PT GRACIA DIKATAMAS

BORE PILE INSPECTION CHECK LIST

Product Identification : Company :

Model No : Contract No :
Engine No : Date of Inspection :
Frame No : Location of Inspc :

No. ITEM CHECKED / BAGIAN YANG DIPERIKSA Remarks

A DRIVER / Operator INFORMATION / Informasi Operator atau Pengemudi

1 Name of Operator / Nama Operator

2 Operator Licence Number / No SIO Operator

3 Class of Driving Licence / Jenis SIO

4 Expire Licence / Masa Berlaku SIO

B VEHICLE INFORMATION / Informasi Kendaraan

1 Licence Plate / Nomor Polisi

2 SILO Valid to / Masa Berlaku SILO

3 Type of Vehicle-Merk /Tipe Kendaraan - Merek

4 Year of Built / Tahun pembuatan

ITEM CHECKED Availability Condition
No. Remarks
BAGIAN YANG DIPERIKSA Yes No Good Fair Poor
Ada Tidak Bagus Kurang Jelek
C VEHICLE CONDITION / Kondisi Kendaraan
1 Km Driven / Kilometer tempuh

2 Glass / Kaca:

2.1 Windshield / Kaca depan

2.2 Rear Window / Kaca belakang

2.3 Side Window / Kaca samping

Windshield wiper / karet pembersih kaca depan

3 Mirror / Spion

3.1 Side / Samping

- Left / Kiri

- Right / Kanan

4 Light / Lampu

4.1 Head / Depan

4.2 Tail / Belakang

4.3 Parking / Parkir

4.4 Indicator - Sign / Signal

4.5 Break / Rem

5 Door Condition / Kondisi pintu

6 Gas / fuel tank door / lid - Gas / Penutup tanki bahan bakar

7 Fuel tank, any leak ? / Tanki bahan bakar, ada kebocoran?

8 Engine / Mesin

9 Exhaust / Knalpot

10 Accu / Aki Electric System

11 Horn / Klakson

12 Safety belt / Sabuk pengaman

13 Speedometer / Speedometer
 ITEM CHECKED Availability Condition
No. Remarks
BAGIAN YANG DIPERIKSA Yes No Good Fair Poor
Ada Tidak Bagus Kurang Jelek
14 Break / Rem
15 Fuel indicator / Indikator bahan bakar

16 Crawler drives
Swing system by hydroulic plunger motor, 360' rotation / Sistim
17
putaran dengan hydroulic motor, 360 derajat
18 Counterweight

19 Mast Prop

20 Main Winch

21 Main rope

22 Crowd Winch

23 Crow Rope

24 Boom

25 Boom Cylinder (Rod&Seal)

26 Mast Pivot
27 Supporting Boom
28 Kinetic Triangle
29 Backstay Cylinter (Rod&Seal)
30 Crowd Sledge
31 Mast(upper section/lower section)

32 Crowd rope tension cylinder

33 Mast head lifting cylinder

34 Masthead

35 Pulleys

36 Rope Swivel

37 Kelly bar

38 Shock absorber

39 Casing driver adapter

40 Driling tools

41 Cardan Joint

42 Fire Exhausthing/Racun Api

43 First Aid / P3K

44 Safety Triangle

45 PPE/Alat Pelindung Diri

Note : 1
2
- Mechanical findings :

- Overall condition : GOOD FAIR POOR

- Conclusion : 1. Meet / Not meet contract spec.
2. Meet contract spec but on condition (specify) :

Inspected by,