F2820-F0092-04 Attachment-29 Page 1 of 1

Procedure No. F2820-P0043-01

Inspection :
GRINDA Capacity :
Owner :
INSPECTION STANDARD User Dept :
(OSHA 29 CFR 1910) TEIR No :
INSPECTION METHOD INSPECTION RESULT REASON FOR NOT
No INSPECTION ITEM STANDARDS
VISUAL FUNCTION CTR ULI COMPLY
1 Side handle Availlable (tersedia) ●
2 Wheel guard Not crack (tidak retak) ●
3 Wheel lock Nut not crack,tight (baut tidak retak,rapat) ●
4 Wrench Availlable (tersedia) ●
5 Spidle lock button Work (berfungsi) ● ●

6 Switch Work (berfungsi) ●

As manufacturing standard, not expired (sesuai dengan standar
7 Wheel
pabrikan, tidak kadaluarsa)
●

8 Body machine Not greased,oil (tidak ada grease,oli) ●

9 Power cord Not scratch,insullated (tidak sobek,terisolasi) ●

10 Motor No spark (tidak ada percikan) ●

INSPECTION STATUS
PASSED Stiker Number

REJECT Stiker Number

HOLD Stiker Number

INSPECTION DURATION : To

SPECIAL NOTE FROM ULI :

INSPECTED BY APPROVED BY

Name and Signature Name and Signature

ULI-WALLSICF-SAF-FORM023 Ver.0.0 26May2023