QUALITY CONTROL INSTALASI FOC dan FOT

Tanggal Quality Control :

Nomor PR :
Nama Pekerjaan :
Nama Rekanan/Vendor :
Nama POP :
Nama Pelanggan :
Alamat Pelanggan :
PTL :
Tgl Realisasi Test & Comm :

I. MATERIAL dan JASA

MATERIAL JASA
NO PEKERJAAN A B C E F G
VOL AWAL VOL AKHIR SATUAN VOL AWAL VOL AKHIR SATUAN

1 Survey jalur kabel max 3 hari LOT

2 Penarikan FOC ADSS Short Span M
3 Penarikan FOC 8000 - 16000m M
4 Penarikan FOC lebih 16000 m M
5 Penarikan FOC under 800 m LOT
Galian Penarikan Jalur Tanah Taman
(Inc. Patok/Tanda, Perbaikan
6 M
tanaman/Aspal/Trotoar,
Perapihan Lokasi)
Galian Penarikan Jalur Rojok Alur (Inc.
Patok/Tanda, Perbaikan
7 M
tanaman/Aspal/Trotoar,
Perapihan Lokasi)
Penarikan gorong2 FOC ADSS Short
8 M
Span
9 Handhole 40x40x40 cm (Permanen) LOT
10 Manhole 80x80x100 cm (Permanen) LOT
11 Jointing per core (excl. labeling) U
Trace core (per
12 U
JB/ODF/Splitter/FDT/FAT)
13 OTDR per core (excl. jointing) U
14 Labeling Joint Box U
Labeling Kabel(1 pole 2 label, khusus
15 U
perapihan label)
16 Labeling In Site Plan (labeling all) U
17 Instalasi FOT MC (POP-CPE) AU
18 Instalasi Splitter GPON / ODP / box AU
Pembongkaran kabel ADSS Short Span
19 M
(incl. re-drumming)
20 Galian Penarikan Jalur Boring (Inc. M
Patok/Tanda, Perbaikan

[Type here]
 tanaman/Aspal/Trotoar,
Perapihan Lokasi)
Penarikan FOC ADSS Long
21 M
(dokumentasi)
22 Jointing ADSS LS per core AU
Pembongkaran kabel ADSS LS(re-
23 M
drumming)
Instalasi CCTV (termasuk survey,
instalasi, dan
24 AU
dokumentasi hasil pekerjaan
serta material UTP max 50m)
Instalasi Access Point (termasuk
survey, instalasi, dan dokumentasi
25 AU
hasil pekerjaan serta material UTP
max 50m)
Instalasi VMS (Video Management
System) termasuk
26 AU
JASA survey, instalasi dan
dokumentasi hasil pekerjaan
Instalasi Drop Wire (termasuk
27 Jasa Penarikan, Aksesoris, M
Jointing, OTDR)
Instalasi Rack dan Power Supply
(rectifier, battery, AC/DCPDB,
28 AU
integrasi, testcomm termasuk
delivery)
Instalasi Rack (12u dan 20u) (rectifier,
battery, AC/DCPDB, integrasi,
29 AU
testcomm termasuk
delivery)
Dismantle perangkat FOT di user/ di
30 AU
POP
31 Penarikan kabel UTP M
Transportasi ADSS SS atau LS jarak >
120Km dari gudang pengambilan kabel
32 LOT
kelokasi penarikan untuk jumlah
kabel >= 1 drum
Subduct HDPE Crsing (min 3 kbl
33 M
FA96/144)
Rumah Kabel (Adaptor > 1000 /1442
34 core) Incl. Pigtail, Adaptor, Protector U
Sleeves, Cassette dan Pondasi)
Rumah Kabel (Adaptor 576 core I/O)
35 Incl. Pigtail, Adaptor, Protector U
Sleeves, Cassette dan Pondasi)
Fitting Deadend, 6 - 48 core satu sisi
36 (Inc. Fitting Deadend, Strain clamp, U
Stop Link, Steel Band, Labeling)
Fitting Suspension, 6-48 core (Inc. Stop
37 U
Link, Steel Band)
38 Fitting Deadend, 96 - 144 core satu sisi U

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 (Inc. Fitting Deadend, Strain clamp,
Stop Link, Steel Band, Labeling)
Fitting Suspension 96-144 core (Inc.
39 U
Stop Link, Steel Band)
Bracket Deadend (Steel Band, Stop
40 U
Link)
Bracket Suspension(Stel Band, Stop
41 U
Link)
42 Splitter Distribusi 1:8 (Spliter only) U
43 Splitter Distribusi 1:16 (Spliter only) U
Patch Cord Single Mode 1 pasang
44 U
1.5m
45 Patch Cord Single Mode 1 pasang 3m U
46 Patch Cord Single Mode 1 pasang 5m U
47 Patch Cord Single Mode 1 pasang 10m U
48 Patch Cord Single Mode 1 pasang 15m U
Patch Cord Multi Mode 1 pasang
49 U
1.5m
50 Patch Cord Multi Mode 1 pasang 3m U
51 Patch Cord Multi Mode 1 pasang 5m U
52 Patch Cord Multi Mode 1 pasang 10m U
53 Patch Cord Multi Mode 1 pasang 15m U
Patch Cord Single Mode single core
54 U
1.5m
Patch Cord Single Mode single core
55 U
3m
Patch Cord Single Mode single core
56 U
5m
Patch Cord Single Mode single core
57 U
10m
Patch Cord Single Mode single core
58 U
15m
59 Joint Box Closure 96 Core U
60 Joint Box Closure 144 Core U
61 Joint Box 24 Core U
62 Joint Box 48 Core U
63 Joint Box 96 Core U
64 Joint Box 144 Core U
ODF Rack Mounted 6 Core (SC upc U
65
Litech)
ODF Wall Mounted 6 Core (SC upc U
66
Litech)
ODF Rack Mounted 12 Core(SC upc U
67
Litech)
ODF Rack Mounted 24 Core(SC upc U
68
Litech)
ODF Rack Mounted 48 Core(SC upc
69 U
Litech)
ODF Rack Mounted 96 core (SC upc
70 U
Litech)

[Type here]
 ODF Rack Mounted 144 core(SC upc
71 U
Litech)
72 Rack Wall Mounted 12 U U
73 Pipa Galvanis 3/4" (2 meter) BTG
74 Pipa Galvanis 1/4" (2 meter) BTG
75 Pipa PVC 3/4" (3 meter) BTG
Subduct HDPE outer Ø 50 mm,inner Ø
76 M
42mm
Rumah Kabel (Adaptor 288 core I/O,
77 Incl. Pigtail, Adaptor, Protector U
Sleeves, Cassette dan Pondasi)
Rumah Kabel (Adaptor 144 core I/O,
78 Incl. Pigtail, Adaptor, Protector U
Sleeves, Cassette dan Pondasi)
Tiang Besi 7 m diameter 5 in x 4 in x
79 BTG
2,5 in (incl Jasa Pasang dan Cat)
Tiang Besi 9 m (4"-3mm-6m, 3"- 3mm-
80 1,5m, 2,5"-3mm-1,5m) (incl Jasa BTG
Pasang dan Cat)
Tiang besi 12m (5"-3mm-6m, 4"-3mm-
81 3m, 3"-3mm-3m) (incl Jasa Pasang dan BTG
Cat)
Tiang Beton 9m - 200 daN (incl Jasa
82 BTG
Psg)
Tiang Beton 12 m 200 daN (incl Jasa
83 BTG
Psg)
Tiang Beton 14 m 350daN (incl Jasa
84 BTG
Psg)
85 I-Ring (4mm x 250mm) U
86 Kawat Selling 10mm U
87 Tension Fitting ADSS LS 900 satu sisi U
88 Tension Fitting ADSS LS 1200 satu sisi U
89 Suspension Fitting ADSS LS 900 U
90 Suspension Fitting ADSS LS 1200 U
91 Spiral Vibration Dumper span 600 U
Tower Fit H+clamp (3 fm 6m,4siku,2 U
92
clamp brsng)
Tower Fit I + clamp (1 fm 6 m, 2 clamp) U
93
brsng
94 Tension Fitting ADSS LS 400/600 1 sisi U
95 Corona coil span 600 U
96 Suspension Fitting ADSS LS 400/600 U
Gantry Box ADSS (stainless steel)24 U
97
core
Gantry Box ADSS (stainless steel)48 U
98
core
Gantry Box ADSS (stainless steel)96 U
99
core
100 Kabel duct dinding (memuat 2 kabel) M
101 Box ODP 16c Out( SC/UPC SM Adptr U

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 9pcs+ 1pc SC/UPC SM Pigtail)
Box ODP 16c Out( SC/UPC SM Adptr U
102 17pcs + 1pc SC/UPC SM Pigtail)
103 Corona coil span 900 U
104 Spiral Vibration Dumper span 900 U

II. INSTALASI PEKERJAAN

Instalasi pekerjaan di Lapangan dinyatakan (Baik/Tidak Baik) dan (Sesuai/Tidak Sesuai) Spesifikasi ICON+.
a.
b.
c.
d.
Kesimpulan :
Hasil pemeriksaan fisik (QC) di Lapangan dengan ini (Dapat/Tidak Dapat) di Terima sehingga (Dapat Diproses/Ditunda) ke
tahap berikutnya.

Menyetujui,
Team Quality Control Rekanan
Project Team Leader

Eneng Nurjanah PT GERBANG SINERGI PRIMA Rizki Novitri

Catatan :

FORM CEKLIST DOK MATERIAL

NO JENIS DOKUMEN QTY (SN) SESUAI TIDAK SESUAI

[Type here]
 1 Surat Pengambilan Kabel
2 Dok OTDR
3 Surat Pengembalian Kabel
4 Surat Pengambilan Perangkat
5 Dok Perangkat Terpasang (Foto SN)
6 Surat Pengembalian Perangkat

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