KONTRAKTOR : PT.

BKS
PROJECT : IT FACILITY BRI TABANAN

CHECK LIST REPORT

Record No. : Date : :
Work : Besi, Bored, pile, Cor Reff.Doc/Wms No. :
Location : Reff.SD No. :
CEKLIST CEKLIST
No Discription KE 1 KE 2
Y N Y N
I Bored
1 Top Tanah Mall Pada Casing 40cm
2 Dia Meter Cassing Sesuai Gambar ( real 55cm)
3 Lot Tali Tambang + Meteran Panjang 20m
4 BP TOWER (DC) Data Centre / Power House (PH) Office ( OFC )

II BESI
1 Overlab
2 Ikatan
3 Sambungan
4 Beton deking

III INSTAL
1 Pengukuran Level Top Casing
2 Gantungsn
3 TOP BESI BOR PILE

III Beton mix & Cor

Beton Fc 30 Mpa Slump 18 ±2 concrete
1 Slump Rencana 18 ±2
2 Slump Realisasi
Slump Ok

Check List Result Result Comment

 Approved

 Approved with note

 Reject

The above work has been installed accordance with drawing and material approved
Prepared by, Checked by, Knowledge / approved by,
PT. BKS - QSPV PT. LAPI ITB PT. LAPI ITB
Name: Sri Djoko Name : Name : Name

Signature Signature : Signature : Signature

Date : Date : Date : Date

 Status :

CHECK LIST REPORT

Page No.

Comments

Comment

awing and material approved

:
KONTRAKTOR : PT.BKS
PROJECT : IT FACILITY BRI TABANAN

CHECK LIST REPORT

Record No. : Date :
Work : Reff.Doc/Wms No. :
Location : Reff.SD No. :

CEKLIST KE CEKLIST KE
No Discription
Y N Y

Check List Result Result Comment

 Approved
  Approved with note

 Reject

The above work has been installed accordance with drawing and material approved
Prepared by, Checked by, Knowledge / approved by,
PT. BKS - QSPV PT. LAPI ITB PT. LAPI ITB
Name : SriJoko Name : Name : Name

Signature Signature : Signature : Signature

Date : Date : Date : Date

 Status :

Page No. 1

CEKLIST KE
Comments
N

Comment
: