RADIOGRAPHY NOTIFICATION FORM

Area/ lokasi:
Working start time/ Pekerjaan dimulai:
Working finish time/ Pekerjaan selesai:
NDE Supervisor/ Phone:
NDE RSO/ Phone:
Night control/ Petugas penerangan:
Working personnel/ Pekerja yang
terlibat:

Description of the work/ Pekerjaan:

Source type:
Radiographic examination (C/S, S/S,
A/S pipe work, etc.):

Remarks/Special Condition (if any)/ Keterangan/ kondisi khusus (jika ada):

Prepared by NDE Coordinator

Signature Date
Received by PTW Coordinator
Signature Date

HTS-SCS-HSEI-EA-018-ANNEX 1