No.

FC-CPPI-08 -27 Rev : 05

Effective date : 30 Jan 2 014

INSPECTION CERTIFICATION MONITORING

;
Divisi : PT. CPPI
Type Of Inspection : Heavy Equipment
Month : April 2019
Duration Remarks
No Equipments name Capacity Qty Certificate number Location Last Inspection Next Inspection
(Year)
1 Forklift diesel truck 3 Ton 1 PAA04 001 07 February 2018 PT. CPPI January 7, 2019 1 Year Waiting Certificate Sn.F14E-30627 Disnaker
Mitsubishi
FD30NT
2 Forklift diesel truck 3 Ton 1 PAA04 003 24 Januari 2018 PT. CPPI January 7, 2019 1 Year Waiting Certificate Sn. F14E-10014
Mitsubishi Disnaker
FD30NT

3 Forklift diesel truck 3 Ton 1 PAA04 002 24 Januari 2018 PT. CPPI January 7, 2019 1 Year Waiting Certificate Sn. F14E-10013
Mitsubishi Disnaker
FD30NT
4 Forklift diesel truck 3 Ton 1 161 / PA-1/ SKPP/ 18.05/ DJM.T/ PT.CPPI Feb 23, 2016 3 Year MRV Progress Sn. CF 14E – 15932
Mitsubishi 2016 PT. CPPI March 20, 2018 1 Year March 20, 2019 Migas
FD30NT PAA04 6 20 – 3 – 2018 Disnaker
432 – BMC/1464-K14/P5/0418-
PAA-3
5 Forklift diesel truck 3,5 Ton 1
Sn. F14E-50452
Mitsubishi PAA04 2 10 – 9 - 2018 PT. CPPI Sept 10, 2018 1 Year Sept 10, 2019
DISNAKER
FD35AAT
6 Forklift diesel truck
Mitsubishi Sn. F28B-50487
5 Ton 1 PAA04 1 10 – 9 - 2018 PT. CPPI Sept 10, 2018 1 Year Sept 10, 2019
FD50KT DISNAKER
 INSPECTION CERTIFICATION MONITORING

7 Forklift electric reach truck 1.5 Ton 1 PAA04 5 20 – 3 – 2018 PT. CPPI March 20, 2018 1 Year March 20, 2019 Sn. 1A.345.202
432 – BMC/1464-K14/P5/0418- Waiting Certification
Crown RR 5210-35 Disnaker
PAA-2
8 Electric Forklift NICHIYU 700 Kg 1 PAA04 4 20 – 3 – 2018 PT. CPPI March 20, 2018 1 Year Waiting Certificate Sn. 121940835
432 – BMC/1464-K14/P5/0418-
PAA-1
9 Wheel Loader 5 Ton 1 666/ PA-1/ SKPP/ 18.05/ DJM.T/ CPPI July 11, 2017 3 Year June 12, 2020 Sn. 175839/ 01
LIU GONG 2017 Migas
CLG 856 DISNAKER
( Sertifikasi MIGAS )
10 Wheel Loader 5 Ton 1 PAA04 08 16 – 5 – 2018 CPPI May 16, 2018 1 Year May 16, 2019 Sn. 176822/ 02
LIU GONG Disnaker
CLG 856
11 Wheel Loader 5 Ton 1 PAA04 09 16 – 5 – 2018 CPPI May 16, 2018 1 Year May 16, 2019 Sn. 1205538/ 03
LIU GONG Disnaker
CLG 856
12 Wheel Loader 5 Ton 1 PAA04 7 19 - 4 2018 CPPI April 19, 2018 1 Year Waiting Certificate Sn. WL1205363 / 04
DISNAKER
LIU GONG 435 – BMC/1464-K14/P5/0418
CLG 856

13 Truck Mounted Crane 3 Ton 1 PAA01 5 1 – 3 - 2016 PT.CPPI March 1, 2016 1 Year March 1, 2017 Sn. 8203
HIAB 1265 AW 0325-BMC/1464-K14/P5/ 0414- 2 ( Tidak disertifikasi/ Rusak )
BP 9184 ZN

14 Truck Mounted Crane 6 Ton 1 PAA01 6 1 – 3 - 2016 PT.CPPI March 1, 2016 1 Year March 1, 2017 Sn. 8400
FERRARI 197-2 0325-BMC/1464-K14/P5/ 0414- 4 6400
BP 8548 DX ( Tidak disertifikasi/ Rusak )

15 Truck Mounted Crane 7 Ton 1 PAA01 1 4 – 11 - 2016 PT. CPPI Nov 04, 2016 1 Year Nov 04, 2017 Sn. 3485
HIAB 260-AWB 2 Disnaker
 INSPECTION CERTIFICATION MONITORING

BP 9864 ZB ( Tidak disertifikasi/ Rusak )

16 Truck Mounted Crane 7 Ton 1 PAA01 6 18 – 08 - 2015 PT. CPPI August 18, 2015 1 Year August 18, 2016 Sn. 5098
HIAB 260-AWB 2 Disnaker
BP 9646 ZB ( Tidak disertifikasi/ Rusak )

17 Truck Mounted Crane 8 Ton 1 PAA01 3 1 – 3 - 2016 PT.CPPI March 1, 2016 1 Year March 1, 2017 Sn. 5177
HIAB 260-AWB 3 0325-BMC/1464-K14/P5/ 0414- 3 ( Tidak disertifikasi/ Rusak )
BP 9353 ZN

18 Truck Mounted Crane 10/ 7 Ton 1 PAA01 4 1 – 3 - 2016 PT.CPPI March 1, 2016 1 Year March 1, 2017 Sn. 5097
HIAB 260-AWB 2 0325-BMC/1464-K14/P5/ 0414- 1 ( Tidak disertifikasi/ Rusak )
BP 9909 ZD

19 Crawler crane 50 Ton 1 663/ PA-1/ SKPP/ 18.05/ DJM.T/ CPPI July 14, 2017 3 Year June 11, 2020 2007027
XCMG QUY 50 2017 Tahun 2007
(SERTIFIKAT MIGAS )

20 Crawler crane 50 Ton CPPI February 28, 2019 1 Year Waiting Certificate 2007050
XCMG QUY 50 1 CC-0505-0433
Tahun 2007 ( Crane Rusak )

21 Crawler crane 50 Ton PAA01 2 22 – 3 - 2018 CPPI March 22, 2018 1 Year Waiting Certificate CC- 0505- 0434 / 2007051
XCMG QUY 50 1 Tahun 2007
DISNAKER

22 Mobile Crane / Zoomlion 55 Ton 1 744 / PA- PT. CPPI Sept 09, 2017 3 Year Sept 09, 2020 Sn. RT 55 – 01 – CPPI / RTT 55 –
Heavy Industry 1/SKPP/18.05/DMJ.T/2017 0155
MIGAS

PAA01 3 24 – 9 - 2018 Sept 24, 2018 1 Year Sept 24, 2019 DISNAKER
 INSPECTION CERTIFICATION MONITORING

23 Crawler crane 100 Ton 1 PAA01 7 23 – 10 - 2017 CPPI January 29, 2019 1 Year Waiting Certificate 2007004
XCMG QUY 100 Tahun 2007
DISNAKER

24 Crawler crane 135 Ton 1 664/ PA-1/ SKPP/ 18.05/ DJM.T/ CPPI July 11, 2017 3 Year June 11, 2020 GN03-02028
KOBELCO 2017 Tahun 2006
CKE 1350-IF (SERTIFIKAT MIGAS )

25 Crawler crane 250 Ton 1 665/ PA-1/ SKPP/ 18.05/ DJM.T/ CPPI July 11, 2017 3 Year June 08, 2020 JD 04-02022

KOBELCO 2017 Tahun 2006

(SERTIFIKAT MIGAS )
CKE 2500-2

26 Crawler crane 250 Ton 1 PAA01 1 21 – 3 – 2018 SCN March 21, 2018 1 Year Waiting Certificate JD 04-02014
KOBELCO 432-BMC/ 1464-K14/ P5/ 0418- Tahun 2006
CKE 2500-2 PAA-4

28 Sany Heavy Industry Co Ltd 45 Ton 1 PAA04 3 – 17 – 10 - 2018 SCN October 17, 2018 1 Year October 17, 2019 Sn. 13RS45300126
DISNAKER
SRSC45C30

29 Sany Heavy Industry Co Ltd 45 Ton 1 PAA04 4 – 17 – 10 - 2018 SCN October 17, 2018 1 Year October 17, 2019 Sn. 13RS45300130
DISNAKER
SRSC45C30

Batam, 05 May 2019

Disusun Oleh : Diketahui Oleh

( Febriyatno / Hajrat ) ( Sudarno )

Safety Man HSE Koordinator & AK3