( FORM : DE-F-69 )

DAYANG ENTERPRISE SDN. BHD.

( 61505-V )

DOCUMENT CHANGE REQUEST

TYPE OF REQUEST : New Form Revised Other:

DATE OF REQUEST : 13/12/19

DESIGNATION/DEPT. : QAQC/ NIPPON PMT
DOCUMENT TITLE : Visual inspection report – piping/ structural
LAST REVISED DATE :
DOCUMENT NO. :
REVISION NO. :

DETAILS OF CHANGE : (To be filled by Applicant)

* New Form please state or define How/Who/When to use the form.

Form is used to verify inspection done on piping and structural during fabrication process. This form
is to be used only for 19S1 Shutdown and Sand Management System project under JX Nippon.
Form will be filled by DESB QC Inspector and verified by Client Representative.

REMARK : (For QAQC use)

Requested By Verified By (QAQC Dept.) Approved By

Name : Name Name
: :
(Director)
Sign : Sign Sign
: :
Date : Date Date
: :

ISSUE 2, REV. 0 SR/HU

AUG ‘17 DE-F-69 / DOCUMENT CHANGE REQUEST