coreg sarc aa} PT PGAS SOLUTION Manufaktur Repair FORMULIR HASIL PENGULIA MAAN 01 ~—pgn FACTORY ACCEPTANCE TEST (FAT] RESULT LST ‘na Ke elt a6 Werk ree repeciot re Bel Votecal ara insole Seid . ara De TURE Ma owner 1 Zarar TR Mer ‘nspeitor eee ita vana Dinspats aces Inspedors gp tnspedied Patios E ‘A Informasl umum pellsanson penguien (General Information text execution) ‘Nama Watera/Perltan Wane of Material Equipment) lus #20 6.65 calon Planggan Mutt Saka act TN. Sei/ Type (No. series / Type) lus: a0ce5 PGAsora Nama Pabrikan (Manufoctrer Name) JPTPGAS SOLUTION WANUFAKTOR & REPAIR Referens Spestitas (References Specfeatons) :|pes.cre-mo.cs-002 den os-cTEPS-80-007 No. ProsedurPengulan (Testing Procedure No.) Jpoas-ca-asce-acr.PR-cod ens Penguin Testa Type) [Faction andesite 1. Pavamater Penerinaan (Aecepiance Gitera) Ursin (Desorption) Nii (Value satuan fit) fs _ | Reaulator a [2 _ | StumShat valve aa/aa [a _ [Meter Ey la | vane 5 [>_[Prv a2/aa (CHa Pengulian (Test Result) Satuan (nt) ‘Dierina Tak era (Accept/Rejec) Keterangan Remark) Is [Pew a2yaa er D.Keimpulen (Conduron) misas/orraer”” Trapelor Pak Rate (hi arty Ineoectr” Inspektor PN JPN inspector), Note kad (fan)0-003/0.52/F03 Revisi: 0 ge PT PERUSAHAAN GAS NEGARA Tbk PT PGAS SOLUTION Manufaktur & Repair BERITA ACARA PENGUJIAN DAN PENERIMAAN DI PABRIK (FACTORY ACCEPTANCE TES TAHUN 2019 psn PT PGAS SOLUTION No. Pada hari ini Senin tanggal Empat bulan Februari tahun Dua Ribu Sembilan Belas, telah selesai dilaksanakan Pengujian dan Penerimaan di Pabrik / FAT oleh Fungsi Pemeriksa/Penguji untuk material peralatan: (On this day, Monday date Four month February year Two Thousand Nineteen have been conducted Factory Acceptance Test / FAT by Examiner Function for materiaV/equioment:) RONG ‘Slum shut valve Regulator, Meter. Valve PRV Pengujian dan Penerimaan di Pabrik / FAT tersebut dilaksanakan pada tanggal Senin 4 Februari 2019 yang berlokasi di Manufaktur & Repair, Jin.Swadaya PLN no.5 Klender dengan hasil sebagai berikut: (Factory Acceptance Test/ FAT has been conducted Monday 4 February , 2019 which is located in Manufacturing & Repair, Jin.Swadaya PLN no.6 Klender with the following results: Nilai Nama Material’ | 6 sens 7 : pias DiterimarTidak} Keterangan / Wo. |, Pemaaian | No_Seti pe | wenis | Pena | coun | Diora | \Roterona (Name of Material/ Type) (Test Type) | (Test (Unity (Accept | (Description / Equipment) Result Reject) Reference) Value) hi} Slum shut valve | 14/25.596-8 Fuction [4.1/1.1 Bar Acc 2. Regulator 415/34.153-4 Fuction 4/1 Bar Acc 3._| Meter 150570 Fuction 20 Bar Acc 4._| Valve VT 14048-15 cd = - = 5. | PRV 15/28251-10 Fuction | 4.2/4.2 Bar Acc. jo. Catatan Punch List ( Punch | og) Punch list els|alz Demikian Berita Acara ini dibuat untuk dapat digunakan sebagaimana mestinya. (This minute of inspection are made to be used accordingly) Performed By PT PGAS Solution Manufacturer & Repair Witness By PT. PGAS Solution Project Internal Regional PT.PGN (PMO) ¢o-ccanszro: ant é 7 PGAS SOLUTION Nanay Ropar "i DAFTAR ane psn gn era aan = == ona ee = = re auheca i moe Fag = Sen | Saesoeee [ae ina 2 Moers |:2 ia eile Teo : pester eat FeTac narta ear Searecpaaans ceanegerie .| Rena | amare eae = qn cea Inspaksl dlatukan berdasa instrukstertulls 3a v Inspections hosed on test struction Tnstruks tertuleteredia di lokael kerja ispetor °? | rorcinsroatonareoriabieaewok = | V location Has inspata ai deta dan aa | ehumentastam 7 Fina resis of specion oe recorded and documented 7 | etesedurinspet onto Tevel2 Inspestion Procedures forlevel2 42 | setstelltutenbersarinstrtl trae | 7 Inspections based on tat traction Memerksa barang dotang eau dengan purchase order, spesias dan/atau 1a | entertains Vv °" | Inspect incoming materials comply with purchase oder, specication end or technic drain. Mil reports, Inspecion Repos NOE Reporte dan sertit creview Kesesuannya 4° amemrhoceramecmamear| Vv dnd certifies tobe reviewed for componce. \aporan-aporan dan sett ateral mampu tlusur v "Waterial traceability reports and | cercieates Perbedsan dapat iinet pada ctatan penetimaan v record ‘Mater dtandai dengan REIECT ou 46 | once v “Meter marke wit RETF or CE 4“ 4s