MATERIAL INSPECTED THIS VISIT

Item Tag No., Batch No.,

Quantity Description
Code Serial No., Cast, Heat No.
Witnessed Burst Test for Cylinders
1 3710
(Batch No. LPG/26.2 L/008 - SR.No: — 3522 to 4024
Witnessed Burst Test for Cylinders
2 3577 & 3935
(Batch No. LPG/26.2 L/008 - SR.No: — 3522 to 4024
Witnessed Burst Test for Cylinders
1 4213
(Batch No. LPG/26.2 L/009 - SR.No: — 4025 to 4527
Witnessed Burst Test for Cylinders
2 4080 & 4438
(Batch No. LPG/26.2 L/009 - SR.No: — 4025 to 4527
Witnessed Burst Test for Cylinders
1 4716
(Batch No. LPG/26.2 L/010 - SR.No: — 4528 to 5030
Witnessed Burst Test for Cylinders
2 4584 & 4941
(Batch No. LPG/26.2 L/010 - SR.No: — 4528 to 5030
Witnessed Burst Test for Cylinders
1 5221
(Batch No. LPG/26.2 L/011 - SR.No: — 5031 to 5533
Witnessed Burst Test for Cylinders
2 5090 & 5447
(Batch No. LPG/26.2 L/011 - SR.No: — 5031 to 5533
Witnessed Burst Test for Cylinders
1 5724
(Batch No. LPG/26.2 L/012 - SR.No: — 5534 to 6036
--
Witnessed Burst Test for Cylinders
2 5593 & 5950
(Batch No. LPG/26.2 L/012 - SR.No: — 5534 to 6036
Witnessed Burst Test for Cylinders
1 6300
(Batch No. LPG/26.2 L/013 - SR.No: — 6037 to 6539
Witnessed Burst Test for Cylinders
2 6199 & 6401
(Batch No. LPG/26.2 L/013 - SR.No: — 6037 to 6539
Witnessed Burst Test for Cylinders
1 6750
(Batch No. LPG/26.2 L/014 - SR.No: — 6540 to 7042
Witnessed Burst Test for Cylinders
2 6645 & 6900
(Batch No. LPG/26.2 L/014 - SR.No: — 6540 to 7042
Witnessed Burst Test for Cylinders
1 7359
(Batch No. LPG/26.2 L/015 - SR.No: — 7043 to 7545
Witnessed Burst Test for Cylinders
2 7118 & 7452
(Batch No. LPG/26.2 L/015 - SR.No: — 7043 to 7545
Witnessed Burst Test for Cylinders
1 7794
(Batch No. LPG/26.2 L/016 - SR.No: — 7546 to 8048
Witnessed Burst Test for Cylinders
2 7601 & 7979
(Batch No. LPG/26.2 L/016 - SR.No: — 7546 to 8048
RESULTS OF Accepted Not Compliant ORDER STATUS: Complete Incomplete
INSPECTION:

L5-FMT-046 Rev. 03
 1.Report Headings: 2.Persons Present 3.Documentation Used /Approval Status 4.Inspection Carried Out 5.HSE Feedback
on the Vendor 6.Results/Conclusions 7.Overall Order Status 8.Next Visit/Exit Call 9.Attachments/Photos

1.0 SUMMARY:

Please refer clause 4.0 of this report for more details.

ATTACHMENTS: NCR Punch list Partial Release Balance Release Full PO Release
RECORD OF HOURS

2.0 PERSONS PRESENT:

3.0 DOCUMENTATION USED / APPROVAL STATUS:
 UAE’S GSO ISO 22991

4.0 INSPECTION CARRIED OUT (reference ITP clause if applicable):

 Witnessed Burst Test for the below mentioned cylinders with Achieved Result :-
Cylinder Capacity Burst Pressure Achieved
Serial No.
(Liter) (Bar)

L5-FMT-046 Rev. 03
 1.Report Headings: 2.Persons Present 3.Documentation Used /Approval Status 4.Inspection Carried Out 5.HSE Feedback
on the Vendor 6.Results/Conclusions 7.Overall Order Status 8.Next Visit/Exit Call 9.Attachments/Photos

26.2 3710 111.12

26.2 4213 110.12
26.2 4716 108.12
26.2 5221 111.62
26.2 5724 109.12
26.2 6300 110.12
26.2 6750 109.12
26.2 7359 108.62
26.2 7794 111.62
 Burst test pressure value for above all meets the standard requirements - Found acceptable.
 Witnessed Mechanical Tests and found to be Satisfactory.
 Verified calibration certificates and found valid.

5.0 HSE FEEDBACK ON VENDOR: General HSE is followed by the Client.

6.0 RESULTS / CONCLUSIONS: Satisfactory .

7.0 OVERALL ORDER STATUS: Ongoing.

DELIVERY:
PO Delivery Date Current Scheduled Delivery Delivery Point Comments
N.A N.A N.A N.A

8.0 NEXT VISIT / EXIT CALL (must give estimated date if no fixed date; include stage/activity details): TBA.

9.0 ATTACHMENTS: NA

Photos:

- End of Report –

L5-FMT-046 Rev. 03