TRANSPORTATION & ACCOMMODATION SERVICE REQUEST

DATE SUBMITTED :
TYPE OF REQUEST TRAVEL CONTACT PHONE & FAX NUMBER
X ROTA (Normal) LNG Site Babo Camp Fax (021) 7854 8671
ROTA (Off Schedule) Babo Base LNG Site Fax (021) 7854 4006
CONTRACTOR Email BR to:
VISITOR
VISITOR GROUP; GROUP NAME: (required SM Approval) Cc BR to:
Additional Cc, as applicable to:
REQUESTER NAME PHONE H&M - Contract H&M Secretary
Rifki Agristian 08121185611

MANAGER NAME PHONE SIGNATURE *Field-Based Sponsor (If approving manager is not Field-Based) NOTE FOR ROTA EMPLOYEE
Junichi Tanigawa 08111739217
Employee working on rota is mandatory to complete data on their
POINT OF HIRE and POINT OF DOMICILE.

TRANSPORTATION SERVICE REQUEST ACCOMMODATION SERVICE REQUEST SPONSOR INFORMATION MCU Validity
BODY WEIGHT incl Babo Camp/
POINT OF HIRE POINT OF DOMICILE TRAVELLING CHECK OUT
NO NAME VANTAGE ID JOB TITLE COMPANY Hand Carry & PURPOSE FROM TO Dormitory/ Shore CHECK IN DATE SPONSOR NAME COST CENTER EXPIRY DATE
(City) (City) DATE DATE
Luggage (Kg) Base/ Stinkul/ Matoa
1 ANTON 20508 JAKARTA BATAM PIPING FITTER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
3 ARIYA MARDI 22840 JAKARTA BATAM PIPING FITTER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
4 IRFAN SYARIFUDIN 20392 JAKARTA YOGYAKARTA RIGGER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
5 RONI WIJAYA 23833 JAKARTA LUWUK WELDER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
6 DWI PURNOMO 22837 JAKARTA LUWUK WELDER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
7 ROFIQ 25811 JAKARTA CILACAP RIGGER/BANKSMAN/SLINGER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
8 MUNASIB UNTUNG 25881 JAKARTA SURABAYA RIGGER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
9 HERI YUSWANDA 28396 JAKARTA BATAM HSE OFFICER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
10 AGUS SOMANTRI 26889 JAKARTA JAKARTA PIPING FITTER PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
11 AGUS DWI PRANYOTO 31121 JAKARTA YOGYAKARTA CRANE OPERATOR PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
12 FIRMANSYAH 29539 JAKARTA PALEMBANG DEPUTY HSE LEAD PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
13 ACHMAD FACHRUDIN 30832 JAKARTA SURABAYA CRANE OPERATOR PENTA-KELSRI 90 ROTA ON SORONG BABO 19-Dec-19 19-Dec-19 CSTS
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PRIMARY JETTY : BXB = BABO, LNGJ = LNG Jetty. SECONDARY JETTY: ARD = Aranday, ARG = Arguni, BINT = Bintuni, KKS = Kokas, MOGO = Mogotira, ON = Onar, OTW = Otowery, SAE = Saengga, TM = Tomu/Ekam, TMBJ = Tanah Merah Baru, TR = Taroy, TOFY = Tofoy, TOMA = Tomage, WRG = Wiriagar

MAIN CAMP LOCATIONS: LNG1 = Dormitory; LNGO = Matoa Camp; LNG = LNG Construction Camp; BXB = Babo Camp

TASR version 1. 2012