IN ASSOCIATION WITH

SOUTH SUMATRA - WEST JAVA GAS PIPELINE PROJECT CP3B CIKANDE-BITUNG DISTRIBUTION PIPELINE

AS-BUILT SURVEY REPORT

Location Report No Alignment Sheet No : KP : : Day/Date Weather Page : : :

NO.

Location / KP

Joint No.

Bending Type & Degree

Reference BM

Coordinate E N

Elevation TOP NGL

Cover Depth

REMARKS

Prepared by: PTG

Monitored/Witnessed by: PMC

Monitored/Witnessed by: PT. PGN

Date :

Date :

Date :

IN ASSOCIATION WITH

SOUTH SUMATRA - WEST JAVA GAS PIPELINE PROJECT CP3B CIKANDE-BITUNG DISTRIBUTION PIPELINE

AS-BUILT SURVEY REPORT

Doc. No. :

Alignment Sheet No Weather

: : Clear / Cloudy / Rainy CENTERLINE COORDINATES

Repeat No. Date spread

: : : ACCEPTANCE REMARKS

KP

BEND ANGLE

E1

BOUNDARY COORDINATES LEFT RIGHT N1 E2 N2

Total Inspection As on Date Previous

Today

Comulative

Remarks

Prepared by: PTG

Monitored/Witnessed by: PMC

Monitored/Witnessed by: PT. PGN

Date : Note :
KP Centerline Bending Type of Bending Boundary

Date :

Date :

: Every joint beetween joint to joint of pipes for centerline, include for boundary and every bending line : Pipe centerline coordinate will be stake out : Coordinate of bending for bending list : type of bending plan view (side bend left and side bend right) eclude for sag bend and over bend : Stake the peg every 50 m at the both side.

Sketch :

IN ASSOCIATION WITH

SOUTH SUMATRA - WEST JAVA GAS PIPELINE PROJECT CP3B CIKANDE-BITUNG DISTRIBUTION PIPELINE

PIPELINE CONSTRUCTION SURVEY INSPECTION REPORT

ALIGNMENT SHEET NO. WEATHER SURVEY FROM KP TO KP : : CLEAR / CLOUDY / RAINY LENGTH IN METER TYPE OF AREA IN BETWEEN CROSSING IF ANY TO KP TYPE NAME DOC.NO. REPORT NO: DATE: SPREAD: FROM KP LENGTH COMMENTS

SL

TOTAL INSPECTION AS ON DATE PREVIOUS TODAY

Prepared by: PTG

CUMMULATIVE
Monitored/Witnessed by: PMC

REMARKS
Monitored/Witnessed by: PT. PGN

Date :

Date :

Date :

IN ASSOCIATION

SOUTH SUMATRA - WEST JAVA GAS PIPELINE PROJECT CP3B CIKANDE-BITUNG DISTRIBUTION PIPELINE

FIELD CHANGE NOTICE

CHAINAGE: ALIGNMENT SHEET NO.: DRAWING NO.(IF ANY): SKETCH (ATTACH SHEET IF REQUIRED) DOC.NO. REPORT NO: DATE: WEATHER:

REASON FOR RE-ROUTING:

BY PT. PTG

AUTHORISED SIGNATORY (PT.PTG) COMMENTS BY (PMC/EMPLOYER)

APPROVED / NOT APPROVED

PMC

ENGINEER / EMPLOYER

IN ASSOCIATION WITH

SOUTH SUMATRA - WEST JAVA GAS PIPELINE PROJECT CP3B CIKANDE-BITUNG DISTRIBUTION PIPELINE

AS-BUILT SURVEY INSPECTION REPORT

ALIGNMENT SHEET NO.: WEATHER: CLEAR / CLOUDY / RAINY SURVEY FROM KP TO KP LENGTH IN METER TYPE OF AREA IN BETWEEN CROSSING IF ANY TYPE NAME DOC.NO. REPORT NO: DATE: SPREAD: FROM KP TO KP LENGTH COMMENTS

SL

TOTAL INSPECTION AS ON DATE PREVIOUS

Prepared by: PTG

TODAY

CUMMULATIVE
Monitored/Witnessed by: PMC

REMARKS
Monitored/Witnessed by: PT. PGN

Date :

Date :

Date :

Notes : KP Centerline Bending Bending Type Boundary

: Every joint of pipe for centerline, include for bending location : The coordinate that used when pipe centerline is installed : The bending coordinate that will used for bending list : The bending type plan (Side Bend Left and Side Bend Right). For sag bend and over bend is exclude : Every 50 meter, the pegs is installed at the both of side.