PT. GURITA LINTAS SAMUDERA GLS - 62.

A
DECK AND ENGINE STORE REQUISITION PK SET
Vessel: TB . AZALEA Department: DECK
Date: 25-Nov-2021
Reqstn. No.: A Z - D - 0 1 4 - 2 0 2 1 A/C Code:
Vsl's Code Dept Running Nbr Year

Part No. or ISSA/ Approved

S/No. Description (Please Mention Details) *** ROB Unit Qty Req.
IMPA Code Qty

1 PARASUTE SIGNAL ( Exp.09-2022 ) 12 PCS 12

2 RED HAND FLARE ( Exp.09-2022 ) 6 PCS 6
3 SMOKE SIGNAL ( Exp.09-2022 ) 2 PCS 2
4 LIFEBUOY SELF-ACTIVATING SMOKE SIGNALS ( Exp.09-2022 ) 2 PCS 2
5 SERVICE LIFERAFT ( JANUARI 2022 SERTIFIKAT MATI ) 2 SET 2
6 SERVICE BREATHING APPARATUS ( JANUARI 2022 SERTIFIKAT 1 SET 1
MATI )
7 SERVICE FIRE ESTINGUISER ( JANUARI 2022 SERTIFIKAT MATI ) 7 PCS 7
8 HRU EXPIRE ( JANUARI 2022 ) 2 UNIT 2
10 PERMINTAAN SERVICE AC
MESS ROOM 1 UNIT 1
CREW CABIN 1 UNIT 1
CAPTAIN 1 UNIT 1
ANJUNGAN 1 UNIT 1

*** For Charts & Publications requisition, pls state onboard edition
as well as full title of Charts (instead of chart numbers only.)
Expected Date Of Supply Port Of Supply
FOR OFFICE USE Prepared by:
Checked By: Signature:
Surv / Supertndt Name: SLAMET AGUNG WIDODO
Date: MUALIM II
Aprroved By Approved by:
Tech / Fleet Mgr Signature:
Date: Master's Name: AGUS SUSANTO
Review By NAHKODA
Tech/Fleet Dir
Date:
Process by
L&P Mgr
Date: