Inspection Certificate

Certificate Number :
046/CER-BSH/JKTI-MK-SIS/VIII/2023

The periodic inspection has been conducted to :

Owner : PT Saptaindra Sejati
Location : Workshop PT SIS
Equipment : Bushing Hammer
Type : Multiple Hole
Weight Off Bushing : 20 kg
Brand : PT Muda Kreatif
Year of Manufacture : 2023
Number of Id : BSH-0001
WLL (kg) : 50
Load Test (Tonne) : -
Colour Code : -
Fitting : No Fitting

Inspection Result :
Feasible to Use

Reference inspection as per procedure :

Minister of Manpower Regulation Republic Indonesia : No. 8 2020 About Lifting Inspection
ASME B30.10 2014 : Hook
ASME BPVC Section V 2019 : Article 6

Inspection Date Expiration Date

August 7, 2023 August 7, 2024

Issued Date :
August 7, 2023

Lisa E. Gunawan
Director
 PERIODIC INSPECTION REPORT
BUSHING HAMMER

Form Report No./02-02-01JKTI/ABA/Hook/2020 REV 0

Report No. 046/CER-BSH/JKTI-MK-SIS/VIII/2023 Page 1/2

Owner PT Saptaindra Sejati WLL (Tonne) 50

Location Workshop PT SIS Load Test (Tonne) -
Number of Id BSH-0001 Type Multiple Hole
Weight Off Bushing 20 kg Colour Code -
Brand PT Muda Kreatif Date of Inspection August 7, 2023
Year of Manufacture 2023 Next Inspection Date August 7, 2024
INSPECTION RECORD
Condition
No. Component Checked Remarks / Picture
Accepted Rejected
missing or illegible
hook manufacturer’s
identifi- cation or
✓ - Accepted During Inspection
secondary
manufacturer’s
identification
missing or illegible
rated load
identification,
✓ - Accepted During Inspection
excessive pitting or
corrosion, cracks,
nicks, or gouges
wear —any wear
exceeding 10% (or as
recom- mended by
the manufacturer) of ✓ - Accepted During Inspection
the original section
dimension of the bush
or its load pin
deformation — any
visibly apparent bend
✓ - Accepted During Inspection
1 Structure or twist from the plane
of the unbent hook
throat opening — any
distortion causing an
increase in throat
opening of 5% not to ✓ - Accepted During Inspection
exceed 1/4 in (6 mm)
(or as recommended
by themanufacturer

inability to lock — any

self-locking hook that ✓ - Accepted During Inspection
does not lock
inoperative latch (if
required) — any
damaged latch or
malfunctioning latch
that does not close
✓ - Accepted During Inspection
the hook’s throat
amaged, missing, or
malfunctioning hook
attach- ment and
securing means
 PERIODIC INSPECTION REPORT
BUSHING HAMMER

Form Report No./02-02-01JKTI/ABA/Hook/2020 REV 0

Report No. 046/CER-BSH/JKTI-MK-SIS/VIII/2023 Page 2/3

Customer PT Saptaindra Sejati WLL (Tonne) 50

Location Workshop PT SIS Load Test (Tonne) -
Number of Id BSH-0001 Type Multiple Hole
Weight Off Bushing 20 kg Colour Code -
Brand PT Muda Kreatif Date of Inspection August 7, 2023
Year of Manufacture 2023 Next Inspection Date August 7, 2024
INSPECTION RECORD
Condition
No. Component Checked Remarks / Picture
Accepted Rejected
thread wear, damage,
✓ - Accepted During Inspection
or corrosion

evidence of excessive
heat exposure or
✓ - Accepted During Inspection
unautho- rized
1 Structure welding

evidence of
unauthorized
alterations such as ✓ - Accepted During Inspection
drilling, machining,
grinding, or othe
Picture :

Proof Load Test

Load Test Holding Time (minutes) Result
- - -
- - -
Refrence Inspection as per procedure :
Permenaker 8 2020 ; ASME B30.10 2014 And ASME BPVC Sect V 2019
Remarks / Recommendetion : All Result
Not defective and damaged on structure Tool Lifting Clucth safe to use
Reviewed / Witnessed by : Autorized Inspector
PT Janji Karya Tehnik Inspeksi

Yusuf Kholis Subhana

Date : Date : August 7, 2023
 NON DESTRUCTIVE TEST
MT

Form Report No./02-02-01JKTI/ABA/Hook/2020 REV 0

Report No. 046/CER-BSH/JKTI-MK-SIS/VIII/2023 Page 3/3

Customer PT Saptaindra Sejati WLL (Tonne) 50

Location Workshop PT SIS Load Test (Tonne) -
Number of Id BSH-0001 Type Multiple Hole
Weight Off Bushing 20 kg Colour Code -
Brand PT Muda Kreatif Date of Inspection August 7, 2023
Year of Manufacture 2023 Next Inspection Date August 7, 2024
Procedure Number : JKTI-MSS/02/MAGNETIC White Contrast : WCP 2
Brands Name /
Material Spec : Forged Steel Magnaflux Cleaner : SKC - S
Type
Magnetic Methode : Yoke Permanent MPI Ink : 7hf
Magnetic Material : Visible Light Intensity : 1300 Lux
Surface Conditiaon : As Forged ; Time Of Examination : After Visual Check ; Scope of Examinantion : Base Forged
Result Type
Part Name Ø / Thickness (mm) Remarks
Accepted Rejected Discontinuities
Sampling Welding Joint - ✓ - - ACC During
Inspection

Picture :

Reviewed / Witnessed by : NDT MT/PT Level II

PT Janji Karya Tehnik Inspeksi

Yusuf Kholis Subhana

Date : Date : August 7, 2023
DRAWING
 Inspection Certificate

Certificate Number :
047/CER-MT/JKTI-MK-SIS/VIII/2023

The periodic inspection has been conducted to :

Owner : PT Saptaindra Sejati
Location : Workshop PT SIS
Equipment : Bushing Hammer
Type : Multiple Hole
Weight Off Bushing : 20 kg
Brand : PT Muda Kreatif
Year of Manufacture : 2023
Number of Id : BSH-0002
WLL (kg) : 50
Load Test (Tonne) : -
Colour Code : -
Fitting : No Fitting

Inspection Result :
Feasible to Use

Reference inspection as per procedure :

Minister of Manpower Regulation Republic Indonesia : No. 8 2020 About Lifting Inspection
ASME B30.10 2014 : Hook
ASME BPVC Section V 2019 : Article 6

Inspection Date Expiration Date

August 7, 2023 August 7, 2024

Issued Date :
August 7, 2023

Lisa E. Gunawan
Director
 PERIODIC INSPECTION REPORT
BUSHING HAMMER

Form Report No./02-02-01JKTI/ABA/Hook/2020 REV 0

Report No. 047/CER-MT/JKTI-MK-SIS/VIII/2023 Page 1/2

Owner PT Saptaindra Sejati WLL (Tonne) 50

Location Workshop PT SIS Load Test (Tonne) -
Number of Id BSH-0002 Type Multiple Hole
Weight Off Bushing 20 kg Colour Code -
Brand PT Muda Kreatif Date of Inspection August 7, 2023
Year of Manufacture 2023 Next Inspection Date August 7, 2024
INSPECTION RECORD
Condition
No. Component Checked Remarks / Picture
Accepted Rejected
missing or illegible
hook manufacturer’s
identifi- cation or
✓ - Accepted During Inspection
secondary
manufacturer’s
identification
missing or illegible
rated load
identification,
✓ - Accepted During Inspection
excessive pitting or
corrosion, cracks,
nicks, or gouges
wear —any wear
exceeding 10% (or as
recom- mended by
the manufacturer) of ✓ - Accepted During Inspection
the original section
dimension of the bush
or its load pin
deformation — any
visibly apparent bend
✓ - Accepted During Inspection
1 Structure or twist from the plane
of the unbent hook
throat opening — any
distortion causing an
increase in throat
opening of 5% not to ✓ - Accepted During Inspection
exceed 1/4 in (6 mm)
(or as recommended
by themanufacturer

inability to lock — any

self-locking hook that ✓ - Accepted During Inspection
does not lock
inoperative latch (if
required) — any
damaged latch or
malfunctioning latch
that does not close
✓ - Accepted During Inspection
the hook’s throat
amaged, missing, or
malfunctioning hook
attach- ment and
securing means
 PERIODIC INSPECTION REPORT
BUSHING HAMMER

Form Report No./02-02-01JKTI/ABA/Hook/2020 REV 0

Report No. 047/CER-MT/JKTI-MK-SIS/VIII/2023 Page 2/3

Customer PT Saptaindra Sejati WLL (Tonne) 50

Location Workshop PT SIS Load Test (Tonne) -
Number of Id BSH-0002 Type Multiple Hole
Weight Off Bushing 20 kg Colour Code -
Brand PT Muda Kreatif Date of Inspection August 7, 2023
Year of Manufacture 2023 Next Inspection Date August 7, 2024
INSPECTION RECORD
Condition
No. Component Checked Remarks / Picture
Accepted Rejected
thread wear, damage,
✓ - Accepted During Inspection
or corrosion

evidence of excessive
heat exposure or
✓ - Accepted During Inspection
unautho- rized
1 Structure welding

evidence of
unauthorized
alterations such as ✓ - Accepted During Inspection
drilling, machining,
grinding, or othe
Picture :

Proof Load Test

Load Test Holding Time (minutes) Result
- - -
- - -
Refrence Inspection as per procedure :
Permenaker 8 2020 ; ASME B30.10 2014 And ASME BPVC Sect V 2019
Remarks / Recommendetion : All Result
Not defective and damaged on structure Tool Lifting Clucth safe to use
Reviewed / Witnessed by : Autorized Inspector
PT Janji Karya Tehnik Inspeksi

Yusuf Kholis Subhana

Date : Date : August 7, 2023
 NON DESTRUCTIVE TEST
MT

Form Report No./02-02-01JKTI/ABA/Hook/2020 REV 0

Report No. 047/CER-MT/JKTI-MK-SIS/VIII/2023 Page 3/3

Customer PT Saptaindra Sejati WLL (Tonne) 50

Location Workshop PT SIS Load Test (Tonne) -
Number of Id BSH-0002 Type Multiple Hole
Weight Off Bushing 20 kg Colour Code -
Brand PT Muda Kreatif Date of Inspection August 7, 2023
Year of Manufacture 2023 Next Inspection Date August 7, 2024
Procedure Number : JKTI-MSS/02/MAGNETIC White Contrast : WCP 2
Brands Name /
Material Spec : Forged Steel Magnaflux Cleaner : SKC - S
Type
Magnetic Methode : Yoke Permanent MPI Ink : 7hf
Magnetic Material : Visible Light Intensity : 1300 Lux
Surface Conditiaon : As Forged ; Time Of Examination : After Visual Check ; Scope of Examinantion : Base Forged
Result Type
Part Name Ø / Thickness (mm) Remarks
Accepted Rejected Discontinuities
Sampling Welding Joint - ✓ - - ACC During
Inspection

Picture :

Reviewed / Witnessed by : NDT MT/PT Level II

PT Janji Karya Tehnik Inspeksi

Yusuf Kholis Subhana

Date : Date : August 7, 2023
DRAWING