PT.

SHAHIB SEJATI

Batan Quality System Services Komite Akreditasi Nasional Lembaga Sertifikasi Sistem Mutu BQSS-10-2010
LSSM - 027 - IDN

BO SS

Jl. Timbul / Jl. H. Abdullah No. 2 Pondok Kelapa, Duren Sawit, Jakarta Timur 13450 Telp. : (021) 86900522 / 86903426 Fax. : (021) 86903426 E-mail : shahib_sjati@cbn.net.id

PT. SHAHIB SEJATI

CLIENT : PROJECT : Job Location Technique : Source Dia./Foc.Spot Activity Current mm Ci/kV mA Sensitivity : : : : DWSI DWDI CONTRACTOR : Welding Process : Object Inspected : Material : Contract No. SWSI

RADIOGRAPHY INSPECTION REPORT

S. Impose

Testing Date Reporting Date :

Report No. : Page :

Exposure time Develop time Film type Single load

Incomplete Fusion Incomplete Penetration

: :

:
Double load Isolated Slag Hollow Bead
Elongated Slag

Intensifying Scr : Peny/IQI : Source Side Film Side SOD/FFD :

Procedure :

Acceptance Criteria :

Drawing No.

Hi - Low

Density

TOTAL WELD : JOINT RADIOGRAPHER :

TOTAL FILM :

4 x 10

Cracks

sheets. QC /AUTHORIZED INSPECTOR :

4 X 15

sheets.

Undercut

Cluster Porosity

THICK NESS

WELDER FILM SEQUENCE CODE

Tungsten Inclusion Excessive Penetration Surface Profile Material Defect Gas Pore

Concavity

FILM MATL IDENTIFICA- JOINT NO. DIMENSI TION ON

Burn Trough

RESULTS REMARKS

7 X 17

CLIENT REPRESENTATIVE :

sheets. THIRD PARTY :

ULTRASONIC EXAMINATION REPORT

Job/Contract No. Project Customer UT Equipment Surface Condition Couplant Stage of Examination Welding Process Calibration Block Test Range Scanning Technique Probe Identification : : : : : : : : : : : : Applicable Code : As Welded Metylan After Welding SMAW IIW V1 ( S/N : BCB ( S/N : Serial No : Ground Flush Oil After Repair SAW ) ) Cable Length Other ( Other ( Other ( Other ( IIW V2 ( S/N : IOW ( S/N : : Procedure No. Ref. Drawing No. Report No. : : : : : ) ) ) ) ) )

Probe Cable Type & Make :

Decibels Frequency (Mhz) Scanning Face Reference Level Probe Angle Gain Correction Scanning Level

Record of Discontinuity Dist. From Ref. Point (mm) Depth from Scanning Face Length (mm) Height (mm) Type of Discontinuity

Result

% DAC

Discontinuity Type:

SP=Spherical

CL=Cylindrical

PL=Planar

Examined By,

Reviewed /Witnessed by

Reviewed /Witnessed by

Reviewed /Witnessed by

NDE Level Date :

ACC

Part Identification

Repair

Remark

LIQUID PENETRANT EXAMINATION REPORT

Job/Contract No. Project Constumer Lighting Equipment Surface Equipment Stage of Examination Welding Process Scope Of Examination Penetrant Type : : : : : : : : : : : Penetrant Developer Type Cleaner Type Part Identification Joint No. Welder Code Length examined As Welded After Welding SMAW Base Material Water washable ( Solvent Removable ( Post Emulsifiable ( Colors Contrast Dry Developer : ....................... min. Ground Flush After Excavation GTAW Weldment ) ) ) Report No. Ref. Drawing No. Material Examined Illumination Level Other ( Other ( Other ( Other ( Application By : ) Other ( Spraying Brushing Dwell Time : .......................... min. Aqueous Dev. Procedure No. Applicable Code Result Non Aqueous Dev. : : Remark : : : : ) ) ) )

: Fluorescent : : Developing Time

Type of Discontinuity

SKETCH

Examined By,

Reviewed /Witnessed by

Reviewed /Witnessed by

Reviewed /Witnessed by

NDE Level Date :

PT. SHAHIB SEJATI

CLIENT : LOCATION : MONDAY
TUESDAY THURSDAY DATE: DATE: DATE: WEDNESDAY DATE: FRIDAY DATE:

Consultant * Inspection & Certification Services

JOB NO :
SATURDAY DATE: SUNDAY DATE:

PERIOD :

TIME SHEET
WORKING DAY TIME COMMENCE TIME FINISH TOTAL HOURS OVER TIME FILMS 10 X 4 CONSUMABLE FILMS 15 X 4 FILMS ......................... FILMS ......................... M.P.I. CHEM/SET D.P.T CHEM/SET G. RAY IR. 192 UNIT X. RAY ULTRASONIC UNIT EQUIPMENT M.P.I. UNIT HOT TEMP. PROBE/SET THICKNESS METER DARK ROOM UNIT VEHICLE

TOTAL

DATE:

JOB DESCRIPTION MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

SUNDAY

NAME OF PERSONNEL / QUALIFICATION 1. ..................................................................................... 6. ..................................................................................... 2. ..................................................................................... 7. ..................................................................................... 3. ..................................................................................... 8. ..................................................................................... 4. ..................................................................................... 9. ..................................................................................... 5. ..................................................................................... 10. .....................................................................................

SIGNED :

CLIENT APPROVAL :

REMARK :

(PT. SHAHIB SEJATI)

MAGNETIC PARTICLE EXAMINATION REPORT

Job/Contract No. Project Location Customer Magnetizing Equipment Contrasting Paint Particle Type & Manufacturer Surface Condition Magnetizing Merhod Stage of Examination Welding Process Scope of Examination : : : : : : : .......................... Wet Non-Fluorescent ( Dry Non-Fluorescent As Welded Continuous After Welding SMAW Base Material Weldment Part Identification Joint No. Walder Code ( Ground Flush Rasidual After Excavitiom GTAW Edge Preparation Other ( Length examined ) Examination Date Report No. Ref. Drawing No. Illumination Level Serial No. Material Examined ) ) Dry Fluorescent Other ( Other ( Other ( Other ( Procedure No. : Applicable Code : Result Remark : : : : : : ) ) ) ) ) ) (

Wet Fluorescent (

Type of Discontinuity

SKETCH

Examined By

Reviewed / Witnessed by

Reviewed / Witnessed by

Reviewed / Witnessed by

Attachment 1

SKETCH

Client Project Material Inspected

: : :

Date

Report No.

Service :

PT. Shahib Sejati

SURAT PERINTAH DINAS LUAR

NO. SPDL :

NO. SPDL :

SURAT PERINTAH DINAS LUAR

Kepada : Sdr. Sdr. Sdr.

Kepada nama - nama tersebut diatas ditugaskan pada :

Kepada : Sdr. Sdr. Sdr.

Kepada nama - nama tersebut diatas ditugaskan pada :

Tanggal Waktu Lokasi Kerja Untuk Pekerjaan Sertifikasi alat ................................ Radiography Test Ultrasonic Test
Kendaraan/Tiket : Keuangan :

: : : :

Tanggal Waktu Lokasi Kerja Untuk Pekerjaan

: : : : Magnetic Particle/Dye Penetrant Test Lainnya : ........................................... ........................................... ...........................................

Sertifikasi alat ................................

Magnetic Particle/Dye Penetrant Test

Radiography Test

Ultrasonic Test

Lainnya : ........................................... ........................................... ...........................................

Kendaraan/Tiket :

Keuangan

1.Transportasi = Rp. ........................ = Rp. ........................ 2. Makan I + TOTAL 3. Makan II = Rp. ........................ = Rp. ........................ Direktur - BBM

: - Advance

= ............................... 1.Transportasi

: - Advance : @Rp. ..................../hari/org x ...... x ...... : @Rp. ..................../hari/org x ...... x ......

= ............................... = Rp. ........................ = Rp. ........................ = Rp. ........................ = Rp. ........................ Dept. Keuangan Direktur +

- BBM

2. Makan I

: @Rp. ..................../hari/org x ...... x ......

3. Makan II

: @Rp. ..................../hari/org x ...... x ......

TOTAL

Jakarta, ................................

Jakarta, ................................ Dept. Operasional Operasional Personalia

Dept. Operasional Operasional Personalia

Dept. Keuangan