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Form ATP H3I AKAH KLUNGKUNG
Form ATP H3I AKAH KLUNGKUNG
Tower Pedestal
Fence
ACPDB
KWH Meter
Foot Step ( if any )
[Name] [Name]
[Date] [Date]
[Signature] [Signature]
VISUAL CHECK
CABLE RUNWAY, CABLE TRAY, GLAND PLATE
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO. INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
Cable Runway
a. Horisontal type Firmly fixed
b. Vertical type Firmly fixed
c. Support & foundation Firmly fixed
d. Inner vertical riser Firmly fixed
1
e. Outer vertical riser Firmly fixed
f. Bracket Firmly fixed
g. Elbow Firmly fixed
h. Cable tee Firmly fixed
i. Nuts & Bolts Tightened
Wall-mounted Cable Tray
a. Horisontal type Firmly fixed
2
b. Vertical type Firmly fixed
c. Nuts & Bolts Tightened
Gland Plate / Breakthrough
a. Placement Conform
3
b. Height Conform
c. Frame Firmly fixed
Notes :
ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED
Name
Date
Signature
FUNCTIONAL CHECK
SUB DISTRIBUTION PANEL (SDP)
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
B FUNCTIONS TESTS
2 MCB for Devices to 'ON' Position Current flows to the end of MCCB
Notes :
ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED
Name
Date
Signature
VISUAL CHECK
SUB DISTRIBUTION PANEL (SDP)
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO. INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
Panel Components
5 Connections between cables and components, using Cable Shoes Firmly fixed / Conform
Notes :
ACC : ACCEPTED
RJT : REJECTED
Name
Date
Signature
VISUAL CHECK of AERIAL INSTALLATION
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
Vertical
Concrete base, 60 cm
7 Painting Conform
11 Miscellaneous
Notes :
ACC : ACCEPTED
RJT : REJECTED
NAME
DATE
SIGNATURE
VISUAL CHECK OF FENCE & LANDSCAPE
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO. INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
Fence and Gate
a. Fence foundation, doesn't have any crack or settlement. Conform
b. BRC panels ( D6 mm Hot Dip Galvanized ) & Posts are good Conform
1 c. Barbed Wire ( shall be 4 layers, galvanized ) are properly instal Conform
d. No corrosion and rust find on barbed wire Conform
e. Gate is properly installed Conform
f. No corrosion and rust find on gate and BRC fence. Conform
g. Correct lock and keys provided Conform
Landscape
a. Correct finished level Conform
2
b. Gravel bedding (t = 10 cm) Conform
c. No blocking on water drainage flows Conform
Access Road
a. Site is accessible by car or minivan in all but extreme weather Conform
4 b. No apparent signs of settlement or cracking Conform
c. Good Finish Conform
d. Effected 3rd Parties Confirm Acceptance Conform
Cleanness And Tidiness
5 a. NO trash and garbage arround and inside of site
b. NO excess materials left
Notes :
ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED
Name
Date
Signature
PUNCHLIST FOR ACCEPTANCE
Note: Major items on page 1, minor items on page 2
SITE ID 180713
Site Name AKAH KULNGKUNG
Region Jawa Timur
Sub Contractor
Completion date:
Signatures
C VERTICALITY CHECK
1 Verticality If tower not usable or safe If tower functional
PT. TOWER BERSAMA PT. BACH MULTI GLOBAL PT. HUTCHISON 3 INDONESIA
________________________
________________________ ________________________ NAME
NAME NAME ________________________
________________________ ________________________ DATE
DATE DATE
________________________
________________________ ________________________ SIGN
SIGN SIGN
GROUNDING CHECK
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO. INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
Control Pit
a. Pipe dia.4" Conform
1
b. Grounding pit cover Provided
c. Number of Control pit Conform
Control Box
2 a. Dimension ( )x( )x( ) cm Conform
b. Earthing busbar ( )x( )x( ) mm Conform
Grounding system
a. Placement Conform
b. Grounding rod : diameter : 5/8"; 4m long Conform
c. Ring Grounding cable BC 50 mm2 Conform
d. Air terminal busbar ( )x( )x( ) mm Provided Number : pcs
e. Connection between Grounding Rod & Grounding Cable CADWELD
f. Connection from Grounding Rod to Base Plate of Tower Done
g. Connection from fence to ring grounding cable Done
3 h. Connection from KWH Meter to ring grounding cable Done
i. Connection from Splitzen to Grounding Rod Done
j. Connection between busbar Done
k. Other grounding connections using Cable Shoes Conform, firmly fixed
l. Splitzen using Alumunium material with 2cm diameter and 60cm
Conform
length
m. Down conductor from splitzen using alumunium cable 70mm2 Conform
n. Using rubber isolator for clamp to the tower Conform
o. Busbar using alumunium material with dimension 300x100x16mm
Done
supporting with 2pieces of ceramics isolator
4 Grounding resistance < 1 ohm
Notes:
ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED
Date
Signature
Keys Function
Function
Keys Amount
OK NOT OK
1 ACPDB
2 KWH meter
3 Fence
Date
Signature
FOUNDATION OF OUTDOOR BTS
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO. INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
BTS Foundation
a. Foundation Conform
2 b. Pedestal / Chimny Conform
c. Finishing Firmly fixed / Conform
d. Painting Conform
3 Cable Tray under outdoor BTS Conform
Pole ACPDB Conform
a. Dynabolt Conform
4 b. Grouting Conform
c. Nuts & Bolts HTB / New / Tightened / Galvanized
d. Bracket ACPDB Conform
Notes :
ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED
* : Choose the suitable one
Name
Date
Signature
VISUAL & FUNCTIONAL CHECK
KWH METER
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
RESULTS
NO INSPECTION ITEMS CRITERIA REMARKS
ACC AWR RJT
b. Foundation of KWH Meter Pole, does't have cracks or settlement Firmly fixed / Conform
3 PLN Capacity
Notes :
ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED
Date
Signature