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To : PT. Tekonomiks NO No.

: 160001
LAB Date Date
: 4-Jan-16
Attn : Mr. Teguh Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 Btl Oil sampling genzet BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Jan-16 Date : Date : 4-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Total NO No.
: 160002
SWPE site Date Date
: 4-Jan-16
Attn : Mr. Irwando Job Job
: JRCB
No.140005

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pak Sarung tangan


1 ea Kain majun
1 ea Air filter
1 ea Oil filter
1 ea Fuel filter
1 ea Racor
2 btl Air accu

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Jan-16 Date : Date : 4-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. BPP NO No.
: 160003
Senipah Date Date
: 5-Jan-16
Attn : Mr. Dody Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 9 ea Stearns Work Vest


2 2 ea Brass Hammer 4.5 LB
3 1 ea Steel Box Tool 3 step
4 2 ea Hammer HBR03
5 4 ea Lakban kertas

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Jan-16 Date : Date : 5-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160004
Date Date
: 2-Jan-16
Attn : Mr. Abd Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Jan-16 Date : Date : 2-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160005
Date Date
: 2-Jan-16
Attn : Mr. Abd Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 liter Solar u/ KT 8839 KH buang sampah

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Jan-16 Date : Date : 2-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160006
Date Date
: 6-Jan-16
Attn : Mr. Abd Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jan-16 Date : Date : 6-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Usaha Raya Adipuratama NO No.
: 150597
Date Date
: 6-Jan-16
Attn : Mr. Sofian Kasan Job Job
: J150313
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 pcs Hot dip galvanized plate 19x300x300 Transport by


2 16 set Ancor bolt galvanize

Jl raya Wajok Km 14,6


Wajok hilir Pontianank - Kalbar
Pak Felix
Star Safety Cargo
85246831326

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jan-16 Date : Date : 6-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Bontang NO No.
: 160008
Date Date
: 6-Jan-16
Attn : Mr. Herlambang Job Job
: J140490
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 27 pcs BR Water meter CI PN10 2" Transport by

2 6 pcs BR Water meter CI PN10 3"


3 1 pcs Flange 2"
4 5 rim Kertas A4
5 12 ea Ballpoint

Machfut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jan-16 Date : Date : 6-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160009
Date Date
: 6-Jan-16
Attn : Mr. Kamal Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 drum Oil lube Mobile


2 4 ea Battery N120
3 3 galon Air accu zuur
4 ea Cable jumper
5 2 lusin Sarung tangan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jan-16 Date : Date : 6-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. MUPECO NO No.
: 160010
Date Date
: 7-Jan-16
Attn : Mr. Sutrisno Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Arm Cyld Hear Re-Chrome

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Jan-16 Date : Date : 7-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160011
Date Date
: 11-Jan-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Jan-16 Date : Date : 11-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Bontang NO No.
: 160012
Date Date
: 11-Jan-16
Attn : Mr. Herlambang Job Job
: J140490
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs BR Water meter Transport by

Machfut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Jan-16 Date : Date : 11-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - SPU NO No.
: 160013
Date Date
: 12-Jan-16
Attn : Mr. Guntoro Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lusin Sarung tangan


2 1 set Tang Ampere
3 1 box Tools
4
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Jan-16 Date : Date : 12-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160014
Date Date
: 12-Jan-16
Attn : Mr. Guntoro Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 drum Drum

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Jan-16 Date : Date : 12-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160015
Date Date
: 12-Jan-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 klg WD40
2 18 ea Lak ban Kertas
3 20 pack Trashbag
4 24 lusin Sarung tangan
5 12 ea Kuas 2"
6 12 ea Kuas 2.5"
7 12 ea Electric tape black
8 6 ea Sikat Kawat
9 1 unit Kamera Pocket Nikon L31 Kembali

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Jan-16 Date : Date : 12-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160015
Date Date
: 13-Jan-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Kamera Pocket Nikon L31

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Jan-16 Date : Date : 13-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160017
Date Date
: 14-Jan-16
Attn : Mr. Muklis / Samsul Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 13 lusin Sarung tangan polkadot


2 5 kg Majun
3 10 ea Sikat kawat
4 5 psg Sarung tangan karet
5 2 ea Lakban hitam
6 2 ea lakban kertas
7
8
9
10
11
12
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Jan-16 Date : Date : 14-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan - PSB NO No.
: 160018
Penajam Date Date
: 14-Jan-16
Attn : Mr. Edi Triono Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Lube oil Cooler Saturn 1300

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Jan-16 Date : Date : 14-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160019
Date Date
: 14-Jan-16
Attn : Mr. Dwi Putra Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 lusin Sarung tangan


2 3 kg Majun
3 5 klg CRC
4 5 klg WD40
5 4 ea Silicone clear
6 3 ea Silicone red high temp.
7 4 ea Electric tape black & rubber
8 3 ea Lakban Coklat
9 3 ea Lakban kertas
10 2 pack Plastic clip
11 1 pack Cable ties 30 cm
12 1 pack Cable ties 20 cm
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Jan-16 Date : Date : 14-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160020
Date Date
: 16-Jan-16
Attn : Mr. Anang Susila / Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 ea Bearing NTN 30309D


2 5 lusin Sarung tangan polkadot

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jan-16 Date : Date : 16-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160021
Date Date
: 16-Jan-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lusin Sarung tangan


2 2 kg Majun
3 2 ea Oil filter
4 2 ea Fuel filter
5 2 ea Racor
6
7
8

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jan-16 Date : Date : 16-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160022
Date Date
: 16-Jan-16
Attn : Mr. Dwi BS Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Dispenser Rusak.

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jan-16 Date : Date : 16-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160023
Date Date
: 16-Jan-16
Attn : Mr. Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 liter Solar u/ Mesin Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jan-16 Date : Date : 16-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Tekenomiks Indonesia NO No.
: 160024
Date Date
: 18-Jan-16
Attn : Mrs. Devi Matria Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Bottle oil sampling Genset G1 & G2

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Jan-16 Date : Date : 18-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI SWP-E NO No.
: 160025
Date Date
: 19-Jan-16
Attn : Mr. Madi Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Lube oil


2 1 set Filter
3 1 ea Racor element
4
5
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Jan-16 Date : Date : 19-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160026
Machining Project Date Date
: 19-Jan-16
Attn : Mr. Rafli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 pcs Roundbar 316L - 11/2 x 6 M


2 5 pcs Roundbar 316L - 13/8 x 6 M
3 4 ea Cartridge 678 black
4 4 ea Cartridge 678 colour

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Jan-16 Date : Date : 19-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160027
HE. Project Date Date
: 19-Jan-16
Attn : Mr. Bachri Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 lusin Sarung Tangan


2 10 kg Majun
3 5 klg CRC
4 3 klg WD
5 4 ea Marker black & white @ 2 ea
6 2 ea Sikat kawat
7 4 ea Silicone clear
8 2 ea lakban kertas
9 12 ea Kuas 4", 3" dan 2" @ 4 ea
10 6 ea Ballpoint
11 2 pack Cable ties 3 x 200 & 4 x 200
12 12 ea Mata gergaji besi
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Jan-16 Date : Date : 19-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160027
HE. Project Date Date
: 19-Jan-16
Attn : Mr. Bachri Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 ea Cartridge 810 black


14 1 ea Cartridge 811 colour
15 10 ea Hose clamp 1/2 "
16 10 ea Hose clamp 3/4 "
17 3 klg Pylox White
18 3 klg Pylox Yellow

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Jan-16 Date : Date : 19-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160028
Date Date
: 23-Jan-16
Attn : Mr. I Gede / Gawitno Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pcs Gasket HBG 1020

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Jan-16 Date : Date : 23-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Pertamina PHE WMO NO No.
: 160029
Date Date
: 22-Jan-16
Attn : Mr. Taufik Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Distance meter KW06-526 Krisbow tool


2 1 ea Meteran
3 1 ea Vernier caliper
4 1 ea Lifevest PPE
5 1 pcs Camera pocket Canon
( u/ keperluan site visit )

HandCarry

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Jan-16 Date : Date : 22-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung santan NO No.
: 160030
Date Date
: 27-Jan-16
Attn : Mr. Iswanto Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Altenator 12v


2 1 pcs Multi digital Tester
3
4
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Jan-16 Date : Date : 27-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - SPU NO No.
: 160031
Date Date
: 28-Jan-16
Attn : Mr. Guntoro Job Job
: JRCB
No.140005

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 psg Sarung tangan


2 1 pcs Wrench Combination
3 1 pcs Avo meter
4 1 pcs Tang ampere
5 1 pcs Kunci filter
6 1 set Tools
7 1 ea Lak ban hitam
8 3 ea Battery AA (A2)
9 2 ea Battery D 1.5 v
10 1 pcs Senter
11 2 pcs Battery 150 A + Air tambah Accu
12
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Jan-16 Date : Date : 28-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Bontang NO No.
: 160032
Date Date
: 28-Jan-16
Attn : Mr. Herlambang Job Job
: J140490
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 pcs BR Water meter 2" Transport by

Pandusiwi

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Jan-16 Date : Date : 28-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Partsindo NO No.
: 160033
Date Date
: 29-Jan-16
Attn : Mr. Amir Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 ea Sample hose

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Jan-16 Date : Date : 29-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160034
Date Date
: 29-Jan-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 36 ea Rinso 450 gr
2 24 ea Vanish 450ml
3 3 ea Tissue 900gr
4 2 ea Stella lemon 400ml
5 2 ea Stella Apple 400ml
6 4 ea Hit orange 2x400ml
7 2 ea SOS orange 2x800ml
8 1 ea SOS Lemon 2x800ml
9 12 ea Biore cool 450
10 2 ea Windex fresh 2x425ml
11 2 ea Rapika lavender 450ml
12 10 ea Soklin blue 900ml
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Jan-16 Date : Date : 29-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160034
Date Date
: 29-Jan-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 12 ea Soklin violet 900ml


14 6 ea Mama lime 800ml
15 4 kg Gula pasir
16 2 ea Max creamer
17 1 ea Kopi kapal api 380gr
18 3 ktk Sariwangi tea
19 4 ea Vixal blue
20 4 ea Vixal green
21 3 ktk Maker kain
22 24 ea Kuas roll kecil refill
23 24 ea Duct tape silver
24 24 klg Contact cleaner CRC
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Jan-16 Date : Date : 29-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160034
Date Date
: 29-Jan-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

25 24 lusin Sarung tangan Polkadot


26 8 pack Battery AA ( A2 )
27 8 pack Battery AAA ( A3 )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Jan-16 Date : Date : 29-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160035
Date Date
: 30-Jan-16
Attn : Mr. J. Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Jan-16 Date : Date : 30-Jan-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Machining NO No.
: 160036
Lawe - Lawe Date Date
: 2-Feb-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pcs Round bar Teflon 2.5" x 2 mtr


2 8 lusin Sarung tangan
3 4 ea Silicone clear
4 3 ea Disc cutting 4"
5 3 ea Disc grinding 4"

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Feb-16 Date : Date : 2-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : SWPE-PECIKO NO No.
: 160037
Date Date
: 2-Feb-16
Attn : Mr.Prima Job Job
: J140005
No. - 55 kva

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Oil Filter
2 1 ea Fuel Filter
3 1 ea Racor
4 1 ea Plastik Trush Bag
5 4 ea Sarung Tangan
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Feb-16 Date : Date : 2-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160038
Date Date
: 3-Feb-16
Attn : Mr. Adb. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Feb-16 Date : Date : 3-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160039
Date Date
: 3-Feb-16
Attn : Mr. Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 tbg APAR 3 kg
2 1 pack kapas
3 1 set Peniti
4 1 ea Getadine
5 1 ea Gunting
6 3 ea Stiker

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Feb-16 Date : Date : 3-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tj Santan NO No.
: 160040
BPP Crew Date Date
: 4-Feb-16
Attn : Mr. Rafli/Sedekial Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 9 set Rain coat


2 50 kg Kain majun
3 12 ea Kuas 4"

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Feb-16 Date : Date : 4-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total NO No.
: 160041
Senipah Date Date
: 4-Feb-16
Attn : Mr. Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Kaca
2
3

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Feb-16 Date : Date : 4-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Vibrasindo NO No.
: 160042
Date Date
: 5-Feb-16
Attn : Mr. Zulfikri Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Vibration Meter

Jl. Radin Inten II No. 61B


Duren Sawit - Jakarta 13440
0815 6141 954
021-29563051

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Feb-16 Date : Date : 5-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160043
Date Date
: 6-Feb-16
Attn : Mr. Gusti Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Fuel filter
2 2 ea Oil filter
3 2 ea Racor
4 1 lusin Sarung tangan
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Feb-16 Date : Date : 6-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Telekonomiks NO No.
: 160044
Date Date
: 9-Feb-16
Attn : Mrs.Devi Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Oil Sample

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Feb-16 Date : Date : 9-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - SisiNubi NO No.
: 160045
Date Date
: 11-Feb-16
Attn : Mr. Bustamin Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 40 liter Lube oil


2 1 ea Oil filter
3 1 ea Fuel filter
4 1 ea Racor
5 1 kg majun
6 1.5 mtr Cable grounding
7 1 lusin Sarung tangan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Feb-16 Date : Date : 11-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160046
Date Date
: 12-Feb-16
Attn : Mr. Narang Sudirman Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 sheet Report “MOH Service Unit Hyster


Forklift” (Original & Copy)

2 2 sheet Manual Book Unit Isuxu Vacuum


Truck & Unit Hyster Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Feb-16 Date : Date : 12-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT.BPP NO No.
: 160047
Senipah Date Date
: 12-Feb-16
Attn : Mr. Dody Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Camera Pocket Canon IXUS 160


2 1 unit Digital Insulatin tester
3 1 unit Clamp meter (after service)
4 5 rim Kertas A4 80 gr
5 6 ea Kuas Roll 10 cm with handle
6 3 pack Cable ties 10 cm
7 3 pack Cable ties 20 cm

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Feb-16 Date : Date : 12-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160048
Date Date
: 13-Feb-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 liter Solar u/ mesin Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Feb-16 Date : Date : 13-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Meindo Elang Indah NO No.
: 160049
Date Date
: 15-Feb-16
Attn : Mr. Ilham Job Job
: J160048
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 ea Kabel power
2 1 pcs Avo meter
3 1 pcs Tang ampere
4 1 box Tools
5 1 pcs Temperature gun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Feb-16 Date : Date : 15-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Meindo Elang Indah NO No.
: 160050
Date Date
: 15-Feb-16
Attn : Mr. Adi Job Job
: J160048
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 roll Kabel power

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Feb-16 Date : Date : 15-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160051
Date Date
: 18-Feb-16
Attn : Mr. Abd. Muin Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Feb-16 Date : Date : 18-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Teknokraft NO No.
: 160052
Date Date
: 18-Feb-16
Attn : Mrs. Arni Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pcs Plunger Transport by


JNE
nb. Coating tungsten carbide

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Feb-16 Date : Date : 18-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI Senipah NO No.
: 160053
Date Date
: 18-Feb-16
Attn : Mr. Dwi Wasaso / Purwanto. Job Job
: JRCB160006
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 80 ea Bolt Grade 5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Feb-16 Date : Date : 18-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160054
Date Date
: 18-Feb-16
Attn : Mr. Didik Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Bolt + nut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Feb-16 Date : Date : 18-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160055
Date Date
: 19-Feb-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Feb-16 Date : Date : 19-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP-Senipah NO No.
: 160056
Date Date
: 23-Feb-16
Attn : Mr. Dody Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Tool Box

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Feb-16 Date : Date : 23-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI Senipah NO No.
: 160057
Date Date
: 25-Feb-16
Attn : Mr. Prima Job Job
: JRCB
No.140005

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 box Tool box Pinjam Ex Pertamina


2 1 unit Grinding Machine 7"
3 1 unit Grinding Machine 5"
4 1 ea Disc Grinding 7"
5 1 ea Disc Cutting 5"
6 1 ea Cable extention

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Feb-16 Date : Date : 25-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - SPU NO No.
: 160058
Date Date
: 25-Feb-16
Attn : Mr. Ilham Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 gln Lube Oil Sae 40


2 1 set Spare part 125 KvA
3 1 ea Air cleaner
4 1 set Consumable
5 1 lght Hose fuel line
6
7
8

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Feb-16 Date : Date : 25-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - Peciko SWPE NO No.
: 160059
Date Date
: 26-Feb-16
Attn : Mr. Guntoro Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 tbg APAR
2 1 roll Fire blanket
3 1 box Tool box
4 2 pcs Face shield
5 1 roll Baricade
6 6 ea Disc cutting 5"
7 13 ea Disc cutting 7"
8 3 ea Disc grinding 5"
9 3 ea Disc grinding 7"
10 1 ea Apron
11 1 ea Tang kombinasi
12 2 ea Obeng + -
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - Peciko SWPE NO No.
: 160059
Date Date
: 26-Feb-16
Attn : Mr. Guntoro Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 ea Tang potong
14 2 ea Socket cable
15 1 lusin Sarung tangan
16 2 ea Lakban Hitam & Kertas
17 1 ea Electric tape black
18 1 pack Cable ties
19 1 ea Mata gergaji besi
20 2 kg Majun
21 2 ea Lem alteco
22 15 ea Masker
23 1 ea Seal tape
24
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160060
Date Date
: 26-Feb-16
Attn : Mr. Irwando Job Job
: J1500034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 drum Lube Oil


2 2 ea Air filter
3 2 ea Fuel filter
4 5 ea Racor
5
6
7

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160061
Date Date
: 26-Feb-16
Attn : Mr. Raffli Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop
2
3

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160062
Date Date
: 26-Feb-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Mr. Muscle Apel


2 1 ea Mr. Muscle lemon
3 6 ea Soklin Pewangi Intpnk
4 4 ea Soklin Pewangi pink
5 5 ea Soklin Pewangi peach
6 9 ea Soklin Pewangi violet
7 6 ea Sunlight lime
8 3 ea SOS pembersih lantai
9 4 ea HIT orange
10 6 ea Rapika lavender
11 2 ea Stella Apple
12 1 ea Stella Lemon
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160062
Date Date
: 26-Feb-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 26 ea Rinso anti noda


14 7 ea Biore bright
15 2 ea Biore anti septic
16 3 ea Biore relax aromatic
17 2 ea Tisue nice 900 gr
18 1 ea Tisue nice 1000 gr
19 12 ea Vanish cair pouch 450ml
20 3 ea Sariwangi tea
21 2 ea Max creamer
22 2 ea kapal api kopi
23 4 kg Gula pasir
24 6 ea Vanish cair pink 500ml
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160062
Date Date
: 26-Feb-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

25 6 ea Vanish pink 1 ltr


26 4 ea Vixal biru
27 4 ea Vixal hijau
28 24 psg Sarung tangan impact
29 24 lusin Sarung tangan polkadot
30 1 ea Stella orange
31
32
33
34

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Feb-16 Date : Date : 26-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160063
Date Date
: 27-Feb-16
Attn : Mr. Junaidi P Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 liter Solar u/ mesin Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Feb-16 Date : Date : 27-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160064
Date Date
: 27-Feb-16
Attn : Mr. Abd Gofur Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Drum bekas Rusak

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Feb-16 Date : Date : 27-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Liebher NO No.
: 160065
Date Date
: 27-Feb-16
Attn : Mrs. Sonia Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 ea Mesabi tube PN : 2610-33750

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Feb-16 Date : Date : 27-Feb-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Rhodes NO No.
: 160066
Date Date
: 1-Mar-16
Attn : Mr. Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea After cooler

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Mar-16 Date : Date : 1-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160067
Date Date
: 1-Mar-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 kg Majun
2 1 ea Cartridge black HP
3 1 ea Epson ink black Re_fill
4 1 unit Clamp meter Sanwa DCM400 P160207

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Mar-16 Date : Date : 1-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron lawe - lawe NO No.
: 160068
Machining Date Date
: 2-Mar-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 lbr Papan meranti semua di potong jadi 2


2 15 btg Balok 5 x10
3 16 btg Balok 5 x 7

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Mar-16 Date : Date : 2-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160069
Date Date
: 4-Mar-16
Attn : Mr. Gusti Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 12 psg Sarung tangan


2 1 pcs Altenator
3 1 pcs Waterpump
4
5
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Mar-16 Date : Date : 4-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Wahyu Perkasa NO No.
: 160070
Date Date
: 5-Mar-16
Attn : Mr. Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Waterjet Pump Return

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Mar-16 Date : Date : 5-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160071
0542 - 7562981 Date Date
: 8-Mar-16
Attn : Mr. Wildan Firman Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 box Bearing compressor

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Mar-16 Date : Date : 8-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Borneo Mulia Baru NO No.
: 160072
Date Date
: 8-Mar-16
Attn : Bapak Dwi Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 38 pcs Jaket Pilot Bordir


2 1 pcs Sample Jaket Pilot

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Mar-16 Date : Date : 8-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160073
Date Date
: 8-Mar-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 pack Amplop Coklat Campur


2 6 klg CRC contact cleaner
3 1 pcs Toner HP black
4 1 pcs Toner HP yellow
5
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Mar-16 Date : Date : 8-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Keysia Technical Indonesia NO No.
: 160074
Date Date
: 10-Mar-16
Attn : Mr. Suwarno Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Barton chart 600&1000 PSI For Repair


2 1 unit Barton chart 600 & 1500 PSI For kalibrasi
3 7 ea Pressure Gauge 1000,60,160,300 For kalibrasi
600,600,1500 PSI

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Mar-16 Date : Date : 10-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total-SPU NO No.
: 160075
CCNUBI Date Date
: 10-Mar-16
Attn : Mr. Irwando Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 kg Kain Majun
2 12 psg Sarung tangan
3 1 ea Racor
4 2 ea Fuel filter
5 1 ea Oil filter
6 35 ltr Oil engine

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Mar-16 Date : Date : 10-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160076
Date Date
: 12-Mar-16
Attn : Mr. Ardian Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 lusin Sarung tangan


2 10 kg Majun
3 6 klg WD 40
4 3 ea Sikat kawat
5 4 ea lakban kertas
6 1 pack Trashbag
7 2 pack Cable ties 30 cm
8 1 pack Cutter re_fill

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Mar-16 Date : Date : 12-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total - Tanjung Batu NO No.
: 160077
Logistic Date Date
: 13-Mar-16
Attn : Mr. Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unitGenset Hartech 135 KvA Transport by


( with wire sling + shackle )
2 35 meter Power Cable
( with basket, wire sling + shackle )

KT 9846 AK

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Mar-16 Date : Date : 13-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160078
Date Date
: 14-Mar-16
Attn : Mr. Taufik Job Job
: JRCB
No.140005

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 60 liter Solar u/ Running Genset

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Mar-16 Date : Date : 14-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160079
PT. Bhumi Phala Date Date
: 14-Mar-16
Attn : Team Bhumi Phala Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 kg Majun
2 4 lusin Sarung Tangan
3 12 klg Contact Cleaner & WD40
4 1 pack Trashbag
5 4 ea Silicone clear
6 3 ea Lakban Kertas & Coklat
7 2 ea Alteco
8 3 ea Seal tape
9 3 ea Kuas 2"
10 1 ea Silicone red
11 12 ea Amplas 120 & 800
12 1 mtr Amplas rol
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Mar-16 Date : Date : 14-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160080
Date Date
: 15-Mar-16
Attn : Mr. Guntoro Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Box Tools 14 item


( Obeng, Tang dan Kunci )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Mar-16 Date : Date : 15-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160081
Machining Project Date Date
: 14-Mar-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 kg Majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Mar-16 Date : Date : 14-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT BPP NO No.
: 160082
Senipah Date Date
: 15-Mar-16
Attn : Mr. Dody Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Mouse
2 1 ea Battery 60A

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Mar-16 Date : Date : 15-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : MUPECO NO No.
: 160083
Date Date
: 16-Mar-16
Attn : Mr. Sutrisno Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Hardness Tester Return

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Mar-16 Date : Date : 16-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. CISTECH ALPHA NO No.
: 160084
INDONESIA Date Date
: 18-Mar-16
Attn : Mrs. Esther Elisabeth Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 pcs TUBE CLEANING NOZZLE


RTL20-1/4-Sting-4 Lance Ridgid
Stinger 1/4" MP 247 OD

Green Sedayu Biz Park Blok DM-6 No.


15
Jl. Daan Mogot Raya Km 18, Kalideres
Jakarta 11840, Indonesia
Phone : +62 21 22522 445 – 447

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Mar-16 Date : Date : 18-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160085
Date Date
: 19-Mar-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Altenator
2 1 ea Termo stat
3 4 psg Sarung tangan
4 4 kg Majun
5 2 ea Oil filter
6 2 ea Fuel filter

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Mar-16 Date : Date : 19-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160086
Date Date
: 19-Mar-16
Attn : Mr. Herlambang Job Job
: J140490
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Grinding machine Pinjam


2 2 ea Pipa HDPE bekas Rusak

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Mar-16 Date : Date : 19-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Tekenomiks Indonesia NO No.
: 160087
Date Date
: 21-Mar-16
Attn : Mrs. Devi Matria Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Bottle oil sampling Genset G1 & G2

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Mar-16 Date : Date : 21-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160088
Date Date
: 21-Mar-16
Attn : Mr. Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Lemari File Cabinet Krisbow

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Mar-16 Date : Date : 21-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160089
Date Date
: 19-Mar-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ mesin Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Mar-16 Date : Date : 19-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Riyan Jaya NO No.
: 160090
Date Date
: 21-Mar-16
Attn : Mr. Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Cable PTO sample

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Mar-16 Date : Date : 21-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160091
Date Date
: 22-Mar-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Mar-16 Date : Date : 22-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Untung Diesel NO No.
: 160062
Date Date
: 23-Mar-16
Attn : Mrs. Imelda Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 unit Electronic unit Injector


Ex Engine genset Perkins 250 KvA
SN : 69141994191 & 69141994182

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Mar-16 Date : Date : 23-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160093
PT. BPP Date Date
: 23-Mar-16
Attn : Mr. N. Lendup Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea USB WIFI
2 1 unit Laptop HP G4 Series
3 1 ea Cooling Pad
4 1 ea Battery Laptop
5 1 ea Tas Laptop

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Mar-16 Date : Date : 23-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Bpk Erik Aprianto NO No.
:
Date Date
: 24-Mar-16
Attn : Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Genset 5 kva merk krisbow second

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Mar-16 Date : Date : 24-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan NO No.
: 160095
Date Date
: 26-Mar-16
Attn : Mr. Wibisono / Muklis Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Drum Bekas Project


2 1 ea Meja Scrap

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Mar-16 Date : Date : 26-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160096
Date Date
: 28-Mar-16
Attn : Mr. Irwando Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Running Genset 400 kVa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Mar-16 Date : Date : 28-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160097
Date Date
: 29-Mar-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 24 ea Rinso anti noda 900gr Transport by Upie


2 12 ea Rapika 250gr
3 8 ea Vixal 800ml
4 8 ea Sabun mandi 450ml
5 24 ea Vanish 450gr
6 20 ea Pengharum ruangan 900ml
7 4 ea Pengharum ruangan 400ml
8 3 ea Tissue 900gr
9 6 ea Pembersih lantai 800gr
10 4 ea Sabun cuci piring 440ml
11 4 ea Pembersih kaca 440 ml
3 ea The sariwangi 50
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Mar-16 Date : Date : 29-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160097
Date Date
: 29-Mar-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 3 ea Kopi 380 gr
14 2 ea Max creamer
15 4 kg gula
16 8 ea Obat nyamuk hit 400 ml
17 1 ea Toner refill Magenta 1025

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Mar-16 Date : Date : 29-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160098
Machining Date Date
: 30-Mar-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lngh Bronze 3" length 1 mtr


2 2 lngh Round bar SS 316 1"

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Mar-16 Date : Date : 30-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160099
Date Date
: 30-Mar-16
Attn : Mr. Bachri / Wahab Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 lusin Sarung tangan


2 12 klg CRC & WD
3 10 ea Kuas 1" & 3"
4 20 ea Amplas 120 & 800
5 2 mtr Amplas roll
6 4 ea Lakban kertas
7 1 pack Tashbag
8 5 ea Silicone clear
9 4 pack Cable ties 10 cm & 30 cm
10 4 ea Electric tape black
11 5 ea Mata gergaji besi
12 2 ea Silicone red high Temp & Alteco
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Mar-16 Date : Date : 30-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160099
Date Date
: 30-Mar-16
Attn : Mr. Bachri / Wahab Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 ea Electric tape rubber


14 2 ea Sikat kawat
15 1 ea Marker snowman black & white
16 5 ea Ballpoint
17 2 ea Map plastik
18 1 ea Kunci filter
19 4 doz Air mineral
20 4 kg Gula
21 1 ea Tea Sari wangi
22 2 ea Kopi kapal Api
23
24
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Mar-16 Date : Date : 30-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160100
Date Date
: 31-Mar-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-Mar-16 Date : Date : 31-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160101
Date Date
: 31-Mar-16
Attn : Mr. N. Lendup Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 ea Cartridge 60 Black & Colour


2 5 ea Marker snowman black
3 5 ea Ballpoint
4 4 ea Post it
5 3 ea Isi stapler
6 2 rim Kertas A4
7 2 ea Lampu 10 watt
8 2 ea Lampu 50 watt

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-Mar-16 Date : Date : 31-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160099
Date Date
: 30-Mar-16
Attn : Mr. Bachri / Wahab Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 kg Majun
2 1 rim Kertas A4

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Mar-16 Date : Date : 30-Mar-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total NO No.
: 160103
Senipah Date Date
: 4-Apr-16
Attn : Mr. Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Shaft MP665 (3 mtr)


2 1 ea Shaft MP665 (22 cm)
3 1 ea Nepple 2 1/16"
4 1 ea Locknut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Apr-16 Date : Date : 4-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI MNT/M&C Senipah NO No.
: 160104
Date Date
: 5-Apr-16
Attn : Mr. Dwi Waseso Job Job
: J120562-176
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 ea Dioda 1 ampere Sample dioda crane SWP-K

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Apr-16 Date : Date : 5-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160105
Date Date
: 5-Apr-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 24 klg WD40
2 12 klg CRC

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Apr-16 Date : Date : 5-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160106
Date Date
: 5-Apr-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar u/ Low test WaterJet Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Apr-16 Date : Date : 5-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160107
Date Date
: 6-Apr-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 120 liter Solar u/ Running test WaterJet Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Apr-16 Date : Date : 6-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160108
Date Date
: 6-Apr-16
Attn : Mr. Bachri Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 12 ea Seal tape
2 2 book Form time sheet

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Apr-16 Date : Date : 6-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Bontang NO No.
: 160109
Date Date
: 6-Apr-16
Attn : Mr. Edy A Job Job
: J140490
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Cover plate flow meter box

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Apr-16 Date : Date : 6-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160110
Date Date
: 8-Apr-16
Attn : Mr. Muchlis Job Job
: J1403112
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 lusin Sarung tangan


2 10 ea Kertas Barton
3 5 ea Kaca mata
4 1 pack Earplug
5 1 pack Masker
6 1 pack Trashbag
7 1 unit Laptop
8 1 unit Camera

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Apr-16 Date : Date : 8-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Inti Permai NO No.
: 160111
Date Date
: 9-Apr-16
Attn : Mrs. Nita Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Radiator ex olimpian engine perkin For repair

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Apr-16 Date : Date : 9-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Teknokraft NO No.
: 160112
Date Date
: 12-Apr-16
Attn : Mr. Paul Renon/Arny Gah Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Plunger For Coating ceramic


2 1 ea Sleeve For Coating HVOF

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Apr-16 Date : Date : 12-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Ekatama NO No.
: 160113
Date Date
: 12-Apr-16
Attn : Mr. Eko Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Hand pump For repair


2 5 ea Hyd jack

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Apr-16 Date : Date : 12-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : NO No.
: 160114
Date Date
: 14-Apr-16
Attn : Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 17 Box Material Box kayu


2 38 Box Material Box kardus
3 1 EA Meja Makan
4 3 EA Kursi kayu sofa
5 6 EA Kursi Makan
6 2 EA Meja Tamu sofa
7 2 EA Meja ukir Ulin
8 1 EA Box Peti kayu ulin
9 3 SET Tempat tidur kecil
10 1 SET Tempat tidur besar
11 1 EA Kasur kecil
12 1 EA Lemari kecil
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Apr-16 Date : Date : 14-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : NO No.
: 160114
Date Date
: 14-Apr-16
Attn : Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 EA Rak Kayu file


14 1 SET Amben Ulin
15 2 ROLL Karpet
16 2 EA Kursi sofa kecil kayu
17 2 ROLL Wood karpet
18 1 BTG Pipa Antena
19 1 LOT Pot Bunga

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Apr-16 Date : Date : 14-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron NO No.
: 160115
PSB penajam Date Date
: 15-Apr-16
Attn : Mr. Sukandar Job Job
: J140053
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Oil filter
2 2 ea Fuel filter
3 2 ea Racor
4 4 kg Kain majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Apr-16 Date : Date : 15-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Traktor Nusantara NO No.
: 160116
Date Date
: 15-Apr-16
Attn : Mr. Adi Prayitno Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Altenator perkins P/N 2871A503


S/N 23MY14215028MB

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Apr-16 Date : Date : 15-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160117
Date Date
: 13-Apr-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 40 liter Solar u/ HiapCrane KT 8902 LY

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Apr-16 Date : Date : 13-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron West Seno NO No.
: 160118
Date Date
: 19-Apr-16
Attn : Mr. Anang Susila / I gede S Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lght Flexible Hose for Diesel Transfer:


HOSE: FUEL OIL 3 IN 100 FEET
LENGTH.
FLEXIBLE STEEL REINFORCED.
RATING MIN 150 PSI
ONE END EQUIPPED WITH CRIMPED 4
IN MNPT FITTING
ONE END EQUIPPED TO FIT 4 IN TODO
CONNECTION, WITH CRIMPED 3 IN
FLANGE 150 LBS A182 F316 RF
HOSE HYDROCARBON RATED,
TEMP RATED 150 DEG F

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Apr-16 Date : Date : 19-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160119
Date Date
: 18-Apr-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Apr-16 Date : Date : 18-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP crew NO No.
: 160120
Tj. Santan Date Date
: 20-Apr-16
Attn : Mr. Bachri Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 kg Kain majun
2 6 lsn Sarung tangan
3 4 ea CRC
4 3 ea WD 40
5 4 ea Silicone clear
6 2 ea Lakban kertas
7 1 ea Cutter
8 2 set Catridge canon
9 2 ea Minyak rem
10 10 ltr Oli 90
11 10 ltr Oli 30
12 10 ltr Oli Hyd
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Apr-16 Date : Date : 20-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP crew NO No.
: 160120
Tj. Santan Date Date
: 20-Apr-16
Attn : Mr. Bachri Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 psg Sarung tangan karet

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Apr-16 Date : Date : 20-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP crew NO No.
: 160121
Date Date
: 22-Apr-16
Attn : Mr. Bustamin Job Job
: - No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Battery Accu 12V Return after recharge


2 1 ea Impact listrik

NOTES : Tool & part milik pribadi


Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Apr-16 Date : Date : 22-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP crew NO No.
: 160122
Date Date
: 22-Apr-16
Attn : Illiyan Job Job
: - No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Gerinda duduk Pinjam sabtu-minggu

NOTES : Tool & part milik pribadi


Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Apr-16 Date : Date : 22-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160123
Via Tanjung Santan Date Date
: 25-Apr-16
Attn : Mr. Anang Susila/ I Gede Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Ea Centralizer teflon
2 1 Ea Pump Head
3 10 Ea Flange 4"
4 3 Ea Coloumn 4" (sample)
5 1 Ea Cetralizer teflon (sample)

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Apr-16 Date : Date : 25-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Terknokraft Asia NO No.
: 160124
Date Date
: 26-Apr-16
Attn : Mr. Paul Renon Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 Ea Bushing (stellite id)


2 3 Ea Line Shaft sleeve (HVOF OD)
3 3 Ea Impeller shaft sleeve (HVOF OD)
4
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Apr-16 Date : Date : 26-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160125
Date Date
: 26-Apr-16
Attn : Mr. Dwi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Apr-16 Date : Date : 26-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160126
Date Date
: 26-Apr-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Dispenser Uchida


2 26 ea Rinso
3 12 ea Pelembut pakaian
4 8 ea Vixal
5 6 ea Sabun mandi Cair
6 24 ea Vanish
7 20 ea Molto
8 4 ea Pengharum Ruangan
9 3 ea Tissue
10 6 ea Pembersih lantai
11 6 ea Sabun cuci piring
12 4 ea Pembersih Kaca
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Apr-16 Date : Date : 26-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160126
Date Date
: 26-Apr-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 3 ea Tea sariwangi
14 3 ea Kopi kapal api
15 2 ea Max creamer
16 5 ea Gula
17 8 ea Obat nyamuk

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Apr-16 Date : Date : 26-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160127
Date Date
: 27-Apr-16
Attn : Mr. Gusti Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Air compressor krisbow 8 bar


2 1 ea Steam gun Bosch
3 8 gln Water Coolant Radiator
4 10 mtr Hose air
5
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Apr-16 Date : Date : 27-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160128
Machining Project Date Date
: 28-Apr-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 lght Roudbar 1" SS 316

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Apr-16 Date : Date : 28-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160129
Date Date
: 27-Apr-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 set Kunci shock


2 1 ea Senter 2 Battery
3 2 kg Majun
4 4 psg Sarung tangan
5 1 pack Trash bag
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Apr-16 Date : Date : 27-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160130
Date Date
: 27-Apr-16
Attn : Mr. Dwi. P Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Apr-16 Date : Date : 27-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160131
Date Date
: 28-Apr-16
Attn : Mr. Bachri Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 lusin Sarung tangan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Apr-16 Date : Date : 28-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP Senipah NO No.
: 160132
Date Date
: 28-Apr-16
Attn : Mr. Dody Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 12 ea Safety glasess Clear


2 12 ea Safety glasess Smoke
3 3 pack Oil Absorbent
4 1 ea Reffil Tinta
5 24 ea Kuas 2"
6 24 ea Kuas 3"
7 24 ea Isolasi Blue
8 24 ea Black Isolasi
9 1 krg Kain majun
10 24 lsn Sarung tangan Polkadot
11 2 pack Plastik clip 30x40
12 12 ea Red Silicone
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Apr-16 Date : Date : 28-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160133
Date Date
: 28-Apr-16
Attn : Mr. Wibisono Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 120 liter Solar u/ Running Waterjet pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Apr-16 Date : Date : 28-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160134
Date Date
: 29-Apr-16
Attn : Mr. Anang Susila / I gede Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Sleeve Jetting Slurry Pump with


Coating HVOF OD shaft sleeve,
Area OD 127mm x 142mm

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Apr-16 Date : Date : 29-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan NO No.
: 160135
Date Date
: 30-Apr-16
Attn : Mr. Edy T / Rudy H Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Discharge head Sepinggan fabrication


2 1 unit Discharge head Sepinggan Sample

Transport
Via Chevron Penajam

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Apr-16 Date : Date : 30-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160136
Date Date
: 30-Apr-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Apr-16 Date : Date : 30-Apr-16 Date :


S/R Coordinator Security Head Department Receiver
To : REA Kaltim NO No.
: 160137
Date Date
: 2-May-16
Attn : Mrs. Sari Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Radiator ( Return ) Unrepair

DT copy di ambil Pak. Yusa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-May-16 Date : Date : 2-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160138
Date Date
: 3-May-16
Attn : Mr. Wahyu D Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 gln Gerigen dari Chevron

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-May-16 Date : Date : 3-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Palu - Sulawesi Tengah NO No.
: 160139
Date Date
: 4-May-16
Attn : Mr. H. Syarifuddin Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 unit Genset 400 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-May-16 Date : Date : 4-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - Bekapai NO No.
: 160140
Date Date
: 6-May-16
Attn : Mr. Ilham Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 kg Majun
2 4 psg Sarung tangan
3 1 pack Cable ties 20 cm
4 1 box Tools complete
5
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-May-16 Date : Date : 6-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. BIS NO No.
: 160141
Date Date
: 9-May-16
Attn : Mr. Anjeev Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Inter Cooler TP 46 Return

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-May-16 Date : Date : 9-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Athaya Abbas Mandiri NO No.
: 160142
Date Date
: 9-May-16
Attn : Mr. Aspian Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Rotor

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-May-16 Date : Date : 9-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160143
Date Date
: 10-May-16
Attn : Mr. Rismal Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar u/ Lowtest Genset 55 kVa


75 kVa dan 125 kVa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-May-16 Date : Date : 10-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160144
Date Date
: 3-May-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 200 lliter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-May-16 Date : Date : 3-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160145
Date Date
: 3-May-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 85 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-May-16 Date : Date : 3-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160146
Date Date
: 10-May-16
Attn : Mr. Dedy Job Job
: HE.No.
Radiator

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 drum Drum bekas Chemical

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-May-16 Date : Date : 10-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Crew BPP NO No.
: 160147
Tj.Santan Date Date
: 11-May-16
Attn : Mr.Rafly Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop Toshiba

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-May-16 Date : Date : 11-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160148
Date Date
: 12-May-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Cylinder head Izuzu


2 6 ea Valve Exhaust
3 6 ea Valve intake
4 12 ea Guide Valve
5 6 ea Seat Valve intake
6 6 ea Seat Valve exhaust

Install new Valve seat & guide valve


Grinding seat valve

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-May-16 Date : Date : 12-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160149
Date Date
: 12-May-16
Attn : Mr. Kamal, Hari Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 set Socket wrench


2 5 kg Majun
3 3 lusin Sarung tangan
4 1 ea Heat Filter
5 100 sheet Oil Absorbant

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-May-16 Date : Date : 12-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan NO No.
: 160150
Date Date
: 16-May-16
Attn : Mr. Ady T / Rudi H Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Discharge Head Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-May-16 Date : Date : 16-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160151
Date Date
: 14-May-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Fuel filter
2 2 ea Oil filter
3 2 ea Racor Element
4
5
6

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-May-16 Date : Date : 14-May-16 Date :


S/R Coordinator Security Head Department Receiver
Delivery Ticket
To : Yermanto NO No.
: 160152
Senipah Date Date
: 14-May-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Camera Panasonic FT 30 WIN 1073


2 1 ea Tas Kamera Digital
3 1 ea Memory Scandisk SD 8 GB
4 1 ea Kabel data & Charger Kamera Digital
5 1 ea CD Panasonic Lumix Kamera Digital
6 1 ea Buku Panduan
7 1 ea Kartu Garansi

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-May-16 Date : Date : 14-May-16 Date :


S/R Coordinator Security Head Department Receiver
Delivery Ticket
To : PT. Teknokraft NO No.
: 160153
Tanggerang Date Date
: 16-May-16
Attn : Arny Gah Job Job
: J-RCB150007
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 ea Shaft sleeve

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-May-16 Date : Date : 16-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Johnson NO No.
: 160154
Date Date
: 18-May-16
Attn : Mr. Aep Saepudin Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 set Special tools (manrail+hand oil pump)


2 1 roll Pipa tembaga 1/4"
3 1 roll Pipa tembaga 3/8"
4 1 set Tool box
5 1 set swaging tools
6 1 lot Kawat silver
7 1 unit Torsi Tekiro
8 1 unit Vaccum pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-May-16 Date : Date : 18-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Johnson NO No.
: 160154
Date Date
: 18-May-16
Attn : Mr. Aep Saepudin Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pcs Coil selenoid


025L02489-000
110VDIN
( Return for changing another part
number )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-May-16 Date : Date : 18-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160156
Machining Project Date Date
: 18-May-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 tbg Tabung Oxygen


PN : 9716152 & 9714770
( Tabung Samator )
Tabung Oxygen BPP di Samator

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-May-16 Date : Date : 18-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160157
Date Date
: 14-May-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 60 liter Solar u/ Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-May-16 Date : Date : 14-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160157
Date Date
: 18-May-16
Attn : Mr. Rikson Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 lusin Sarung tangan Hand carry

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-May-16 Date : Date : 18-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160159
Crew BPP Tj.Santan Date Date
: 20-May-16
Attn : Mr.Rafly Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop Asus complete


after repair

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-May-16 Date : Date : 20-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160160
Date Date
: 20-May-16
Attn : Mr. Dwi Yanto Job Job
: J140488
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 75 liter Solar U/ Hiap Crane KT 8902 LY Driver Tabri


Ambil barang ke Total Senipah

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-May-16 Date : Date : 20-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160161
Date Date
: 20-May-16
Attn : Mr. Abu Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Pinjam mesin Potong rumput

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-May-16 Date : Date : 20-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160162
Date Date
: 23-May-16
Attn : Mr. Bandu Job Job
: HE.No.
Dept

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Kayu pallet bekas Radiator

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-May-16 Date : Date : 23-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160163
Date Date
: 23-May-16
Attn : Mr. Dwi Yanto Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 180 liter Solar U/ Hiap Crane KT 8902 LY Driver Tabri


Ambil barang ke Tanjung Santan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-May-16 Date : Date : 23-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160164
Date Date
: 24-May-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 pcs Toner HP Black & Cyan Transport by


2 1 pcs Coverall Edy Prasetya size L
3 48 klg WD40
4 12 ea Wire rope tape
5 12 ea lakban kertas
6 Iwan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-May-16 Date : Date : 24-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Primer Oil NO No.
: 160165
Natuna Date Date
: 24-May-16
Attn : Mr. Gusti Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Safety Body Harneess

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-May-16 Date : Date : 24-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160166
Date Date
: 25-May-16
Attn : Mr. Ilham Job Job
: JRCB140005
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Running Genset 250 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-May-16 Date : Date : 25-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Kasongan Bumi Kencana NO No.
: 160167
Date Date
: 26-May-16
Attn : Mr. Adlan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit AC condenser 376-6723


ex. MG002

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-May-16 Date : Date : 26-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160168
Date Date
: 27-May-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 26 ea Rinso anti noda


2 10 ea Kispray
3 8 ea Vixal
4 5 ea Sabun mandi
5 24 ea Vanish
6 22 ea Molto
7 4 ea Pengharum ruangan
8 3 ea Tissue
9 6 ea Pembersih lantai
10 8 ea Sabun Cuci piring
11 2 ea Tea sariwangi
12 3 ea Kopi kapal api
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-May-16 Date : Date : 27-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160168
Date Date
: 27-May-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 2 ea Max creamer
14 8 kg Gula
15 8 ktk Obat nyamuk
16 5 rim Kertas A4
17 24 ea Ballpoint black
18 24 ea Ballpoint blue
19 24 ea Marker snowman black
20 12 ea Double tape
21 3 box Masker kain

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-May-16 Date : Date : 27-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160169
Date Date
: 30-May-16
Attn : Mr. Prima Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-May-16 Date : Date : 30-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160170
Date Date
: 31-May-16
Attn : Mr. Rafli Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop Asus Driver Mahfut


( After Service )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-May-16 Date : Date : 31-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160170
Machining Project Date Date
: 31-May-16
Attn : Mr. Rafli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 48 lusin Sarung tangan


2 12 ea Safety eyewear clear frame clear
3 12 ea Safety eyewear clear frame purple
4 12 ea Disc grinding 5"
5 12 ea Disc cutting 5"
6 1 unit Hammer Drill machine Makita HP1630
7 1 pcs Aluminium round bar 7" Lgth 1 mtr

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-May-16 Date : Date : 31-May-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160172
Date Date
: 2-Jun-16
Attn : Mr. Ardian Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 15 lusin Gloves Hand polkadot


2 10 kg Majun warna
3 5 ea WD-40
4 1 ea Cutter re-fill
5 3 ea Marker Snowman white
6 6 ea Glue alteco
7 2 pack Plastic Trash bag
8 3 ea Lak ban hitam
9 1 ea Lak ban kertas
10 2 pack Cable ties 30 cm
11 8 ea Battery size D 1,5 V
12 2 klg Lem fox
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Jun-16 Date : Date : 2-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Sarana Indo Persada NO No.
: 160173
HP 085217423177 Date Date
: 1-Jun-16
Attn : Mr. Djohan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Hydraulic pump Shibaura Repair

Jl. Batu Tulis NO 26A. Kebon Kelapa


Gambir Jakarta 10120
Phone : ( 021 ) 38902500
Transport by

Artha Milenia

NOTES : 02138902500
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Jun-16 Date : Date : 1-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. KBK Kasongan NO No.
: 160174
Date Date
: 3-Jun-16
Attn : Mr. Warehouse Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Radiator Return


Unrepair

Transport by

Suhari
KT 8134 YB

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Jun-16 Date : Date : 3-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Sarana Indo Persada NO No.
: 160175
HP 085217423177 Date Date
: 3-Jun-16
Attn : Mr. Djohan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 unit Hydraulic pump Shibaura Repair

Jl. Batu Tulis NO 26A. Kebon Kelapa


Gambir Jakarta 10120
Phone : ( 021 ) 38902500
Transport by

Artha Milenia

NOTES : 02138902500
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Jun-16 Date : Date : 3-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160176
Date Date
: 3-Jun-16
Attn : Mr. Taufik Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 ea Racor element

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Jun-16 Date : Date : 3-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160177
Date Date
: 5-Jun-16
Attn : Mr. Herman Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 set Mechanical Seal


2 1 set O ring
3
4
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Jun-16 Date : Date : 5-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160178
Date Date
: 4-Jun-16
Attn : Mr. Guntoro Job Job
: JRCB140005
No. - 75

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar u/ Genset 75 kVa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Jun-16 Date : Date : 4-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160179
Date Date
: 6-Jun-16
Attn : Mr. Irwando Job Job
: JRCB140005
No. - 50

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar u/ Genset 50 kVa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jun-16 Date : Date : 6-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160180
Date Date
: 6-Jun-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jun-16 Date : Date : 6-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160181
Date Date
: 6-Jun-16
Attn : Mr. Rafli / N. lendup Job Job
: J110499
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 set Service Report

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jun-16 Date : Date : 6-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160182
Date Date
: 6-Jun-16
Attn : Mr. Nandang Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 200 liter Solar U/ Hiap Crane KT 8902 LY


Antar Lathe Machine ke
Tanjung Santan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jun-16 Date : Date : 6-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Alie Service NO No.
: 160183
Date Date
: 6-Jun-16
Attn : Mr. Candra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Out door AC u/ di service di kantor


Alie Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Jun-16 Date : Date : 6-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160184
Date Date
: 7-Jun-16
Attn : Mr. Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 24 psg Sarung tangan Impact

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Jun-16 Date : Date : 7-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160185
Date Date
: 8-Jun-16
Attn : Mr. Sukandar Job Job
: JRCB140005
No. - 250

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 40 liter Solar u/ Genset 250 kVa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Jun-16 Date : Date : 8-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Metatech Engineering NO No.
: 160186
Date Date
: 8-Jun-16
Attn : Mrs. Asi latifah Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Shaft for coating

Kp. Baru Asih No. 28


Rt 14/04 Muncul Serpong
Tangerang Selatan
Phone : (021) 75870314
Transport by
Artha Milenia

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Jun-16 Date : Date : 8-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina SPBG NO No.
: 160187
Rapak - BPN Date Date
: 8-Jun-16
Attn : Mr. Job Job
: JRCB140005
No. - 250

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Genset 250 kVa


2 4 roll Kabel 150mm 26 meter

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Jun-16 Date : Date : 8-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160188
Date Date
: 8-Jun-16
Attn : Mr. Qamal / Hari Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 drum Oil lube


2 2 ea Air filter

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Jun-16 Date : Date : 8-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Karya Prima NO No.
: 160189
Date Date
: 9-Jun-16
Attn : Mr. Sindu Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Plate 2400 x 1600 Tickness 5 mm


( Roll plate as drawing )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Jun-16 Date : Date : 9-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU - V NO No.
: 160190
Date Date
: 10-Jun-16
Attn : Mr. Mogam Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 unit HT ( handy talky )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Jun-16 Date : Date : 10-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160191
Date Date
: 11-Jun-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Oil filter
2 2 ea Fuel filter
3 4 psg Sarung tangan
4 3 kg Majun
5 2 ea Racor
6 6 ea Trashbag

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Jun-16 Date : Date : 11-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160192
Date Date
: 10-Jun-16
Attn : Mr. Riyan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Cartridge 678 Black


2 2 ea Cartridge 678 Colour

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Jun-16 Date : Date : 10-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Metatech Engineering NO No.
: 160193
Date Date
: 11-Jun-16
Attn : Mrs. Asti latifah / Sidik L. Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 7 ea Shaft sleeve for coating

Kp. Baru Asih No. 28


Rt 14/04 Muncul Serpong
Tangerang Selatan
Phone : (021) 75870314

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Jun-16 Date : Date : 11-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Metatech NO No.
: 160194
Tangerang Selatan Date Date
: 11-Jun-16
Attn : Mr. Abd. Gofur Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Caliper ( micro meter )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Jun-16 Date : Date : 11-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160195
Date Date
: 14-Jun-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 24 lusin Sarung tangan polkadot


2 1 gln Hand cleaner
3 2 roll Manila rope
4 2 kotak Battery AA ( A2 )
5 2 kotak Battery AAA ( A3 )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Jun-16 Date : Date : 14-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Jakarta NO No.
: 160196
Date Date
: 15-Jun-16
Attn : Mr. Roy Lasmana Job Job
: J130214
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Syncho Panel


2 2 pcs Rachet belt
3 1 ea Oil filter
4 2 ea Fuel filter

Komplek Pergudangan Taman Tekno


Blok A1/27 BSD Serpong
Tangerang Selatan 15314 – Indonesia
Phone : 021 - 7588 1861

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Jun-16 Date : Date : 15-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina SPBG NO No.
: 160197
Rapak - BPN Date Date
: 16-Jun-16
Attn : Mr. Job Job
: JRCB140005
No. - 250

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 roll Kabel 150mm 25 meter


2 1 unit Genset DEG 250 Kva

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jun-16 Date : Date : 16-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160198
Date Date
: 17-Jun-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Lemari Arsip ( Filling Cabinet )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 17-Jun-16 Date : Date : 17-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160199
Date Date
: 20-Jun-16
Attn : Mr. Nandang Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 200 liter Solar U/ Hiap Crane KT 8902 LY Driver Tabri


ke Chevron Tanjung Santan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Jun-16 Date : Date : 20-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160200
Date Date
: 21-Jun-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pack Cable Ties, 200 mm


2 3 pack Cable Ties, 300 mm
3 3 pack Cable Ties, 400 mm
4 12 ea Electrical Rubber (3M Scotch 23)
5 24 klg C&C Contact Cleaner
6 6 klg CRC-2-26
7 24 pack Trash Bag
8 24 ea Kuas, 2.5”
9 24 ea Amplas 400
10 24 ea Amplas 600
11 1 pcs Toner HP Laserjet yellow
12
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Jun-16 Date : Date : 21-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160201
Date Date
: 22-Jun-16
Attn : Mr. Dedy Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 set Kayu bekas pallet

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Jun-16 Date : Date : 22-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160202
Date Date
: 23-Jun-16
Attn : Mr. Prima Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Jun-16 Date : Date : 23-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : TOTAL TEPI - Senipah NO No.
: 160203
Date Date
: 24-Jun-16
Attn : Mr. Anthya Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs MP-665 Lower Shaft


L 383 mm x OD 38.1 mm

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Jun-16 Date : Date : 24-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160204
Date Date
: 27-Jun-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Jun-16 Date : Date : 27-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Sahare WHS NO No.
: 160205
Date Date
: 27-Jun-16
Attn : Mr. Sahare Job Job
: BesiNo.
Scrap

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pick up Besi Scrap KT 8642 LR


2 1 truck Besi Scrap KT 8750 AP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Jun-16 Date : Date : 27-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP-Senipah NO No.
: 160206
Date Date
: 28-Jun-16
Attn : Mr. Dody/Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 26 ea Sabun cuci rinso 700 gr


2 12 ea Rapika 250 ml
3 8 btl Cleaner vixal 1000 ml
4 5 ea Biore reffil 500 ml
5 24 btl Vanish
6 24 ea Molto 1000 ml
7 4 btl Bayfresh lemon
8 3 pack Tissue 900gr
9 6 btl SOS 800ml
10 6 ea Sunligth 800ml
11 4 ea Pembersih kaca
12 3 pack The celup sariwangi
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Jun-16 Date : Date : 28-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP-Senipah NO No.
: 160206
Date Date
: 28-Jun-16
Attn : Mr. Dody/Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pack Kopikapal api


2 2 ea Max creamer
3 8 kg Gula pasir
4 8 btl Obat nyamuk
5 1 tbg Apar refill
6 2 ea Meteran 5 mtr
7 4 ea Coverall an Supriyanto dan jefri Songo
8 1 set Screwdriver set
9 2 ea grease gun
10
11
12
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Jun-16 Date : Date : 28-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Sahare WHS NO No.
: 160207
Date Date
: 28-Jun-16
Attn : Mr. Sahare Job Job
: BesiNo.
Scrap

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pick up Besi Scrap KT 8642 LR

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Jun-16 Date : Date : 28-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : Sahare WHS NO No.
: 160208
Date Date
: 30-Jun-16
Attn : Mr. Sahare Job Job
: BesiNo.
Scrap

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Tank Scrap KT 8990 LQ

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Jun-16 Date : Date : 30-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160209
Date Date
: 30-Jun-16
Attn : Mr. Nandang Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 200 liter Solar U/ Hiap Crane KT 8902 LY Driver Tabri


ke Chevron Tanjung Santan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Jun-16 Date : Date : 30-Jun-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP-Penajam NO No.
: 160210
Date Date
: 1-Jul-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Oil filter Driver Tabri


2 2 ea Fuel filter
3 2 ea Racor
4 6 psg Sarung tangan polkadot
5 3 kg Kain majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Jul-16 Date : Date : 1-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. TRI ARTHA MANUNGGAL NO No.
: 160211
Date Date
: 11-Jul-16
Attn : Mr. Ketut Suada Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 box List Terlampir


for Calibration

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Jul-16 Date : Date : 11-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Road and Load Business Leade NO No.
: 160212
AADI Date Date
: 13-Jul-16
Attn : Mr. Harald Goldstein Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Sensor Load Cell


RMA# 1628009

Aanderaa Data Instruments AS


Sanddalsringen 5b
P.O. Box 103, Midtun
N-5843 Bergen, Norway
O: +47 55 60 48 70
M: +47 932 29 367
harald.goldstein@xyleminc.com

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Jul-16 Date : Date : 13-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160213
Date Date
: 16-Jul-16
Attn : Mr. Junaidi P Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jul-16 Date : Date : 16-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160214
Date Date
: 16-Jul-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Jul-16 Date : Date : 16-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160215
Date Date
: 18-Jul-16
Attn : Mr. Nandang Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar U/ Hiap Crane KT 8902 LY Driver Iwan


ke Kilo

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Jul-16 Date : Date : 18-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160216
Date Date
: 20-Jul-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 24 ea Lakban kertas
2 1 pcs Toner HP Laserjet Black
3 1 pcs Toner HP Laserjet Magenta
4 1 pcs Epson 664 black ink
5 24 lusin Sarung tangan polkadot
6 8 klg Chemola wirerope grease
7 2 krng Majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Jul-16 Date : Date : 20-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160217
Date Date
: 23-Jul-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 70 Liter Solar u/ Genset BPP 55 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Jul-16 Date : Date : 23-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU V NO No.
: 160218
Balikpapan Date Date
: 25-Jul-16
Attn : Mr. Mogam Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 unit Radio HT ( Handy Talkie )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Jul-16 Date : Date : 25-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. All Rig BPN NO No.
: 160219
Date Date
: 25-Jul-16
Attn : Mr. Jonhy Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Service & Inspection Hand carry by All Rig


Wire four legs

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Jul-16 Date : Date : 25-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160220
Date Date
: 26-Jul-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 26 ea Rinso 900 gr Transport by


2 12 ea Trika 250 ml
3 8 ea Vixal 800 ml
4 8 ea Biore 450 ml Upie
5 28 ea Vanish 150 ml
6 24 ea Soklin pewangi 900 ml
7 4 ea Pengharum ruangan
8 3 ea Tissue 900 gr
9 6 ea Pembersih Lantai 800 ml
10 6 ea Sabun cuci piring 800 ml
11 4 ea Pembersih kaca 440 ml
12 8 ea Obat Nyamuk Hit 400 ml
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Jul-16 Date : Date : 26-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160220
Date Date
: 26-Jul-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 ea Stempel ( Checked + Posted )


14 5 ea Tea sariwangi isi 50
15 2 ea Kopi kapal api
16 1 ea Max creamer
17 8 kg Gula pasir
18 48 psg Pipe hand gloves G-tek
19 24 ea Chinstrap
20 24 ea Suspension safety helmet

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Jul-16 Date : Date : 26-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160221
Date Date
: 27-Jul-16
Attn : Mr. Agung N / Tommy A Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 ea V belt 3V900
2 6 ea V belt 3V800

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Jul-16 Date : Date : 27-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160222
Date Date
: 27-Jul-16
Attn : Mr. Kamal / Hari Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 drum Oil Lube


2 1 unit TV 22" Polytron + Bracket
3 2 ea Oil filter
4 2 ea Fuel filter
5 5 kg Majun
6 2 lusin Sarung tangan
7 2 pack Trashbag
8 6 ea Ballpoint
9 1 unit Dispenser

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Jul-16 Date : Date : 27-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Prima Cipta NO No.
: 160223
Date Date
: 27-Jul-16
Attn : Mr. M. Fadly Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Drive coupling


PN : KC 6022

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Jul-16 Date : Date : 27-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : From Chevron PSB Penajam NO No.
: 160224
BPP Balikpapan Date Date
: 29-Jul-16
Attn : Mr. Taufik Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit TV AKARI 21"


2 1 unit Dispenser UCHIDA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Jul-16 Date : Date : 29-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160225
Date Date
: 30-Jul-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 mtr Cable Extention


2 3 kg Majun
3 4 psg Sarung tangan
4 1 pack Trashbag

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Jul-16 Date : Date : 30-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160226
Date Date
: 30-Jul-16
Attn : Mr. Fredy Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 200 liter Solar U/ Hiap Crane KT 8902 LY Driver Tabri


ke Chevron Tanjung Santan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Jul-16 Date : Date : 30-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160227
Date Date
: 30-Jul-16
Attn : Mr. Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar U/ Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Jul-16 Date : Date : 30-Jul-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160228
Date Date
: 1-Aug-16
Attn : Mr. Abd Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar U/ Forklift BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Aug-16 Date : Date : 1-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPN Expo - Lamaru NO No.
: 160229
Date Date
: 1-Aug-16
Attn : Mr. David Job Job
: Internal
No. Expo 2016

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Drum kosong


2 2 ea Gerigen
3 2 roll Hose + fuel gun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Aug-16 Date : Date : 1-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP Expo 2016 NO No.
: 160230
Date Date
: 1-Aug-16
Attn : Mr. Taufik Job Job
: Internal
No. Expo 2016

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar U/ Hiap Crane KT 8902 LY

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Aug-16 Date : Date : 1-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan NO No.
: 160231
Date Date
: 2-Aug-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 150 liter Solar U/ Hiap Crane KT 8902 LY


Antar Waterjet + Compressor

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Aug-16 Date : Date : 2-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160232
Date Date
: 2-Aug-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Toner HP Magenta


2 1 pcs Toner HP Black
3 1 pcs Toner HP Yellow

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Aug-16 Date : Date : 2-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160233
Machining Project Date Date
: 4-Aug-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 rim Kertas A4 Transport by


2 15 lbr Amplop coklat
3 2 ktk Ballpoint
4 2 tbg Acetylene
PN : 10595 & 10434

Upie

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Aug-16 Date : Date : 4-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160234
PT. Bhumi Phala Perkasa Date Date
: 4-Aug-16
Attn : Mr. Qamal M Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Safety shoes size 7


2
3
4

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Aug-16 Date : Date : 4-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160235
Machining Project Date Date
: 5-Aug-16
Attn : Mr. Fredy Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar U/ Hiap Crane KT 8902 LY


Antar Round bar + Mayekawa

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Aug-16 Date : Date : 5-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160236
Date Date
: 6-Aug-16
Attn : Mr. Dwi BS Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 18 batang Besi ulir Scrap


( dari Sahare )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 6-Aug-16 Date : Date : 6-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160237
Date Date
: 8-Aug-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 set Shaft and Coupling spline


main lube oil pump TEK - 3000

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Aug-16 Date : Date : 8-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160238
Date Date
: 8-Aug-16
Attn : Mr. Fredy Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 liter Solar U/ Mobil KT 8331 KI

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Aug-16 Date : Date : 8-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP Expo 2016 NO No.
: 160239
Date Date
: 8-Aug-16
Attn : Mr. Sukandar Job Job
: Internal
No. Expo 2016

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Genset 250 kvA


2 1 unit Genset 135 kvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Aug-16 Date : Date : 8-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Metatech Engineering NO No.
: 160240
Date Date
: 9-Aug-16
Attn : Mrs. Asti latifah / Sidik L. Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 9 pcs Bushing Column 24 kg


2 3 pcs Bushing Case
3 1 pcs Bushing Throat
4 9 pcs Bearing sleeve
5 1 pcs Shaft sleeve throat
6 2 pcs Impeller wear ring discharge Kp. Baru Asih No. 28
7 2 pcs Impeller wear ring suction RT 14/04 Muncul Serpong
8 2 pcs Casing wear ring Tangerang Selatan
9 2 pcs Casing hub ring Phone : (021) 75870314

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Aug-16 Date : Date : 9-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160241
Date Date
: 9-Aug-16
Attn : Mr. M Taufik Job Job
: JRCB160003
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 liter Solar u/ Genset 75 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Aug-16 Date : Date : 9-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP Expo 2016 NO No.
: 160242
Date Date
: 9-Aug-16
Attn : Ilham Nc Job Job
: Internal
No. Expo 2016

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Ea Fuel gun
2 2 Ea Fuel water sparator
3 2 Ea Fuel racor element
4 2 Ea gerigen

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Aug-16 Date : Date : 9-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP Expo 2016 NO No.
: 160243
Date Date
: 10-Aug-16
Attn : Prima Job Job
: Internal
No. Expo 2016

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Ea Kikir bulat
2 1 Ea Kikir setengah lingkaran
3 1 Ea Hammer besi
4 1 Ea Handle socket
5 1 Ea Socket 16
6 1 Ea Socket 17

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Aug-16 Date : Date : 10-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron -Santan NO No.
: 160244
Dept.Maintenance Date Date
: 11-Aug-16
Attn : Mr.Ruskandar/Wiji.S Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Radiator After Repair

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Aug-16 Date : Date : 11-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Indah Jaya NO No.
: 160245
Balikpapan Date Date
: 11-Aug-16
Attn : Mr.Taufan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit FIP Hino H07D Handcarried by Taufan


2 6 ea Injector

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Aug-16 Date : Date : 11-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : EXPO 2016 NO No.
: 160246
Date Date
: 11-Aug-16
Attn : Mr. Prima Job Job
: Internal
No. EXPO 2016

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 liter Solar u/ Genset 75 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Aug-16 Date : Date : 11-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. ELTA NO No.
: 160247
Date Date
: 11-Aug-16
Attn : Mr. Harto Job Job
: J160167
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Condensor AC
for repair

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Aug-16 Date : Date : 11-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160248
Date Date
: 13-Aug-16
Attn : Mr. Dwi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Fogging

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Aug-16 Date : Date : 13-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160249
Date Date
: 16-Aug-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Altenator Perkins


PN : 287IA503 24 watt

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Aug-16 Date : Date : 16-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Penajam NO No.
: 160250
Date Date
: 17-Aug-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 150 liter Solar U/ Hiap Crane KT 8902 LY

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 17-Aug-16 Date : Date : 17-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : chevron penajam NO No.
: 160252
Date Date
: 19-Aug-16
Attn : sukandar Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea oil filter
2 2 ea fuel filter
3 2 ea racor
4 1 pak plastik sampah
5 3 kg majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Aug-16 Date : Date : 19-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP - Chevron NO No.
: 160252
Date Date
: 22-Aug-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar U/ Water Jet Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Aug-16 Date : Date : 22-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. ELTA Radiator NO No.
: 160253
Date Date
: 23-Aug-16
Attn : Mr. Harto Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 pcs Core Radiator


for Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Aug-16 Date : Date : 23-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160254
PT. Bhumi Phala Date Date
: 24-Aug-16
Attn : Mr. Rafli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop Toshiba + Charger


2

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Aug-16 Date : Date : 24-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160255
Date Date
: 26-Aug-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Aug-16 Date : Date : 26-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160256
Date Date
: 27-Aug-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 40 liter Solar u/ Fogging BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Aug-16 Date : Date : 27-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Mess Senipah NO No.
: 160257
Date Date
: 26-Aug-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 26 ea Rinso
2 12 ea Rapika
3 8 ea Cleaner Vixal
4 8 ea Biore refill
5 23 ea Vanish
6 24 ea Molto
7 4 ea Bay fresh lemon
8 4 ea Nice tissue
9 6 ea SOS
10 6 ea Sunlight refill
11 4 ea Mr. Muscle
12 6 ktk Tea celup sariwangi
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Aug-16 Date : Date : 26-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Mess Senipah NO No.
: 160257
Date Date
: 26-Aug-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 2 pck Kopi kapal api


14 2 ea Max creamer
15 7 kg Gula pasir
16 8 btl Obat nyamuk spray
17 3 ktk Masker kain
18 1 set Carfit ( karet alas mobil )
19 24 lusin Sarung tangan
20 4 ea Epson 664 Yellow,Magenta,Cyan,Blk
21 1 pcs Casio Stopwatch
22 1 pcs Clamp meter Fluke 376

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Aug-16 Date : Date : 26-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU V NO No.
: 160258
Date Date
: 30-Aug-16
Attn : Mr. Illyan S Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 lusin Sarung tangan polkadot


2 5 kg Majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Aug-16 Date : Date : 30-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : Balai Besar Barang & Bahan NO No.
: 160259
Tehnik ( B4T ) Date Date
: 30-Aug-16
Attn : Mr. Zulhadian Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 set Material Plate SA 516 Gr. 152 kg


70 Thickness 45 mm

2 1 set Pipe / Round Bar S-Duplex


4” Schd XXS

Bpk. Zulhadian
Jl. Sangkuriang No. 14, Dago
Bandung – 40135
Hp. 0811237304 Transport by

AMA logistic
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Aug-16 Date : Date : 30-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160260
Date Date
: 31-Aug-16
Attn : Mr. Jerry Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 60 liter Solar u/ Water Jet Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-Aug-16 Date : Date : 31-Aug-16 Date :


S/R Coordinator Security Head Department Receiver
To : SACCAP S.A.S NO No.
: 160261
Date Date
: 1-Sep-16
Attn : Mr. Olivier Chanteau Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Ball Valve 2" 100 kg

SACCAP S.A.S
CS 3422 – 112 – 114
avenue de Vendome Trasnport by
41034 BLOIS Cedex – FRANCE
Tel. +33 (0) 2 54 52 53 20
Fax. +33 (0) 2 54 52 33 22 Spedco

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Sep-16 Date : Date : 1-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Metatech Engineering NO No.
: 160262
Date Date
: 2-Sep-16
Attn : Mrs. Asi latifah / Sidik L Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Intermediate saft sleeve

Kp. Baru Asih No. 28


Rt 14/04 Muncul Serpong
Tangerang Selatan
Phone : (021) 75870314
Transport by
Artha Milenia

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Sep-16 Date : Date : 2-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160263
Date Date
: 2-Sep-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 ea Ear plug
2 5 rim Kertas A4
3 10 ea Kuas Roll
4 10 ktk Trigonal clip No.3
5 1 ktk Staples refill 20 bxs
6 24 ea Ballpoint black
7 24 ea Ballpoint blue

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Sep-16 Date : Date : 2-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160264
Date Date
: 3-Sep-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Unit Laptop HP 1000-1111TU


2 1 Unit Charger Laptop HP
3
4
5
6
7

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Sep-16 Date : Date : 3-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Berau - KalTim NO No.
: 160265
Date Date
: 5-Sep-16
Attn : Mr. Ali Mahrus Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 90 lbr Kawat Bronjong 350 rb RP 31.500.000,-

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Sep-16 Date : Date : 5-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160266
Machining Project Date Date
: 5-Sep-16
Attn : Mr. N. Lendup Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Safety shoes size 42


2 2 pcs Cover All
3 1 pcs Safety Helmet

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Sep-16 Date : Date : 5-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : pertamina RU-V NO No.
: 160267
Date Date
: 5-Sep-16
Attn : Mr. Illiyan Job Job
: J140065
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 lsn Hand Gloves

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Sep-16 Date : Date : 5-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160268
Machining Project Date Date
: 7-Sep-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Shaft 316 OD 2 1/4 x 2 mtr Transport by

3 2 ea Teflon OD 2" 1/2 x 2 mtr


4 2 ea Bronze OD 2" ID 1" x 2 mtr
5 2 ea Bronze OD 2 1/2" ID 1" x 2 mtr
6 2 ea Bronze OD 5 1/2" ID 3" x 2 mtr
7 6 ea Shaft shiping pump OD 1 1/2" x 2 mtr
8 3 ea Shaft coolong pump OD 1" x 2 mtr
9 1 ktk Esab 316L x 2.5
10 1 ktk Esab 316L x 3.2
11 5 Lusin Sarung Tangan Upie
12 5 kg Majun
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Sep-16 Date : Date : 7-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160268
Machining Project Date Date
: 7-Sep-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 2 tbg Oxygen PN : 1741116


PN : MR02
14 4 ea Silicone clear

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Sep-16 Date : Date : 7-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. ELTA Radiator NO No.
: 160269
Date Date
: 7-Sep-16
Attn : Mr. Harto Job Job
: J160185
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Core Radiator


for Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Sep-16 Date : Date : 7-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160270
Date Date
: 9-Sep-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Battery Modem Bolt

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Sep-16 Date : Date : 9-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : VICO Muara Badak NO No.
: 160271
Date Date
: 9-Sep-16
Attn : Mr. Mahfut Job Job
: J120613-145,146,147
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Hiap Crane KT 8902 LY

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Sep-16 Date : Date : 9-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160273
Date Date
: 10-Sep-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 lusin Sarung tangan


2 2 kg Majun
3 2 ea Oil filter
4 2 ea Fuel filter
5 2 ea Racor element
6 4 btl Oil sample genset
7
8

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Sep-16 Date : Date : 10-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160272
Date Date
: 14-Sep-16
Attn : Mr. Sakka Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Sep-16 Date : Date : 14-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160274
Date Date
: 14-Sep-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Discharge Head pump


2 1 set Jig / Tool Discharge Head pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Sep-16 Date : Date : 14-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. ELTA Radiator NO No.
: 160275
Date Date
: 14-Sep-16
Attn : Mr. Harto Job Job
: J160191
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Condensor
for Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Sep-16 Date : Date : 14-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160276
Date Date
: 16-Sep-16
Attn : Mr. Herman / Dayu P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Top Shaft sleeve PBE 2600 Sample from Chevron


2 1 ea Shaft sleeve PBE 2600 old Sample from Chevron
3 1 ea Bushing bronze Sample from Chevron
4 2 ea Shaft sleeve PBE 2600 new From BPP to Chevron
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Sep-16 Date : Date : 16-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160277
Date Date
: 16-Sep-16
Attn : Mr. Abu B Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Mesin potong rumput Pinjam

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Sep-16 Date : Date : 16-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160278
Date Date
: 20-Sep-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Sep-16 Date : Date : 20-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160279
Date Date
: 20-Sep-16
Attn : Mr.Ichwan Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Caliver 24 inch

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Sep-16 Date : Date : 20-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT.INDAH JAYA NO No.
: 160280
Date Date
: 21-09-2016
Attn : Mr.Topan Job Job
: J160190
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea FIP (Fuel Injection Pump)

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-09-2016 Date : Date : 21-09-2016 Date :


S/R Coordinator Security Head Department Receiver
To : Coates Hire NO No.
: 160281
Date Date
: 21-Sep-16
Attn : Mr. Ilham Job Job
: JRCB160003
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar u/ Hiapcrane KT 8902 LY


ambil genset di coates hire

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Sep-16 Date : Date : 21-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160282
Date Date
: 21-Sep-16
Attn : Mr. Raffli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop ASUS

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Sep-16 Date : Date : 21-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Mulia Makmur NO No.
: 160283
Sangatta Date Date
: 22-Sep-16
Attn : Mr. Dion PS Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 115 sheet Kawat Bronjong

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Sep-16 Date : Date : 22-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160284
Date Date
: 23-Sep-16
Attn : Mr. Dody A / yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 12 psg Handgloves Impact Mec Dex size M P160779


2 7 psg Handgloves Impact Mec Dex size L
3 1 psg Handgloves Impact Mec Dex size XL

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Sep-16 Date : Date : 23-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160285
Date Date
: 24-Sep-16
Attn : Mr. Raffli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Personal Computer Complete P160824


2 2 pcs Coverall size M P160796
3 2 pcs Coverall size S P160796
4 4 pcs Coverall size L P160796
5 8 pcs Coverall size XL P160796
6 5 pcs Safety Shoes size 7 P160797
7 1 pcs Safety Shoes size 40 P160797
8 2 pcs Safety Shoes size 42 P160797

Transport by
Iwan
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Sep-16 Date : Date : 24-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160286
Date Date
: 24-Sep-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Fogging area BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Sep-16 Date : Date : 24-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160287
Date Date
: 27-Sep-16
Attn : Mr. N. Lendup Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Cartridge HP black
2 2 ea Cartridge HP colour

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Sep-16 Date : Date : 27-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160288
Date Date
: 27-Sep-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 26 ea Rinso 700 gr
2 12 ea Rapika 250 ml
3 8 ea Vixal 1000 ml
4 8 ea Biore refill 500 ml
5 24 ea Vanish pembersih Grease / oli
6 24 ea Molto 1000 ml
7 4 ea Bay fresh
8 4 ea Tissue 900 gr
9 6 btl SOS lantai 800 ml
10 6 ea Sunlight 800 ml
11 3 ea Mr. Muscle
12 8 ktk Sariwangi celup isi 50
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Sep-16 Date : Date : 27-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160288
Date Date
: 27-Sep-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 ea Kopi kapal api


14 2 ea Max creamer 500 gr
15 8 kg Gula pasir
16 8 btl HIT Obat nyamuk
17 3 ktk Masker kain
18 10 ea Stabilo yellow
19 10 ea Stabilo pink

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Sep-16 Date : Date : 27-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160289
Date Date
: 28-Sep-16
Attn : Mr. Gede Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea ISO Tank Conection

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Sep-16 Date : Date : 28-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160290
Date Date
: 29-Sep-16
Attn : Mr. Triono Subekti Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Lube oil pump york compressor 5 kg

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Sep-16 Date : Date : 29-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160268
Machining Project Date Date
: 29-Sep-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 ea Shaft 316 OD 1 1/16" x 3.5 mtr Transport by

Machfut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Sep-16 Date : Date : 29-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160292
Date Date
: 30-Sep-16
Attn : Mr. Bustamin Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 ea Fuel filter
2 2 ea Air filter
3 2 ea Oil filter
4 10 gln Coolant Radiator

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Sep-16 Date : Date : 30-Sep-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160293
Date Date
: 2-Oct-16
Attn : Mr. Herman / Dayu P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Shaft sleeve with coating Sample


2 2 ea Shaft coloumn PAY 2600 old
3 5 ea Shaft coloumn PAY 2600 new new
4 9 ea Bearing shive coloumn new
5 1 ea Shaft sleeve troat new
6 1 ea Bearing bushing case new
7 10 ea Key connection new
8 1 ea Coupling Sample
9 1 set Two half ring Sample from Chevron

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Oct-16 Date : Date : 2-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160293
Date Date
: 2-Oct-16
Attn : Mr. Herman / Dayu P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Pump PAY 1200

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Oct-16 Date : Date : 2-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU V NO No.
: 160294
Date Date
: 4-Oct-16
Attn : Mr. Wibisono Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 lusin Sarung Tangan


2 6 ea Lakban Hitam
3 2 pack Cable ties 30 cm

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Oct-16 Date : Date : 4-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160295
Date Date
: 4-Oct-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 24 lusin Sarung tangan polkadot


2 2 krng Majun @ 50 kg
3 48 ea WD 40
4 6 ea Sikat Kawat
5 4 ea Coolpix nikon camera case
6 3 box Swipe oil absorbent

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Oct-16 Date : Date : 4-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Eka Jaya Aki NO No.
: 160296
Date Date
: 4-Oct-16
Attn : Mr. Junai Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 15 ea Battery UPS ICAL ex BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Oct-16 Date : Date : 4-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160297
Date Date
: 11-Oct-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 ea Valve in
2 6 ea Valve Ex
3 12 ea Seat valve
4 12 ea Valve guide
5 1 ea Cylinder head

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Oct-16 Date : Date : 11-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160298
Date Date
: 5-Oct-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Pinion gear
2 1 ea Ring gear

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Oct-16 Date : Date : 5-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Bima Kaltim Utama NO No.
: 160299
Date Date
: 5-Oct-16
Attn : Mr. Albert Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 ea Seat Injector HINO H07D


2 1 ea Seat Injector (Geunuine) Sample

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Oct-16 Date : Date : 5-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Chevron NO No.
: 160300
PSB Date Date
: 5-Oct-16
Attn : Mr. Kamal Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 Gln Water Coolant


2 1 Drum Oli Engine Mobil Delvac 15W-40

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 5-Oct-16 Date : Date : 5-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Derka-Traykabelindo NO No.
: 160301
Jakarta Date Date
: 7-Oct-16
Attn : Mr. Dicky Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 21 ea Cable tray 150x50x3000 mm


Dikembalikan

Expedisi by:

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Oct-16 Date : Date : 7-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU V NO No.
: 160302
Date Date
: 8-Oct-16
Attn : Mr. Wibisono Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 lusin Sarung tangan Polkadot


2 4 ea Lakban Hitam

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Oct-16 Date : Date : 8-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160303
Date Date
: 8-Oct-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Safety Shoes size 5 P160811


2 4 pcs Safety Shoes size 6 P160811
3 6 pcs Safety Shoes size 7 P160811
4 5 pcs Safety Shoes size 8 P160811
5 3 pcs Safety Shoes size 9 P160811
6 8 pcs Coverall size M P160812
7 12 pcs Coverall size L P160812
8 16 pcs Coverall size XL P160812
9 2 pcs Coverall size 2XL P160812
Trasport by Upie

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 8-Oct-16 Date : Date : 8-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160304
Date Date
: 7-Oct-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 210 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Oct-16 Date : Date : 7-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP - PT. MSJ NO No.
: 160305
Date Date
: 7-Oct-16
Attn : Mr. Prima Job Job
: J160197
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 15 liter Low test Genset PT. MSJ

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Oct-16 Date : Date : 7-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan NO No.
: 160306
Date Date
: 11-Oct-16
Attn : Mr. Edi Triono Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Discharge head pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Oct-16 Date : Date : 11-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Tricon Dos Sejahtera NO No.
: 160307
Date Date
: 12-Oct-16
Attn : Mr. Efendi S Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 pcs Round Bar SS 316 dia 1,5" x 3,5 mtr 175 kg

Jl.Angkasa, Gedung MGK Lt.UG Transport by


Blok D 11 No.2 - Jakarta
Telp: 021 2907 0800 AMA logistic
Hp.081243348962

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Oct-16 Date : Date : 12-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : TEKONOMIK NO No.
: 160308
Date Date
: 12-Oct-16
Attn : Mrs.Devi Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea oli genset 1
2 1 ea oli genset 2

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Oct-16 Date : Date : 12-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160309
Date Date
: 13-Oct-16
Attn : Mr. Jerry Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar u/ Low test Waterjet

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Oct-16 Date : Date : 13-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160310
Date Date
: 14-Oct-16
Attn : Mr. Kamal / Hari Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 ea Racor element
2 1 ea Air cleaner

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Oct-16 Date : Date : 14-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP - Pertamina NO No.
: 160311
Date Date
: 17-Oct-16
Attn : Mr. Illyan Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar u/ Hiapcrane KT 8092 LY


ke Pertamina antar Barang

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 17-Oct-16 Date : Date : 17-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Teknokraft NO No.
: 160312
Date Date
: 18-Oct-16
Attn : Mr. Paul Renon / Arny Gah Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 ea Sleeve interstage shaft


2 2 ea Upper lower shaft sleeve
3 1 ea Throad shaft sleeve

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Oct-16 Date : Date : 18-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - Balikpapan NO No.
: 160313
Date Date
: 19-Oct-16
Attn : Mr. Dwi N Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 ea Impeller shaft sleeve Material Ex. PAY 1200


2 3 ea Bearing sleeve coloumn
3 3 ea Bushing spider bearing
4 1 ea Bushing spider bearing ( Tungsten )
5 2 ea Bushing bearing throat

Hand carry by
Mr. Dwi N

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Oct-16 Date : Date : 19-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160314
Date Date
: 19-Oct-16
Attn : Mr. Sakka Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 40 liter Cleaning miller

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Oct-16 Date : Date : 19-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160315
Date Date
: 20-Oct-16
Attn : Mr. Guntoro Job Job
: Engine
No. Dept.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar U/ Low test Genset 135 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Oct-16 Date : Date : 20-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : TOTAL SPU NO No.
: 160316
Date Date
: 20-Oct-16
Attn : Mr.Ilham NC Job Job
: Engine
No. Dept.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Set Parts for generator-set 135 kva


2 3 Ea Water accu

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Oct-16 Date : Date : 20-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI Handil NO No.
: 160317
Date Date
: 20-Oct-16
Attn : Mr. Prima Job Job
: JRCB160003
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 150 liter Solar U/ Hiap Crane KT 8092 LY


antar Genset 135 KvA ke Handil

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 20-Oct-16 Date : Date : 20-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI SPU NO No.
: 160318
Date Date
: 21-Oct-16
Attn : Mr. Prima Job Job
: JRCB160003
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 box Tool box


2 1 pcs Kremping
3 1 pcs Avo meter
4 1 pcs Tang ampere

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Oct-16 Date : Date : 21-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron (PSB) NO No.
: 160319
Date Date
: 22-10-2016
Attn : Ilham NC Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 EA Oil Filter
2 EA Fuel Filter
1 EA Oil Cooler
1 Mtr Selang

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-10-2016 Date : Date : 22-10-2016 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160320
Date Date
: 25-Oct-16
Attn : Mr. Ilham Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar U/ Forklift BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Oct-16 Date : Date : 25-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160321
Date Date
: 25-Oct-16
Attn : Mr. Jerry Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar U/ Running Waterjet Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Oct-16 Date : Date : 25-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160322
Date Date
: 25-Oct-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 26 ea Rinso 900 gr
2 12 ea Pelembut pakaian
3 8 ea Vixal
4 12 ea Sabun Mandi
5 24 ea Vanish
6 24 ea Molto
7 4 ea Pengharum ruangan
8 3 ea Tissue
9 6 ea Pembersih lantai
10 6 ea Sabun cuci piring
11 4 ea Pembersih kaca
12 4 ea Sari wangi tea
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Oct-16 Date : Date : 25-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160322
Date Date
: 25-Oct-16
Attn : Mr. Yermanto / Dody A Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 ea Kopi kapal Api


14 2 ea Max creamer
15 5 ea Gula pasir
16 10 ea Obat nyamuk spray
17 3 ea Masker kain

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Oct-16 Date : Date : 25-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Sepinggan NO No.
: 160323
Date Date
: 26-Oct-16
Attn : Mr. Rudy Hartono Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 ea SKF bearing 7220 BECBM

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Oct-16 Date : Date : 26-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Batakan NO No.
: 160324
Date Date
: 26-Oct-16
Attn : Mr. Agus Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 pcs Coverall XL
2 2 pcs Helmet green
3 2 pcs Safety shoes size 8
4 1 pcs Gerobak Artco
5 1 lbr Terpal 4 x 6
6 1 ea Pipa 4"

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Oct-16 Date : Date : 26-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160325
Date Date
: 27-Oct-16
Attn : Mr. Jerry Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar U/ Running Waterjet Pump

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 27-Oct-16 Date : Date : 27-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160326
BPP Machining Project Date Date
: 28-Oct-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 8 pcs Roubd Bar SS 316 dia 1,5" x 3,5 mtr


2 1 pcs Safety Shoes size 5
3 1 pcs Safety Shoes size 6
4 1 pcs Safety Shoes size 7
5 1 pcs Safety Shoes size 8

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Oct-16 Date : Date : 28-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : PSB-CHEVRON NO No.
: 160327
Date Date
: 29-10-2016
Attn : Mr.Madi Job Job
: No. 150034

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 3 jerigen Water Coolant


2 6 ea Pulpen
3 5 ea Cutter

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-10-2016 Date : Date : 29-10-2016 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160328
Date Date
: 29-Oct-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar U/ Fogging BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Oct-16 Date : Date : 29-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160329
Date Date
: 31-Oct-16
Attn : Mr. N Lendup Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop tanpa charger P160205

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-Oct-16 Date : Date : 31-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU V - BPN NO No.
: 160330
Date Date
: 31-Oct-16
Attn : Mr. Nandang Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 50 liter Solar U/ Hiap Crane KT 8092 LY


antar Material ke Pertamina RU V

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 31-Oct-16 Date : Date : 31-Oct-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160331
Date Date
: 1-Nov-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 300 liter Solar u/ Genset BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Nov-16 Date : Date : 1-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Alie Service NO No.
: 160332
Date Date
: 3-Nov-16
Attn : Mr. Anton Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Compressor air conditioner For service


split panasonic

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Nov-16 Date : Date : 3-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. ELTA Radiator NO No.
: 160333
Date Date
: 4-Nov-16
Attn : Mr. Harto Job Job
: J160242
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Condensor
for Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Nov-16 Date : Date : 4-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160334
Date Date
: 4-Nov-16
Attn : Mr. Dwi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 15 liter Solar u/ mobil KT 8839 KH Buang Sampah

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 4-Nov-16 Date : Date : 4-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. HILTI NO No.
: 160335
Date Date
: 10-Nov-16
Attn : Mr. Giyam Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Jack Hammer HILTI TE 1500 AVR For Service

NOTES :
Prepared by, Checked by, Approved by, 3
Sign : Sign : Sign : Sign

Date : 10-Nov-16 Date : Date : 10-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160336
Date Date
: 11-Nov-16
Attn : Mr. Hari / Kamal Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lusin Sarung tangan


2 1 kg Majun
3 1 klg WD
4 20 gln Coolant radiator
5 2 ea Racor element
6 2 ea Air filter
7 2 ea Fuel filter
8 2 ea Oil filter
9 1 unit Mesin Steam
10 1 unit Motor starter
11 2 pcs Battery 120 A
12 1 pcs Impact Electric + cable extention
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Nov-16 Date : Date : 11-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160337
Date Date
: 11-Nov-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Wire cutting Transport by


2 2 pcs Strap wrench 18"
3 10 ea Duct tape 2" Nashua
4 1 ea Toner HP laserjet Black
5 1 ea Toner HP laserjet Yellow
6 1 ea Toner HP laserjet Magenta
7 1 ea Toner HP laserjet Cyan

Pak Udin

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 11-Nov-16 Date : Date : 11-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Widya Wasesa NO No.
: 160338
Date Date
: 12-Nov-16
Attn : Mrs. Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Printer Epson L200 For Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Nov-16 Date : Date : 12-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Pertamina RU V BPP NO No.
: 160339
Date Date
: 14-Nov-16
Attn : Mr. Nandang Job Job
: J160045
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 60 liter Solar u/ HiapCrane KT 8902 LY


Ambil barang ke Pertamina

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Nov-16 Date : Date : 14-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160340
Date Date
: 12-Nov-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Fogging area BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 12-Nov-16 Date : Date : 12-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP.PSB NO No.
: 160341
Date Date
: 14/11/2016
Attn : Mr. Madi and Bustamin Job Job
: J.150035
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Ea ECU Perkins P/N 7092693 C1


2 1 Ea ECU Perkins P/N 1833342 C1
3 5 Pcs Sensor Perkins

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14/11/2016 Date : Date : 14/11/2016 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160342
Date Date
: 14-Nov-16
Attn : Mr. Abd. Mu'in Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Nov-16 Date : Date : 14-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160343
Date Date
: 14-Nov-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Crank shaft


2 1 pcs Cilynder block

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Nov-16 Date : Date : 14-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To PT.INDAH JAYA NO No.
: 160344
Date Date
: 15-Nov-16
Attn : Mr.Taufan Job Job
: JRCB
No.160003-250 KVA

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 UNIT Fuel Injection Pump


2 6 UNIT Injector

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Nov-16 Date : Date : 15-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160345
Date Date
: 15-Nov-16
Attn : Mr. Dody A / Yermanto Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Printer Epson L200 After Service

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Nov-16 Date : Date : 15-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Samator Gas Industri NO No.
: 160346
BPN Date Date
: 17-Nov-16
Attn : Mr. Yohanes Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 tbg Tabung Oxygen Return


PN : 9714770
( Tabung Milik Samator )

Transport by

Upie
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 17-Nov-16 Date : Date : 17-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PSB-CHEVRON NO No.
: 160347
Date Date
: 17-11-2016
Attn : Mr.Madi Job Job
: J150034-psb
No. chevron

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 16 btl Air Tambah Baterai


2 10 mtr Cable Scren
3 12 psg Sarung Tangan
4 1 kg Majun

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 17-11-2016 Date : Date : 17-11-2016 Date :


S/R Coordinator Security Head Department Receiver
To : Bhumi Phala BPN NO No.
: 160348
From HDPE Project Date Date
: 18-Nov-16
Attn : Mr. Warehouse BPP Job : J140490

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 4 pcs Gerobak Artco


2 9 pcs Sekop
3 1 pcs Mata Cangkul

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Nov-16 Date : Date : 18-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160349
Date Date
: 18-Nov-16
Attn : Mr. Dody A / Yermanto Job : J120562

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 psg Handgloves Light duty G-Tek


2 24 lusin Handgloves Polkadot Transport by

Machfut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Nov-16 Date : Date : 18-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PSB-CHEVRON - Penajam NO No.
: 160350
Date Date
: 18-Nov-16
Attn : Mr. Sukandar Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lusin Sarung tangan


2 1 kg Majun
3 4 ea Electric tape Black, yellow, red, blue
4 1 ea Valve 1/2"
5 3 ea Connector
6 5 ea Teflon
7 1 ea Silicone clear

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Nov-16 Date : Date : 18-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160351
Date Date
: 18-Nov-16
Attn : Mr. Taufik Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 150 liter Solar u/ Hiap Crane KT 8902 LY


Antar Genset ke Chevron Penajam

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Nov-16 Date : Date : 18-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PSB-CHEVRON - Penajam NO No.
: 160352
Date Date
: 18-Nov-16
Attn : Mr. Kamal Mahabu Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Genset DENYO DCA 300 SP


2 1 unit Power cable basket
3 8 roll Cable power size 150 mm

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 18-Nov-16 Date : Date : 18-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV. Indah Jaya NO No.
: 160353
Balikpapan Date Date
: 21-Nov-16
Attn : Mr.Taufan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Injection pump


2 6 ea Injector

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Nov-16 Date : Date : 21-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160354
Date Date
: 21-Nov-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Cylinder head


2 6 pcs Seat Valve

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Nov-16 Date : Date : 21-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB - Penajam NO No.
: 160355
Date Date
: 21-Nov-16
Attn : Mr. Kamal Mahabu Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Laptop ACER


2 1 pcs Avometer Sanwa SN : 16045006230
3 1 pcs Connector 7X-1686
4 1 unit ECM 1833342C8-6526771-R1
5 1 unit Perkins Communication 27610255
6 1 unit Laptop Lenovo2251/SDPPI/2011/3871

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 21-Nov-16 Date : Date : 21-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160356
Machining Project Date Date
: 22-Nov-16
Attn : Mr. Rafli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 ea Cartridge 678 black


2 5 ea Cartridge 678 colour
3 12 klg WD40
4 12 ea Silicone rubber sealant
5 3 pail Oli Dromus Cooling
6 6 ea Center drill 3/8"
7 1 unit Laptop Acer + Charger u/ pak Lendup

Transport by
Machfut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Nov-16 Date : Date : 22-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160357
Date Date
: 22-Nov-16
Attn : Mr. Nandang Job Job
: J140312
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 160 liter Solar u/ Hiap Crane KT 8902 LY


ke Chevron Tanjung Santan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Nov-16 Date : Date : 22-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160358
Date Date
: 22-Nov-16
Attn : Mr. Dody A / Yermanto Job : J120562

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 pcs Coverall u/ Usman Hanafiah


2 105 sheet Form Monthly Maintenance Transport by
3 100 sheet Form 3 monthly

Iwan

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 22-Nov-16 Date : Date : 22-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PSB-CHEVRON - Penajam NO No.
: 160359
Date Date
: 24-Nov-16
Attn : Mr. Gusti Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 ea Injector perkins
2
3
4
5

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Nov-16 Date : Date : 24-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT.MSJ-SAMARINDA NO No.
: 160360
Date Date
: 23-Jan-00
Attn : Job : 160190-160197

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 Unit motor stater perkins 1103


2 1 Unit Alternator perkins 1104
3 1 Unit Turbo Charger perkins 1104
4

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 23-Jan-00 Date : Date : 23-Jan-00 Date :


S/R Coordinator Security Head Department Receiver
To : Tjokro Bersaudara NO No.
: 160361
Date Date
: 24-Nov-16
Attn : Mr. Ichwan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Cylinder head


2 3 pcs Valve in
3 3 pcs Valve ex
4 6 pcs Guide
5 3 pcs Seat in
6 3 pcs Seat ex
7 1 pcs Crankshaft 1103
8 1 pcs Pin piston
9 3 pcs Conrod
10 3 pcs Bushing conrod

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 24-Nov-16 Date : Date : 24-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160362
Machining Project Date Date
: 25-Nov-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 2 pcs Cover all Riyan P

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 25-Nov-16 Date : Date : 25-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160363
Date Date
: 26-Nov-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Fogging area BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 26-Nov-16 Date : Date : 26-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Total TEPI - Senipah NO No.
: 160364
Date Date
: 28-Nov-16
Attn : Mr. Erwin Job Job
: PO No.
Saccap

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Hiap Crane KT 8902 LY


antar Ballvalve ke WHS Total

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Nov-16 Date : Date : 28-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT SARANA DAYA HUTAMA NO No.
: 160365
( Kampung Baru ) Date Date
: 28-Nov-16
Attn : Mr. Budiono Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Cylinderhead Hino


2 6 ea Injector seat holders

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 28-Nov-16 Date : Date : 28-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT.BAROKAH GALANGAN NO No.
: 160366
SAMARINDA Date Date
: 29-Nov-16
Attn : Mr.Bustamin-Mr.Sukandar Job Job
: J160278
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Load Bank


2 8 roll Cable Power
3 1 box Tool Box

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP - Samarinda NO No.
: 160367
Date Date
: 29-Nov-16
Attn : Mr. Prima Job Job
: J160278
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 20 liter Solar u/ mobil KT 8927 LI


ke PT.BAROKAH GALANGAN
Samarinda

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : TJOKRO BERSAUDARA NO No.
: 160368
Date Date
: 29-Nov-16
Attn : Mr.Ichwan Job Job
: J160197
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Ciilender Block Perkins 1104


2 1 ea Cilender Head Perkins 1104
3 1 ea Crankshaft Perkins 1104
4 4 ea Conecting Rod perkins 1104

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV.INTI PERMAI NO No.
: 160369
Date Date
: 29-Nov-16
Attn : Job Job
: J160197
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 ea HOSE Radiator

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : CV.INDAH JAYA NO No.
: 160370
Date Date
: 29-Nov-16
Attn : Mr.Taufan Job Job
: J160197
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Fuel Injection Pump Delphy


2 4 ea Injector

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160371
Date Date
: 29-Nov-16
Attn : Mr. Dody A / Yermanto Job Job
: J160371
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 12 ea Vanis
2 12 ea Sabun Cuci
3 6 ea Rapika
4 3 ea Vixal
5 5 ea Sabun mandi
6 11 ea Pelembut pakaian
7 2 ea Pengharum ruangan
8 2 ea Tissue
9 4 ea Pembersih lantai
10 3 ea Sabun cuci piring
11 2 ea Pembersih kaca
12 2 ktk Sariwangi
NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Office Senipah NO No.
: 160371
Date Date
: 29-Nov-16
Attn : Mr. Dody A / Yermanto Job Job
: J160371
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

13 1 bks Kopi kapal api


14 1 ktk Max creamer
15 3 kg gula pasir
16 4 btl Obat Nyamuk
17 1 ktk Masker kain
18 1 ea Toner Epson 664 Magenta
19 1 ea Toner Epson 664 Black
20 1 ea Toner Epson 664 Cyan
21 1 ea Toner Epson 664 Yellow

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 29-Nov-16 Date : Date : 29-Nov-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160372
Machining project Date Date
: 1-Dec-16
Attn : Mr. Gawitno Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 150 liter Solar u/ Hiap Crane KT 8902 LY


ambil coloumn ke chevron lawe2

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 1-Dec-16 Date : Date : 1-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : HINO Balikpapan NO No.
: 160373
Date Date
: 2-Dec-16
Attn : Mr. Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Cylinder head for install


2 6 ea Seat injector

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Dec-16 Date : Date : 2-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Lawe - Lawe NO No.
: 160374
Machining project Date Date
: 2-Dec-16
Attn : Mr. Riyan P Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 5 lusin Sarung tangan for install


2 2 klg WD40

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 2-Dec-16 Date : Date : 2-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron PSB Penajam NO No.
: 160375
Date Date
: 3-Dec-16
Attn : Mr. Madi Job Job
: J150034
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 lusin Sarung tangan


2 1 kg majun
3 1 ea Lem besi
4 1 pcs Drill machine
5 2 ea Hole buff
6 1 ea Amplas 800

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 3-Dec-16 Date : Date : 3-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Congvetor Jasa NO No.
: 160376
Cabang Balikpapan Date Date
: 7-Dec-16
Attn : Mr. Luluk Hanafi Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 6 unit EUI ( Electonic unit injector )


Ex Perkins 1300 PSB
SN : - 69143243 215
SN : - 69143243 201
SN : - 69143243 193
SN : - 69143243 220
SN : - 69143243 224
SN : - 69143243 235

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 7-Dec-16 Date : Date : 7-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT.DANISWARA CIPTA NO No.
: 160377
PRATAMA-BATAKAN Date Date
: 07-des-2016
Attn : Mr.Agung Prayogi Job Job
: J160197
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Skid perkins 1104


2 1 ea Atap Skid
3 1 ea Support Skid

NOTE: No Pol KT8529LQ

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 07-des-2016 Date : Date : 07-des-2016 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160378
Machining Project Date Date
: 9-Dec-16
Attn : Mr. Rafli Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pail Ridgit Threading oil Transport by


2 1 pcs Teflon Dia 2" length 1.5 mtr
3 3 pcs Hacksaw blade
4 48 lusin Sarung tangan polkadot Illyan
5 12 ea Lakban kertas
6 12 ea Disc cutting 5"
7 12 ea Disc grinding 5"
8 3 ea Nylon Dia 1" length 1.5 mtr

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 9-Dec-16 Date : Date : 9-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT.DHARMAHENWA NO No.
: 160379
Date Date
: 09 Des 16
Attn : Mr.Denny Santoso Job Job
: J160239/J160240
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 UNIT PERKINS 1103


( No Pintu GS1164 )

2 1 UNIT PERKINS 1104


( No Pintu GS1117 )

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 09 Des 16 Date : Date : 09 Des 16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Tanjung Santan NO No.
: 160380
Cevron Attaka Date Date
: 10-Dec-16
Attn : Mr. Anang Susila Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 21 ea Pipe Nepple sch 160 A106 1/2" x 4"


2 24 ea Pipe Nepple sch 160 A106 3/4" x 4"
3 19 ea Pipe Nepple sch 160 A106 1" x 4"
4 25 ea Pipe Nepple sch 80 A106 11/2" x 4"
5 25 ea Pipe Nepple sch 80 A106 11/2" x 6"
6 25 ea Pipe Nepple sch 80 A106 2" x 4"
7 25 ea Pipe Nepple sch 80 A106 2" x 6"

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Dec-16 Date : Date : 10-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160381
Date Date
: 10-Dec-16
Attn : Mr. Junaidi Putra Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ Fogging Area BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Dec-16 Date : Date : 10-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160382
Date Date
: 10-Dec-16
Attn : Mr. Fredy Job Job
: Facility
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 100 liter Solar u/ Forklift BPP

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 10-Dec-16 Date : Date : 10-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Bima Kaltim Utama NO No.
: 160383
Date Date
: 13-Dec-16
Attn : Mr. Mikel Job Job
: J160197
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 ea Exhaust elbow
2 1 ea Thermostart
3 3 ea Sender sensor
4 ea Bolt
5 ea Nut

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 13-Dec-16 Date : Date : 13-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : PT. Bhumi Phala NO No.
: 160384
Date Date
: 14-Dec-16
Attn : Illiyan Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 288 ea primary tip


2 1 unit angle meter

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Dec-16 Date : Date : 14-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160385
Date Date
: 14-Dec-16
Attn : Mr. Ida Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Grinding Machine 4" Pinjam 1 hari

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Dec-16 Date : Date : 14-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : Kharisma Motor NO No.
: 160386
Date Date
: 14-Dec-16
Attn : Mr. Nono Job Job
: J160190
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 pcs Muffler
2 1 pcs Flexible expantion + Accessories

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Dec-16 Date : Date : 14-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160387
Date Date
: 14-Dec-16
Attn : Mr. Prima Job Job
: J160190
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 10 liter Solar u/ washing engine Job PT. MSJ

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 14-Dec-16 Date : Date : 14-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP - Office Senipah NO No.
: 160388
Date Date
: 15-Dec-16
Attn : Mr. Fredy Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 30 liter Solar u/ mobil KT 8331 KI


ke Senipah

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Dec-16 Date : Date : 15-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP NO No.
: 160389
Date Date
: 15-Dec-16
Attn : Mr. Madi Job Job
: JRCB160004
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar u/ Running Genset 75 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 15-Dec-16 Date : Date : 15-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : Chevron Westseno NO No.
: 160390
Date Date
: 16-Dec-16
Attn : Mr. Gunawan/I Gede Job Job
: J140298
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 1 unit Pump 1200 A

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Dec-16 Date : Date : 16-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : BPP - Office Senipah NO No.
: 160391
Date Date
: 16-Dec-16
Attn : Mr. Nandang Job Job
: J120562
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 60 liter Solar u/ Hiapcrane KT 8092 LY


ke Senipah ambil Container

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 16-Dec-16 Date : Date : 16-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : NO No.
:
Date Date
:
Attn : Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Dec-99 Date : Date : 30-Dec-99 Date :


S/R Coordinator Security Head Department Receiver
To : BPP -Total NO No.
: 160393
Date Date
: 19-Dec-16
Attn : Mr. Madi Job Job
: JRCB160003
No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

1 25 liter Solar u/ Running Genset 75 KvA

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 19-Dec-16 Date : Date : 19-Dec-16 Date :


S/R Coordinator Security Head Department Receiver
To : NO No.
:
Date Date
:
Attn : Job Job
: No.

NO. QUANTITY DESCRIPTION WEIGHT (KG) REMARKS

NOTES :
Prepared by, Checked by, Approved by, Recelved In Good condition by
Sign : Sign : Sign : Sign

Date : 30-Dec-99 Date : Date : 30-Dec-99 Date :


S/R Coordinator Security Head Department Receiver

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