Professional Documents
Culture Documents
Report No.
Area / Unit
System No.
Subcon. Name
Tolerence
System Description :
Dwg. No/Rev.
See Attachment
of
Level : 2
T.O.P EL
mm
Elevation
No
Result
Column No
Remarks
Drawing
Prepared by
Actual
Deviation
Accepted
Inspected by
SUBCONT
Witnessed by
ADHI-GS E&C
Name :
Name :
Date :
Date :
Reject
PERTAMINA/PMC
Name :
Date :
Form No. : SS-01
of
Report No.
Project No.
PILE NO.
Location
Inspection Date
DWG. No
Subcon Name
Item/Material Name
Date inspection :
No.
1
Page :
Check Result
Inspection Items
Accept
Reject
Remark
Welding consumable
Electrode E-7016
Beveled end
45.+ 5
Attachment :
Yes
No
Note :
Name :
Date :
Prepared by
Inspected by
Witnessed by
SUBCONT
ADHI-GS E&C
PERTAMINA/PMC
Name :
Date :
Name :
Date :
Form No. : SS-02
Project / No. :
Report No. :
Area / Unit. :
System No. :
System Description :
Subcon Name :
Dwg.No/Rev. :
Tolerence :
1 DIMENSION
1.
POSITION
NOMINAL
DIMENSION
Result
Result
Result
ACTUAL
POSITION
NOMINAL
DIMENSION
ACTUAL
POSITION
NOMINAL
DIMENSION
ACTUAL
2.WELD,VISUAL CHECK,LENGTH
THROAT
REINFORCEMENT
3.SHAPE,VISUAL CHECK,BEND
TWIST
SURFACE CONDITION
SURFACE CONDITION
Prepared by
Inspected by
SUBCONT
Name :
Date :
Witnessed by
ADHI GS E&C
ADHI-GS
Name :
Date :
PERTAMINA/PMC
Name :
Date :
Form No. : SS-03
Project / No.
Report No.
Area / Unit
System No.
Subcon. Name
System Description :
Tolerence :
Dwg. No/Rev.
DWG. No
Location
Bolt size
Prepared by
Test Q'ty
Test
Torque
Inspected by
SUBCONT
Remarks
Witnessed by
ADHI-GS E&C
PERTAMINA/PMC
Name :
Name :
Name :
Date :
Date :
Date :
Form No. : SS-04
COLUMN PLUMBNESS
INSPECTION REPORT
Page :
Project / No.
Report No.
Area / Unit
System No.
System Description :
Subcon. Name
Dwg. No/Rev.
Tolerence
Measured Dimension
Column No.
of
Results
Tolerance
Top
Prepared by
Bottom
Remarks
Accept
Witnessed by
Inspected by
SUBCONT
Reject
ADHI-GS E&C
PERTAMINA/PMC
Name :
Name :
Name :
Date :
Date :
Date :
Form No. : SS-05
FINAL INSPECTION
FOR STEEL STRUCTURE
Page :
Project / No.
Report No.
Area / Unit
System No.
Subcon. Name
System Description :
Dwg. No/Rev.
of
No.
Check Items
Welding Inspection
Prepared by
Results
Remarks
Inspected by
SUBCONT
Witnessed by
ADHI-GS E&C
PERTAMINA/PMC
Name :
Name :
Name :
Date :
Date :
Date :
Form No. : SS-06
Report No.
Area/Unit
Item
Location
Subcon. Name
Dwg.No/Rev.
No.
Check Items
Material Check
Surface Cleaning
Precast Formwork
Dimension Check
Concrete pouring
Prepared by
Results
Inspected by
SUBCONT
Name :
Date :
Page :
Remarks
Witnessed by
ADHI-GS E&C
Name :
Date :
of
PERTAMINA/PMC
Name :
Date :
From No. : SS-07
Report No.
Area/Unit
Item
Location
Subcon. Name
Page : of
No.
Check Items
Surface Cleaning
Results
Remarks
Prepared by
Inspected by
Witnessed by
SUBCONT
ADHI-GS E&C
PERTAMINA/PMC
Name :
Name :
Name :
Date :
Date :
Date :
From No. : SS-08
Page : of
Project / No.
Report No.
Area / Unit
Item
Location
System No
Dwg. No/Rev.
System Description
Site
Garnet
Sand
Sa2.5
Grade :
Sa2
Method :
Airless Spray
To
ST3
Auto Blast
Power Tool
Mesh
To
Micron
DESCRIPTION :________________________________
Conventional Spray
Brush
Roller
Material Type
Dry Bulb ( c )
A
Batch Numbers
B
Wet Bulb ( c )
Mixing Ratio
Minimum WFT Specified
Relative Humidity ( % )
Type
Thinner
% Add
Dew Point ( c )
WFT After Thinning
Coat
Steel Temperature ( c )
DFT "Specified"
Total
MEASURING POINT/DRY FILM THICKNESS (m) AVERAGE
Q'TY
AVERAGE
1
Prepared by
Inspected by
SUBCONT
Witnessed by
ADHI-GS E&C
PERTAMINA/PMC
Name :
Name :
Name :
Date :
Date :
Date :
Form No. : SS-09
Dwg. No.
Area/Unit
Subcon :
No.
Prepared by
Results
Inspected by
SUBCONT
Name :
Date :
of
Report No.
Witnessed by
AHDI-GS E&C
Name :
Date :
Remark
PERTAMINA/PMC
Name :
Date :
Form No. : SS-10
Page : of
To
Notification No.
Discipline
Subcon. Name
Request Date
We would like to have your presence for inspection / test according to the following schedule
The under noted work is completed (except as noted)
This is to inform you that the following inspection / test will be carried out at the schedule time mentioned below :
Item
DWG. NO.
REV
Q'TY
WEIGHT
RESULT
REMARK
(Kg)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by
Inspected by
ADHI-GS E&C
SUBCONT
Witnessed by
Name :
Name :
PERTAMINA/PMC
Name :
Date :
Date :
Date :
Form No. : SS-11