Lds-Jsa-001 - Jsa Forklift

SUMMARY OF LIFTING EQUIPMENT INSPECTION
Client Name : PT. APEXINDO PRATAMA DUTA Tbk. Location : RANIWORO RIG
Date : January 2014 WO No. : 062/STI-WO/12-13
TYPE OF INSPECTION RESULT OF INSPECTION

Date of SERIAL SWL/WLL/
NO CATEGORY ITEM / EQUIPMENT LOCATION DEFECT FOUND SUGGESTION REMARKS
Inspection NUMBER PAYLOAD
VISUAL NDT TEST ACCEPTED REJECTED
Page 1 of 62

1 SC 6-Jan-14 Bow Shackle with safety bolt RWO SC O2 55 ton Below Rig floor √ — — √ — — — Fit For Use
2 SC 6-Jan-14 Bow Shackle with safety bolt 17479 - 04 55 ton Below Rig floor √ — — √ — — — Fit For Use
3 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 25 feet SOE-01415 3 ton Cantiliver area √ - — — √ Broken wire Remove from servis Not fit for use
4 WRS 6-Jan-14 1 leg wire rope sling with ferrule, 40 x 2100 mm TC-12396-1 18.5 ton Cantiliver area √ — — √ — — — Fit For Use
6 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm 00E-6124-03 3 ton Cantiliver area √ — — √ — — — Fit For Use
7 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 8000 mm F12J 3919 3.7 ton Cantiliver area √ — — √ — — — Fit For Use
9 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm 00E - B098-15 3 ton Cantiliver area √ — — √ — — — Fit For Use
10 WRS 6-Jan-14 2 legs wire rope, 26 x 2530 mm KIM 14485 10 ton Cantiliver area √ — — √ — — — Fit For Use
11 WRS 6-Jan-14 1 leg wire rope sling with ferrule, 18 x 1500 mm BTCT-1381-04 3 ton Cantiliver area √ — — √ — — — Fit For Use
12 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm MTC - 0032050 3 ton Cantiliver area √ — — √ — — — Fit For Use
13 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm TOTAL13091493 3 ton Cantiliver area √ - — √ — — — Fit For Use
14 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm 11 / 0112 / 238 3.2 ton Cantiliver area √ - — √ — — — Fit For Use
15 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm AR 17561 3 ton Cantiliver area √ - — √ — — — Fit For Use
16 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 7000 mm F10E 2064 3 ton Cantiliver area √ - — √ — — — Fit For Use
17 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm TOTAL13091297 3.7 ton Cantiliver area √ - — √ — — — Fit For Use
18 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm TOTAL 300 3.7 ton Cantiliver area √ - — √ — — — Fit For Use
19 SC 6-Jan-14 Bow Shackle with safety bolt 2098817 8.5 ton Main deck area √ - — √ — — — Fit For Use
20 SC 6-Jan-14 Bow Shackle with safety bolt F08C 1160 4 3/4 ton Main deck area √ - — √ — — — Fit For Use
21 CB 6-Jan-14 Chain Block ( MNF : Kondo ) NSC CB - 34 3 ton Main deck area √ - — √ — — — Fit For Use
22 BC 6-Jan-14 Beam Clamp 980078 3360 lbs Main deck area √ √ — √ — — — Fit For Use
Note : Report still in progress

Pad eye samson post & Support Samson post in main deck area there is not inspection because had the hansd tied CCU
Prepared by,
PT. Safetech Indonesia
Rusdiansyah
Inspector Client Representative
Page 2 of 62
PT. LD SERVIS
Desk. pekerjaan : Forklift Inspection No JSA : FI-2015-LDS001

Lokasi inspeksi : Tanggal Diajukan : 03 November 2015
Referensi : LOLER Tanggal Direvisi : 10 April 2018
Persyaratan APD Minimal: Coverall, Sepatu Safety, Sarung Tangan, Helm Safety dan persyaratan APD lain selama dibutuhkan
Langkah
Tindakan Potensi Bahaya Tindakan Pencegahan Dilakukan Oleh
Bekerja
miskomunikasi antara klien

dan pelaksana kerja. Lakukan pembicaraan mengenai keselamatan, pertemuan
1 Safety talk, dan diskusi JSA Informasi mengenai bahaya untuk penilaian risiko sebelum bekerja Inspector & Client
& resiko tidak tersampaikan
miskomunikasi antara klien

2 Membuat izin Kerja/Work Permit dan pelaksana kerja. Koordinasi antara klien dan pelaksana pekerjaan Inspektor.
Kesalahan informasi pada
lembar izin kerja.
Memeriksa lokasi kerja apakah terjatuh, tergelincir, Sebelum inspeksi, cek lokasi kerja, setiap penilaian risiko
### 3 memungkinkan untuk melakukan pekerjaan harus mengevaluasi dan mempertimbangkan Inspektor/ Asisten
pekerjaan di tempat tersebut tersandung setiap potensi kerusakan atau bahaya
Kurangnya peralatan, Pastikan perlengkapan dan peralatan yang akan digunakan

4 Mempersiapkan peralatan untuk Perlatan yg digunakan tidak sudah diperiksa melalui checklist peralatan yg sesuai dengan Inspektor/Asisten
bekerja sesuai dengan fungsinya, scope pekerjaan, Pastikan perlatan berfungsi dengan baik
Perlatan rusak dan cek validasi sertifikat kalibrasi perlatan yg digunakan
terjatuh, tergelincir, Gunakan APD dan peralatan dengan baik dan benar,
5 Inspeksi visual tersandung, bekerja pada Inspektor/Asisten
ketinggian, terjepit perhatikan pijakan kaki ketika melangkah.
Pembersihan awal sebelum iritasi, tergelincir, terjatuh, Gunakan APD dan peralatan dengan baik dan benar,
6 melakukan inspeksi tersandung perhatikan pijakan kaki ketika melangkah. Inspektor/Asisten
Melakukan pengujian NDT pada iritasi, tergelincir, terjatuh, Gunakan APD dengan baik dan benar, Pastikan pencahayaan
7 critical event terhirup chemical cukup untuk melakukan NDT, jangan melawan arah angin Inspektor
ketika menyemprotkan chemical
PT. LD SERVIS
Desk. pekerjaan : Forklift Inspection No JSA : FI-2015-LDS001

Lokasi inspeksi : Tanggal Diajukan : 03 November 2015
Referensi : LOLER Tanggal Direvisi : 10 April 2018
memasang police line diarea yg akan digunakan, Pastikan

forklift dalam keadaan baik, pastikan operator memahami
beban terjatuh, fork distorsi, pekerjaan yg akan dilakukan, pastikan peralatan yg
8 Proof Load Test overload digunakan sesuai dengan kapasitasnya dan dibuktikan Inspektor
dengan sertifikat yg masih valid, gunakan hanya 1 orang
signal man yg memberikan instruksi ketika melakukan load
test.
iritasi, tergelincir, terjatuh, Gunakan APD dengan baik dan benar, Pastikan pencahayaan
9 NDT setelah load test tersandung, terhirup cukup untuk melakukan NDT, jangan melawan arah angin Inspektor
chemical ketika menyemprotkan chemical,
ergonomi, kesalahan Pastikan semua data yg di catat sesuai dengan yg tertera

Catatan inspeksi pencatatan, fatigue pada data plate/marking yg ada di peralatan yg dikerjakan, Inspektor/Asisten
(kelelahan) review dengan dokumen manufactur/ laporan sebelumnya.
Gunakan APD dengan baik dan benar, bersihkan area

10 Pembersihan dan penyusunan peralatan tercecer,terjatuh, kerja,gunakan check list peralatan untuk memastikan tidak Inspector/Asisten
peralatan tergelincir, tersandung ada peralatan yg tercecer/lupa, pastikan peralatan yg telah
digunakan dalam kondisi baik dan berfungsi
11 Menutup ijin kerja/Closed permit Inspector
### Dilakukan Oleh: JSA Diperiksa Oleh : Diperiksa Oleh : Disetujui Oleh :
###
###
Iles Aidil/Theresia Anna Fransiska
Tanggal Bekerja: QHSE PT. LD Servis Pemilik/Perwakilan Perusahaan
###
PT. LD SERVIS
JOB SAFETY ANALYSIS
Job Description : Lifting Equipment & Lifting Gear Inspection Issued Date : August 28, 2014
Place of Inspection : PT. FMC Technology Last Reviewed Date :
References : As per owner requirement Reviewed by :
Minimum PPE Required : Coveral, Safety Shoes, Hand Gloves, Safety Helmet Any Requirement PPE as
Jon Step Actions Potential Hazard Loss Accident Preventive Actions Actions By
1 Job Safety meeting miss communication between client and safety talks, pre job meeting risk assessment
performed to work
2 work permit miss communication between client and safety talks, pre job meeting risk assessment
performed to work
a. Examination check for work location make a
possible move to do work. Prior to be checked first working location before doing work, any risk assesment
3 fall slip stumble to work should be evaluate and consider for any potential damage or dangerous
b. Visual check for unit to have a test hazard.
Prior to be checked first working location before doing work, any risk assesment
4 Preparation for equipment to do work. fall slip stumble to work should be evaluate and consider for any potential damage or dangerous
hazard.
Prior to be checked first working location before doing work, any risk assesment
5 Visual inspection and dimension check fall slip stumble to work should be evaluate and consider for any potential damage or dangerous
hazard.
6 Pre cleaning for method before applying testing. irritation slip, fall, stumble using PPE safety glasses coverall
Applying NDT testing and Tag Number for several

7 irritation slip, fall, stumble using PPE safety glasses coverall
equipment which has no identification number.
8 Testing of pad eyes slip fall stumble using PPE safety glasses coverall
9 Inspection record irritation slip, fall, stumble using PPE safety glasses coverall
10 Post cleaning and housekeeping slip fall stumble using PPE safety glasses coverall
11 Close permit (job finished)
Performed by : JSA Reviewed by : Reviewed by Approved by :

PT. LD SERVIS
JOB SAFETY ANALYSIS
Job Description : Lifting Equipment & Lifting Gear Inspection Issued Date : August 28, 2014
Place of Inspection : PT. FMC Technology Last Reviewed Date :
References : As per owner requirement Reviewed by :
Approved by :
1
3 Iles Aidil
4 QHSE PT. LD Servis Owner / User Representative

Page 7 of 62

1 BP 7-Jan-14 Bushing push N/A N/A Rig floor √ √ — √ — — — Fit For Use
2 BP 7-Jan-14 Hook bushing push (4 ea) N/A N/A Rig floor √ √ — √ — — — Fit For Use
3 LC 7-Jan-14 Lifting Cap 7 5/8 LC 05 / PN 32 4.6 ton Main deck (Port side ) √ √ — √ — — — Fit For Use
4 LC 7-Jan-14 Lifting Cap 5 1/2 BX 12 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
6 LC 7-Jan-14 Lifting Cap 7 5/8 LC 024 4.6 ton Main deck (Port side ) √ √ — √ — — — Fit For Use
8 LC 7-Jan-14 Lifting Cap 4 1F LC 45 / 2141 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
9 LC 7-Jan-14 Lifting Cap 4 1F 1389 / BX 13 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
16 LC 7-Jan-14 Lifting Cap 4 1/2 1F LC 22 4.6 ton Main deck (Port side ) √ √ — √ — — — Fit For Use
19 LC 7-Jan-14 Lifting Cap 7 5/8 BX 17 4.6 ton Main deck (Port side ) √ √ — √ — — — Fit For Use
23 SLF 7-Jan-14 Skid life boat APD BLF - 601 3000 kg Top Deck √ — — √ — — — Fit For Use
24 WRS 7-Jan-14 2 Legs wire rope sling, 18 x 3000 mm AR 15428 5 ton Top Deck √ — — √ — — — Fit For Use
25 WRS 7-Jan-14 1 Leg wire rope sling soft eye, 16 x 1000 mm 12 / 2432 / 9 2.16 ton Main deck (Port side ) √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 8 of 62

1 SC 6-Jan-14 Bow Shackle with safety bolt RWO SC O2 55 ton Below Rig floor √ — — √ — — — Fit For Use
2 SC 6-Jan-14 Bow Shackle with safety bolt 17479 - 04 55 ton Below Rig floor √ — — √ — — — Fit For Use
3 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 25 feet SOE-01415 3 ton Cantiliver area √ - — — √ Broken wire Remove from servis Not fit for use
7 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 8000 mm F12J 3919 3.7 ton Cantiliver area √ — — √ — — — Fit For Use
9 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm 00E - B098-15 3 ton Cantiliver area √ — — √ — — — Fit For Use
10 WRS 6-Jan-14 2 legs wire rope, 26 x 2530 mm KIM 14485 10 ton Cantiliver area √ — — √ — — — Fit For Use
11 WRS 6-Jan-14 1 leg wire rope sling with ferrule, 18 x 1500 mm BTCT-1381-04 3 ton Cantiliver area √ — — √ — — — Fit For Use
12 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm MTC - 0032050 3 ton Cantiliver area √ — — √ — — — Fit For Use
13 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm TOTAL13091493 3 ton Cantiliver area √ - — √ — — — Fit For Use
14 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm 11 / 0112 / 238 3.2 ton Cantiliver area √ - — √ — — — Fit For Use
15 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 6000 mm AR 17561 3 ton Cantiliver area √ - — √ — — — Fit For Use
16 WRS 6-Jan-14 1 leg wire rope sling soft eye, 16 x 7000 mm F10E 2064 3 ton Cantiliver area √ - — √ — — — Fit For Use
17 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm TOTAL13091297 3.7 ton Cantiliver area √ - — √ — — — Fit For Use
18 WRS 6-Jan-14 1 leg wire rope sling soft eye, 18 x 6000 mm TOTAL 300 3.7 ton Cantiliver area √ - — √ — — — Fit For Use
19 SC 6-Jan-14 Bow Shackle with safety bolt 2098817 8.5 ton Main deck area √ - — √ — — — Fit For Use
20 SC 6-Jan-14 Bow Shackle with safety bolt F08C 1160 4 3/4 ton Main deck area √ - — √ — — — Fit For Use
21 CB 6-Jan-14 Chain Block ( MNF : Kondo ) NSC CB - 34 3 ton Main deck area √ - — √ — — — Fit For Use
25 LC 6-Jan-14 Lifting Cap 3 1/2 1F LC 06 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
Page 9 of 62

27 LC 6-Jan-14 Lifting Cap 4" 1F LC 45 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
29 LC 6-Jan-14 Lifting Cap LC 47 / 1382 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
30 LC 6-Jan-14 Lifting Cap LC 05 / A 4856 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
31 LC 6-Jan-14 Lifting Cap LC 15 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
32 LC 6-Jan-14 Lifting Cap 3 1/2 1H LC 53 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
33 LC 6-Jan-14 Lifting Cap 4" 1F LC 41 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
42 LC 6-Jan-14 Lifting Cap 3 1/2 1F NCB 1145 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
43 LC 6-Jan-14 Lifting Cap N/A N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
44 LC 6-Jan-14 Lifting Cap 13821 LP 3532 N/A Main deck (Port side ) √ √ — √ — — — Fit For Use
45 LC 6-Jan-14 Lifting Cap 7 5/8 LC 37 / BX 04 4.6 ton Main deck (Port side ) √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 10 of 62

50 SP 5-Jan-14 Pad eye Samson post SP 28 - Main Deck area √ √ — √ — — — Fit For Use
70 SSP 5-Jan-14 Support Samson post - - Main Deck area √ √ — √ — — — Fit For Use
Page 11 of 62

83 SP 5-Jan-14 Pad eye Samson post SP 48 - Cantiliver area √ √ — √ — — — Fit For Use
87 DC 5-Jan-14 Pad eye David Crane DV 01 - Main Deck (port side) √ √ — √ — — — Fit For Use
88 DC 5-Jan-14 Pad eye David Crane DV 02 - Main Deck (star boat side) √ √ — √ — — — Fit For Use

Pad eye samson post & Support Samson post in main deck area there is not inspection because had the hansd tied CCU
Prepared by,
Rusdiansyah
Page 12 of 62

1 BT 5-Jan-14 Traveling beam trolley 0160056 V1 10 ton Below cantiliver √ √ — √ — — — Fit For Use
2 CB 5-Jan-14 Chain block ( MNF : OSM ) 0451 643 10 ton Below cantiliver √ √ — √ — — — Fit For Use
3 SC 5-Jan-14 Bow Shackle with safety bolt RWO SC 05 12 ton Below cantiliver √ — — √ — — — Fit For Use
4 BT 5-Jan-14 Traveling beam trolley NTG 0055 V1 10 ton Below cantiliver √ √ — √ — — — Fit For Use
5 CB 5-Jan-14 Chain block ( MNF : OSM ) 045 E 645 10 ton Below cantiliver √ √ — √ — — — Fit For Use
6 SC 5-Jan-14 Bow Shackle with safety bolt RWO SC 06 12 ton Below cantiliver √ — — √ — — — Fit For Use
7 BT 5-Jan-14 Traveling beam trolley 23349 5 ton Below cantiliver √ √ — √ — — — Fit For Use
8 WRS 5-Jan-14 2 Legs wire rope sling, 18 x 2700 mm AR 17570 3.7 ton Below cantiliver √ — — √ — — — Fit For Use
9 WRS 5-Jan-14 1 Leg wire rope sling with ferrule, 43 x 4450 mm A 024 24.8 ton Below cantiliver √ — — √ — — — Fit For Use
10 PE 5-Jan-14 Pad eye PM 11 2 ton Pump room √ √ — √ — — — Fit For Use
11 PE 5-Jan-14 Pad eye PM 1 - Pump room √ √ — √ — — — Fit For Use
17 PE 5-Jan-14 Pad eye PM 16 1.5 ton Pump room √ √ — √ — — — Fit For Use
Page 13 of 62

47 PE 5-Jan-14 Pad eye PM 07 N/A Pump room √ √ — — √ pad eye bend Repair Fit For Use
48 SC 5-Jan-14 Stoper Catwork N/A - Cantiliver area √ √ — √ — — — Fit For Use
49 TJ 5-Jan-14 Tool Joint N/A - Cantiliver area √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 14 of 62

1 CCU 4-Jan-14 Container CNHU 8028843 5000 kg Main deck (port side) √ — — √ — — — Fit For Use
2 WRS 4-Jan-14 4 legs wire rope sling, 24 x 4000 mm SL 2022119 8.6 ton Main deck (port side) √ — — √ — — — Fit For Use
3 SC 4-Jan-14 Bow Shackle with safety bolt SC 01 8028843 6.5 ton Main deck (port side) √ — — √ — — — Fit For Use
7 SC 4-Jan-14 Bow Shackle with safety bolt SC 1294 55 ton Main deck (port side) √ — — √ — — — Fit For Use
8 CH 4-Jan-14 Clamp House 9 ea N/A Main deck (port side) √ √ — √ — — — Fit For Use
9 SB 4-Jan-14 Snatch Block ( MNF : MC Kissick ) E 412 4 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
10 SB 4-Jan-14 Sperder Bar SB - 01 4 ton Leg 3 ( port side ) √ √ — √ — — — Fit For Use
11 WRS 4-Jan-14 2 legs wire rope sling, 22 x 6000 mm AR 16236 7.8 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
12 WRS 4-Jan-14 1 leg wire rope sling with ferrule, 22 x 2000 mm AR 16237 5.65 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
13 WRS 4-Jan-14 1 leg wire rope sling with ferrule, 22 x 2000 mm AR 16238 5.65 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
14 SC 4-Jan-14 Bow Shackle with safety bolt SC 01 SB 1 6.5 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
18 SC 4-Jan-14 Bow Shackle with safety bolt RWO SC 1 LEG 3 3.25 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
19 PE 4-Jan-14 Pad eye LEG 3 - PE 01 2 ton Leg 3 ( port side ) √ √ — √ — — — Fit For Use
Single leg steel wire rope both ands fitted with closed
20 WRS 4-Jan-14 spelter socket, 64 x 40000 mm 13 / 2708 / 1 60.52 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
21 WRS 4-Jan-14 spelter socket, 64 x 40000 mm 13 / 2708 / 2 60.52 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
22 WRS 4-Jan-14 1 leg wire rope sling soft eye, 64 x 14000 mm 13 / 2489 / 1 60. 52 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
23 WRS 4-Jan-14 1 leg wire rope sling soft eye, 64 x 14000 mm 13 / 2489 / 2 60. 52 ton Leg 3 ( port side ) √ — — √ — — — Fit For Use
24 PE 4-Jan-14 Pad eye N/A - Leg 3 ( port side ) √ √ — √ — — — Fit For Use
Page 15 of 62

29 PE 4-Jan-14 Pad eye LEG 2 - PE 01 2 ton Leg 2 ( star boat side ) √ √ — √ — — — Fit For Use
30 PE 4-Jan-14 Pad eye EL - 01 N/A Leg 2 ( star boat side ) √ √ — √ — — — Fit For Use
32 PE 4-Jan-14 Pad eye STL - 01 N/A Leg 2 ( star boat side ) √ √ — √ — — — Fit For Use
39 SB 4-Jan-14 Snatch Block ( MNF : MC Kissick ) 1 C 107 4 ton Leg 2 ( star boat side ) √ — — √ — — — Fit For Use
40 PE 4-Jan-14 Pad eye LEG 1 - PE 01 2 ton Leg 1 ( star boat side ) √ √ — √ — — — Fit For Use
41 SB 4-Jan-14 Snatch Block ( MNF : MC Kissick ) 1E 412 4 ton Leg 1 ( star boat side ) √ — — √ — — — Fit For Use
42 SC 4-Jan-14 Bow Shackle with safety bolt RWO SC 1 LEG 1 4 3/4 ton Leg 1 ( star boat side ) √ — — √ — — — Fit For Use
43 SC 4-Jan-14 Bow Shackle with safety bolt RWO SC 2 LEG 1 4 3/4 ton Leg 1 ( star boat side ) √ — — √ — — — Fit For Use
44 BT 4-Jan-14 Beam trolley RWB 5 0.5 ton Pump room √ √ — √ — — — Fit For Use
48 BT 4-Jan-14 Beam trolley RWB 9 1 ton Pump room √ √ — √ — — — Fit For Use
49 BT 4-Jan-14 Beam trolley RWB 11 5 ton Engine room √ √ — √ — — — Fit For Use
50 BT 4-Jan-14 Beam trolley TF - CR 01 0.5 ton Compreesor room √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 16 of 62

1 PE 3-Jan-14 Pad eye gas separator 6 ea N/A Rig floor √ √ — √ — — — Fit For Use
2 PE 3-Jan-14 Pad eye tong post 3 ea N/A Rig floor √ √ — √ — — — Fit For Use
3 PE 3-Jan-14 Pad eye Iron roughnek 11 ea N/A Rig floor √ √ — √ — — — Fit For Use
4 SC 3-Jan-14 Bow Shackle with safety bolt 108B 0272 2 ton Rig floor √ — — √ — — — Fit For Use
5 SC 3-Jan-14 Bow Shackle with safety bolt F12H 2926 12 ton Rig floor √ — — √ — — — Fit For Use
6 SC 3-Jan-14 Bow Shackle with safety bolt 153-0 35 ton Rig floor √ — — √ — — — Fit For Use
7 SC 3-Jan-14 Bow Shackle with safety bolt SP 54 35 ton Rig floor √ — — √ — — — Fit For Use
8 WRS 3-Jan-14 1 leg wire rope sling soft eye, 28 x 3000 mm 4888 10.5 ton Rig floor √ — — √ — — — Fit For Use
9 SC 3-Jan-14 Bow Shackle with safety bolt F12K 4167 17 ton Rig floor √ — — √ — — — Fit For Use
10 SC 3-Jan-14 Bow Shackle with safety bolt F12L 4453 8.5 ton Rig floor √ — — √ — — — Fit For Use
11 SC 3-Jan-14 Bow Shackle with safety bolt N/A 8.5 ton Rig floor √ — — √ — — — Fit For Use
12 SC 3-Jan-14 Bow Shackle with safety bolt RWO SC 07 8.5 ton Rig floor √ — — √ — — — Fit For Use
13 SC 3-Jan-14 Bow Shackle with safety bolt FV - 2605 8.5 ton Rig floor √ — — √ — — — Fit For Use
14 SC 3-Jan-14 Bow Shackle with safety bolt RWO SC 03 12 ton Rig floor √ — — √ — — — Fit For Use
16 SC 3-Jan-14 Bow Shackle with safety bolt N/A 4. 3/4 ton Rig floor √ — — √ — — — Fit For Use
17 SC 3-Jan-14 Bow Shackle with safety bolt 4011489 35 ton Rig floor √ — — √ — — — Fit For Use
19 SC 3-Jan-14 Bow Shackle with safety bolt SC RW 51 50 ton Rig floor √ — — √ — — — Fit For Use
20 SC 3-Jan-14 Bow Shackle with safety bolt SC RW 32 50 ton Rig floor √ — — √ — — — Fit For Use
21 PE 3-Jan-14 Pad eye Rig floor RF 01 N/A Rig floor √ √ — √ — — — Fit For Use
25 PE 3-Jan-14 Pad eye Rig floor RF 05 4 ton Rig floor √ √ — √ — — — Fit For Use
Page 17 of 62

36 PE 3-Jan-14 Pad eye Rig floor N/A N/A Rig floor √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 18 of 62

1 SC 2-Jan-14 Bow Shackle with safety bolt F11G 2166 17 ton Crown Block area √ — — √ — — — Fit For Use
2 SC 2-Jan-14 Bow Shackle with safety bolt N/A 6.5 ton Crown Block area √ — — √ — — — Fit For Use
3 PE 2-Jan-14 Pad eye CRP 01 5 ton Crown Block area √ √ — √ — — — Fit For Use
4 PE 2-Jan-14 Pad eye CRP 09 N/A Crown Block area √ √ — √ — — — Fit For Use
5 SB 2-Jan-14 Snatch Block ( MNF : Westrn Block ) 900114 N/A Crown Block area √ — — √ — — — Fit For Use
6 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) N/A 4 ton Crown Block area √ — — √ — — — Fit For Use
7 SC 2-Jan-14 Bow Shackle with safety bolt RWO SC 02 CB 50 ton Crown Block area √ — — √ — — — Fit For Use
8 WRS 2-Jan-14 1 leg wire rope sling with ferrule, 53 x 33000 mm F12G 2782 35 ton Rig floor (port side) √ — — √ — — — Fit For Use
9 SB 2-Jan-14 Snatch Block ( MNF : Westrn Block ) 5 ton 5358 Crown Block area √ — — √ — — — Fit For Use
10 PE 2-Jan-14 Pad eye CRP 03 5 ton Crown Block area √ √ — √ — — — Fit For Use
11 WRS 2-Jan-14 1 leg wire rope sling soft eye, 16 x 1000 mm B/4 - 17382 3 ton Rig floor (port side) √ — — √ — — — Fit For Use
12 SC 2-Jan-14 Bow Shackle with safety bolt RWO SC 07 CB 8.5 ton Crown Block area √ — — √ — — — Fit For Use
13 SC 2-Jan-14 Bow Shackle with safety bolt RWO SC 05 CB 8.5 ton Crown Block area √ — — √ — — — Fit For Use
14 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) 8842 4 ton Crown Block area √ — — √ — — — Fit For Use
15 SB 2-Jan-14 Snatch Block ( MNF : Westrn Block ) 14800 N/A Crown Block area √ — — √ — — — Fit For Use
16 PE 2-Jan-14 Pad eye CA 06 2 ton Mongky boat area √ √ — √ — — — Fit For Use
24 PE 2-Jan-14 Pad eye CA 15 6.5 ton Mongky boat area √ √ — √ — — — Fit For Use
25 PE 2-Jan-14 Pad eye CA 17 6.5 ton Mongky boat area √ √ — √ — — — Fit For Use
26 PE 2-Jan-14 Pad eye CA 16 N/A Mongky boat area √ √ — √ — — — Fit For Use
Page 19 of 62

29 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) 1F 110 4 ton Mongky boat area √ — — √ — — — Fit For Use
30 SC 2-Jan-14 Bow Shackle with safety bolt SC RWO 01 MB 3.25 ton Mongky boat area √ — — √ — — — Fit For Use
32 WRS 2-Jan-14 1 leg wire rope sling soft eye, 16 x 1000 mm 12/2433/18 2.18 ton Mongky boat area √ — — √ — — — Fit For Use
33 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) 1A 312 4 ton Mongky boat area √ — — √ — — — Fit For Use
34 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) 1E 412 4 ton Mongky boat area √ — — √ — — — Fit For Use
37 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) 1A 120 N/A Mongky boat area √ — — √ — — — Fit For Use
40 SB 2-Jan-14 Snatch Block ( MNF : Westrn Block ) 775254 10 ton Mongky boat area √ — — √ — — — Fit For Use
41 SB 2-Jan-14 Snatch Block ( MNF : Westrn Block ) 14560 / 1 N/A Mongky boat area √ — — √ — — — Fit For Use
53 SC 2-Jan-14 Bow Shackle with safety bolt SC 144 55 ton Mongky boat area √ — — √ — — — Fit For Use
56 SB 2-Jan-14 Snatch Block ( MNF : MC Kissick ) N/A 1 ton Mongky boat area √ — — √ — — — Fit For Use
57 SC 2-Jan-14 Bow Shackle with safety bolt E08C 1158 17 ton Mongky boat area √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 20 of 62

1 PE 1-Jan-14 Pad eye MD 3 - Main Deck √ √ — √ — — — Fit For Use
2 WRS 1-Jan-14 1 leg wire rope sling soft eye, 13 x 1000 mm ST 1173 2 ton Main Deck √ — — √ — — — Fit For Use
3 CCU 1-Jan-14 Personal Basket 1668 - 12 - Main Deck √ — — √ — — — Fit For Use
4 ML 1-Jan-14 Master Link ( MNF : Crosby ) ML PB 01 - Main Deck √ — — √ — — — Fit For Use
5 ML 1-Jan-14 Master Link ( MNF : Crosby ) ML PB 02 - Main Deck √ — — √ — — — Fit For Use
6 WRS 1-Jan-14 4 legs wire rope sling, 13 x 5000 mm 6309-15 / 1 1.8 ton Main Deck √ — — √ — — — Fit For Use
7 WRS 1-Jan-14 1 leg wire rope sling with ferrule, 16 x 15000 mm 6309-15 / 2 3.9 ton Main Deck √ — — √ — — — Fit For Use
8 SC 1-Jan-14 Bow Shackle with safety bolt N/A 4 3/4 ton Main Deck √ — — √ — — — Fit For Use
15 WS 1-Jan-14 Webbing Sling ( MNF : KWRS ) 6417 - 18 5140 lbs Main Deck √ √ — √ — — — Fit For Use
16 CH 1-Jan-14 Clamp Hoses N/A - Below rig floor (port side) √ √ — √ — — — Fit For Use
23 WRS 1-Jan-14 1 leg wire rope sling soft eye, 13 x 1000 mm 12 / 0487 /7 2.16 ton Rig floor (port side) √ — — √ — — — Fit For Use
Page 21 of 62

27 PE 1-Jan-14 Pad eye N/A - Rig floor (port side) √ √ — √ — — — Fit For Use
32 CH 1-Jan-14 Clamp Hoses N/A - Rig floor (port side) √ √ — √ — — — Fit For Use
41 DL 1-Jan-14 Diverter line ( 6 pad eye ) DL - 01 - BOP Area √ √ — √ — — — Fit For Use
45 BS 1-Jan-14 BOP Stamp ( 12 pad eye ) N/A - BOP Area √ √ — √ — — — Fit For Use
46 BS 1-Jan-14 BOP Stamp ( 4 pad eye ) N/A - Below rig floor (port side) √ √ — √ — — — Fit For Use
47 GW 1-Jan-14 Gang Way GW 01 - Bop Area (port side) √ √ — √ — — — Fit For Use
48 SL 1-Jan-14 Spol lifting N/A - Main Deck (port side) √ √ — √ — — — Fit For Use
49 WFL 1-Jan-14 Wire Frame Lifting N/A - Main Deck (port side) √ √ — √ — — — Fit For Use
50 LD 1-Jan-14 Lifting Dru m RWO LD 02 300 kg Main Deck (port side) √ √ — √ — — — Fit For Use
51 CCU 1-Jan-14 Storage Container APD - SC-F01 4000 kg Main Deck (port side) √ — — √ — — — Fit For Use
52 WRS 1-Jan-14 4 legs wire rope sling, 22 x 3000 mm 11 / 1832 11.4 ton Main Deck (port side) √ — — √ — — — Fit For Use
53 CCU 1-Jan-14 Container CNHU-8028859 5000 kg Main Deck (port side) √ — — √ — — — Fit For Use
54 WRS 1-Jan-14 4 legs wire rope sling, 24 x 4000 mm RW 10 8.6 ton Main Deck (port side) √ — — √ — — — Fit For Use
55 SC 1-Jan-14 Bow Shackle with safety bolt SC 01 RW 10 6.5 ton Main Deck (port side) √ — — √ — — — Fit For Use
There is part clamp hoses in below rig floor area no inspection because not reached
Prepared by,
Rusdiansyah
Page 22 of 62
Date : December 2013 WO No. : 062/STI-WO/12-13

57 PE 31-Dec-13 Pad eye PAC 20 - AC Room √ — — √ — — — Fit For Use
60 WRS 31-Dec-13 spelter socket, 48 x 10500 mm 11102728 26 ton AC Room √ — — √ — — — Fit For Use
61 WRS 31-Dec-13 Single leg steel wire rope both ands fitted with closed F11G 2726 26 ton AC Room √ — — √ — — — Fit For Use
spelter socket, 48 x 10500 mm
62 WRS 31-Dec-13 Single leg steel wire rope both ands fitted with closed F11G 2727 26 ton AC Room √ — — √ — — — Fit For Use
63 WRS 31-Dec-13 spelter socket, 48 x 10500 mm F11G 2728 26 ton AC Room √ — — √ — — — Fit For Use
64 WRS 31-Dec-13 1 leg wire rope sling with ferrule,36 x 18000 mm F11G 2161 15 ton AC Room √ — — √ — — — Fit For Use
65 LC 31-Dec-13 Lifting Cap N/A - AC Room √ √ — √ — — — Fit For Use
67 LC 31-Dec-13 Lifting Cap 3 1/2 1F B - 41 - AC Room √ √ — √ — — — Fit For Use
68 LC 31-Dec-13 Lifting Cap 2 3/8 1 F 2 - 0051 - AC Room √ √ — √ — — — Fit For Use
69 LC 31-Dec-13 Lifting Cap 2 3/8 1 F 2 - 004 E - AC Room √ √ — √ — — — Fit For Use
70 LC 31-Dec-13 Lifting Cap J - 8658-63-1 - AC Room √ √ — √ — — — Fit For Use
72 LC 31-Dec-13 Lifting Cap L - 031 - AC Room √ √ — √ — — — Fit For Use
73 LC 31-Dec-13 Lifting Cap 658 R - AC Room √ √ — √ — — — Fit For Use
75 LC 31-Dec-13 Lifting Cap 5397-01-4037 - AC Room √ √ — √ — — — Fit For Use
76 LC 31-Dec-13 Lifting Cap 41 / 2 1F - AC Room √ √ — √ — — — Fit For Use
Page 23 of 62

Prepared by,
Rusdiansyah
Page 24 of 62

1 PE 31-Dec-13 Pad eye N/A - Engine Room √ √ — √ — — — Fit For Use
19 PE 31-Dec-13 Pad eye EP 13 - Engine Room √ — — √ — — — Fit For Use
Page 25 of 62

35 PE 31-Dec-13 Pad eye EP 4 2 ton Engine Room √ — — √ — — — Fit For Use
39 BTR 31-Dec-13 Beam Trolly V - 003 1 ton Engine Room √ √ — √ — — — Fit For Use
40 BTR 31-Dec-13 Beam Trolly V - 001 1 ton Engine Room √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 26 of 62

1 SP 30-Dec-13 Pad eye Samson post SP - 01 - Cantiliver √ √ — √ — — — Fit For Use
Page 27 of 62

28 PE 29-Dec-13 Pad eye LCR 01 - Cantiliver √ √ — √ — — — Fit For Use
29 SSP 30-Dec-13 Support Samson post N/A - Cantiliver √ √ — √ — — — Fit For Use
41 PE 29-Dec-13 Pad eye N/A - Cantiliver √ √ — √ — — — Fit For Use
58 WRS 29-Dec-13 1 leg wire rope sling soft eye, 16 x 6000 mm 00E B002-65 3 ton Cantiliver √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 28 of 62

1 PE 29-Dec-13 Pad eye URF 55 - Below rig floor (start boat) √ √ — √ — — — Fit For Use
2 TB 29-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA TB 42 6800 kg Below rig floor (start boat) √ — — √ — — — Fit For Use
8 PE 29-Dec-13 Pad eye SP - Below rig floor (start boat) √ √ — √ — — — Fit For Use
9 PE 29-Dec-13 Pad eye SP - Below rig floor (start boat) √ √ — √ — — — Fit For Use
10 TB 29-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA RWO TB - 021 6800 kg Below rig floor (start boat) √ — — √ — — — Fit For Use
13 PE 29-Dec-13 Pad eye N/A - Dirverter 29 1/2 " √ √ — √ — — — Fit For Use
19 CCU 29-Dec-13 Protektor Basket PB - 01 - Cantiliver √ √ — √ — — — Fit For Use
20 CCU 29-Dec-13 Protektor Basket PB - 02 - Cantiliver √ √ — √ — — — Fit For Use
21 WRS 29-Dec-13 1 leg wire rope sling with m.link, 18 x 1500 mm AA 5760 4 .6 ton Cantiliver √ — — √ — — — Fit For Use
22 SC 29-Dec-13 Bow Shackle with safety bolt N/A 4 3/4 ton Cantiliver √ - — √ — — — Fit For Use
23 SC 29-Dec-13 Bow Shackle with safety bolt N/A 4 3/4 ton Cantiliver √ - — √ — — — Fit For Use
24 TB 29-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA RWO TB - 024 6800 kg BOP Area √ — — √ — — — Fit For Use
25 TB 29-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA RWO TB - 025 6800 kg BOP Area √ — — √ — — — Fit For Use
26 SC 29-Dec-13 Bow Shackle with safety bolt SC 145 55 ton BOP Area √ - — √ — — — Fit For Use
Page 29 of 62

27 SC 29-Dec-13 Bow Shackle with safety bolt 102810 55 ton BOP Area √ - — √ — — — Fit For Use
28 PE 29-Dec-13 Pad eye LC - BOP Area √ √ — √ — — — Fit For Use
29 PE 29-Dec-13 Pad eye LC - BOP Area √ √ — √ — — — Fit For Use
30 PE 29-Dec-13 Pad eye N/A - BOP Area √ √ — √ — — — Fit For Use
38 CCU 29-Dec-13 Oxygent Rack OR - RW 01 500 kg Main deck √ √ — √ — — — Fit For Use
39 WRS 29-Dec-13 2 legs wire rope sling, 13 x 700 mm APD 15100 2.3 ton Main deck √ — — √ — — — Fit For Use
40 SC 29-Dec-13 Bow Shackle with safety bolt SC 01 APD 15100 3.25 ton BOP Area √ - — √ — — — Fit For Use
41 SC 29-Dec-13 Bow Shackle with safety bolt SC 02 APD 15100 3.25 ton BOP Area √ - — √ — — — Fit For Use
42 GW 29-Dec-13 Gang Way GW - 02 - BOP Area (start boat) √ √ — √ — Heavy Corrosion Repair Fit For Use
Prepared by,
Rusdiansyah
Page 30 of 62

1 HK 28-Dec-13 Hook OHC N/A 30 ton Below rig floor (port side) √ √ — √ — — — Fit For Use
2 HK 28-Dec-13 Hook OHC N/A 30 ton Below rig floor (port side) √ √ — √ — — — Fit For Use
3 CBK 28-Dec-13 Chain Block ( MNF : Vital ) RWO CB 01 1 ton Below rig floor (port side) √ √ √ — √ Can not be hold load Remove from servis Not fit for use
4 SC 28-Dec-13 Bow Shackle with safety bolt 207097 13.5 ton Below rig floor (port side) √ — — √ — — — Fit For Use
5 SB 28-Dec-13 Snatch Block RWO-SB 03 N/A Below rig floor (port side) √ — — √ — — — Fit For Use
6 SB 28-Dec-13 Snatch Block 106 N/A Below rig floor (port side) √ — — √ — — — Fit For Use
7 SB 28-Dec-13 Snatch Block SNB - 02 N/A Below rig floor (port side) √ — — √ — — — Fit For Use
8 CBK 28-Dec-13 Chain Block ( MNF : Kito corp ) 002215 2 ton Below rig floor (port side) √ — — √ — — — Fit For Use
9 TB 28-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA RWO TB 011 6800 kg Below rig floor (port side) √ - — √ — — — Fit For Use
10 TB 28-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA RWO TB 012 6800 kg Below rig floor (port side) √ - — √ — — — Fit For Use
11 TB 28-Dec-13 Turnbuckle ( MNF : Lebus USA ) TB - 39 - Below rig floor (port side) √ - — √ — — — Fit For Use
12 CBK 28-Dec-13 Chain Block ( MNF : OSM ) 1112C2 / 8 3 ton Below rig floor (port side) √ √ √ — √ Heavy Corrosion Remove from servis Not fit for use
13 CBK 28-Dec-13 Chain Block ( MNF : Vital ) RWO CB - 02 2 ton Below rig floor (port side) √ √ — √ — — — Fit For Use
14 CBK 28-Dec-13 Chain Block ( MNF : Vital ) RWO CB - 03 1.5 ton Below rig floor (port side) √ √ — √ — — — Fit For Use
15 TB 28-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA TB 40 6800 kg Below rig floor (port side) √ √ — √ — — — Fit For Use
18 TB 28-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Lebus USA RWO TB - 013 6800 kg Below rig floor (port side) √ √ — √ — — — Fit For Use
Page 31 of 62

26 PC 28-Dec-13 Pipe Clamp 3" PC 02 - Below rig floor (back side) √ √ — √ — — — Fit For Use
42 PC 28-Dec-13 Pipe Clamp 3" PC 19 - Below rig floor √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 32 of 62

1 PE 27-Dec-13 Pad eye URF - 05 - Below Rig Floor √ √ — √ — — — Fit For Use
11 PE 27-Dec-13 Pad eye URF - 45 2.5 ton Below Rig Floor √ √ — √ — — — Fit For Use
Page 33 of 62

35 PE 27-Dec-13 Pad eye N/A - Below Rig Floor √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 34 of 62

1 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 18x 36000 mm 10/0800/2 4.6 ton Barit Room √ - — √ — — — Fit For Use
2 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 18x 36000 mm AR 16688 4.6 ton Barit Room √ - — √ — — — Fit For Use
3 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 18x 6000 mm 11/2176/1 4.62 ton Barit Room √ - — √ — — — Fit For Use
4 WRS 26-Dec-13 1 leg wire rope sling with master link, 26 mm BB2891 8.6 ton Barit Room √ - — √ — — — Fit For Use
5 WRS 26-Dec-13 2 legs wire rope sling with ferrule, 20 x 1700 mm SLB 08206 8 ton Barit Room √ - — √ — — — Fit For Use
6 WRS 26-Dec-13 4 legs wire rope sling with ferrule poraner, 19x4000 687 / 087 10 ton Barit Room √ - — √ — — — Fit For Use
mm
7 WRS 25-Dec-13 2 legs wire rope sling with hook, 20 x 8000 mm 09 / 1435 8.68 ton Barit Room √ - — — √ Broken wire Remove from servis Not fit for use
8 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 16 x 10000 mm STCT 1379-01 4 MT Life boat No.2 √ - — √ — — — Fit For Use
9 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 16 x 1500 mm CGY 96322 3 ton Life boat No.2 √ - — √ — — — Fit For Use
10 SC 26-Dec-13 Bow Shackle with safety bolt SC RWO 01 LB 2 4 3/4 ton Life boat No.2 √ - — √ — — — Fit For Use
14 ML 26-Dec-13 Master Link SHFE 1191 8 ton Life boat No.2 √ - — √ — — — Fit For Use
16 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 16 x 1500 mm NTAL 16-5 3 ton Life boat No.2 √ - — √ — — — Fit For Use
17 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 16 x 10000 mm BTCT -1380-22 4 MT Life boat No.2 √ - — √ — — — Fit For Use
18 SC 26-Dec-13 Bow Shackle with safety bolt RW 26 85 ton Main Deck ( front ) √ - — √ — — — Fit For Use
21 SC 26-Dec-13 Bow Shackle with safety bolt 12 A10176 4 3/4 ton Main Deck ( front ) √ - — √ — — — Fit For Use
22 SC 26-Dec-13 Bow Shackle with safety bolt 3455 A 4 3/4 ton Main Deck ( front ) √ - — √ — — — Fit For Use
23 PE 26-Dec-13 Pad eye N/A - Main Deck ( front ) √ √ — √ — — — Fit For Use
24 PE 26-Dec-13 Pad eye N/A - Main Deck ( front ) √ √ — √ — — — Fit For Use
25 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 62 x 20000 mm 9494 55 ton Main Deck ( front ) √ - — √ — — — Fit For Use
Page 35 of 62

26 WRS 26-Dec-13 1 leg wire rope sling with ferrule, 62 x 20000 mm RWO SL 011 55 ton Main Deck ( front ) √ - — √ — — — Fit For Use
29 PE 26-Dec-13 Pad eye N/A 3 ton Main Deck ( front ) √ √ — √ — — — Fit For Use
30 PE 26-Dec-13 Pad eye N/A 3 ton Main Deck ( front ) √ √ — √ — — — Fit For Use
31 PE 26-Dec-13 Pad eye PH - 06 2 ton Main Deck ( front ) √ √ — √ — — — Fit For Use
32 PE 26-Dec-13 Pad eye PH - 02 2 ton Main Deck ( front ) √ √ — √ — — — Fit For Use
33 SC 26-Dec-13 Bow Shackle with safety bolt RWO SC 09 17 ton Main Deck ( front ) √ - — √ — — — Fit For Use
34 SC 26-Dec-13 Bow Shackle with safety bolt RWO SC 03 12 ton Main Deck ( front ) √ - — √ — — — Fit For Use
35 PE 26-Dec-13 Pad eye LB 2 - 01 - Life boat No.2 √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 36 of 62

1 WRS 25-Dec-13 1 leg wire rope sling with ferrule, 21 x 3000 mm RWO SL 011 8.7 ton Life boat No. 3 √ - — √ — — — Fit For Use
2 SC 25-Dec-13 Bow Shackle with safety bolt SC RWO 01 LB 3 13.5 ton Life boat No. 3 √ - — √ — — — Fit For Use
3 SC 25-Dec-13 Dee Shackle with safety bolt 81245325 N/A Life boat No. 3 √ - — √ — — — Fit For Use
4 SC 25-Dec-13 Bow Shackle with safety bolt F 10 D 1799 6.5 ton Life boat No. 3 √ - — √ — — — Fit For Use
5 SC 25-Dec-13 Bow Shackle with safety bolt F12H 2893 6.5 ton Life boat No. 3 √ - — √ — — — Fit For Use
6 WRS 25-Dec-13 1 leg wire rope sling with ferrule, 21 x 3000 mm 3256 / 1 8.7 ton Life boat No. 3 √ - — √ — — — Fit For Use
8 SC 25-Dec-13 Dee Shackle with safety bolt 8124537 N/A Life boat No. 3 √ - — √ — — — Fit For Use
11 PE 25-Dec-13 Pad eye LB 1 - PE 01 - Life boat No.1 √ √ — √ — — — Fit For Use
25 SC 25-Dec-13 Bow Shackle with safety bolt SC RWO 03 LB 1 3.25 Life boat No.1 √ - — √ — — — Fit For Use
Page 37 of 62

27 WRS 25-Dec-13 1 leg wire rope sling with ferrule, 18 x 10000 mm BTCT 1379-02 4 ton Life boat No.1 √ - — √ — — — Fit For Use
29 SC 25-Dec-13 Bow Shackle with safety bolt SH 01 4 3/4 ton Life boat No.1 √ - — √ — — — Fit For Use
30 WRS 25-Dec-13 1 leg wire rope sling with ferrule, 18 x 6000 mm F10 20307 4.16 ton Barit Room √ - — √ — — — Fit For Use
31 WRS 25-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm A6A 4.16 ton Barit Room √ - — √ — — — Fit For Use
32 WRS 25-Dec-13 2 legs wire rope sling with ferrule, 20 x 6000 mm RW 13 8 ton Barit Room √ - — √ — — — Fit For Use
33 WRS 25-Dec-13 1 leg wire rope sling soft eye, 18 x 3000 mm AG 21 4.16 ton Barit Room √ - — √ — — — Fit For Use
34 WRS 25-Dec-13 2 legs wire rope sling with ferrule, 16 x 2000 mm 11 / 2171 4.24 ton Barit Room √ - — √ — — — Fit For Use
35 WRS 25-Dec-13 2 legs wire rope sling with ferrule, 16 x 5700 mm 11 / 2172 4 ton Barit Room √ - — √ — — — Fit For Use
36 WRS 25-Dec-13 2 legs wire rope sling with ferrule, 20 x 6000 mm RW 14 8 ton Barit Room √ - — √ — — — Fit For Use
37 WRS 25-Dec-13 4 legs wire rope sling with ferrule, 20 x 6500 mm F11E-1393 9.8 ton Barit Room √ - — √ — — — Fit For Use
38 WRS 25-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm R 3583 4.16 ton Barit Room √ - — √ — — — Fit For Use
39 WRS 25-Dec-13 1 leg wire rope sling soft eye, 16 x 5600 mm 00E 2098-14 3 ton Barit Room √ - — √ — — — Fit For Use
40 WRS 25-Dec-13 2 legs wire rope sling with hook, 20 x 6000 mm 09.1438 8.63 ton Barit Room √ √ — √ — — — Fit For Use
41 WRS 25-Dec-13 2 legs wire rope sling with hook, 20 x 8000 mm RW 18 8 ton Barit Room √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
42 WRS 25-Dec-13 1 leg wire rope sling with Hook, 26 x 6000 mm SL SR 02 8.6 ton Barit Room √ - — √ — — — Fit For Use
43 WRS 25-Dec-13 1 leg wire rope sling soft eye, 20 x 6000 mm 11 / 2177 /1 6.2 ton Barit Room √ - — √ — — — Fit For Use
44 WRS 25-Dec-13 1 leg wire rope sling soft eye, 20 x 6000 mm 11 / 2177 /2 6.2 ton Barit Room √ - — √ — — — Fit For Use
45 WRS 25-Dec-13 2 legs wire rope sling with ferrule, 18 x 6000 mm FK 6958 6 ton Barit Room √ - — √ — — — Fit For Use
46 WRS 25-Dec-13 1 leg wire rope sling with ferrule, 24 x 2440 mm 11 / 2178/1 6.2 ton Barit Room √ - — √ — — — Fit For Use
47 WRS 25-Dec-13 1 leg wire rope sling with ferrule, 24 x 2440 mm 11 / 2178/2 6.2 ton Barit Room √ - — √ — — — Fit For Use
48 WRS 25-Dec-13 2 legs wire rope sling with ferrule, 18 x 1000 mm 10/3914/1-2 5.8 ton Barit Room √ - — √ — — — Fit For Use
49 WRS 25-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 1121742 4.15 ton Barit Room √ - — √ — — — Fit For Use
50 WRS 25-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm R - 0343 4.1 ton Barit Room √ - — √ — — — Fit For Use
51 WRS 25-Dec-13 1 leg wire rope sling soft eye, 16 x 6000 mm 00L- B001-13 3 ton Barit Room √ - — √ — — — Fit For Use
52 WRS 25-Dec-13 1 leg wire rope sling soft eye, 19 x 7000 mm F10E - 2030 4.16 ton Barit Room √ - — √ — — — Fit For Use
53 WRS 25-Dec-13 1 leg wire rope sling soft eye, 16 x 7000 mm 11/2169 / 4 3.06 ton Barit Room √ - — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 38 of 62

1 WRS 24-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm MTC - 00035 -1 4 ton Main Deck Area √ - — √ — — — Fit For Use
2 WRS 24-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm STF 80 4 ton Main Deck Area √ - — √ — — — Fit For Use
3 WRS 24-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm R 3251 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
4 WRS 24-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm F 081 2774 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
5 WRS 24-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm TF 116 4 ton Main Deck Area √ - — √ — — — Fit For Use
6 WRS 24-Dec-13 1 leg wire rope sling soft eye, 12 x 1300 mm SLL 1173 2 ton Main Deck Area √ - — √ — — — Fit For Use
7 WRS 24-Dec-13 1 leg wire rope sling with ferrule, 18 x 1000 mm 10/ 3901 /4 8 ton Main Deck Area √ - — √ — — — Fit For Use
8 WRS 24-Dec-13 1 leg wire rope sling with ferrule, 18 x 1000 mm 10/ 3901 /3 8 ton Main Deck Area √ - — √ — — — Fit For Use
9 WRS 24-Dec-13 1 leg wire rope sling with ferrule, 40 x 21000 mm RW - SL 01 18.5 ton Main Deck Area √ - — √ — — — Fit For Use
10 WRS 24-Dec-13 1 leg wire rope sling soft eye, 18 x 36000 mm 16686 4.16 ton Main Deck Area √ - — √ — — — Fit For Use
11 CCU 24-Dec-13 Work Basket Rani woro - 11 250 kg Main Deck Area √ - — √ — Desigent pad eye no diagonal Repair Fit For Use
12 CCU 24-Dec-13 Waste Thinner Tank BES WTT 08-01 1000 kg Main Deck Area √ - — √ — — — Fit For Use
13 CCU 24-Dec-13 Waste Oil Tank BES WOT 07-02 1000 kg Main Deck Area √ - — √ — — — Fit For Use
14 CCU 24-Dec-13 Hydro Carbon Waste TSH - 04-01 1500 kg Main Deck Area √ - — √ — — — Fit For Use
15 CCU 24-Dec-13 Waste Basket APD RWO WS-07 5000 kg Main Deck Area √ - — √ — — — Fit For Use
16 CCU 24-Dec-13 Waste Basket APD RWO WS-02 5000 kg Main Deck Area √ - — √ — — — Fit For Use
17 CCU 24-Dec-13 Waste Trash Skip BES TSN 02-02 1520 kg Main Deck Area √ - — √ — — — Fit For Use
18 CCU 24-Dec-13 Waste Oil Tank BES WOT 07-01 1000 kg Main Deck Area √ - — √ — Different WLL of Shackle Replace With Same WLL Fit For Use
19 CCU 24-Dec-13 Waste Basket SMW-05-01 3000 kg Main Deck Area √ - — √ — — — Fit For Use
20 CCU 24-Dec-13 Work Basket PB - 02 500 kg Main Deck Area √ - — √ — — — Fit For Use
21 WRS 24-Dec-13 4 legs wire rope sling, 20 x 3210 mm AR - 3219 9.8 ton Main Deck Area √ - — √ — — — Fit For Use
22 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 WTT-0801 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use
Page 39 of 62

26 WRS 24-Dec-13 4 legs wire rope sling, 18 x 1000 mm 10/3902 8.7 ton Main Deck Area √ - — √ — — — Fit For Use
27 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 WOT 0302 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use
31 WRS 24-Dec-13 2 legs wire rope sling, 18 x 1000 mm 103811 5.2 ton Main Deck Area √ - — √ — — — Fit For Use
32 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 TSH 0401 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use
33 SC 24-Dec-13 Bow Shackle with safety bolt SC 02 TSH 0401 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use
34 WRS 24-Dec-13 4 legs wire rope sling, 20 x 2440 mm AR 1778 11.8 ton Main Deck Area √ - — √ — — — Fit For Use
35 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 RWO WS 07 6.5 ton Main Deck Area √ - — √ — — — Fit For Use
39 WRS 24-Dec-13 2 legs wire rope sling, 18 x 1000 mm 10 / 3910 5.8 ton Main Deck Area √ - — √ — — — Fit For Use
40 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 TSN 02-02 6.5 ton Main Deck Area √ - — √ — — — Fit For Use
41 SC 24-Dec-13 Bow Shackle with safety bolt SC 02 TSN 02-02 6.5 ton Main Deck Area √ - — √ — — — Fit For Use
42 WRS 24-Dec-13 4 legs wire rope sling, 18 x 1000 mm ST 4252 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
43 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 WOT 0701 3.25 ton Main Deck Area √ - — √ — — — Fit For Use
44 SC 24-Dec-13 Bow Shackle with safety bolt SC 02 WOT 0701 3.25 ton Main Deck Area √ - — √ — — — Fit For Use
47 WRS 24-Dec-13 4 legs wire rope sling, 26 x 2500 mm F10D - 1150 16.5 ton Main Deck Area √ - — √ — — — Fit For Use
48 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 SMW 0501 6.5 ton Main Deck Area √ - — √ — — — Fit For Use
52 WRS 24-Dec-13 4 legs wire rope sling, 16 x 1500 mm F11C-0872 6.3 ton Main Deck Area √ - — √ — — — Fit For Use
53 SC 24-Dec-13 Bow Shackle with safety bolt SC 01 F11C-0872 3.25 ton Main Deck Area √ - — √ — — — Fit For Use
57 WRS 24-Dec-13 1 leg wire rope sling with ferrule, 45 x 4600 mm RWO A 025 24.8 ton Main Deck Area √ - — √ — — — Fit For Use

Repair pad eye shall be refer to BS EN 12079 - 2006
Prepared by,
Rusdiansyah
Page 40 of 62

1 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm RWO SL 05 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
2 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 6000 mm TC 9822 3 ton Main Deck Area √ - — √ — — — Fit For Use
3 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm F09F 2079 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
4 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 00E 6124 - 18 3 ton Main Deck Area √ - — √ — — — Fit For Use
5 WRS 23-Dec-13 1 leg wire rope sling soft eye, 26 x 19500 mm B4 - 624 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
6 WRS 23-Dec-13 1 leg wire rope sling soft eye, 22 x 12000 mm SMN 01 5.6 ton Main Deck Area √ - — √ — — — Fit For Use
7 WRS 23-Dec-13 2 legs wire rope sling soft eye, 16 x 6500 mm RA 073 / 74 4.2 ton Main Deck Area √ - — √ — — — Fit For Use
8 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm RWO SL 06 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
9 WRS 23-Dec-13 1 leg wire rope sling soft eye, 26 x 7000 mm B 61349 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
10 WRS 23-Dec-13 1 leg wire rope sling soft eye, 19 x 6000 mm BB 2911 4.6 ton Main Deck Area √ - — √ — — — Fit For Use
11 WRS 23-Dec-13 1 leg wire rope sling soft eye, 26 x 7000 mm B 61351 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
12 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 6000 mm DRT - 145 3.8 ton Main Deck Area √ - — √ — — — Fit For Use
13 WRS 23-Dec-13 1 leg wire rope sling with ferrule, 16 x 3000 mm AR - 7058 3 ton Main Deck Area √ - — √ — — — Fit For Use
14 WRS 23-Dec-13 1 leg wire rope sling soft eye, 22 x 3000 mm 10 F - 2360 5.65 ton Main Deck Area √ - — √ — — — Fit For Use
15 WRS 23-Dec-13 1 leg wire rope sling soft eye, 22 x 3000 mm 10 F - 2360 5.65 ton Main Deck Area √ - — √ — — — Fit For Use
1 leg wire rope sling with Master link & ferrule, 22 x

16 WRS 23-Dec-13 1100 mm AA6016 - 7 6.2 ton Main Deck Area √ - — √ — — — Fit For Use
17 WRS 23-Dec-13 1 leg wire rope sling with ferrule, 32 x 1500 mm BB 289 13.1 ton Main Deck Area √ - — √ — — — Fit For Use
1 leg wire rope sling with double Master link & ferrule,
18 WRS 23-Dec-13 32 x 1100 mm AD - 143 13 ton Main Deck Area √ - — √ — — — Fit For Use
19 WRS 23-Dec-13 1 leg wire rope sling with ferrule, 20 x 2200 mm RW - 05 4.62 ton Main Deck Area √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
20 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm MTC 0003 - 50 4 ton Main Deck Area √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
21 WRS 23-Dec-13 1 leg wire rope sling with double Master link & ferrule, AA - 6010 - 3 6.2 ton Main Deck Area √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
22 x 1100 mm
22 WRS 23-Dec-13 1 leg wire rope sling soft eye, 26 x 9200 mm BB 2892 8.6 ton Main Deck Area √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
Page 41 of 62

23 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm MTC 00035756 4.ton Main Deck Area √ - — √ — — — Fit For Use
24 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 12000 mm RWO - SL 07 4.1 ton Main Deck Area √ - — √ — — — Fit For Use
25 WRS 23-Dec-13 1 leg wire rope sling soft eye, 19 x 4000 mm AR 18153 4.15 ton Main Deck Area √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
27 WRS 23-Dec-13 1 leg wire rope sling soft eye, 22 x 8000 mm FY - 5800 6 ton Main Deck Area √ - — √ — — — Fit For Use
28 WRS 23-Dec-13 1 leg wire rope sling soft eye, 21 x 8000 mm VO 496808 4.6 ton Main Deck Area √ - — √ — — — Fit For Use
30 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 7000 mm AR - 17564 3 ton Main Deck Area √ - — √ — — — Fit For Use
31 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 00E -0124-131 3 ton Main Deck Area √ - — √ — — — Fit For Use
32 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm R - 12527 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
33 WRS 23-Dec-13 1 leg wire rope sling with ferrule, 26 x 13000 mm 08 / 3477/1 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
34 WRS 23-Dec-13 1 leg wire rope sling with ferrule, 26 x 13000 mm 08 / 3478/1 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
35 WRS 23-Dec-13 spelter socket, 40 x 49000 mm AR 14250 19.5 ton Main Deck Area √ √ — √ — — — Fit For Use
36 WRS 23-Dec-13 Single leg steel wire rope both ands fitted with closed AR 14245 19.5 ton Main Deck Area √ √ — √ — — — Fit For Use
38 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 00E - 6124-11 4.15 ton Main Deck Area √ - — — √ Broken wire Remove from servis Not fit for use
39 WRS 23-Dec-13 4 legs wire rope sling, 16 x 2350 mm FMC RTB 055-1 6.2 ton Main Deck Area √ - — √ — — — Fit For Use
40 WRS 23-Dec-13 4 legs wire rope sling, 18 x 6000 mm AR 17321 7.8 ton Main Deck Area √ - — √ — — — Fit For Use
41 WRS 23-Dec-13 1 leg wire rope sling soft eye, 26 x 7000 mm B6 - 1347 8.6 ton Main Deck Area √ - — √ — — — Fit For Use
43 WRS 23-Dec-13 1 leg wire rope sling soft eye, 12 x 5000 mm RWO SL - 010 1.55 ton Main Deck Area √ - — √ — — — Fit For Use
44 WRS 23-Dec-13 1 leg wire rope sling soft eye, 19 x 10000 mm BIC 0851 - 29 5 ton Main Deck Area √ - — √ — — — Fit For Use
45 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 00 E - 6124-119 3 ton Main Deck Area √ - — √ — — — Fit For Use
46 WRS 23-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 12 / 2812 / 242 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
47 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm F 03F - 2043 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
48 WRS 23-Dec-13 1 leg wire rope sling soft eye, 16 x 5000 mm BTC - P3214 -7 3.5 ton Main Deck Area √ - — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 42 of 62

1 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm F 1317 / 263 4.14 ton Main Deck √ - — √ — — — Fit For Use
2 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm ER 225 4 ton Main Deck √ - — √ — — — Fit For Use
3 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 3168 / 188 4 ton Main Deck √ - — √ — — — Fit For Use
4 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm R 1432 3.7 ton Main Deck √ - — √ — — — Fit For Use
5 WRS 22-Dec-13 2 legs wire rope sling, 13 x 3500 mm RW - SL 02 2.7 ton Main Deck √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
6 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 11/1240/1308 3.7 ton Main Deck √ - — √ — — — Fit For Use
7 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm BTC 01314 - 37 3.7 ton Main Deck √ - — √ — — — Fit For Use
8 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 4000 mm AR 18274 4.15 ton Main Deck √ - — √ — — — Fit For Use
10 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm F08H 2582 3.7 ton Main Deck √ - — √ — — — Fit For Use
12 WRS 22-Dec-13 1 leg wire rope sling soft eye, 22 x 10000 mm S 05 WR 70 5.6 ton Main Deck √ - — √ — — — Fit For Use
13 WRS 22-Dec-13 1 leg wire rope sling soft eye, 16 x 5600 mm IVT 018 3 ton Main Deck √ - — √ — — — Fit For Use
14 WRS 22-Dec-13 1 leg wire rope sling soft eye, 16 x 5600 mm 00E / 098-12 3 ton Main Deck √ - — √ — — — Fit For Use
15 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 05 /07 / 210 3.7 ton Main Deck √ - — √ — — — Fit For Use
16 WRS 22-Dec-13 1 leg wire rope sling with ferrule, 35 x 12000 mm K 6324 15 ton Main Deck √ - — √ — — — Fit For Use
17 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 11 / 0103 / 146 3.7 ton Main Deck √ - — √ — — — Fit For Use
18 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm RWO SL 03 3.7 ton Main Deck √ - — √ — — — Fit For Use
19 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 11 / 3598 / 685 3.7 ton Main Deck √ - — √ — — — Fit For Use
20 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm RWO SL 04 3 ton Main Deck √ - — √ — — — Fit For Use
21 WRS 22-Dec-13 1 leg wire rope sling soft eye, 16 x 10000 mm 10 /4592 /6 3.28 ton Main Deck √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
22 WRS 22-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm B7 - 1766 3.3 ton Main Deck √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
23 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm AR 18478 4. 16 ton Main Deck √ - — √ — — — Fit For Use
24 WRS 22-Dec-13 1 leg wire rope sling soft eye, 19 x 9000 mm W 1558 / 11 4.5 ton Main Deck √ - — √ — — — Fit For Use
25 WRS 22-Dec-13 1 leg wire rope sling soft eye, 20 x 2000 mm B 82896 5 ton Main Deck √ - — √ — — — Fit For Use
Page 43 of 62

26 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm DRT 0039 3.7 ton Main Deck √ - — √ — — — Fit For Use
27 WRS 22-Dec-13 1 leg wire rope sling soft eye, 22 x 8000 mm 11/2179/2 6.2 ton Main Deck √ - — √ — — — Fit For Use
28 WRS 22-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 00E 6124 - 19 3 ton Main Deck √ - — — √ Broken wire Remove from servis Not fit for use
29 WRS 22-Dec-13 1 leg wire rope sling soft eye, 20 x 8500 mm 11 /259/9 4.62 ton Main Deck √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
30 WRS 22-Dec-13 1 leg wire rope sling soft eye, 22 x 8000 mm RW 08 8 ton Main Deck √ - — √ — — — Fit For Use
31 WRS 22-Dec-13 1 leg wire rope sling with ferrule, 16 x 10500 mm DO - 19683 3 ton Main Deck √ - — √ — — — Fit For Use
32 WRS 22-Dec-13 1 leg wire rope sling with ferrule, 16 x 8000 mm 11 / 2170 / 1 3.03 ton Main Deck √ - — √ — — — Fit For Use
33 WRS 22-Dec-13 1 leg wire rope sling soft eye, 22 x 10000 mm SOE WR 56 5.6 ton Main Deck √ - — √ — — — Fit For Use
34 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm 13091220 3.7 ton Main Deck √ - — √ — — — Fit For Use
35 WRS 22-Dec-13 1 leg wire rope sling soft eye, 22 x 10000 mm SOE WR 101 5.6 ton Main Deck √ - — √ — — — Fit For Use
36 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm 11 / 3585 / 55 3 ton Main Deck √ - — √ — — — Fit For Use
37 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm R 1424 3.7 ton Main Deck √ - — √ — — — Fit For Use
38 WRS 22-Dec-13 1 leg wire rope sling with ferrule, 20 x 6000 mm BB 2900 4.6 ton Main Deck √ - — √ — — — Fit For Use
39 WRS 22-Dec-13 1 leg wire rope sling soft eye, 24 x 6000 mm E 10K 3411 6.7 ton Main Deck √ - — √ — — — Fit For Use
40 WRS 22-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm 13091218 3.7 ton Main Deck √ - — √ — — — Fit For Use
41 WRS 22-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm MTC 00320 - 30 3 ton Main Deck √ - — — √ Broken wire & Corrosion Remove from servis Not fit for use
Prepared by,
Rusdiansyah
Page 44 of 62

31 LD 21-Dec-13 Lifting Drum RWO LD 01 N/A Main Deck Area √ √ — √ — — — Fit For Use
32 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm R 0743 3.7 ton Main Deck Area √ - — — √ Broken Wire & Heavy Corrosion Remove from servis Not fit for use
33 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 5500 mm 00EB 001-23 3 ton Main Deck Area √ - — √ — — — Fit For Use
34 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 5500 mm 1301 - 1 3 ton Main Deck Area √ - — √ — — — Fit For Use
35 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm MIC 01314-44 5 ton Main Deck Area √ - — √ — — — Fit For Use
37 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm C 00035 / 15 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
38 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 00-6124-95 3 ton Main Deck Area √ - — √ — — — Fit For Use
53 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm MTC 08235-13 3 ton Main Deck Area √ - — √ — — — Fit For Use
54 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm S 4038 - 31 4.6 ton Main Deck Area √ - — √ — — — Fit For Use
55 WRS 21-Dec-13 2 legs wire rope sling soft eye, 18 x 1630 mm AR 14267 7.8 ton Main Deck Area √ - — √ — — — Fit For Use
56 WRS 21-Dec-13 4 legs wire rope sling soft eye, 18 x 1800 mm BM SL 01 16.3 ton Main Deck Area √ - — √ — — — Fit For Use
57 SC 21-Dec-13 Bow Shackle with safety bolt F12H 2923 12 ton Main Deck Area √ - — √ — — — Fit For Use
58 SC 21-Dec-13 Bow Shackle with safety bolt 136 - 11 8.5 ton Main Deck Area √ - — √ — — — Fit For Use
59 SC 21-Dec-13 Bow Shackle with safety bolt RWO SC 06 6.5 ton Main Deck Area √ - — √ — — — Fit For Use
60 SC 21-Dec-13 Bow Shackle with safety bolt RWO SC 07 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use
61 SC 21-Dec-13 Bow Shackle with safety bolt RWO SC 08 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use
62 SC 21-Dec-13 Bow Shackle with safety bolt F12K 4140 4 3/4 ton Main Deck Area √ - — √ — — — Fit For Use

Prepared by,
Rusdiansyah

1 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm F12G 2517 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
4 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm R - 1614 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
5 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 1113/75/202 4.16 ton Main Deck Area √ - — √ — — — Fit For Use
6 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm SL 0010 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
7 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 112174.9 4.16 ton Main Deck Area √ - — √ — — — Fit For Use
8 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 5500 mm 3.5 ton 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
9 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm FIE - 9000611 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
10 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm MTC 01314-7 3.7 ton Main Deck Area √ - — — √ Broken Wire Remove from servis Not fit for use
12 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm FIK 0901023 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
13 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 5600 mm 005 - 6124-133 3.7 ton Main Deck Area √ - — √ — — — Fit For Use
15 WRS 21-Dec-13 1 leg wire rope sling soft eye, 16 x 5600 mm IVT 012 3 ton Main Deck Area √ - — √ — — — Fit For Use
16 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 8000 mm HIC 0131183 5 ton Main Deck Area √ - — — √ Broken Wire Remove from servis Not fit for use
17 WRS 21-Dec-13 1 leg wire rope sling soft eye, 18 x 6000 mm 11001674 3.7 ton Main Deck Area √ - — — √ Broken Wire & Heavy Corrosion Remove from servis Not fit for use
18 WRS 21-Dec-13 Single leg steel wire rope both ands fitted with closed SL 2745 / AG 61 18 ton Main Deck Area √ √ — √ — — — Fit For Use
19 WRS 21-Dec-13 Single leg steel wire rope both ands fitted with closed RM2742-AW280 18 ton Main Deck Area √ √ — √ — — — Fit For Use
20 WRS 21-Dec-13 Single leg steel wire rope both ands fitted with closed RW 2810 / AG 59 18 ton Main Deck Area √ √ — √ — — — Fit For Use
21 WRS 21-Dec-13 spelter socket, 39 x 8500 mm RM 2744 / AG 62 18 ton Main Deck Area √ √ — √ — — — Fit For Use

22 WRS 21-Dec-13 Single leg steel wire rope both ands fitted with closed AG 63 18 ton Main Deck Area √ √ — √ — — — Fit For Use
23 WRS 21-Dec-13 spelter socket, 39 x 8500 mm BB 1209 18 ton Main Deck Area √ √ — √ — — — Fit For Use
25 WRS 21-Dec-13 spelter socket, 39 x 8500 mm AW 2802 / AG 64 18 ton Main Deck Area √ √ — √ — — — Fit For Use
27 WRS 21-Dec-13 Single leg steel wire rope both ands fitted with closed BB 1210 18 ton Main Deck Area √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah

1 WRS 20-Dec-13 1 leg wire rope sling soft eye, 16 x 8000 mm 10/4529/10 3.28 ton Mecanic Room √ - — √ — — — Fit For Use
2 CB 20-Dec-13 Chain Block ( MNF : Vital ) RWO 201 1 ton Mecanic Room √ √ — √ — — — Fit For Use
3 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) 1C 107 4 ton Mecanic Room √ - — √ — — — Fit For Use
4 ML 20-Dec-13 Mater Link ( MNF : Crosby ) RWOL 001 4 ton Mecanic Room √ - — √ — — — Fit For Use
5 SC 20-Dec-13 Bow Shackle with safety bolt F10 325R 4 3/4 Mecanic Room √ - — √ — — — Fit For Use
6 SC 20-Dec-13 Bow Shackle with safety bolt TK 03221 4 3/4 Mecanic Room √ - — √ — — — Fit For Use
7 SC 20-Dec-13 Bow Shackle with safety bolt RWO SC 01 4 3/4 Mecanic Room √ - — √ — — — Fit For Use
8 EB 20-Dec-13 Eye Bolt 7/8 RWO EB 001 N/A Mecanic Room √ √ — √ — — — Fit For Use
12 EB 20-Dec-13 Eye Bolt RWO EB 005 N/A Mecanic Room √ √ — √ — — — Fit For Use
24 EB 20-Dec-13 Eye Bolt RWO EB 017 0.95 ton Mecanic Room √ √ — √ — — — Fit For Use

Prepared by,
Rusdiansyah

1 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) RWO SB 01 12 ton Store √ - — √ — — — Fit For Use
2 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) 1106/109224 8 ton Store √ - — √ — — — Fit For Use
3 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) RWO SB 02 8 ton Store √ - — √ — — — Fit For Use
4 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) SB - R 02 N/A Store √ - — √ — — — Fit For Use
5 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) 169481 12 ton Store √ - — √ — — — Fit For Use
6 SB 20-Dec-13 Snatch Block ( mnf : Mc Kissick ) 1407 7 ton Store √ - — √ — — — Fit For Use
7 SB 20-Dec-13 Snatch Block ( mnf : Western Oklahoma ) 775254 N/A Store √ - — √ — — — Fit For Use
8 LC 20-Dec-13 Lifting Cap ( 3.1/2" Reg Pin ) A 14 - 15 N/A Store √ √ — √ — — — Fit For Use
9 LC 20-Dec-13 Lifting Cap ( 4.1/2" Reg Box ) J-13-0074-3 N/A Store √ √ — √ — — — Fit For Use
10 LC 20-Dec-13 Lifting Cap ( 4.1/2" Reg Box ) J-23-0074-4-2 N/A Store √ √ — √ — — — Fit For Use
11 LC 20-Dec-13 Lifting Cap ( 4.1/2" Reg Box ) J-13-0074-4-1 N/A Store √ √ — √ — — — Fit For Use
12 LC 20-Dec-13 Lifting Cap ( 3.1/2" Reg Pin ) A 14 - 3 N/A Store √ √ — √ — — — Fit For Use
13 LC 20-Dec-13 Lifting Cap ( 3.1/2" Reg Box ) A 14 - 10 N/A Store √ √ — √ — — — Fit For Use
14 LC 20-Dec-13 Lifting Cap ( 3.1/2" Reg Box ) A 14 - 3 N/A Store √ √ — √ — — — Fit For Use
15 LC 20-Dec-13 Eye Bolt 11894 N/A Store √ √ — √ — — — Fit For Use
16 TB 20-Dec-13 Turnbuckle ( 3/8" - 1/2" ) MNF : Mordec J5Q RWO TB 01 9200 lbs Store √ - — √ — — — Fit For Use
Page 51 of 62

26 CSL 20-Dec-13 Chain Sling with clevis grap hook, 3/8" x 20 ft RWO CSL 001 9200 lbs Store √ - — √ — — — Fit For Use
33 CSL 20-Dec-13 Chain Sling with clevis grap hook, 3/8" x 20 ft RWO CSL 008 9200 lbs Store √ √ — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 52 of 62

Page 53 of 62

55 WRS 19-Dec-13 1 leg wire rope sling soft eye, 16 x 2000 mm AR 21757 3 ton Store √ - — √ — — — Fit For Use
65 WRS 19-Dec-13 1 leg wire rope sling soft eye, 22 x 3000 mm 12/1596/1 6.2 ton Store √ - — √ — — — Fit For Use
69 WRS 19-Dec-13 1 leg wire rope sling with ferrule, 38 x 1820 mm AR19578 17.7 ton Store √ - — √ — — — Fit For Use
70 WRS 19-Dec-13 1 leg wire rope sling with ferrule, 38 x 1820 mm AR19579 17.7 ton Store √ - — √ — — — Fit For Use
71 WRS 19-Dec-13 1 leg wire rope sling with ferrule, 26 x 8500 mm FO8419 8 ton Store √ - — √ — — — Fit For Use
72 WRS 19-Dec-13 1 leg wire rope sling with ferrule, 26 x 8500 mm FO8420 8 ton Store √ - — √ — — — Fit For Use
75 WRS 19-Dec-13 1 leg wire rope sling with ferrule, 16 x 1300 mm BTCT1381 - 01 3 ton Store √ - — √ — — — Fit For Use
76 WRS 19-Dec-13 1 leg wire rope sling with ferrule, 16 x 1300 mm BTCT1381 - 03 3 ton Store √ - — √ — — — Fit For Use
79 WRS 19-Dec-13 1 leg wire rope sling soft eye, 26 x 1500 mm AR1983 7.8 ton Store √ - — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 54 of 62

1 SC 19-Dec-13 Bow Shackle with safety bolt RWO SC 01 8.5 ton Store √ — — √ — — — Fit For Use
7 SC 19-Dec-13 Bow Shackle with safety bolt F12H 2907 8.5 ton Store √ — — √ — — — Fit For Use
13 SC 19-Dec-13 Bow Shackle with safety bolt F12H 2927 12 ton Store √ — — √ — — — Fit For Use
14 SC 19-Dec-13 Bow Shackle with safety bolt F12H 2928 12 ton Store √ — — √ — — — Fit For Use
15 SC 19-Dec-13 Bow Shackle with safety bolt F12K 4167 12 ton Store √ — — √ — — — Fit For Use
16 SC 19-Dec-13 Bow Shackle with safety bolt RWO SC 01 12 ton Store √ — — √ — — — Fit For Use
Page 55 of 62

43 WRS 19-Dec-13 1 leg wire rope sling soft eye, 26 x 1500 mm AR1984 7.8 ton Store √ - — √ — — — Fit For Use
44 WRS 19-Dec-13 1 leg wire rope sling soft eye, 12 x 3960 mm RWO SL 01 1.7 ton Store √ - — √ — — — Fit For Use
45 WRS 19-Dec-13 1 leg wire rope sling soft eye, 22 x 2800 mm B5403 6.2 ton Store √ - — √ — — — Fit For Use
47 WRS 19-Dec-13 1 leg wire rope sling soft eye, 19 x 2000 mm FO 2896 3.40 ton Store √ - — √ — — — Fit For Use
48 WRS 19-Dec-13 1 leg wire rope sling soft eye, 19 x 2500 mm SL 2C5014 9.7 ton Store √ - — √ — — — Fit For Use
49 WRS 19-Dec-13 1 leg wire rope sling soft eye, 19 x 10 000 mm RWO SL 02 3.40 ton Store √ - — √ — — — Fit For Use
50 WRS 19-Dec-13 2 legs wire rope sling with hook, 22 x 6000 mm F12H 2933 5.65 ton Main Deck √ √ — √ — — — Fit For Use
51 WRS 19-Dec-13 2 legs wire rope sling with hook, 26 x 6200 mm 0128S 114 11.8 ton Main Deck √ √ — √ — — — Fit For Use
52 WRS 19-Dec-13 2 legs wire rope sling with hook, 22 x 6200 mm 11/0355/1 8.7 ton Main Deck √ √ — √ — — — Fit For Use
53 WRS 19-Dec-13 1 leg wire rope sling soft eye, 19 x 4600 mm AF 581 4.6 ton Store √ — — √ — — — Fit For Use
54 WRS 19-Dec-13 2 legs wire rope sling with hook, 19 x 2870 mm FP 7116 3 ton Store √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 56 of 62

1 SPB 18-Dec-13 Spreader Bar for lifting Chemical PJL 03 2000 kg Port Side √ √ — √ — — — Fit For Use
2 SC 18-Dec-13 Bow Shackle with safety bolt SC 01 PJL 03 4 3/4 ton Port Side √ — — √ — — — Fit For Use
6 SC 18-Dec-13 Bow Shackle with safety bolt SC 05 PJL 03 3.25 ton Port Side √ — — √ — — — Fit For Use
14 WBS 18-Dec-13 Webbing Sling ( MNF : Lift-Tex ) 238493 7 ton Port Side √ — — √ — — — Fit For Use
16 WBS 18-Dec-13 Webbing Sling ( MNF : Lift-Tex ) 238495 7 ton Port Side √ — — — √ Ripped Remove from servis Not Fit For Use
18 WBS 18-Dec-13 Webbing Sling ( MNF : Interrig Sling CO LTD ) 66044 6 ton Port Side √ — — √ — — — Fit For Use
19 WBS 18-Dec-13 Webbing Sling ( MNF : Allsafe PMS ) 30585 4 ton Port Side √ — — √ — — — Fit For Use
20 WBS 18-Dec-13 Webbing Sling ( MNF : Rema Holland ) 70029 3 ton Port Side √ — — √ — — — Fit For Use
21 WBS 18-Dec-13 Webbing Sling ( MNF : Spanset ) RWO 01 WBS 3 ton Port Side √ — — √ — — — Fit For Use
22 WBS 18-Dec-13 Webbing Sling ( MNF : Allsafe PMS ) RWO 02 WBS 4 ton Port Side √ — — √ — — — Fit For Use
23 WBS 18-Dec-13 Webbing Sling ( MNF : Spanset ) RWO 03 WBS 2 ton Port Side √ — — √ — — — Fit For Use
24 WBS 18-Dec-13 Webbing Sling ( MNF : Emirate Safety Servic ) TS 222 6 ton Port Side √ — — √ — — — Fit For Use
Page 57 of 62

26 WBS 18-Dec-13 Webbing Sling ( MNF : Speed Lift ) BS 3481 6 ton Port Side √ — — √ — — — Fit For Use
28 WBS 18-Dec-13 Webbing Sling ( MNF : N/A ) RWO 04 WBS 5 ton Port Side √ — — — √ Ripped Remove from servis Not Fit For Use
29 WBS 18-Dec-13 Webbing Sling ( MNF : Superlift ) RWO 05 WBS 4 ton Port Side √ — — — √ Ripped Remove from servis Not Fit For Use
30 WBS 18-Dec-13 Webbing Sling ( MNF : Lift-tex ) 238496 6 ton Port Side √ — — — √ Ripped Remove from servis Not Fit For Use
31 WBS 18-Dec-13 Webbing Sling ( MNF : Gearset ) 607626 5 ton Port Side √ — — — √ Ripped Remove from servis Not Fit For Use
33 WBS 18-Dec-13 Webbing Sling ( MNF : Superlift ) 660265 6 ton Port Side √ — — √ — — — Fit For Use
34 WBS 18-Dec-13 Webbing Sling ( MNF : Superlift ) 460256 6 ton Port Side √ — — √ — — — Fit For Use
35 WBS 18-Dec-13 Webbing Sling ( MNF : Safety Marine Servic ) F1112 5 ton Port Side √ — — √ — — — Fit For Use
36 WBS 18-Dec-13 Webbing Sling ( MNF : Allsafe PMS ) RWO WBS 06 6 ton Port Side √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 58 of 62

57 SC 17-Dec-13 Bow Shackle with safety bolt RWO SC 03 9.5 ton Port Side √ — — √ — — — Fit For Use
63 SC 17-Dec-13 Bow Shackle with safety bolt F12K 14151 8.5 ton Port Side √ — — √ — — — Fit For Use
69 SC 17-Dec-13 Bow Shackle with safety bolt F12K 4175 17 ton Port Side √ — — √ — — — Fit For Use
75 SC 17-Dec-13 Bow Shackle with safety bolt F12H 2924 12 ton Port Side √ — — √ — — — Fit For Use
76 SC 17-Dec-13 Bow Shackle with safety bolt F12H 3031 12 ton Port Side √ — — √ — — — Fit For Use
78 SC 17-Dec-13 Bow Shackle with safety bolt RWO SC 01 12 ton Port Side √ — — √ — — — Fit For Use
Page 59 of 62

85 SC 17-Dec-13 Bow Shackle with safety bolt F12H 2895 6.5 ton Port Side √ — — √ — — — Fit For Use
87 SC 17-Dec-13 Bow Shackle with safety bolt LEE 43074 6.5 ton Port Side √ — — √ — — — Fit For Use
91 SC 17-Dec-13 Bow Shackle with safety bolt F12L 4453 8.5 ton Port Side √ — — √ — — — Fit For Use
94 SC 17-Dec-13 Bow Shackle with safety bolt 3CM120 35 ton Port Side √ — — √ — — — Fit For Use
95 SC 17-Dec-13 Dee Shackle with safety bolt RWO SC 01 35 ton Port Side √ — — √ — — — Fit For Use
96 SC 17-Dec-13 Bow Shackle with safety bolt RJ 01 4 3/4 ton Port Side √ — — — √ Difference pin shackle MNF Remove from servis Replace
97 SC 17-Dec-13 Bolt Shackle with safety bolt SC 06 4 3/4 ton Port Side √ — — √ — — — Fit For Use
98 SC 17-Dec-13 Bolt Shackle with safety bolt LEEU 3074 6.5 ton Port Side √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 60 of 62

1 CBK 17-Dec-13 Chain Block MNF : Vital CB - 2-1 2 ton Port Side √ √ — — √ Heavy Corossion Remove from servis Not fit for use
2 CBK 17-Dec-13 Chain Block MNF : OZ Block Chain Hosit 106021 2 ton Port Side √ √ — √ — — — Fit For Use
3 CBK 17-Dec-13 Chain Block MNF : Vital 36146 5 ton Port Side √ √ — √ — — — Fit For Use
4 CBK 17-Dec-13 Chain Block MNF : OSM 13030061 5 ton Port Side √ √ — √ — — — Fit For Use
5 CBK 17-Dec-13 Chain Block MNF : Vital CB - 5 - 1 5 ton Port Side √ √ — √ — — — Fit For Use
8 CBK 17-Dec-13 Chain Block MNF : Kito Corp 654021 5 ton Port Side √ √ — √ — — — Fit For Use
11 WRS 17-Dec-13 2 legs wire rope sling, 18 x 2000 mm FO8H - 2516 5.7 ton Port Side √ - — √ — — — Fit For Use
12 WRS 17-Dec-13 1 leg wire rope sling soft eye with hook, 38 x 5000 mm E 12H - 2934 16.7 ton Port Side √ √ — √ — — — Fit For Use
13 WRS 17-Dec-13 1 leg wire rope sling soft eye, 52 x 6200 mm TAG/C/12/0110-1 34.7 ton Port Side √ - — √ — — — Fit For Use
14 WRS 17-Dec-13 4 Legs Wire rope Sling NSC - SL 13 9.7 ton Port Side √ - — √ — — — Fit For Use
15 WRS 17-Dec-13 2 Legs wire rope sling with hook, 22 x 6350 mm 09/1436/1 -2 8.7 ton Port Side √ √ — — √ Broken wire Remove from servis Not fit for use
17 WRS 17-Dec-13 4 legs Wire rope Sling, 16 x 5000 mm F09C 1086 6.5 ton Port Side √ — — √ — — — Fit For Use
18 WRS 17-Dec-13 4 Legs Wire rope Sling, 20 x 4500 mm F09J 3653 9.8 ton Port Side √ — — √ — — — Fit For Use
19 WRS 17-Dec-13 1 leg wire rope sling with hook, 22 x 5300 mm 09 / 1437 5 ton Port Side √ √ — √ — — — Fit For Use
20 WRS 17-Dec-13 2 legs wire rope sling with hook, 26 x 6000 mm F12H 2931 11 ton Port Side √ √ — √ — — — Fit For Use
21 WRS 17-Dec-13 2 legs wire rope sling, 22 x 2780 mm RWO SL 200 10 ton Port Side √ — — √ — — — Fit For Use
22 WRS 17-Dec-13 2 legs wire rope sling with hook, 26 x 6000 mm TAG/C/12/2053 11.8 ton Port Side √ — — √ — — — Fit For Use
23 WRS 17-Dec-13 4 Legs Wire rope Sling, 22 x 6000 mm 14237 11.8 ton Port Side √ — — √ — — — Fit For Use
24 WRS 17-Dec-13 1 leg wire rope with hook, 40 x 4500 mm TC / 1232 18 ton Port Side √ √ — √ — — — Fit For Use
25 WRS 17-Dec-13 1 leg wire rope sling soft eye, 35 x 6000 mm B 8836 15 ton Port Side √ — — — √ Broken wire Remove from servis Not fit for use
Page 61 of 62

26 WRS 17-Dec-13 1 leg wire rope sling soft eye, 35 x 6000 mm 138873 15 ton Port Side √ — — √ — — — Fit For Use
27 WRS 17-Dec-13 1 leg wire rope sling with ferrule, 16 x 4750 mm FO8H - 2520 2.70 ton Port Side √ — — √ — — — Fit For Use
Prepared by,
Rusdiansyah
Page 62 of 62

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SUMMARY OF LIFTING EQUIPMENT INSPECTION

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Note : Report still in progress

Desk. pekerjaan : Forklift Inspection No JSA : FI-2015-LDS001

miskomunikasi antara klien

miskomunikasi antara klien

Kurangnya peralatan, Pastikan perlengkapan dan peralatan yang akan digunakan

Desk. pekerjaan : Forklift Inspection No JSA : FI-2015-LDS001

memasang police line diarea yg akan digunakan, Pastikan

ergonomi, kesalahan Pastikan semua data yg di catat sesuai dengan yg tertera

Gunakan APD dengan baik dan benar, bersihkan area

11 Menutup ijin kerja/Closed permit Inspector

Applying NDT testing and Tag Number for several

11 Close permit (job finished)

Performed by : JSA Reviewed by : Reviewed by Approved by :

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Note : Report still in progress

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Note : Report still in progress

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

Note : Report still in progress

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

10 PE 5-Jan-14 Pad eye PM 11 2 ton Pump room √ √ — √ — — — Fit For Use

11 PE 5-Jan-14 Pad eye PM 1 - Pump room √ √ — √ — — — Fit For Use

12 PE 5-Jan-14 Pad eye PM 45 - Pump room √ √ — √ — — — Fit For Use

13 PE 5-Jan-14 Pad eye PM 46 - Pump room √ √ — √ — — — Fit For Use

14 PE 5-Jan-14 Pad eye PM 40 - Pump room √ √ — √ — — — Fit For Use

15 PE 5-Jan-14 Pad eye PM 6 - Pump room √ √ — √ — — — Fit For Use

16 PE 5-Jan-14 Pad eye PM 13 - Pump room √ √ — √ — — — Fit For Use

19 PE 5-Jan-14 Pad eye PM 35 - Pump room √ √ — √ — — — Fit For Use

20 PE 5-Jan-14 Pad eye PM 34 - Pump room √ √ — √ — — — Fit For Use

21 PE 5-Jan-14 Pad eye PM 7 - Pump room √ √ — √ — — — Fit For Use

22 PE 5-Jan-14 Pad eye PM 8 - Pump room √ √ — √ — — — Fit For Use

23 PE 5-Jan-14 Pad eye PM 51 - Pump room √ √ — √ — — — Fit For Use

24 PE 5-Jan-14 Pad eye PM 43 - Pump room √ √ — √ — — — Fit For Use

25 PE 5-Jan-14 Pad eye PM 44 - Pump room √ √ — √ — — — Fit For Use

26 PE 5-Jan-14 Pad eye PM 18 - Pump room √ √ — √ — — — Fit For Use

Date : January 2014 WO No. : 062/STI-WO/12-13

TYPE OF INSPECTION RESULT OF INSPECTION

27 PE 5-Jan-14 Pad eye PM 19 - Pump room √ √ — √ — — — Fit For Use

28 PE 5-Jan-14 Pad eye PM 31 - Pump room √ √ — √ — — — Fit For Use

29 PE 5-Jan-14 Pad eye PM 14 - Pump room √ √ — √ — — — Fit For Use

30 PE 5-Jan-14 Pad eye PM 38 - Pump room √ √ — √ — — — Fit For Use

34 PE 5-Jan-14 Pad eye PM 30 - Pump room √ √ — √ — — — Fit For Use