PatimOne Consul FoRM -04 PACKAGE 5 CONTRACT CAR TERMINAL CONSTRUCTION REQUEST FOR INSPECTION (RFI) Reference No._[TWWHAPTBPS-RFL-OV-23/004 Date Fe ‘Speceation/ Seetion 1.11.2 Coordination of Works | Pay item No n Spectiaton/ leanen 1. Ct Works: 2 Oo ey Na Location IcA1~A 31CA02, 1604, 3605 (Patimban - Subang, West Java - Indonesia) Date & Time for Inspection/ Measurement (5 Fb 2023 a 09:00 a (QUALITY REPORT, Wo con Dac. [ef ZO Fama, [= 1. [Existing Benchmark Verieation TWA PPS HS GEO = ‘Attachment 1: Schedule of Inspection = J. attachment 2 Location Drawing fr BM Verfieation 3 le. Atachment 3 : Equpment Uist 5 [Attachment 4 : Equipment Speciation 2 fe. Attachment 5 Cathicate of Caltatin a | QUANTITY REPORT Dialed Descrinion/Secon/Location Desion. | Acual Me ‘ofthe Activity tobe Inspected Unit | ouantty | Quantity | éference 1 \Verfcation of Bisting Bencturark (as attached) Nes, 4 TOTAL [CONTRACTOR'S NOTES: frUnWiA Contact Person: Teaar 7 (Chet Surveyor TOA Corp Sr, Surveyor TOA Corp Package 5, Patinban Project Pacage 5, Fimban Project (052215035200) osisza0658) ENGINEER'S REVIEW /COMMENTS ‘The above work(s) were inspected/surveyed withthe folowing resi ape 8 | Accepted, subject to comments (pease see below comments) 8 Wi, ejected (Pease see betow comments Fay) —=~SCSCSCS~*~S~SS [BASED OW THE ABOVE RESULTS, THE NEXT STAGE WAY ] WAY NOT PROCEED ‘The Contractor ‘The Enainesr loate:03~62~1003 ate: 3 Feb 2023 ste: 3re6 3 loate: loot: