Bad performance Report

INSURANCE/NON INSURANCE
PLEASE REMARK IF Insurance claim

Site 2271874_Yos Sudarso

Linggau

Document Version: 1.0

Date: 25 OKT 2016

PT. HUAWEI SERVICES

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Incident Detail
Site ID 2271874
Site Name Yos Sudarso Linggau
Area Mgr / Region Southern West / Southern Sumatera
Date/Time Problem 25 Okt 2016
Incident Battery rectifier defect
TT / WO & Description :
CM-20161025-01882

Item name : Battery rectifier Powerfit FT110-12

Quantity : 2 bank / 8 pcs
Date evidence:
PR no

I. INCIDENT CHRONOLOGY (describe chronology incident based

on real condition)

Date/Time Description

Sulton Effendi CM site 2271874_Yos Sudarso linggau and Test Battery no

25 Okt 2016 / 12:40 WIB
backup Power PLN off

25 Okt 2016 / 12:40 WIB Romadona Measure battery by ebims

25 Okt 2016 / 12:40 WIB Battery broken satmid IR by Ebim

II. IMPACTED (describe impact of incident)

No backup power when PLN off

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III. DETAIL ASSET (describe detail of asset due incident)

Assert Stolen/Damage After Recovery

Impact Price

(per meter Price Material

NO Asset Name NE System Qty Material ID / unit) Total EWO EWO
Battery Powerfit BTS UL & OL &
1 3G 8

IV. DOCUMENTATION

Foto material site

Photo evidence Photo 1 ( material on site, photos open door) Photo 2 (material on site, including item)

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Before
Installation:

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Remark( If Photo
not complete)

After
Installation:

Remark( If Photo
not complete)

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Berita Acara Polisi/ Police Report

Remark:(If
Police
report not
available) :
PIC FOP Manager & GM

Name/ID : Name/ID:
Date & time : Date & time :

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