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Total Sheet

PT. DHARMA PRATAMA SEJATI


PT. DONGGI SENORO LNG

17

VENDOR's name :
OWNER's name :
PT. JGC INDONESIA AND JGC CORPORATION CONSORTIUM
PURCHASER's name :
Project name
Donggi Senoro LNG Project
Purchase Order No. :
0-5151-P-31A0-001-A
Equipment/Material name : PAINTING WORKS
Item number
Document title:

Inspection and Test Plan


(Internal Pipe Blasting)

VENDOR's document No.:

DSLNG Project

ISSUE PURPOSE
RESULT CODE : A, B, N, F
NEXT STATUS : FA, FI, FC, AB
RESUBMISSION DATE :

FA
FC
(

)
)

RESPONSIBLE DEPT. :

REVIEWED BY :

(
(

Review Date:

A
FC

FQC

S. Kuritsubo
12-SEP-2012

)
)
)

A : Approved without Comment; B : Approved with Comment


N : Not Approved; F : Not Subject to Review
Approval or review hereunder shall not be construed to relieve Supplier /
Subcontractor of his responsibilities and liability under the Contract.

0-5151-20

JOB NO.

PURCHASE ORDER NO.


PURCHASE ORIG.
R DOC. NO.

V-

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I 17-SEP 2

31A0-001-A

SERIAL

REV.

043

Donggi Senoro LNG Project


Inspection and Tes Plan
For Pipe Internal Blasting

JGC Doc. No. : V-31A0-001-A-043 Rev. 2


DPS Doc. No. : DPS-DSLNG-QCL-003 Rev. 2
Sheet No. 2 of 10

LIST OF CONTENTS
1.

GENERAL ................................................................................................................
1.1 Purpose .............................................................................................................
1.2 Scope ................................................................................................................
1.3 Reference ..........................................................................................................
1.4 Definition ...........................................................................................................

3
3
3
3
3

2.

PLAN .......................................................................................................................

3.

LIST OF VERIFYING DOCUMENT FORMAT..................................................................

ATTACHMENT
Attachment-01
Appendix-1
Appendix-2
Appendix-3
Appendix-4
Appendix-5
Appendix-6
Appendix-7

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IN7-SEP- 2
1

Inspection & Test Plan


Painting Inspection Record Sheet (FORM NO. DPS-QCPF-IBIRS)
Internal Blasting Daily Progress Report (FORM NO. DPS-QCPF-IBPROG)
Temporary Facilities and Eqp Check List (FORM NO. DPS-QCPF-TFEC)
Equipment Inspection Report (FORM NO. DPS-QCPF-EQIR)
Master List Calibration (FORM NO. DPS-QCPF-MLCA)
Material Inspection Acceptance for Abrasive Material
(FORM NO. DPS-QCPF-MTIA-1)
Blotter Test (FORM NO. DPS-QCPF-BLTC)

Donggi Senoro LNG Project


Inspection and Tes Plan
For Pipe Internal Blasting

1.

GENERAL

1.1

Purpose

JGC Doc. No. : V-31A0-001-A-043 Rev. 2


DPS Doc. No. : DPS-DSLNG-QCL-003 Rev. 2
Sheet No. 3 of 10

This Inspection & Testing Plan (ITP) desciribes a guide for internal blasting work executors who
assigned to prepared and establish a quality for blasting work and execute the plan to measure
the workmanship compliance to the specified standard and criteria.
The purpose of this ITP is to ensure that internal blasting work are inspected and tested in
accordance with the relevant standard and codes and project specification.
This ITP shall covers the inspection and testing activities during the blasting which applied to the
internal surface of a limited selection of pipe at the fabrication shop yard/Painting shop yard
activities, including the inspection that shall be done by each party involved in the project.
1.2

Scope
This ITP was developed and made after review of JGCs document related to Inspection and test
Plan of Pipe Internal Blasting.
This ITP shall be covered for Pipe Internal Blasting as per commissioning activity.

1.3

References

1.4

JGC Doc. No. S-900-13A0-001 : Specification for Painting


Document no. V-31A0-001-A-022 : Work Method Statement for Internal Pipe Blasting.

Definition
1.4.1. Hold Point (H)
The inspection and test activity is mandatory witness point to Contractor, Company, and
Authority (if applicable) and the subsequent activity beyond this point must not proceed
without the approval by these parties.
1.4.2. Witness (W)
Physically attend the inspection activity to check the correct execution. Witness must
documented using the approval Inspection Form.
1.4.3. Review (R)
Assess adequacy and completeness of Quality Control Document, such as the inspection
and test record, other Quality Qontrol Records and Certificate. Review must be
ducumented using the approved Inspection Form.
1.4.4. Inspection (I)
Implementation of inspection and test activity such as measuring, surveying, examining,
testing and comparing the results with specified requirements, inorder to establish
whether conformity is achieved for ach caracteristic. Inspection and test must be
documented using approved Inspection Form.
1.4.5. Spot Witness (SW)
Witness by sampling ; subcontractor can proceed with the test/inspection when the JGC
inspector is not present at the notified time.

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IN7-SEP- 2
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Donggi Senoro LNG Project


Inspection and Tes Plan
For Pipe Internal Blasting

JGC Doc. No. : V-31A0-001-A-043 Rev. 2


DPS Doc. No. : DPS-DSLNG-QCL-003 Rev. 2
Sheet No. 4 of 10

1.4.6. Surveillance (S)


Monitoring of work in progress, test and inspections.
2.

PLAN
The Detail of Inspection & Testing Plan (ITP) shall be shown in Attachment-01 Inspection &
Test Plan (ITP).

3.

LIST OF VERIFYING DOCUMENT FORMAT


Tabel for verifying document format which is applicable for this ITP as below:

Appendix No.

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IN7-SEP- 2
1

Description

DPS Form No.

Appendix-1

Internal Blasting Inspection Record Sheet

FORM NO. DPS-QCPF-IBIRS

Appendix-2

Internal Blasting Daily Progress Report

FORM NO. DPS-QCPF-IBPROG

Appendix-3

Temporary Facilities and Eqp. Check List

FORM NO. DPS-QCPF-TFEC

Appendix-4

Equipment Inspection Report

FORM NO. DPS-QCPF-EQIR

Appendix-5

Master List Calibration

FORM NO. DPS-QCPF-MLCA

Appendix-6

Material Inspection Acceptance


(Abrasive Material)

FORM NO. DPS-QCPF-MTIA-1

Appendix-7

Blotter Test

FORM NO. DPS-QCPF-BLTC

Donggi Senoro LNG Project


Inspection and Test Plan
For Pipe Internal Blasting

JGC Doc. No. V-31A0-001-A-043 Rev. 2


DPS Doc. No. DPS-DSLNG-QC-002 Rev. 2
Sheet No. 5 of 10
DPS Ref.
No.*2
Attachment

INSPECTION AND TEST PLAN


DESCRIPTION OF WORK / LOCATION 1 :
Item

0
0.1

1.
1.1

Activity Description

Extent

*3

All construction
drawings are available
at site
Internal Blasting
Equipments in
acceptable condition.

*4

---

01

Rev.No.

Rev.Date 10/04/12

Status

For Construction

Contractor
Responsible
Personnel *8

Verifying
Documents/
QCR's *9

PIPE INTERNAL BLASTING AT SHOP


Controlling Document/
Method *5

All documents required


for earth work

---

As above

Acceptance Criteria *6
[Applicable QC Work
Instruction No.]
Available on site with
Approved For Construction
status.

Frequency *7

Before starting
work

---

---

Responsibility
Category 10
DPS

JGC

DS

---

-----

Workshop, equipments,
facilities and inspection
tools shall be in
accordance with project
specification which
describe in related JGC's
documents

Inspection acceptance for


workshop and facilities are
available. Certificate of
Compliance for construction
equipment are available.
Calibration certificates for
inspection tools are available
and maintained.

Before starting
work.

QC Inspector,
Supervisor,
Mechanic

DPS-QCPF-TFEC
DPS-QCPF-EQIR
DPS-QCPFMLCA

(*)

Supplier's material data


sheet, Visual check,
Check by label indication

The material will be selected


by Contractor in accordance
with: V-31A0-001-A-022:
Garnet, used as abrasive for
pipe internal blasting carbon
steel. As per ISO 8504-2.
[QWI-102].

Once/ Each
batch at material
receiving

Material
Controller,
QC Inspector

DPS-QCPFMTIA-1

ABRASIVE MATERIAL RECEIVING


Check abrasive brand
name and type

Random
Sampling

A
R
I : Inspection
;1H2 : Hold Point ; R : Review ; W : Witness ; SW : Spot Witness ; S : Surveillance
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(*) Initial stage of facility setting to be checked

Donggi Senoro LNG Project


Inspection and Test Plan
For Pipe Internal Blasting

JGC Doc. No. V-31A0-001-A-043 Rev. 2


DPS Doc. No. DPS-DSLNG-QC-002 Rev. 2
Sheet No. 6 of 10
DPS Ref.
No.*2
Attachment

INSPECTION AND TEST PLAN


DESCRIPTION OF WORK / LOCATION 1 :
Item

Activity Description
*3

Extent
*4

1.2

Check correct size of


abrasive

2.

INTERNAL BLASTING CONDITION

2.1

Weather

Random
Sampling

2.2

Atmospheric
Temperature

Random
Sampling

2.3

Substrate Surface
Temperature

Random
Sampling of all
surface

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Random
Sampling

As above
01

Rev.No.

Rev.Date 10/04/12

Status

For Construction

Contractor
Responsible
Personnel *8

Verifying
Documents/
QCR's *9

PIPE INTERNAL BLASTING AT SHOP


Controlling Document/
Method *5

Acceptance Criteria *6
[Applicable QC Work
Instruction No.]

Frequency *7

Responsibility
Category 10
DPS

JGC

DS

Supplier's material data


sheet, Visual check,
Check by label indication

Depend on Suppliers
instruction to achieve the
required surface roughness &
remove mill scale and/or
preservation material. [QWI102], [QWI-104] [QWI-401]

Once/ Each
batch at material
receiving

Material
Controller,
QC Inspector

DPS-QCPFMTIA-1

S/R

Specified weather
condition must be
required for the
application of Surface
Preparation, check by
visual
Checked and Measured
by Thermometer

No rain, strong wind, fog or Min. once before


mist. [QWI-001]
surface
preparation

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

Ambient Temperature shall be Min. once before


and surface
exceed between 10OC
Specification
for preparation
40OC,
Painting, JGC Doc. No.S-90013A0-001 Sec. 13 [QWI-002]

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

Checked and Measured Surface shall be 3OC above Min. once before
by Substrate Surface dew point and between 10OC surface
and 40OC, Specification for preparation
Thermometer
Painting, JGC Doc. No.S-90013A0-001 Sec. 13 [QWI-003]

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

I : Inspection 0;1H2 : Hold Point ; R : Review ; W : Witness ; SW : Spot Witness ; S : Surveillance


P-2

Donggi Senoro LNG Project


Inspection and Test Plan
For Pipe Internal Blasting

JGC Doc. No. V-31A0-001-A-043 Rev. 2


DPS Doc. No. DPS-DSLNG-QC-002 Rev. 2
Sheet No. 7 of 10
DPS Ref.
No.*2
Attachment

INSPECTION AND TEST PLAN


DESCRIPTION OF WORK / LOCATION 1 :
Item

Activity Description

Extent

*3

*4

As above
01

Rev.No.

Rev.Date 10/04/12

Status

For Construction

Contractor
Responsible
Personnel *8

Verifying
Documents/
QCR's *9

PIPE INTERNAL BLASTING AT SHOP


Controlling Document/
Method *5

Acceptance Criteria *6
[Applicable QC Work
Instruction No.]

Frequency *7

Responsibility
Category 10
DPS

JGC

DS

2.4

Relative Humidity

Random
Sampling

Checked and Measured RH shall not exceed 85%, Min. once before
by hygrometer.
Specification for Painting, JGC surface
Doc.
No.S-900-13A0-001- preparation
Rev.02 Sec. 13 [QWI-004]

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

2.5

Surface Condition

All Surface

Visual Check

Foreman,
QC Inspector

3.

COMPRESSED AIR/ABRASIVE

3.1

Dryness, Contamination Random


of Compressed Air
Sampling

3.2

Pressure of
Compressed Air

3.3

Dryness, Contamination Random


of Abrasive Material
Sampling

4.

SURFACE PREPARATION

4.1

Check abrasive brand


name and type

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Random
Sampling

Random
Sampling

No impurities
Min. once before
[QWI-301], [QWI-401], [QWI- surface
501], [QWI-502], [QWI-503]
preparation

Visual Check and/or


No impurities
White Cloth Test by
Blotter Test correct
terminology.
Visual Check, measured Supplier's material data sheet
by
Pressure
Gauge
(Hypodermic
Needle
Pressure Gauge)
Visual Check
No impurities

Min. once prior


to use

Foreman,
Mechanic

DPS-QCPFBLTC

S/R

Min. once prior


to use

Foreman,
QC Inspector

DPS-QCPFEQIR

S/R

Once/ Each
batch at material
receiving

QC Inspector

---

S/R

Supplier's material data Same as Item 1.1 of this ITP


sheet,
Visual
check, [QWI-102], [QWI-104], [QWICheck by label indication 401]

Once/ Each
batch prior to
use

Foreman,
QC Inspector

DPS-QCPFMTIA-1

S/R

I : Inspection 0;1H2 : Hold Point ; R : Review ; W : Witness ; SW : Spot Witness ; S : Surveillance


P-2

Donggi Senoro LNG Project


Inspection and Test Plan
For Pipe Internal Blasting

JGC Doc. No. V-31A0-001-A-043 Rev. 2


DPS Doc. No. DPS-DSLNG-QC-002 Rev. 2
Sheet No. 8 of 10
DPS Ref.
No.*2
Attachment

INSPECTION AND TEST PLAN


DESCRIPTION OF WORK / LOCATION 1 :
Item

Activity Description
*3

Extent
*4

01

Rev.No.

Rev.Date 10/04/12

Status

For Construction

Contractor
Responsible
Personnel *8

Verifying
Documents/
QCR's *9

Once/ Each
batch prior to
use

Foreman ,
QC Inspector

Free from water/oil/mud etc., Once/ Prior to


Document Ref. no. V-31A0- surface
001-A-022.
preparation

PIPE INTERNAL BLASTING AT SHOP


Controlling Document/
Method *5

Acceptance Criteria *6
[Applicable QC Work
Instruction No.]

Responsibility
Category 10
DPS

JGC

DS

DPS-QCPFMTIA-1

S/R

Foreman,
QC Inspector

---

S/R

Check correct size of


abrasive

4.3

Check surface condition Random


before surface
Sampling
preparation

Visual check.

4.4

Atmospheric
Temperature

Random
Sampling

Supplier's material data Same as Item 2.2 of this ITP


sheet,
Checked
and [QWI-001], [QWI-002]
Measured
by
Thermometer

Min. once before


surface
preparation

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

4.5

Substrate Surface
(steel) Temperature

Random
Sampling

Supplier's material data Same as Item 2.3 of this ITP


sheet,
Checked
and [QWI-001], [QWI-003]
Measured by Substrate
Surface Thermometer

Min. once before


surface
preparation

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

4.6

Relative Humidity

Random
Sampling

Supplier's material data Same as Item 2.4 of this ITP


sheet,
Checked
and [QWI-001], [QWI-004]
Measured by hygrometer.

Min. once before


surface
preparation

Foreman,
QC Inspector

Form-01.
JGC Doc. No.S900-13A0-001

S/R

4.7

Check the surface


cleanliness

All Surface
within range of
vision

Visual check confirm with


ISO 8501-1 or SSPC.
Vol.2 Chapter.2

Min. once/during
& after surface
preparation work

Foreman,
QC Inspector,
Painting
Supervisor

Form-01.
JGC Doc. No.S900-13A0-001

Supplier's material data Same as Item 1.2 of this ITP


sheet,
Visual
check, [QWI-102] [QWI-401], [QWICheck by label indication 406]

Frequency *7

4.2

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Random
Sampling

As above

Free from mill scale and/or


preservation material.
SP-6 in SSPC or Sa2 in ISO
8501-1. Document ref. no. V31A0-001-A-022

I : Inspection 0;1H2 : Hold Point ; R : Review ; W : Witness ; SW : Spot Witness ; S : Surveillance


P-2

Donggi Senoro LNG Project


Inspection and Test Plan
For Pipe Internal Blasting

JGC Doc. No. V-31A0-001-A-043 Rev. 2


DPS Doc. No. DPS-DSLNG-QC-002 Rev. 2
Sheet No. 9 of 10
DPS Ref.
No.*2
Attachment

INSPECTION AND TEST PLAN


DESCRIPTION OF WORK / LOCATION 1 :
Item

Activity Description
*3

Extent
*4

Random
sampling

Controlling Document/
Method *5
Checked using adhesive
tape as ISO 8502-3:1992

FINAL INSPECTION AFTER INTERNAL BLASTING

5.1

Check Appearance/
Defect etc.

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01

Rev.No.

Rev.Date 10/04/12

Status

For Construction

Contractor
Responsible
Personnel *8

Verifying
Documents/
QCR's *9

PIPE INTERNAL BLASTING AT SHOP

5.

All Surface
within range of
vision

As above

Visual Check

Acceptance Criteria *6
[Applicable QC Work
Instruction No.]

Frequency *7

Responsibility
Category 10
DPS

JGC

DS

Max dust quantity rating : 2


and size class : 2

Min. once/during
& after surface
preparation work

Foreman,
QC Inspector,

Form-01.
JGC Doc. No.S900-13A0-001

No free water/water pond,


abrasive material residue,
contaminant etc. inside of
pipe.
Acceptable rating of flash
rust. Document ref. no. V31A0-001-A-022

Min once before


installing the
cover on both
end of pipe

Foreman,
QC Inspector

1. Form-01.
JGC Doc. No.S900-13A0-001

SW

I : Inspection 0;1H2 : Hold Point ; R : Review ; W : Witness ; SW : Spot Witness ; S : Surveillance


P-2

2. DPS-QCPFIBPROG

Donggi Senoro LNG Project


Inspection and Test Plan
For Pipe Internal Blasting

JGC Doc. No. V-31A0-001-A-043 Rev. 2


DPS Doc. No. DPS-DSLNG-QC-002 Rev. 2
Sheet No. 10 of 10
DPS Ref.
No.*2
Attachment

INSPECTION AND TEST PLAN


DESCRIPTION OF WORK / LOCATION 1 :
Item

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Activity Description
*3

Extent
*4

As above
01

Rev.No.

Rev.Date 10/04/12

Status

For Construction

Contractor
Responsible
Personnel *8

Verifying
Documents/
QCR's *9

PIPE INTERNAL BLASTING AT SHOP


Controlling Document/
Method *5

Acceptance Criteria *6
[Applicable QC Work
Instruction No.]

Frequency *7

Responsibility
Category 10
DPS

JGC

Note :
Description of Work/Location The particular work and its general location on site.
DPS Ref. No. The unique Document Registration Number of a specific ITP.
Activity Description Specific and sequential activities or the detailed work elements leading to the completion of the work.
Extent min. extent of the inspection shall complete in order to meet JGC requirement.
Controlling Documents The document(s) applicable to or related to the specific activity, which are used as a reference for conducting of inspections and tests as
mentioned in Project Quality Plan (Doc. No. V-31A0-001-A-041). The specifications, codes & standards, and local regulations, etc. with an identified section
No. to be applied to the inspection and test shall be referred to in conjunction with Inspection and Test Methods.
Acceptance Criteria The specific benchmark defined by the Project Document for acceptance of the work by Company, including the requirements and criteria
associated with local regulations and codes and standards.
Frequency The frequency of inspection, verification or testing that needs to be conducted for a particular activity.
Contractor Responsible Personnel The Contractors personnel directly responsible for the conduct of verification for the particular activity.
Verification Documents / QCRs This identify the QCR pro-forma inspection report form to be used to verify and record acceptance of the work activity.
Responsibility Category Use to identify the extent of involvement of each organization per activity in terms of :
Inspection I;

Review R ;

Hold Point H;

Spot Witness SW ;

Witness W ;

Surveillance S ;

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P-2

DS

Appendix-1
FORM NO. DPS-QCPF-IBIRS

INTERNAL BLASTING INSPECTION RECORD SHEET


Document

Job No
Client
Project Name
Area of Unit
Name of Substrate
( Equipment No. or Line
No. or Identification No.)

:
:
:
:
:

:
:
:

Cover both end of pipe

Abrasive Material Data


Material :
- Manufacture Name
- Product Name

Inspection Date and Time :


Start (Year, Month, Date, Time)
Finish (Year, Month, Date, Time)
Internal Pipe Surface Cleanless
Application Conditions
Atmospheric Temperature
Substrate Surface Temperature
Relative Humidity
Weather

2
3

Others
- Memo

Witnessed/Reveiwed by :

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IN7-SEP- 2

:
:
:
:

C
C
%

:
:

Signature :
Date
Inspected by

Sheet No.

DS
:
:

JGC

PT DPS

Appendix-2
FORM NO. DPS-QCPF-IBPROG

PT. DHARMA PRATAMA SEJATI


DS LNG Project
Cilegon Shop

INTERNAL BLASTING DAILY PROGRESS REPORT


Internal Blasting Work for Pipe
Report No. :

Date:

Other

Reducer

Cap

TEE

Elbow 45

Flange

Blind Flange

(m)

Pipe

Other

Elbow 90

Work Volume (M)

Pipe
Reducer

Cap

TEE

Elbow 45

Elbow 90

Blind Flange

Flange

DIA
Inch

Pipe

Description

HEAT NO.

No

SCH

SIZE

Item Quantity (ea)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL

Prepared by
PT. Dharma Pratama Sejati

Approved by
JGC

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IN7-SEP- 2
1

Work V (M)

Date

Job
Card.
No.

Appendix-3
FORM NO. DPS-QCPF-TFEC
Donggi Senoro LNG Project
PT Dharma Pratama Sejati
Job. No.

Date

Ref. No.

System No.

PCWBS

FWBS

TEMPORARY FACILITIES AND EQUIPMENT CHECK LIST


Purpose : [ ] for Commencement of Work
[ ] Demonstration/Test-run
Item
1. Permit

Check Point
[ ] Construction permit

Result
[ ] Accept
[ ] Reject

2. Plan

[ ] Overall Execution Plan

[ ] Accept

[ ] Work Method Statement

[ ] Reject

[ ] Work Instruction Procedure


3. Workshop

[ ] Enclosing of blasting/painting area

[ ] Accept

[ ] Ventilation for blasting/painting

[ ] Reject

[ ] Abrasive recycle
[ ] Lighting
[ ] Fire prevention/Fire extinguisher
[ ] Paint storage
[ ] Abrasive storage
[ ] .
4. Equipment Condition

[ ] Folk lift(s)

[ ] Accept

[ ] Compressor(s)

[ ] Reject

[ ] Blasting tank(s) & hose ass'y


[ ] Airless spray(s) & hose ass'y
[ ] Paint Mixer(s)
[ ] Generator Set(s)
5. Inspection Tool

[ ] Inspection Tool(s) & List

[ ] Accept

[ ] Calibration Certificate(s) & List

[ ] Reject

FINAL JUDGEMENT

Prepared by,
PT DPS

Approved by,
JGC

Approved by,
DS

________________
Date :

Date :

Date :

2
DR01A

P-2
IN
17-SE

[ ] Accept
[ ] Reject

Remarks

Appendix-4

FORM NO. DPS-QCPF-EQIR

Donggi Senoro LNG Project


PT Dharma Pratama Sejati
Job. No.

Date

Ref. No.

System No.

PCWBS

FWBS

EQUIPMENT INSPECTION REPORT

NO

QTY

IDENTIFICATION

CAPACITY

CONDITION

REMARKS

PREPARED BY
PT DPS

CHECKED BY
JGC

APPROVED BY
JGC

Date :

Date :

Date :

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IN7-SEP- 2
1

EQUIPMENT NAME

Appendix-5

FORM NO. DPS-QCPF-MLCA

Donggi Senoro LNG Project

Job. No.

PT Dharma Pratama Sejati

Report No.

Report Date

Sheet No.

MASTER LIST CALIBRATION

No

Equipt. No.

Prepared by
PT DPS

A
R
D
1
0
2
IN P- 2
Date :

17-SE

Brand Name

Location

Frequency

Calibration
Date

Calibration
Bureau

System No.

PCWBS

FWBS

Calibration Method

Tolerance

Verified by
PT DPS

Date :

Remarks

Appendix-6

FORM NO. DPS-QCPF-MTIA-1


Job. No.
Report Date
DN No.
Delivery Date
System No.
PCWBS
FWBS

MATERIAL INSPECTION ACCEPTANCE


(ABRASIVE MATERIAL)

Donggi Senoro LNG Project


PT Dharma Pratama Sejati

:
:
:
:
:
:
:

Sheet No.

DESCRIPTION
No.

Abrasive
Type

Brand Name

Supplier

of

VERIFICATION
Size

Unit

Qty

Packing

Contaminant

Size

Unit

Qty

Total
Qty

Received by
PT DPS

Verified by,
PT DPS

Approved by
JGC

Approved by
DS

Material Control
Date

QA/QC Officer
Date :

QC Manager
Date :

QC Manager
Date :

A
R
D
1
0
2
IN7-SEP- 2
1

Remark

Appendix-7

FORM NO. DPS-QCPF-BLTC


Donggi Senoro LNG Project

Job. No.

PT Dharma Pratama Sejati

Report Date

Record No.

System No.

PCWBS

FWBS

BLOTTER TEST
1. Test Date

3. Location

4. Item Test
5. Inspection Tools :
6. Method

8. Test Result

No oil discoloration on the collector; no water contaminant on the collector


Acceptance Criteria:
No oil discoloration on the collector; no water contaminant on the collector
Accept

9. Remarks

Test Carried out by:


QC

Date :

A
R
D
1
0
2
IN7-SEP- 2
1

Reject

Not Applicable

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