Form - Daily Report 1

Jaringan Gas Bumi untuk Rumah Tangga di Kota Samarinda, Kalimantan Timur
SURVEY DAILY REPORT

Location: Day/Date:
Report No. Weather:
Description
Time Personnel:
Tools :
Activities From KP : To KP : Result Totally Unit
07.00-08.00
08.00-09.00
09.00-10.00
10.00-11.00
11.00-12.00
12.00-13.00
13.00-14.00
14.00-15.00
15.00-16.00
16.00-17.00
Work Plan for Tomorrow
Progress
Previous: Today: Cumulative:
Note :
Prepared by Checked by Reviewed by Reviewed by
Sub Contractor Cotractor Prosys Bangun Persada PPK
Sign
Name
Date
Comment
CLEARING DAILY REPORT

Date : Area :
Report No : Page : of
Weather :
A. ACTIVITY
KP TOTAL
NO. Volume (m2) REMARKS
FROM TO (MTR)
B. EQUIPMENT
WORKING STANDBY
WORK IN TYPE AND SERIES OF
NO. REMARKS
KP EQUIPMENT QTY HOURS QTY HOURS
C. MANPOWER
WORKING STANDBY
NO. MANPOWER REMARKS
QTY HOURS QTY HOURS
D. PROGRESS PREVIOUS TODAY CUMMULATIVE

(Report No. / mtr) (mtr) (mtr)
Prepared by: Approved by Acknowledged by

CONTRACTOR Prosys Bangun Persada Pejabat Pembuat Komitmen
Date Date Date :

GRADING DAILY REPORT

Date : Area :
Report No : Page : of
Weather :
A. ACTIVITY
KP TOTAL
NO. Volume (m3) REMARKS
FROM TO (MTR)
B. EQUIPMENT
WORKING STANDBY
WORK IN TYPE AND SERIES OF
NO. REMARKS
C. MANPOWER
WORKING STANDBY
QTY HOURS QTY HOURS

Prepared by: Approved by Acknowledged by

Date Date Date :

DAILY TRENCHING REPORT

Project : Location :
Report No : Weather :
Date : Soil Condition: Dry Swamp Rocky
WIDTH (M) VISUAL

FROM JOINT TO JOINT LENGTH (M) DEPTH (M)
Top Bottom INSPECTION
B. EQUIPMENT
WORK IN TYPE AND SERIES OF WORKING STANDBY
NO. REMARKS
C. MANPOWER
WORKING STANDBY
QTY HOURS QTY HOURS

Prepared by: Approved by Acknowledged by Reviewed by,

CONTRACTOR Prosys Bangun Persada Pejabat Pembuat Komitmen PJIT
Date : Date : Date : Date :

PIPE STRINGING REPORT

Project : Location:
Report No : From KP: To KP :
Alignment Sheet No. : Weather :
Location KP Dia. Thick Length Bending Condition/

Visual Inspection
No. Date Pipe No Heat No Type of Bending & Remarks
Degree
From To (Inch) (mm) (m) Accepted Damaged Note
EQUIPMENT
WORKING STANDBY
NO. WORK IN KP TYPE AND SERIES OF EQUIPMENT REMARKS
QTY HOURS QTY HOURS
MANPOWER
NO. WORKING STANDBY
MANPOWER REMARKS
QTY HOURS QTY HOURS
PROGRESS PREVIOUS TODAY CUMMULATIVE


CONTRACTOR Prosys Bangun Persada Pejabat Pembuat Komitmen PJIT

BENDING REPORT
Project : Location
Date : Weather
Report No : Alignment Sheet No. : of
To be PIPE IDENTIFICATION INSPECTION
TYPE OF ANGLE
BEND.ID.NO. Located at Thk Pipe Heat Length
BEND OF BEND Gauged Pipe Body Bevel Coating
KP (mm) No. No. (M)
TYPE
B. EQUIPMENT AND
WORK IN SERIE
NO. WORKING STANDBY REMARKS
KP S OF
EQUIP
MENT QTY HOURS QTY HOURS
C. MANPOWER
REMA
NO. MANPOWER WORKING STANDBY
RKS
QTY HOURS QTY HOURS


CONTRACTOR Prosys Bangun Persada Pejabat Pembuat Komitm PJIT

BENDING QUALIFICATION TEST (BQT)
Date : Area :
Report No : Alignment Sheet No. : of
Pipe No. : BQT No. :

Heat No. : Wall Thickness :
Manufacturer : Diameter :
Date of QT : Pipe Length :
Operator Name : Coating Thicknees :
Description of Bending Machine :
Make / Model / Serial No's :
Mandrel Type : Air Hydraulic
Make / Model / Serial No's : Make / Model / Serial No's :
Compressor Type :
Make / Model / Serial No's :
BQT DETAIL
Type of Bend :
Target Bend Angle :
Increamnet No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Bend Increment (degree) Under Force
Pull Measurement (mm)
Bend Increment (degree) After Relax
Pipe Thicknees (before bending)
Pipe Thicknees (after bending)
Coating Thicknees (external)

Damage : pipe wrinkle, pipe buckle, coating scratch, coating tear off, etc.
Roundnees (96% dia. Gauging plate) : indicate the test result
Coating Holiday Test : reading result
Inspection Before Bending Inspection After Bending

Ovality Check Ovality Check
Holiday Test Holiday Test
Check Thickness Check Thickness
(tension/compression/neutral axis side) (tension/compression/neutral axis side)
BQT Result Acceptable Not Acceptable

CONTRACTOR Pejabat Pembuat Komitmen PJIT
Prosys Bangun Persada
Date Date Date Date :

LAPORAN
WELDING SCHEMATIC
Proyek :
No. Laporan :
Tanggal :
No. Joint :
BENDING/ELBOW :
No. Pipa :
No. Heat :
Panjang (m) :
Panjang
Kumulatif (m) :
No. Joint :
BENDING/ELBOW :
No. Pipa :
No. Heat :
Panjang (m) :
Panjang
Kumulatif (m) :
No. Joint :
BENDING/ELBOW :
No. Pipa :
No. Heat :
Panjang (m) :
Panjang
Kumulatif (m) :
Prepared by Approved by Acknowledged by

(...…..…………..………….) (...…..………….………….) (...…..………………….………….)
I-001/0.24/F20
Revisi : 01
inda, Kalimantan Timur
Reviewed by
embuat Komitmen PJIT
………….………….) (...…..………….………….)
Report No.: Date :
Jaringan Gas Bumi untuk Rumah Tangga di Kota Samarinda, Kalimantan Timur Page : of
Project : Size / Material :

Employer
Contractor
:
:
WELDING INSPECTION REPORT Welding Code
WPS & PQR no.
:
:
Welder ID No.
Number of
NO. Joint No. Pipe No. Heat No Length Bend Detail Date Visual Location / KP Number Remarks
ROOT HOT PASS FILLER 1 FILLER 2 FILLER 3 CAPPING NDT Report
L R L R L R L R L R L R
TOTAL LENGTH : Jts M
Electrodes Size AWS No. Batch No. Weather :

Root
Hot
Filler Condition :
Capping
Prepared By / Contractor Approved By / Prosys Acknowledged By / PPK Reviewed By / PJIT
Name : Name : Name : Name :
Signature : Signature : Signature : Signature :

REPAIR WELDING
Kp : Material : Report No :
Direction : Diameter : Date Repair :

Wall Thick. : Page No :
WELDING DATA
WPS Welded No. : Joint No. :

Welder Code Who Produced The Defect : Date :
Defect Data
0
315 45
270 90
225 135
Type Of Defect :
Size Of Defect :
180
Circumferential Position :
RT Report No. :
Note :
Removal Of Defect
Air Gouging Grinding Cut-Out
Repair Data
Joint NO. : RT Report No. :

WPS Welded No. : MPI Report No. :
Welder ID : UT Report No. :
Defect Excavation Position : Repair Time : to
Remarks :
WELD JOINT AFTER REPAIRED ARE :
VISUALLY ACCEPTABLE
RT ACCEPTABLE

Contractor Prosys Bangun Persada PPK PJIT

FIELD JOINT COATING

Employer : Weather :
Location : Report No. :
Contractor : Date :
Pipe Surface Preparation Holiday Test Remark

Relative Adhesion Type of Heat
Time Dew Temperature Heating of Visual
No Joint No. KP No. Humidity Test/Peel Shrinkable
(WIB) Point (Before Pipe (oC) Check
(RH) Test Sleeves
Start Work) Cleanliness Surface Profile Kv Result
EQUIPMENT
WORKING STANDBY
WORK
NO. TYPE AND SERIES OF EQUIPMENT REMARKS
IN KP QTY HOURS QTY HOURS
MANPOWER
WORKING STANDBY
QTY HOURS QTY HOURS

Prepared by, Approved by, Acknowledged by, Reviewed by,

Contractor Prosys PPK PJIT

LAPORAN
PENURUNAN PIPA
Proyek : Lokasi :
No. Laporan : Cuaca Waktu
Tanggal :
Wall Thickness : mm
A. AKTIVITAS
No. Lasan (joint
Section KP Number Inspeksi Visual
number) Panjang Test Lapisan
No
(m) Holiday Pasir
Dari Ke Dari Ke Coating Pipe Body
B. PERALATAN
Bekerja Standby
No. Peralatan Keteran
Jumlah Jam Jumlah Jam
C. TENAGA KERJA
Bekerja Standby
No. Pekerja Keteran
Jumlah Jam Jumlah Jam
D. PROGRESS
Sebelumnya Hari ini Total
(m) (m) (m)
Prepared by, Approved by Acknowledged by

Contractor Prosys Bangun Persada Pejabat Pembuat Komitmen
(...…..…..………………….) (...….....…………………….) (…….…..…………………….)

alimantan Timur
Cerah Berawan Hujan
nspeksi Visual
Keterangan
Dasar
Galian
Keterangan
Keterangan
Reviewed by
PJIT
(…….…..…………………….)
BACKFILLING REPORT
Project name : Weather :
Report No : Location :
Date : From KP ……..to KP…….
JOINT NO. BACKFILL DEPTH
LENGTH VISUAL
FROM TO (M) SAND LAYER (M) TOP OF PIPE (M) INSPECTION
EQUIPMENT
WORK IN TYPE AND SERIES OF WORKING STANDBY
NO. REMARKS
MANPOWER
WORKING STANDBY
QTY HOURS QTY HOURS


PT. Krakatau Engineering Prosys Bangun Persada Pejabat Pembuat Komitmen PJIT

PAINTING REPORT
EMPLOYER : WEATHER :
LOCATION : COMPRESSOR TYPE :
CONTRACTOR : PRESSURE :
PROJECT TITLE : NO. NOZZLE :
DATE :
SURFACE PREPARATION REPORT NO. :
RUST GRADE : A B C D
CLEANLINESS METHOD : SSPC SP-10 SSPC SP-3 / SP-2
BLASTING DATE :
SURFACE PROFILE :
PAINTING MIXING METHOD :
DIA / WFT (Coat) DFT (Coat)

NO DESCRIPTION PIPE NO. RESULT REMARK
AREA
1st 2 nd 3rd Finish 1st 2 nd 3rd Finish
MATERIAL COATING
MERK
COLOR
BATCH THINNER NUMBER
No. Batch bag. A
No. Batch bag. B
ENVIRONMENTAL TEST
Dry temperature
Wet temperature
Steel Temperature
Dew Point ©
Rh (%)
PT. KE
Inspector PMC
PGN
NOTE:
PREPARED BY Approved By Acknowledged by REVIEWED BY,

Contractor Prosys Bangun Persada PPK PJIT
DATE: DATE: DATE: DATE:

Project Name : Size / Material :
Engineer
Contractor
Section
:
:
: From KP……. to KP ……..
PIPE BOOK PIPELINE TRACKING RECORD Date
Report No.
Page
:
:
:
1st Repair 2nd Repair 2nd Repair Pre-Hydrostatic
Bend Detail Welder ID No. RADIOGRAPHIC TEST 1st Repair Welding MPI UT Field Joint Coating Peel Test Trenching Lowering In Backfill Thermit Welding
Length Cummulative WPS repair Radiographic Test Welding Radiographic Test Test
NO. Joint No. Pipe No. Heat No Date WPS No. Visual
(mm) (mm) Report ROOT FILLER 1 FILLER 2 FILLER 3 CAPPING No. Report Report Report Report Report Report Report Report Report Report Report Report Report
Angle Type Date Report No. Date Result Date Date Date Date Date Date Date Date Date Date Date Date Date
No. L R L R L R L R L R No. No. No. No. No. No. No. No. No. No. No. No. No.
TOTAL LENGTH : Jts M
Prepared By / Contractor Approved By / Prosys Acknowledged By / PPK Reviewed By / P J I T

:
Name : Name : Name : Name :
:
Signature : Signature : Signature : Signature :
:
MATERIAL RECEIVING REPORT

Report No. : Start Loading :
Date : FinishLoading :
Location/Received at : Transport Destination :
Pipe Size : Weather :
Result Of Inspection (ACC or Rejected)

Length of Trailer Police Wall Thk.
No. Pipe No. Heat No. Bevel + Holiday
Pipe (m) No. (mm) Visual Marking
Cap Test
Total Pipe : Pcs
Prepared by: Witnessed by: Approved by Acknowledged by

CONTRACTOR PIPE SUPPLIER Prosys Bangun Persada Pejabat Pembuat Komitmen
Date: Date: Date: Date:

Form - Daily Report 1

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Jaringan Gas Bumi untuk Rumah Tangga di Kota Samarinda, Kalimantan Timur

SURVEY DAILY REPORT

Activities From KP : To KP : Result Totally Unit

Work Plan for Tomorrow

Prepared by Checked by Reviewed by Reviewed by

Sub Contractor Cotractor Prosys Bangun Persada PPK

CLEARING DAILY REPORT

D. PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by: Approved by Acknowledged by

Date Date Date :

GRADING DAILY REPORT

D. PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by: Approved by Acknowledged by

Date Date Date :

DAILY TRENCHING REPORT

WIDTH (M) VISUAL

D. PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by: Approved by Acknowledged by Reviewed by,

Date : Date : Date : Date :

PIPE STRINGING REPORT

Location KP Dia. Thick Length Bending Condition/

PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by: Approved by Acknowledged by Reviewed by,

Date : Date : Date : Date :

D. PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by: Approved by Acknowledged by Reviewed by,

Date : Date : Date : Date :

BENDING QUALIFICATION TEST (BQT)

Pipe No. : BQT No. :

Description of Bending Machine :

Make / Model / Serial No's :

Mandrel Type : Air Hydraulic

Make / Model / Serial No's : Make / Model / Serial No's :

Target Bend Angle :

Coating Thicknees (external)

Inspection Before Bending Inspection After Bending

BQT Result Acceptable Not Acceptable

Prepared by: Approved by Acknowledged by Reviewed by,

Date Date Date Date :

Prepared by Approved by Acknowledged by

inda, Kalimantan Timur

Project : Size / Material :

TOTAL LENGTH : Jts M

Electrodes Size AWS No. Batch No. Weather :

Prepared By / Contractor Approved By / Prosys Acknowledged By / PPK Reviewed By / PJIT

Name : Name : Name : Name :

Signature : Signature : Signature : Signature :

Date : Date : Date : Date :

Direction : Diameter : Date Repair :

WPS Welded No. : Joint No. :

Air Gouging Grinding Cut-Out

Joint NO. : RT Report No. :

Prepared by: Approved by Acknowledged by Reviewed by,

Date : Date : Date : Date :

FIELD JOINT COATING

Pipe Surface Preparation Holiday Test Remark

PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by, Approved by, Acknowledged by, Reviewed by,

Date : Date : Date : Date :

Prepared by, Approved by Acknowledged by

(...…..…..………………….) (...….....…………………….) (…….…..…………………….)

Cerah Berawan Hujan

PROGRESS PREVIOUS TODAY CUMMULATIVE

Prepared by: Approved by Acknowledged by Reviewed by,