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QI-S.0.

06
Doc.No.:

Contrac No:
4650000076
Subject : Survey Data Report Project No: 171612 Date :
Project : Gas Development Project For The Unitization Of The Jambaran Tiung Biru Field System/Subsystem No. :
Cilent : PEPC Location
Reference Drawing : Rev
COORDINATE ACTUAL COORDINATE DESIGN DIFFERENT Acc. ELEVATION Acc.
No. Point No. Diff. REMARKS / SKETCH
N E N E N E Y/N ACTUAL DESIGN Y/N

Remarks :

Prepared by Checked / Approved by Reviewed / Witnessed by

SUBCONTRACTOR CONTRACTOR COMPANY

Print Name

Signature

Date

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