FIELD INSPECTION

REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0004
SYSTEM NO. :
DATE : 15-Mar-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Megah Mulia Baja
DELIVERY DATE : 15 March 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 6mm Y181004 B09 1 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 213033

COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0005
SYSTEM NO. :
DATE : 4-Mar-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Pratiwi Prima Baja
DELIVERY DATE : 03 March 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 3mm Y180829B12 5 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 219327
2 Inspection Material Certificate No. 195873
3 Inspection Material Certificate No. 3184176
COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0005
SYSTEM NO. :
DATE : 4-Mar-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Pratiwi Prima Baja
DELIVERY DATE : 03 March 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 10mm V2XR 1 X

2 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 6mm 416796 1 X

3 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 16mm 411570 1 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 219327
2 Inspection Material Certificate No. 195873
3 Inspection Material Certificate No. 3184176
COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0005
SYSTEM NO. :
DATE : 4-Feb-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Carbonsteel Material SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Sinarindo Megah Perkasa
DELIVERY DATE : 04 February 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 H Beam 250x250x9x14 B18101703 4 X

2 Pipa 1 1/2" Sch 80 @6m N/A 4 X

3 Pipa 2" Sch 80 @6m 11206842-2 1 X

4 Beton Polos 22m x 12m N/A 1 X

5 Plat Strip 6x100 6m N/A 2 X

6 Beton Polos 16m x 12m N/A 1 X

7 Plat Strip4x50 6m N/A 2 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 0476/LT.GRD/I/2019
2 Inspection Material Certificate No. 1446/IX/ISTW/18
3 Inspection Material Certificate No. F356070
COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0004
SYSTEM NO. :
DATE : 1-Feb-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Megah Mulia Baja
DELIVERY DATE : 30 January 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 10mm N4TH 1 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 135474

COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0003
SYSTEM NO. :
DATE : 31-Jan-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Pratiwi Prima Baja
DELIVERY DATE : 30 January 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 8mm TIKD 2 X

Plate ASTM A240/A240M-16a 304L 5"x20 Thk 3mm

2 417937 1 X
(perforated)

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 213035

COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0002
SYSTEM NO. :
DATE : 31-Jan-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Megah Mulia Baja
DELIVERY DATE : 30 January 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 6mm Y181004 B09 6 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 213035

COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001

 FIELD INSPECTION
REPORT

ITP NO. :
INSPECTION GR. :
REPORT NO. : SRI-QC-MRI-0001
SYSTEM NO. :
DATE : 16-Jan-19
BACK TO ITP
INSPECTION TYPE : WORK NO. :
ITEM NO. :
EQUIPMENT/MATERIAL RECEIVING INSPECTION
AREA/LOCATION : Workshop Soreang
ITEM DESCRIPTION : Plate SS 304L SIGNATURE
INSPECTION NOTICE NO. : PREPARED BY CHECK BY REVIEWED BY
CLIENT'S INSPECTOR : / / / / / /
CONTRACTOR'S INSPECTOR : Vinas Kusdinar
SUB-CONTRACTOR'S INSPECTOR : N/A
EQUIPMENT DETAIL
REQUISITION NO. :
DESCRIPTION :
SUPPLIER/VENDOR : PT. Sustec Indonesia
DELIVERY DATE : 14 January 2019
DRAWING NO. :
INSPECTION ITEM
NO. CHECK ITEMS HEAT NUMBER QTY ACC REJ NA REMARK

1 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 6mm T8VP 1 X

2 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 6mm Y180827E09 5 X

3 Plate ASTM A240/A240M-16a 304L 5"x20 Thk 6mm Y180422B07 5 X

10

11

12

13

ATTACHMENT LIST
NO. DOCUMENT DESCRIPTION REMARKS
1 Inspection Material Certificate No. 206190
2 Inspection Material Certificate No. 202098
3 Inspection Material Certificate No. 206191
COMMENT/SKETCH :
LEGEND ACC : ACCEPTED N.A : NOT APPLICABLE REJ : REJECT

FORM NO. GM-001