FLEET DIVISION

FORM
PERMINTAAN PERBAIKAN
Repair Order
Nama Kapal
Vessel
Bagian
Department
No. Permintaan
Requisition No.
Tanggal
Date
MERATUS MEDAN 2 DECK 01 23/06/2011
Nama Peralatan
Equipment Items
RADAR I ! RADAR 2 ! INMARSAT C
Mer"
T#$e
Type

N%& Ser#al Alat
Serial Number

V%lta'e/P(a)e
Pen*ela)an Ker+)a"an
Description
RADAR 1 , KANAN - TUNIN.N/A LEMA0
RADAR 2 , KIRI - SERIN. MATI SENDIRI
INMARSAT C ADDRES KIRIM! TIDAK SEMUAN/A TERKIRIM
1a"t+ $en2ele)a#an
Lead Time
Ur'ent
0ar#
Days
M#n''+
Weeks

Tan''al
Date

Peralatan 3#"#r#m 4er)ama 3en'an
Equipment sent with
No.
Nama Peralatan
Item
Jumlah
Quantity
Kondisi
Condition
No.
Nama Peralatan
Item
Jumlah
Quantity
Kondisi
Condition





Tan''al/ Date Tan''al/ Date Tan''al/ Date
Pem#nta $er4a#"an %le(!
Requested by
Nama/ Name
5a4atan/ Position
D#"eta(+# %le(!
cknowled!ed by
Nama/ Name
5a4atan/ Position
D#)et+*+# %le(!
ppro"ed by
Nama/ Name
5a4atan/ Position
Keteran'an
Remarks
6er# tan3a 7(e7" ,- $a3a "%ta" 2an' )e)+a#&
#i"e the check mark $% in the proper bo&'
5#"a "%l%m #)#an "+ran' ata+ a3a #n8%rma)# tam4a(an! (ara$
3#lam$#r"an lem4aran tam4a(ann2a&
I( there is lack in (illin! column or any additional in(ormation) please add the
additional pa!es'
C2l#n3er l#ner M/E 9 A/E t#3a" 4%le( 3#la) *#"a reta"&
*ylinder liner +,E - ,E must not be welded i( crack is (ound'
D#)tr#4+)#
Distribution
Or#'#nal Pener#ma Or3er ,4en'"el/ "%ntra"t%r-
.ob Recei"er $workshop, sub contractor%
C%$2 1 Pem4+at Or3er ,Ka$al/ 6a'#an Ter"a#t-
.ob Issuer $"essel, related department%
C%$2 2 Penan''+n' 5a:a4
Person In *har!e
Re;#)#%n / F#le / Fre< R2 / OV / SET D%7& N%& FRARM=SUP00>
Re;#)#%n Date 0?/06/2010 Pa'e 1 of 1
F%rmat N%! MRT@FR@STD&?&2@01&01
Re;#)#%n 2