PT LD.

SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name : Rossi Date
Position : INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Offshore
DATE Description Day off
FROM TO Days
26-May-14 8:00 17:00 PT. EXPRO (LGI Job)
27-May-14 ~ ~ PT. EXPRO (LGI Job)
28-May-14 8:00 17:00 PT. EXPRO (LGI Job)
29-May-14 ~ ~ PT. EXPRO (LGI Job)
30-May-14 8:00 17:00 Office
31-May-14 ~ ~ Day Off
1-Jun-14 ~ ~ Day Off
2-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
3-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
4-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
5-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
6-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
7-Jun-14 ~ ~ Day Off
8-Jun-14 ~ ~ Day Off
9-Jun-14 8:00 17:00 Day Off 1
10-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
11-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
12-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
13-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
14-Jun-14 ~ ~ Day Off
15-Jun-14 ~ ~ Day Off
16-Jun-14 8:00 17:00 Sakit 1
17-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
18-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
19-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
20-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
21-Jun-14 ~ ~ Day Off
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
24-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
25-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)

TOTAL 0 Days
Made by, Checked and Approved by,

OPERATION

Name : Rossi Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

onshore Overtime
Days Hrs
1
1
1
1

1
1
1
1
1

1
1
1
1

1
1
1
1

1
1
1

20 Days hours
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name Elvin Rowanda Date
Position :Asst. INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Offshore
DATE Description Day off
FROM TO Days
26-May-14 8:00 17:00 PT. EXPRO (LGI Job)
27-May-14 8:00 17:00 PT. EXPRO (LGI Job)
28-May-14 8:00 17:00 PT. EXPRO (LGI Job)
29-May-14 8:00 17:00 PT. EXPRO (LGI Job)
30-May-14 8:00 17:00 PT. FMC (LGI Job)
31-May-14 ~ ~ Day Off
1-Jun-14 ~ ~ Day Off
2-Jun-14 8:00 17:00 PT. FMC (LGI Job)
3-Jun-14 8:00 17:00 PT. FMC (LGI Job)
4-Jun-14 8:00 17:00 PT. FMC (LGI Job)
5-Jun-14 8:00 17:00 PT. FMC (LGI Job)
6-Jun-14 8:00 17:00 PT. FMC (LGI Job)
7-Jun-14 8:00 17:00 PT. FMC (LGI Job)
8-Jun-14 ~ ~ Day Off
9-Jun-14 8:00 17:00 PT. FMC (LGI Job)
10-Jun-14 8:00 17:00 PT. FMC (LGI Job)
11-Jun-14 8:00 17:00 PT. FMC (LGI Job)
12-Jun-14 8:00 17:00 PT. FMC (LGI Job)
13-Jun-14 8:00 17:00 PT. FMC (LGI Job)
14-Jun-14 ~ ~ Day Off
15-Jun-14 ~ ~ Day Off
16-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
17-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
18-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
19-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
20-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
21-Jun-14 3:30 22:00 RIG RANIWORO 1
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
24-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
25-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)

TOTAL 1 Days
Made by, Checked and Approved by,

OPERATION

Name : Elvin Rowanda Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

onshore Overtime
Days Hrs
1
1
1
1
1

1
1
1
1
1
1

1
1
1
1
1

1
1
1
1
1

1
1
1

23 Days hours
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name Nico Date
Position : Asst. INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Offshore
DATE Description Day off
FROM TO Days
26-May-14 8:00 17:00 PT. EXPRO (LGI Job)
27-May-14 8:00 17:00 PT. EXPRO (LGI Job)
28-May-14 8:00 17:00 PT. EXPRO (LGI Job)
29-May-14 8:00 17:00 PT. EXPRO (LGI Job)
30-May-14 8:00 17:00 Office
31-May-14 ~ ~ Day Off
1-Jun-14 ~ ~ Day Off
2-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
3-Jun-14 8:00 17:00 PT.FMC (LGI Job)
4-Jun-14 8:00 17:00 PT.FMC (LGI Job)
5-Jun-14 8:00 17:00 PT.FMC (LGI Job)
6-Jun-14 8:00 17:00 PT.FMC (LGI Job)
7-Jun-14 ~ ~ Day Off
8-Jun-14 ~ ~ Day Off
9-Jun-14 8:00 17:00 PT.FMC (LGI Job)
10-Jun-14 8:00 17:00 PT.FMC (LGI Job)
11-Jun-14 8:00 17:00 PT.FMC (LGI Job)
12-Jun-14 8:00 17:00 PT.FMC (LGI Job)
13-Jun-14 8:00 17:00 PT.FMC (LGI Job)
14-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
15-Jun-14 ~ ~ Day Off
16-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
17-Jun-14 8:00 17:00 PT.FMC (LGI Job)
18-Jun-14 8:00 17:00 PT.FMC (LGI Job)
19-Jun-14 8:00 17:00 PT.FMC (LGI Job)
20-Jun-14 8:00 17:00 PT.FMC (LGI Job)
21-Jun-14 ~ ~ PT.FMC (LGI Job)
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00 PT.FMC (LGI Job)
24-Jun-14 8:00 17:00 PT.FMC (LGI Job)
25-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)

TOTAL 0 Days
Made by, Checked and Approved by,

OPERATION

Name : Nico Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

onshore Overtime
Days Hrs
1
1
1
1

1
1
1
1
1

1
1
1
1
1
1

1
1
1
1
1
1

1
1
1

24 Days hours
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

April-May 2014
INSPECTION AND CERTIFICATION
Name : Rusdiansyah Date
Position : INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Offshore
DATE Description Day off
FROM TO Days
26-May-14 8:00 17:00
27-May-14 ~ ~ Isra' Mi'Raj Nabi Muhammad
28-May-14 8:00 17:00
29-May-14 ~ ~ Kenaikan Isa Al-masih
30-May-14 8:00 17:00
31-May-14 ~ ~ Day Off
1-Jun-14 ~ ~ Day Off
2-Jun-14 8:00 17:00
3-Jun-14 8:00 17:00
4-Jun-14 8:00 17:00
5-Jun-14 8:00 17:00
6-Jun-14 8:00 17:00
7-Jun-14 ~ ~ Day Off
8-Jun-14 ~ ~ Day Off
9-Jun-14 8:00 17:00
10-Jun-14 8:00 17:00
11-Jun-14 8:00 17:00
12-Jun-14 8:00 17:00
13-Jun-14 8:00 17:00
14-Jun-14 ~ ~ Day Off
15-Jun-14 ~ ~ Day Off
16-Jun-14 8:00 17:00
17-Jun-14 8:00 17:00
18-Jun-14 8:00 17:00
19-Jun-14 8:00 17:00
20-Jun-14 8:00 17:00
21-Jun-14 ~ ~ Day Off
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00
24-Jun-14 8:00 17:00
25-Jun-14 8:00 17:00

TOTAL 0 Days
Made by, Checked and Approved by,

OPERATION

Name : Rusdiansyah Name :

Signature : Signature :
 28-May-14

(At the latest)

lambat)

onshore Overtime
Days Hrs

Days hours
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name : Rahim Date
Position : INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Offshore
DATE Description Day off
FROM TO Days
26-May-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
27-May-14 ~ ~ Isra' Mi'Raj Nabi Muhammad
28-May-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
29-May-14 ~ ~ Kenaikan Isa Al-masih
30-May-14 8:00 17:00 Inspection of LGI (W/S P.BHI CHEVRON PENAJAM) 1
31-May-14 ~ ~ Day Off
1-Jun-14 ~ ~ Day Off
2-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
3-Jun-14 8:00 17:00 Hydrotest CEH & LGI (W/S P.BHI Facility 2 Bppn)
4-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
5-Jun-14 8:00 17:00 Hydrotest CEH and Change Colour Code all unit (Facilicity 2)
6-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
7-Jun-14 8:00 17:00 Floresend Of Packer (W/S P.BHI Facility 2 Bppn)
8-Jun-14 ~ ~ Day Off
9-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
10-Jun-14 8:00 17:00 MPI CEH and Change Colour Code all unit (Facilicity 2)
11-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
12-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
13-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
14-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
15-Jun-14 ~ ~ Day Off
16-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)
17-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
18-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
19-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
20-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
21-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
22-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
23-Jun-14 ~ ~ Pel.Pembinaan Teknis Kualifikasi Inspektur Katup Pengaman Migas
24-Jun-14 ~ ~ Istirahat 1
25-Jun-14 13:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)

TOTAL 1 Days 1 Days

Made by, Checked and Approved by,

OPERATION

Name : Rahim Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

onshore Overtime
Days Hrs
1

1
1
1
1
1
1

1
1
1
1
1
1

16 Days hours
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name Waluyo Sugito Date
Position : Asst INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Onshore
DATE Description Day off
FROM TO Days
26-May-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
27-May-14 ~ ~ Isra' Mi'Raj Nabi Muhammad
28-May-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
29-May-14 ~ ~ Kenaikan Isa Al-masih
30-May-14 8:00 17:00 Inspection of LGI (W/S P.BHI CHEVRON PENAJAM)
31-May-14 ~ ~ Day Off
1-Jun-14 ~ ~ Day Off
2-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
3-Jun-14 8:00 17:00 Hydrotest CMT & LGI (W/S P.BHI Facility 2 Bppn) 1
4-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
5-Jun-14 8:00 17:00 Hydrotest CMT and Change Colour Code all unit (Facilicity 2) 1
6-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
7-Jun-14 8:00 17:00 Floresend Of Packer (W/S P.BHI Facility 2 Bppn) 1
8-Jun-14 ~ ~ Day Off
9-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
10-Jun-14 8:00 17:00 MPI CMT and Change Colour Code all unit (Facilicity 2) 1
11-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
12-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
13-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
14-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
15-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
16-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
17-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
18-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
19-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
20-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
21-Jun-14 ~ ~ Day Off
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
24-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1
25-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn) 1

TOTAL 13 Days
Made by, Checked and Approved by,

OPERATION

Name : Waluyo Sugito Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

Offshore Overtime
Days Hrs

1
1
1
1
1
1
1
1
1
1

11 Days
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name Reza Date
Position : Assist. INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Offshore
DATE Description Day off
FROM TO Days
26-May-14
27-May-14
28-May-14
29-May-14
30-May-14
31-May-14
1-Jun-14
2-Jun-14
3-Jun-14
4-Jun-14
5-Jun-14
6-Jun-14
7-Jun-14
8-Jun-14
9-Jun-14
10-Jun-14
11-Jun-14
12-Jun-14 8:00 17:00 Office
13-Jun-14 8:00 17:00 Office
14-Jun-14 ~ ~ Day Off
15-Jun-14 ~ ~ Day Off
16-Jun-14 8:00 17:00 PT.FMC (LGI Job)
17-Jun-14 8:00 17:00 PT.FMC (LGI Job)
18-Jun-14 8:00 17:00 Day Off 1
19-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
20-Jun-14 8:00 17:00 PT. EXPRO (LGI Job)
21-Jun-14 ~ ~ Day Off
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00 PT.FMC (LGI Job)
24-Jun-14 8:00 17:00 PT.FMC (LGI Job)
25-Jun-14 14:00 17:00 Inspection of LGI (W/S P.BHI Facility 2 Bppn)

TOTAL 1 Days 0 Days

Made by, Checked and Approved by,

OPERATION

Name : Reza Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

onshore Overtime
Days Hrs

1
1

1
1

1
1
1

7 Days hours
 PT LD. SERVIS
Ruko balikpapan Baru Sentra Eropa III, Block AC.6 No.3
Balikpapan 76115, East Kalimantan - Indonesia
Phone / Fax +62 542 - 7204212, +62 8125558245

MONTHLY TIME SHEET

May-June 2014
INSPECTION AND CERTIFICATION
Name Hanan Pramudiyo Date
Position : Asst INSPECTOR
This form must be submitted for review to operation at the end of every month (At the late
Form ini harus di serahkan kepada Operation setiap akhir bulan (Paling lambat)

TIME Onshore
DATE Description Day off
FROM TO Days
26-May-14
27-May-14
28-May-14
29-May-14
30-May-14
31-May-14
1-Jun-14
2-Jun-14
3-Jun-14
4-Jun-14
5-Jun-14
6-Jun-14
7-Jun-14
8-Jun-14
9-Jun-14
10-Jun-14
11-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
12-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
13-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
14-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
15-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
16-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
17-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
18-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
19-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
20-Jun-14 8:00 17:00 Inspection of LGI (W/S P.BHI Muara Badak)
21-Jun-14 ~ ~ Day Off
22-Jun-14 ~ ~ Day Off
23-Jun-14 8:00 17:00 PT. EXPRO (LGI Job) 1
24-Jun-14 8:00 17:00 PT. EXPRO (LGI Job) 1
25-Jun-14 8:00 17:00 PT. EXPRO (LGI Job) 1

TOTAL 3 Days
Made by, Checked and Approved by,

OPERATION

Name : Hanan Pramudiyo Name :

Signature : Signature :
 25-Jun-14

(At the latest)

lambat)

Offshore Overtime
Days Hrs

1
1
1
1
1
1
1
1
1
1

10 Days