DEVIATION REPORT KALTIM-5 PROJECT

Attn. CC. : Mr. Yiyik Wibowo (IKPT-Toyo GSM) : Mr. Jakub Tarigan (PM Kaltim-5) REPORT NO DATE PAGE : : 31 Oktober 2013 : 1 OF 1

A. ITEM NO. / LINE NO. / ITEM NAME STG - 2, field instrument installation at run-down tank

B. DESCRIPTION OF DEVIATION * No maintenance / operational access for installation of field instruments

C. ACTION TO BE TAKEN * Provide access for maintenance and operational activities

D. PHOTO / SKETCH * Attached

E. RESULTS ACCEPTED (DATE : NOT ACCEPTED (DATE : PREPARED BY

) ) APPROVED BY

Rachmadi I.

Wahyuda PJS

ATTACHMENT PHOTO / SKETCH (IF NEEDED)

PT-6731

DEVIATION CONTROL LIST KALTIM-5 PROJECT

DATE : NO REPORT NO ITEM NO/LINE NO DESCRIPTION ISSUED DATE RESTORATION COMPLETION DATE SHEET NO. DICIPLINE IN CHARGE

: STATUS