PT.

TAKENAKA INDONESIA

PIPING PRESSURE TEST & LEAKAGE FUNCTION TEST

Project : AEON MALL DELTAMAS
Date : Report No. : …………/QC/ME.15 / AEON / 2022
System :
Location :
Drwg Reff. :

1 Time & Date of testing : START COMPLETE

Date : Date :
Time : Time :
2
2 Testing Result : Working Pressure : kg/cm
2
Pressure Tested * : kg/cm
2
Pressure Reading after 2 hours : kg/cm
2
Pressure Difference : kg/cm
% Difference : %

Noted :
Pressure Test should be conducted after Pipe Flushing
* Water Pressure Test = Working Pressure x 1,5

INSPECTION RESULT

Approved Approved with Comment Not Approved

Re-inspection Required Yes No

Acceptable for Next Work Yes No

REMARK / NON-CONFORMANCE :

Inspected by : Inspected by : Checked by : Approved by:

PT. SHINRYO INDONESIA PT. TAKENAKA INDONESIA PT. TAKENAKA INDONESIA PT. TAKENAKA INDONESIA

Date : / / Date : / / Date : / / Date : / /

FORM NO.: ITP-QC/ME.15 ISSUED DATE: 22-03-2022