision No.
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PEKANBARU: Surya Dumai Group Building, 5th Floor, JL. Jend. Sudirman No. 395,

Appendix A ERP ORGANIZATION
STRUCTURE OF ORGANIZATION AS MEMBER OF CRISIS CENTER
Owners
DZ
SM
OM
MM
Emergency Control Team :
Commissioners
EMERGENCY CONTROL CENTER
(ECC)
Authority
Site Control Center

(SCC)
FAC
Dispatch Team
(FAC)
Employee Car e Team
Emer gency Suppor t Management Team (ESMT)
Passenger Sur vivor s Team
Go Team
ART
Family Assistant Team

(FAT)
Injur ed Car e Team
Go Team
Deceased Car e Team
Investigation and For ensic Team
Claim and Insur ance Team
Air cr aft Removal Team
Tr avel Document Team
(ART)
Medical Assistant Team
Revision No.
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OPERATION CONTROL CENTER

(OCC)
EMERGENCY ASSESMENT TEAM (EAT)
Page App A - 0
Emergency Coordinator
Emergency Coordinator Assistant
Media Liaison Officer
Emergency Communications Officer
Emergency Incident Recorder
ECC Support Team :

Safety Officer
Managers and Chiefs
Staff Call Out

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Appendix B - FORMS
Appendix B
FORMS
Revision No.
: 02
Date of Issued
: July 2015
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Appendix B - FORMS
B.1. EMERGENCY QUICK REFERENCE PROCEDURES
Emergency Procedures Quick Reference will be available for all locations :
EMERGENCY QUICK REFERENCE PROCEDURES
Dalam Keadaan Dar ur at ikuti petunjuk di baw ah ini :

1. Bunyikan alarm (jika kondisi benar-benar darurat).
2. Memberitahukan kepada atasan anda (Chief atau Manager).
3. Selamatkan fasilitas kantor (yang dianggap perlu).
4. Segera mengikuti jalur evakuasi menuju titik kumpul (muster
area).
5. Hubungi Safety Department:
Safety Manager
081378878788
+62-21 5367 0888 ext. 80204
[Berikan informasi kepada Safety Department secara lengkap mengenai kejadian tersebut]
Revision No.
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Appendix B - FORMS
B.2 EMERGENCY FLIGHT FOLLOWING CHART
No contact with aircraft > 15 minutes
Continue Calling
En-route # - try other #
YES
Contact
NO
UNCERTAINTY
Info to:
- Operation Manager
(081283111541)
- Safety Manager
(081378878788)
- Contact any possible landing
sites
- Determine a/c position and fuel
endurance
- Continue try contact a/c

PAN receiv ed
If a call is receiv ed it may
be necessary to mov e
straight to the Alert Phase
Declare Uncertainty Phase Continue Calling
YES
Contact
NO

MAYDAY Call receiv ed
If a call is receiv ed it may
be necessary to mov e
straight to the Distress
Phase
ALERT
- Inform to Emergency Crisis
Center, the flight plan, last
position report, endurance at
last position, POB, crew, etc.
- Status of aircraft
- En-route w eather and
destination
Declare Alert Phase Continue Calling
YES
Contact
NO
Request position report
No contact with aircraft known emergency or zero fuel
Calling from ditching a/c

receiv ed
Stand dow n Emergency

Response Serv ices
Declare Distress Phase
Aircraft located
YES
Revision No.
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DISTRESS
- Inform Crisis Center of Distress
status (021-29298888)
- Continue to coordinate all
emergency activities
NO
- SAR to continue under the

direction of BASARNAS (+62- 21
6570 1116.
- Contact NTSC(+62- 21 384 7601
- Matthew Air to render assistance
as required
Page App B - 2

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Appendix B - FORMS
B.3. EMERGENCY NOTIFICATIONS
B.3.1 Emergency Coordinator
Managed by
:
RISDIANTO SIMAMORA
Job Title
Mobile Phone
Office Phone
:
:
:
Safety Manager
(+62) 813 788 78 788
(+62) 21-2929 8888 ext. 80204
Fax
Residence Phone
Address
:
:
:
(+62) 21-2929 8878

APL Tower-Central Park 28thFloor. JL. Letjen. S. Parman Kav. 28
Grogol Petamburan, Jakarta Barat 11470

risdianto.simamora@first-resources.com
Email
B.3.2 Emergency Coordinator Assistant

Managed by
Title
Mobile Phone
:
:
:
CAPT. HERUYONO
Operation Manager
(+62) 821 11811958
Office Phone
Fax
Residence Phone
:
:
:
(+62) 21-2929 8888

(+62) 21-2929 8878
Address
Email
:
:
APL Tower-Central Park 28thFloor. JL. Letjend. S. Parman Kav. 28

heruyono.hry@first-resources.com
Managed by
Job Title
Mobile Phone
:
:
:
CAPT. SUHARTO
Managing Director
(+62) 81213111952
Office Phone
Fax
Residence Phone
Address
:
:
:
:
(+62) 21-2929 8888 ext. 80200

(+62) 21-2929 8878
(+62) 251 753 7211
Email
suharto.sht@first-resources.com
B.3.3. Media Liaison Officer
B.3.4. Family Assistance Center

Managed by
Job Title
Mobile Phone
:
:
:
RISDIANTO SIMAMORA
Safety Manager
(+62) 813 7887 8788
Office Phone
Fax
Residence Phone
Address
:
:
:
:
(+62) 21-2929 8888 ext. 80204

(+62) 21-2929 8878
Email
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Appendix B - FORMS
or
Managed by
CAPT. SUHARTO
Job Title
Mobile Phone
Office Phone
:
:
:
Managing Director
(+62) 81213111952
(+62) 21-2929 8888 ext. 80200
Fax
Residence Phone
Address
:
:
:
(+62) 21-2929 8878

(+62) 251 753 7211
Email
B.3.5. Aircraft Removal Team

Name
Title
Mobile Phone
:
:
:
EKO PURWANTO
Maintenance Manager
(+62) 81383429105
Office Phone
Fax
Address
:
:
:
(+62) 21-2929 8888 ext. 80210

(+62) 21-2929 8878
Email
eko.purwanto@first-resources.com
Or
Name
Title
Mobile Phone
:
:
:
YUNIA WAHYU ADY SETIAWAN

Chief Inspector
(+62) 81329411113
Office Phone
Fax
Address
Email
:
:
:
:
(+62) 21-2929 8888

(+62) 21-2929 8878
ady.setiawan@first-resources.com
B.3.6 Go Team (Investigations/ Forensic Team)

Name
Title
:
:
CAPT. WILLY BAKER FOENAY

Chief Pilot
Mobile Phone
Office Phone
Fax
Address
:
:
:
:
(+62) 81332042015
(+62) 21-2929 8888
(+62) 21-2929 8878
Email
willybakerfoenay@yahoo.com
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Appendix B - FORMS
Or
Name
Title
Mobile Phone
Office Phone
:
:
:
Chief Inspector
(+62) 81329411113
(+62) 21-2929 8888
Fax
Address
Email
:
:
:
(+62) 21-2929 8878

B.3.7 Emergency Assessment Team And Emergency Management Team

EAT Chairman
1. Managing Director
Managed by
Job Title
Mobile Phone
Office Phone
:
:
:
:
CAPT. SUHARTO
Managing Director
(+62) 81213111952
(+62) 21-2929 8888 ext. 80200
Fax
:
Residence Phone :
Address
:
(+62) 21-2929 8878

(+62) 251 753 7211
Email
Or
2. Safety Manager
Name
:
Job Title
Mobile Phone
Office Phone
:
:
:
RISDIANTO SIMAMORA
Safety Manager
(+62) 813 7887 8788
(+62) 21-2929 8888 ext. 80204
Fax
:
Residence Phone :
Address
:
(+62) 21-2929 8878

Email
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Appendix B - FORMS
EAT Members
1. Operations Manager (OPS)
:
:
:
CAPT. HERUYONO
Operation Manager
(+62) 821 11811958
Office Phone
:
Fax
:
Residence Phone :
(+62) 21-2929 8888

(+62) 21-2929 8878
Address
Email

heruyono.hry@first-resources.com
Managed by
Title
Mobile Phone
:
:
Or
2. Chief Pilot
Name
CAPT. WILLY BAKER FOENAY
Title
Mobile Phone
Office Phone
:
:
:
Chief Pilot
(+62) 81332042015
(+62) 21-2929 8888
Fax
Address
Email
:
:
:
(+62) 21-2929 8878

willybakerfoenay@yahoo.com
3. Technical Manager (TEC)

Name
EKO PURWANTO
Title
Mobile Phone
Office Phone
:
:
:
Maintenance Manager
(+62) 81383429105
(+62) 21-2929 8888 ext. 80210
Fax
Address
Email
:
:
:
(+62) 21-2929 8878

eko.purwanto@first-resources.com
Or
4. Chief Inspector
Name
Title
Mobile Phone
:
:
:

Chief Inspector
(+62) 81329411113
Office Phone
Fax
Address
Email
:
:
:
:
(+62) 21-2929 8888

(+62) 21-2929 8878
Revision No.
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Date of Issued
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Page App B - 6

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Appendix B - FORMS
B.4. COMPLETE INJURY / ILLNESS FORM
The injury/illness form must be completed in the event any person (including employee, contractor, visitor, customer)
sustains an injury or becomes ill while performing company business or using company facilities.
B.4.1 Ground Injury/ Illness Report
INJURY / ILLNESS REPORT FORM
GROUND INJURY REPORT

Name :............................................................
Check here if a crew member was on board :........................................................
Gender :.........................................................
Light condition (daylight, night, twilight) :................................................................
Age :.............................................................
Weather condition (clear, fog, rain) :.......................................................................
Job Title :......................................................
Aviation activity at time of injury :............................................................................
Date of Injury :...............................................

Where on the ground did this happen (aircraft, gate, jetway, maintenace facility, ramp, taxyway, office):............................................
................................................................................................................................................................................................................
................................................................................................................................................................................................................
If on the aircraft, where on the aircraft (cabin, cockpoit, door way, emergency exit, fuselage, galley, lavatory, stairs,
wings)?...............
................................................................................................................................................................................................................
................................................................................................................................................................................................................
Type of aircraft : .....................................................................................................................................................................................
Description of injury :...............................................................................................................................................................................
................................................................................................................................................................................................................
Briefly describe what happen, include any additional information and/or contributing factors: ............................................................
................................................................................................................................................................................................................
Medical treatment :
None
First Aid only
Beyond First Aid
Report by :
Name :.........................................................................
Job title :......................................................................
Department :...............................................................
Date of issue :.............................................................
Forward The Completed Form To The Safety Department
Revision No.
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Appendix B - FORMS
B.4.2 In Flight Injury Report Form
INJURY / ILLNESS REPORT FORM
IN FLIGHT INJURY REPORT

Name :............................................................
Phase of flight (Climb, Enroute, Descent, Landing) :..............................................
Gender :.......................................................
Type of Aircraft :......................................................................................................
Age :..............................................................
Job Title :.......................................................
Date of Injury :...............................................
Where on the aircraft did this occur ( Cabin, Cockpit, Galley, Lavatory ) ? ...........................................................................................
................................................................................................................................................................................................................
................................................................................................................................................................................................................
Description of injury : ..............................................................................................................................................................................
................................................................................................................................................................................................................
................................................................................................................................................................................................................
Briefly describe what happen, include any additional information and/or contributing factors :..............................................................
................................................................................................................................................................................................................
................................................................................................................................................................................................................
Medical treatment :
None
First Aid only
Beyond First Aid
Report by :
Name :.........................................................................
Job title :......................................................................
Department :...............................................................
Date of issue :.............................................................
Forward The Completed Form To The Safety Department
Revision No.
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Date of Issued
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Appendix B - FORMS
TRAINING RECORD
Form No. SMS-MAN/01
Name
: ______________________
Endorsements : ______________________
License Type & No.

Base
: _______________________
: _______________________
Initial Training
Training
Date
Instructor Name (print and sign)
Date
Instructor Name (print and sign)
Flight Safety Program

Emergency Response Plan
Continuation Training and Safety Briefings

Training
Revision No.
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Appendix B - FORMS
SAFETY HAZARD OBSERVATION FORM

Form No. SMS-MAN/02
Please SEND or FAX to Safety Department

(Kirim atau Fax ke Departemen Safety)
Fax : 021-2929 88878

Email : risdianto.simamora@first-resources.com
SUBMITTED BY :
(Dilaporkan oleh)
PHONE :
Telepon
LOCATION
(Lokasi)
DATE
:
(Tanggal)
UNSAFE ACT
(Perbuatan Tidak Aman)
SAFE ACT
(Perbuatan Aman)
UNSAFE CONDITION
(Kondisi Tidak Aman)
SAFE CONDITION
(Kondisi Aman)
OBSERVE DESCRIPTION :
(Penjelasan Observasi)
IMMEDIATE CORRECTIVE ACTION (for Unsafe Condition) :

Tindakan Perbaikan Segera (untuk kondisi tidak aman)
YOUR SUGGESTION FOR IMPROVING SAFETY :

(Saran Anda untuk Meningkatkan Keselamatan)
FOR OFFICIAL USE ONLY (Digunakan untuk petugas saja)

Ref. No.
Responded by
Action
Date
Notes: Please fill mark in the
Revision No.
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Appendix B - FORMS
VOLUNTARY SAFETY REPORT

Form No. SMS-MAN/03
The information supplied in this form will only be used to enhance safety. You may choose to
not provide your name. If you do provide your name, upon receipt of this form your name and
position will be removed and discarded. Under no circumstances will your identity be disclosed
to any person in the airport or to any other organization, agency or person without your
express permission.
When you have completed your part of the form, it should be given to the Airport Safety Officer
or any member of the Airport Safety Committee.
Name
: ______________________________________________
Organization Position : ______________________________________________
[Name and position to be discarded by the Safety Officer]
Revision No.
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Appendix B - FORMS
PART A
TO BE COMPLETED BY THE PERSON IDENTIFYING THE HAZARD
Please fully describe the Hazard.
.
Date of occurrence: _________________________
Time: ______________________
Location
: _________________________
Description
: ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
In your opinion, what is the likelihood of a similar occurrence happening again?

Likely
1
Rare
5
What do you consider could be the worst possible consequence if this occurrence did happen
again?
Catastrophic
1
Revision No.
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Date of Issued
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Minor damage
5
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Appendix B - FORMS
PART B
TO BE COMPLETED BY THE SAFETY OFFICER
The report has been de-identified and entered into the company database
Signature : ________________________
Name
Date
: ___________________________
: ________________________
Rate the likelihood of the hazard recurring

Very Likely
1
2
Rate the worst-case consequences
Catastrophic
1
2
Rare
5
Minor Damage
5
What action is required to ELIMINATE or CONTROL the hazard and PREVENT injury?
Resources Required
: ______________________________________________________
______________________________________________________
Responsibility for action : ______________________________________________________

______________________________________________________
Revision No.
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Appendix B - FORMS
Referred to : ______________________________ for further action.
Signature : ______________________________ Date : ___________________________
Forwarded to the Safety Committee for review.
Signed
: ______________________________ Date : ___________________________
Appropriate Feedback given to staff.
Signed
:_______________________________ Date : ___________________________
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 14

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Appendix B - FORMS
ACCIDENT AND INCIDENT REPORT FORM

Form No. SMS-MAN/04
To be completed by the Airport Safety Officer or senior representative of the Airside Operator
for all accidents and incidents this would likely seriously endanger people, aircraft, vehicles, or
equipment.
Name of person that completed this report:
Organization and Position
Telephone number
Date of Accident/Incident
Time
Location
Date of Report
Names of Witnesses
Witness 1
Name
:
Address :
Telephone:
Witness 2
Name
:
Address :
Telephone:
Witness 3
Name
:
Address :
Telephone:
Revision No.
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Date of Issued
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Appendix B - FORMS
Details
Details of the accident/incident: (Include details of people involved, aircraft, vehicles, and
equipment. Include details of what took place that contributed to the accident /incident)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Details of any injuries:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Details of damage to aircraft/vehicles/equipment/facilities:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 16

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Appendix B - FORMS
AUDIT CHECK LIST

Form No. SMS-MAN/05A
General Information:
This checklist is applicable to all internal and external audits.
Audit Information
Person /Organization undertaking audit
Organization being audited
Information Sources
Documents Reviewed
(list all documents reviewed in course of the audit)

Note: This includes all Safety Reports and Safety
Checklists pertaining to the operator to be audited
for the previous 12 months.
Individuals Interviewed
(list all persons interviewed including title)
Operations Assessed
(list all operations that were observed during the

course of the audit- e.g. fuelling of a SAAB 340B)
Note; For the observation phase of the audit use
Safety Checklists.
Management:
Is there a formal safety policy statement?
Does the policy statement explicitly address

apron and aircraft safety?
Is the safety policy statement endorsed by
the Board?
Is the safety policy statement reviewed and
revised at suitable intervals
Is the safety policy publicized within the
organization ?
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 17

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Appendix B - FORMS
Are safety performance indicators defined?
Are levels of safety reviewed to check that they
are still appropriate
Is the Organizations SMS readily available to
staff
Does the safety policy state that each individual
has a responsibility for safety?
Does the safety policy state who is ultimately
accountable for safety in the organization?
Does the organization have a dedicated safety
officer?
Does the Safety Officer report directly to the
Board?
How, and by whom, are
standards and procedures?
internal
safety
Are Safety Standards and procedures reviewed

regularly?
How is non-compliance with organizational
safety standards and procedures identified and
dealt with?
How is non-compliances with Airport safety
standards and procedures identified and dealt
with?
Are safety accountabilities reviewed after an
organization change has taken place?
If the organization is a subsidiary or division of a
parent organization, is safety accountability and
reporting linked into the parent organization?
How?
Does the organization have a safety committee?
What processes are in place for staff to raise
safety concerns with senior management?
How, and by whom, are safety improvement
suggestions investigated?
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 18

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Appendix B - FORMS
How, and by whom, are all proposed changes to
operations or equipment assessed to determine
their safety impact?
Internal Accident/Incident Investigation

Does a process exist for investigating accidents
and/or incidents?
Is the process investigating safety significant
occurrences defined?
How are
whom?
accidents/incidents
reported?
By
How
are
reports
of Accidents/incidents
investigated and recorded? By Whom?
Who decides if corrective action is necessary?
How are corrective actions monitored to ensure
implementation?
Is there a requirement for safety audits within
the organization?
Who determines the need for corrective actions
arising from the results of safety audits?
Training
Are safety responsibilities defined for each
individual working on the airside?
Are individuals licensed to operate on the
airside?
How
are
the
competency
requirements
determined for safety responsibilities? By
whom? Consider equipment operation, driving
on airside etc.
Where are the competency requirements for
safety responsibilities recorded?
How is it decided if a member of staff meets the
competency
requirements
for
safety
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 19

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Appendix B - FORMS
responsibilities?
How often are staff competencies reviewed to
ensure that the staff remain competent for their
safety responsibilities?
What process is followed if it is determined that
a member of staff is not fully competent for the
safety responsibilities assigned?
Airside Supervision
What
arrangements are in place to enable
detection of safety deviations from policy
,standards and procedures?
Is the supervision proportionate to the safety
requirements of the practice or procedure?
Are practices and procedures that affect
safety routinely monitored?
Equipment/Vehicle Maintenance
Is there a procedure for determining if airside
equipment/vehicles meet safety requirements?
What is the frequency of the equipment/vehicle
checks for safety requirements? What is
checked?
Are there formal records of the safety checks of
airside equipment? Review a sample of the
records.
Note: For fuel concessionaire that hoses have to be pressure checked
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 20

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Appendix B - FORMS
SUB- CONTRACTORS
Form No. SMS-MAN/05B
Management
Does the contract state that sub contractor must
satisfy ADAs safety management standards
and procedures?
How are the safety requirements for sub
contractors determined and by whom?
How, and by whom are safety requirements
communicated to the sub-contractors?
How, and by whom, is it decided whether the
sub contractor has an acceptable SMS in
place?
What procedures are in place to check that
sub contractors comply with PT. MATTHEW
AIR NUSANTARA safety requirements?
How is the competence of sub contractors staff
checked? Check records re training to utilize
equipment, drive on airside etc.
Does the sub
committee?
contractor
have
safety
How is the competence of sub contractor staff

checked?
a member the sub-contractor staff is not fully
competent for the safety responsibilities
assigned?
What arrangements are in place to enable
detection of safety deviations from policy,
Is the supervision proportionate to the safety
requirements of the practice or procedure?
Are practices and procedures that affect safety
routinely monitored?
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 21

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Appendix B - FORMS
INTERNAL AUDITS
Form No. SMS-MAN/05C
Note: In auditing the sub-contractor directly the Concessionaire checklists should be used
Does the maintenance management system

define systems and equipment required for safe
operation of the airport as Critical Systems?
Review Maintenance management system
documents.
Are safety critical systems and equipment
inspected on a regular basis?. How often?
How are safety critical maintenance deficiencies
reported? How are they actionned? How many
have occurred in the past 12 months?
How and who follows up on sub-contractor
repairs
of safety
critical systems and
equipment?
If replacement or major repair of safety critical
systems is required how is this programmed?
What authorities are required for the capital
replacement of safety critical systems or
equipment?
Are regular condition reports prepared for
mission critical equipment noting any safety
deficiencies? How are these reports followedup? By whom?
Are risk assessments of identified and potential
hazards undertaken/ By whom?
Have Safety Department staffs received airside
safety training? How is this recorded?
Have any safety incidents/accidents occurred in
the previous 12 months where equipment,
systems or infrastructure was determined to be
a part of the causal factors? How were these
followed up?
Are vehicles and equipment subject to a check
of safety systems on a regular basis? What is
the frequency?
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 22

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Appendix B - FORMS
Operations
What training is given to the Follow-Me re
marshalling of aircraft, driving on airside and
other safety responsibilities?
How is this training recorded?
Who determines the training requirements?
What are these requirements based on?
Who monitors the driving and marshalling of the
Follow-Me to ensure that they are following PT.
MATTHEW AIR NUSANTARA safety practices
and procedures?
What training is given to drivers re airside safety
and airside driving? How is it recorded?
Who monitors the driving practices on airside of
the PT. MATTHEW AIR NUSANTARA drivers?
Do Follow-me and drivers inspect safety
systems and equipment in vehicles prior to
operation? How is this recorded?
How often does the Follow Me inspect the
maneuvering surfaces? How are deficiencies or
safety hazards reported?
Review Follow-Me
reports for last 12 months
How are Follow-Me reports followed-up? Is a
record kept?
Are the calibration of navigational aids and gate
guidance systems regularly checked? By Who?
How are reports followed up?
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 23

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Appendix B - FORMS
AIR TRAFFIC SERVICES

Form No. SMS-MAN/05D
Management/Reporting
What arrangements are in place to enable the
Are safety responsibilities defined for each
individual working in the unit?
Where are the competency requirements for
safety responsibilities recorded?
How is it decided if a staff member meets the
competency
requirements
for
safety
responsibilities?
How often are staff competencies reviewed to
ensure that staffs remain competent to execute
their safety responsibilities?
a member of staff is not fully competent for their
safety responsibilities?
Supervision
Is sufficient staff available to meet current and
future operational requirements?
Do all air traffic controllers at the unit have valid
licenses and ratings in accordance with ICAO
Annex 1 requirements?
What arrangements are in place to enable the
Is the level of supervision proportionate to the
safety requirements of the unit?
Are practices and procedures affecting safety,
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 24

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Appendix B - FORMS
Training
Are staff given re-currency training to ensure
that they can maintain their competency
following periods of significant absence?
Do staff members receive training prior to the
introduction of any new equipment or new
procedures?
Operating
Does the unit have adequate operational and
supervisory staff to provide safe air traffic
services?
Have there been any recent changes to ATS
procedures or equipment used to perform ATS
tasks?
Are practices and procedures that affect safety
Are current procedures appropriate in relation to
current traffic levels and/or traffic mix?
Are controllers well rested before beginning
their work?
What arrangements are in place to enable
Equipment
Do staff members have reliable and adequate
systems (i.e., comm., nav, radar, flight data and
MET systems) to assure safe aircraft
separation?
Is there a procedure for determining if ATS
equipment meets safety requirements?
Are written records maintained when safetycritical equipment fails? (e.g., nav, comm, radar,
flight data or MET systems, approach aids,
airport lighting, or major power systems which
could adversely affect flight safety? Review all
records).
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 25

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Appendix B - FORMS
AIRSIDE OBSERVATION FORM

Form No. SMS-MAN/05E
Personnel Safety
Yes
No
Safety vests are being worn.
[]
[]
Hearing protection is being worn near aircraft with engines running.
[]
[]
Rider on equipment without seats.
[]
[]
Personnel walk, do not run.
[]
[]
Personnel stay out of danger zones near aircraft, particularly engines.
[]
[]
Personnel conduct is orderly.
[]
[]
No personnel eating, drinking or smoking airside.
[]
[]
No signs of personnel being under the influence of drugs or alcohol
[]
[]
FOD is picked up and disposed of in designated containers.
[]
[]
FOD containers are in place and are less than full.
[]
[]
All vehicles observe speed limits.
[]
[]
All vehicles give right of way to aircraft.
[]
[]
Vehicles stop at blind spots.
[]
[]
Other Observations:
[]
[]
Foreign Object Debris
Vehicle Operations
Comments : ______________________________________________________________________
______________________________________________________________________
Airside Operator(s) Observed (Check Box)
Airport Staff
[]
ERS
[]
Airline
[]
Ground Handler
[]
Fuelling Company
[]
Government
Inspection Services
[]
Date
Location
Observer
Signature
Date Report Filed
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 26

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Appendix B - FORMS
SAFETY OFFICE CHECKLISTS

Form No. SMS-MAN/05F
1. Aircraft Operations
Aircraft Ground Movements and Parking
Yes
No
Ground crews are ready and in position before flights arrive.

Vehicles and equipment approach aircraft only after aircraft anti-collision light is turned off.
Aircraft are parked only in approved parking,
The marshaller or ground crew chief perform a pre-departure walk-around of the aircraft.
FOD has been removed from the apron parking, approach and departure paths, as well
as any obstructions prior to arrival and immediately after departure of an aircraft.
The apron and parking areas are free of any fuel or hydraulic oil spills.
If there was a fuel spill, was the airline contacted and asked to decide whether
loading/unloading should be terminated prior to clean up.
There is required clearance between all aircraft during parking.
Ground crew check around aircraft for cargo, personnel, vehicles and other aircraft before
commencing push back or giving engine start-up signal
All vehicles and ground crew are clear of air bridge before operation
Comments

Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Airline
Foreign Object Debris
Yes
No
FOD is picked up and disposed of in designated containers.

FOD containers are in place and are less than full.
Equipment and vehicles are free of FOD.
Ground Crew checks for FOD in gate area prior to aircraft arrival
Ground crew checks for FOD in gate area and on apron behind aircraft prior to push
back
Cabin service crews dispose of cabin waste in appropriate containers
Cabin service crews pick up any waste material dropped on airside
All equipment including loading bridges are tied down prior to a typhoon
Equipment is placed in approved marshalling areas or storage containers when not in
use
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 27

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Appendix B - FORMS
Equipment that may be subjected to jet blast is appropriately stowed.
Any FOD on the apron is removed by ground handling agent supervising the
embarkation/debarkation
Plastic waste from cargo operations on the apron is removed from the apron area as
soon as possible and not placed in FOD Containers
Comments

Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Airline
2. Aircraft Servicing
Fuelling
Yes
No
Fuelling vehicles are positioned to allow rapid removal of aircraft and other servicing
vehicles during an emergency.
Fuel dispensers are grounded/ bonded when refueling is in process.
Refueling hoses and hydrant pits are clearly marked before fuelling commences and
during fuelling.
When hydrant refueling is taking place, the lanyard is attached to the shut off valve and
remains taut and unobstructed during the refueling
Fuelling is controlled by a dead man controller and a fuel company representative
Path to emergency stop button is clear and free of obstructions
Fuelling vehicle brakes are set before refueling commences
Fire extinguisher on fuel vehicle is within certification dates
Fire extinguishers on air side are clear of all obstructions
Fuel vehicle has appropriate quantities of fuel absorbent material to clean up small spills
No vehicles are parked or stopped under aircraft wing tank vents
Cell phones are not used within 15 meters of a refueling aircraft.
There is no smoking by any person on the apron.
No vehicle/equipment parked or stopped within 5 meters (16 ft) of an aircraft which is
being refueled starts its engines while refueling is taking place.
No vehicle/equipment parked or stopped within 5 meters (16 ft) of an aircraft which is
being refueled has its engines running while refueling is taking place.
Aircraft external lights and strobe system is off during refueling
Connection and disconnection of electrical equipment is not carried out during refueling
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 28

JAKARTA
Telp: (021) 5367 0888, Fax: (021) 5367 1888, 5367 2888

Appendix B - FORMS
Ground Handler has verified that hot surfaces on aircraft engines , brakes and auxiliary
power units (APUs) will not interfere with fuelling operations
Where hydrant refueling takes place, no fuel is allowed to accumulate in the hydrant pits
Fuel spills of any magnitude are reported promptly to aircraft pilot, senior ground handler
and ADA staff
Comments
Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Airline
Baggage/Cargo Handling
Yes
No
Ground handling vehicles and equipment do not block fuel truck exit
All equipment is checked to ensure it is not producing metallic FOD ( rusted metal
pieces etc.)
Prepositioned trailers/carts are parked in appropriate areas with brakes and/or chocks
applied
Spills of any hazardous materials are reported promptly to airline pilot, senior ground
handling supervisor and PT. MATTHEW AIR NUSANTARA
3. Vehicle Operation
Safe Vehicle and Equipment Operations
Yes
No
Driver has an airside drivers permit.

Vehicles and mobile equipment have an airport permit.
Vehicles are using designated vehicle lanes.
Drivers are obeying airside traffic control signs and markings
Vehicles are driving within speed limits.
Vehicles using the airside are equipped with radios, as required, and are using them to
obtain permission to access the runway/taxiway and monitor ATC transmissions when on
the apron.
Vehicles without an airport permit or a temporary permit are escorted by appropriately
equipped vehicles. (ATS should be contacted to verify that proper procedures were being
followed.)
Vehicles without radios but with an airport operating permit are properly escorted onto the
runway/taxiways when required to access these areas
Vehicles are equipped with hazard beacons.
Vehicle beacons are operating while vehicle is in motion on the airside
Vehicles not equipped with a beacon are escorted by a properly equipped vehicle
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 29

JAKARTA
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Appendix B - FORMS
Vehicles yield right of way to aircraft.
Vehicles come to a complete stop at blind spots.
The vision of the operator is not obstructed by any extended superstructure or load.
Vehicle(s) operated on the apron are in sound mechanical order; e.g.,., have adequate
lights, rear view mirrors, horn, brakes, steering, tires, reverse alarm and a clear vision
from the drivers seat.
Vehicles are started in neutral or parked position.
After equipment is positioned at an aircraft, the gear shift is in neutral or park, and the
parking brakes/chocks are set before any other control is operated.
Vehicles avoid restricted areas under aircraft wings and tail.
No equipment or vehicles are left unattended at any time in the movement area.
Before aircraft arrive and depart, vehicles and ground equipment are parked in designated
areas that will not be affected by jet blast/prop wash or cause obstruction to: the
arriving/departing aircraft, other arriving/departing aircraft, vehicle traffic lanes and other
aircraft parking stands.
Vehicles not servicing an aircraft are at least 15 meters from an aircraft,
A guide is used to position equipment and vehicles close to aircraft.
Backing up is done safely with adequate clearance, guides are used when reversing
around aircraft with reverse alarm functioning.
The driver is seated in the drivers position when starting and operating a vehicle or
powered equipment.
Equipment is being used only for intended purpose.
Trailers, cart and dollies are always pulled, never pushed.
Carts and containers are fully secured, and when they have no brakes chocks are used to
prevent inadvertent movement around aircraft. Carts are not used as a climbing aid to
access an aircraft
Baggage, mail and cargo are towed in appropriate trailers.
All powered equipment when approaching an aircraft make a full stop 50 feet from the
aircraft and then again at 8 feet.
Vehicles are not driven over electrical cords, fuel hoses, grounding wires, safety lanyards
or other hoses.
Ground equipment and vehicles are fuelled in a safe area away from aircraft.
Parked vehicles/equipment have parking brake set or are chocked.
Unattended vehicles and mobile equipment are parked in designated parking and storage
areas.
Unattended vehicles are not left running
Vehicles around aircraft do not block any fuelling vehicle which is in the process of fuelling
an aircraft
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 30

JAKARTA
Telp: (021) 5367 0888, Fax: (021) 5367 1888, 5367 2888

Appendix B - FORMS
Comments

Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Airline
4. Actions of Individuals
Airside Personnel
Yes
No
Yes
No

Hearing protection is being worn near aircraft when engines are running.
Riders are prohibited on equipment without seats.
Personnel are in position prior to aircraft arrival
Personnel assigned to lavatory service use mask and rubber gloves.
Personnel walk, do not run.
Personnel do not approach aircraft until hazard lights are turned off.
Personnel conduct is orderly.
There is no eating, drinking or smoking airside.
There are no signs of personnel being under the influence of drugs or alcohol
Comments

Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Airline
5. Airport Infrastructure and Services

Airside Maintenance
Vehicles stopped in runway strip are positioned to be moved out of strip quickly
Vehicles operating in runway strip are radio equipped
Vehicles operating in runway strip are using hazard beacon when engine is running
Personnel working in runway strip are trained re aircraft operational hazards and are
supervised by person in direct contact with ATC
All cut grass or other organic material is gathered up and disposed of to prevent blowing
FOD
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 31

JAKARTA
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Appendix B - FORMS
Helipad checked for FOD every 4 hours
Grass is cut to appropriate height
Ditches along runways are free of debris and outlets are free flowing
Helipad are swept daily
Helipad touch down zone lights are checked daily
helipad approach lights are checked weekly or upon complaint
Hazard lights are checked daily
Navigational aids are checked as required
Servicing of U/S navigational aids is undertaken on a priority basis
Diesel generators are regularly inspected and exercised
Diesel generator fuel tanks are no less than full at all times
Apron lights are checked daily
Aircraft gate guidance system is checked daily and recalibrated as required
Airside fire hydrants are checked regularly and exercised
Airside emergency stop buttons are checked daily and tested regularly
Runway friction is checked regularly
Maneuvering area surfaces are checked for cracks, spilling, damaged joint seals etc on a
weekly basis
Airside signage lights are checked daily
Airside markings are checked monthly for wear
Fire lanes are marked and kept clear at all times
Comments

Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Airline
6. Environmental Conditions
Wildlife Control
Yes
No
Bird scaring equipment is checked regularly for operation

Bird strikes are reported and remains collected
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 32

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Appendix B - FORMS
Mammals on runway/ taxiways are promptly removed or scared away
Bird scaring guns and ammunition is stored appropriately in locked cabinets
Bird , mammal and rodent poisons are stored appropriately in locked cabinets
Rodent control activities are undertaken regularly
Weather Conditions
Typhoon and electrical storm warning systems are checked and exercised regularly
All visual landing aids are recalibrated after any major earth tremors
All maneuvering surfaces are checked for distress after any major earth tremors
Comments

Airport Staff
ERS
Ground Handler
Fuelling Company
Date
Location
Revision No.
: 02
Date of Issued
: July 2015
Airline
Page App B - 33

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Appendix B - FORMS
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 34

JAKARTA
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Appendix B - FORMS
No
Item Description
General And Certificate
Quality Control
Qualified Personnel
Technical Data Control/ Publication Status
Shelf Life Program
Tools & Test Equipment Calibration
Training
Records and Report
Housing Facility
Comments
10 Safety/ Security/ Fire Protection

11 Storage
Recommendation
Revision No.
: 02
Date of Issued
: July 2015
Page App B - 35

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SAFETY

PT. MATTHEW AIR NUSANTARA

SAFETY MANAGEMENT SYSTEM MANUAL

SAFETY MANAGEMENT PLAN

MANUAL CONTROL SYSTEM

1.3.2. Page Control System

MANUAL REVISION AND DISTRIBUTION PROCEDURE

1.4.1. Revision Procedures

1.4.2. Record of Revisions

1.4.3. Distribution List

SAFETY MANAGEMENT SYSTEM MANUAL

SAFETY MANAGEMENT SYSTEM MANUAL

Safety is a primary importance in our operations. Each of us has the responsibility to

SAFETY MANAGEMENT SYSTEM MANUAL

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

The Safety Management System is regulatory approved document and its

SAFETY MANAGEMENT PLAN

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

MANUAL CONTROL SYSTEM

1.3.2 Page Control System

SAFETY MANAGEMENT SYSTEM MANUAL

SAFETY MANAGEMENT SYSTEM MANUAL

Note : 1. Company logo

SAFETY MANAGEMENT SYSTEM MANUAL

MANUAL REVISION AND DISTRIBUTION PROCEDURE

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

Revisions for the Safety Management System will be distributed with

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

: July 24, 2013

Safety Management System Holder

SAFETY MANAGEMENT SYSTEM MANUAL

SMS REGULATORY REQUIREMENT

2.2. SAFETY MANAGEMENT REGULATION

2.3. ICAO REQUIREMENTS

2.4. STATE SAFETY PERFORMANCE

2.5. MATTHEW AIR NUSANTARA SMS REGULATORY

SAFETY MANAGEMENT SYSTEM MANUAL

SAFETY MANAGEMENT SYSTEM MANUAL

SAFETY MANAGEMENT REGULATION

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

DGCA AC 120-92 Amdt. 1 Safety Management System.

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

STATE SAFETY PERFORMANCE

SAFETY MANAGEMENT SYSTEM MANUAL

SAFETY MANAGEMENT SYSTEM MANUAL

2. Performance monitoring for all State safety functions (licensing, certification,

PT. MATTHEW AIR NUSANTARA SMS REGULATORY REQUIREMENT

: July 24, 2013

SAFETY MANAGEMENT SYSTEM MANUAL

SCOPE OF SAFETY MANAGEMENT SYSTEM

OPERATION OF WORK SCOPE

NATURE OF ORGANIZATION IN AVIATION

EQUIPMENT AND FACILITIES IN

SMS OPERATIONS AND / OR ADMINISTRATION

ELEMENTS OF SAFETY MANAGEMENT SYSTEM

Safety Objective and Goals

3.6.3. Roles and Responsibilities

3.6.4. Non-Punitive Reporting Policy