site id 180713

Site Name AKAH KULNGKUNG

Alamat Dusun Gede Desa Akah Kecamatan Klungkung,Klungkung-Bali
Heigh 52 M
 EARTHING AND LIGHTNING PROTECTION CERTIFICATE

Project : Date Performe : __________________________________

Site Name : AKAH KULNGKUNG Site Address :
Dusun Gede Desa Akah Kecamatan
Test Instrument : Klungkung,Klungkung-Bali

Test Method : Tester's Name : __________________________________

TEST POINT RESULT (OHMS) REMARKS

Tower Pedestal
Fence

Outdoor BTS Foundation

Main Busbar
Cable Tray

ACPDB
KWH Meter
Foot Step ( if any )

PT. TOWER BERSAMA PT. BACH MULTI GLOBAL

[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

PT. TOWER BERSAMA: PT BACH MULTI GLOBAL: MANAGED SERVICE :

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

A VOLTAGES MEASUREMENTS form KWH to SDP

1 R - N Cable : Volt BTS ± 10% / MSC,BSC, HUB ± 5%

S - N Cable : Volt BTS ± 10% / MSC,BSC, HUB ± 5%

T - N Cable : Volt BTS ± 10% / MSC,BSC, HUB ± 5%

2 R - S Cable : Volt BTS ± 10% / MSC,BSC, HUB ± 5%

R - T Cable : Volt BTS ± 10% / MSC,BSC, HUB ± 5%

S - T Cable : Volt BTS ± 10% / MSC,BSC, HUB ± 5%

3 G - N Cable : Volt < 3 volt

B FUNCTIONS TESTS

Current flows to the MCCB for Devices

1 MCB in the SDP to 'ON' Position
R, S & T Indicator Lamps are lit

2 MCB for Devices to 'ON' Position Current flows to the end of MCCB

3 KWH meter Spin normally

Notes :

ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED

PT. TOWER BERSAMA: PT. BACH MULTI GLOBAL: MANAGED SERVICE :

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

1 Panel Dimensions :( ) x ( )x( ) Conform

2 Painting Neat / Conform

Panel Components

a. MCCB / MCB (Input) : ………….……A, ………….……pcs Firmly fixed / Conform

3 / 1 phases * : ………….……A, ………….……pcs Firmly fixed / Conform

3 / 1 phases * : ………….……A, ………….……pcs Firmly fixed / Conform

3 / 1 phases * : ………….……A, ………….……pcs Firmly fixed / Conform

3 3 / 1 phases * : ………….……A, ………….……pcs Firmly fixed / Conform

b. Arrestor : Firmly fixed / Conform

c. Lamps : Firmly fixed / Conform

d. KWH meter : Firmly fixed / Conform

e. MCCB/COS at MDP : A Firmly fixed / Conform

f. Power Cable from MDP-SDP 4 x …………...……mm2 Firmly fixed / Conform

4 Wiring Diagram at the back of the Panel Door Provided

5 Connections between cables and components, using Cable Shoes Firmly fixed / Conform

Notes :

ACC : ACCEPTED

AWR : ACCEPTED WITH REMARKS

RJT : REJECTED

* : Choose the suitable one

PT. TOWER BERSAMA: PT. BACH MULTI GLOBAL: MANAGED SERVICE :

Name

Date

Signature
 VISUAL CHECK of AERIAL INSTALLATION

SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :

Pole to Pole (span) Remarks

NO. INSPECTION ITEMS CRITERIA ACC / AWR / RJT
1 2 3 4
1 Daya PLN KVA
Free from any obstacle
2 Cable route / position
(e.g. trees )
Ground level clearance
3 (High Pole - (1.5+ 0.2)) m
(minimum)
4 Pole distance (span) <50 m

5 Stay wire/over head guy First pole, End pole

6 Placement of Pole Depth 0.2 x length

Vertical

Concrete base, 60 cm

7 Painting Conform

8 Cable sag 50-80 cm

9 Pole bracket, turn buckle, Firmly fixed, 30 cm fr top

10 Pole strap with dist. Ring, Firmly fixed,10 cm fr top

11 Miscellaneous

Notes :

ACC : ACCEPTED

AWR : ACCEPTED WITH REMARKS

RJT : REJECTED

PT. TOWER BERSAMA : MANAGED SERVICE :

PT. BACH MULTI GLOBAL:

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

PT. TOWER BERSAMA: PT BACH MULTI GLOBAL: MANAGED SERVICE :

Name

Date

Signature
 PUNCHLIST FOR ACCEPTANCE
Note: Major items on page 1, minor items on page 2

Site ID Number : 180713 TBG & E Representative …………………………………….. Clearance Confirmed

Site Name : AKAH KULNGKUNG Signature …………………………………….. Date …………………
PT. Bach Multi Global Representative …………………………………….. PT. Bach Multi Global
Subcontractor : Tower Bersama Group Signature …………………………………….. Manage Service as
Total Number of Defects Listed…………………. PT. Bach Multi Global Manage Representative …………………………………….. H3I Representative
Date of Check…………………………………….. Signature …………………………………….. ………………………

1) MAJOR ITEMS - list all items ticked as major deficiency on checklist

Target Date Clearance

Method of
Item Description Proposed Remedy To be filled
Verification Date
within 24 hours Manage Service
Revisit
1
Photo
Revisit
2
Photo
Revisit
3
Photo
Revisit
4
Photo
Revisit
5
Photo
Revisit
6
Photo
Revisit
7
Photo
Revisit
8
Photo
Revisit
9
Photo
Revisit
10
Photo
2) MINOR ITEMS - list all items ticked on checklist as minor deficiency
 Target Date Clearance
Method of
Item Description Proposed Remedy To be filled
Verification Date
within 24 hours Manage Service
Revisit
1
Photo
Revisit
2
Photo
Revisit
3
Photo
Revisit
4
Photo
Revisit
5
Photo
Revisit
6
Photo
Revisit
7
Photo
Revisit
8
Photo
Revisit
9
Photo
Revisit
10
Photo
Revisit
11
Photo
Revisit
12
Photo
Revisit
13
Photo
Revisit
14
Photo
Revisit
15
Photo
Revisit
16
Photo
Revisit
17
Photo
Revisit
18
Photo
Revisit
19
Photo
Revisit
20
Photo
 Electrical and Grounding Testing Checklist

SITE ID 180713
Site Name AKAH KULNGKUNG
Region Jawa Timur
Sub Contractor

Survey and Design Activities CME Supervisor MS Approval

General Condition of existing electrical equipment

Existing PLN condition
Existing ACPDB panel condition
Circuit breaker overload current rating, fault current rating,
identification labels / door table

Earth Connection on busbar, tower leg, fence

Existing grounding arrangement - check ohmic value, max
allowed Value < 1ohm

Earth electrode connection

Spare lug capacity in Earth Bar
Check alarm Panel Condition
Update as built drawing
Add field design comments to drawing
Temperature level of Air Conditioner unit at 25º C

Completion date:

Signatures

PT. TOWER BERSAMA Manage Service

Revision number: 01 11 Document title: Electrical and Grounding Testing Checklist

Date of issue: February 17, 2010 of Document number: 132387X/WP1/09-9.24
References: Site RFI M9 18 Release status: Released
 SITE INSPECTION PUNCH LIST - GREENFIELD
SITE ID : 180713
SITE NAME : AKAH KULNGKUNG
TYPE OF SITE :
TOWER HEIGHT : 52 M
ACCEPTANCE DATE :
NO. INSPECTION ITEMS RESULTS Deficiecy for Conditional Acceptance
ACC MAJOR MINOR Major Minor
A VISUAL CHECK OF TOWER
I FOUNDATION
1 Dimensions If major deviation frm design If no structural significance
2 Concrete If cube test fails If cosmetic deficiency
3 Anchor If effect structural significance
4 Finishing Works If effecting footing If no structural significance
II STEEL STRUCTURE
1 Base Plate If effecting structural integrity If bolts tight and rectification
possible afterwards
2 Bordes Plate If effecting structural integrity If bolts tight and rectification
possible afterwards
3 Ladder & Bracket If tower not accessible Minor if it can be rectified after
equipment installed.
4 Welding If effecting structural integrity If bolts tight and rectification
possible afterwards
5 Holes If effecting structural integrity If bolts tight and rectification
possible afterwards
6 Galvanizing Thickness Minor
7 Nuts & Bolts If effecting structural integrity If bolts tight and rectification
possible afterwards
8 Spring & Plate Ring If effecting structural integrity If bolts tight and rectification
possible afterwards
9 Tower members If effecting structural integrity Minor if it does not threaten
safety or integrity
10 Painting (if any) Minor
II ACCESSORIES
1 Lightning Protection Normally major If providing suitable protection
and rectification possible
2 Obstruction Warning Light If all OBL not functional If at least the top or singular OBL
is functional
3 Automatic Switch Minor
4 Yard Lamp Functionality Minor
5 Identity Plate Minor

B BOLT TIGHTENING TORQUE

1 M24 Minor
2 M20 Minor
3 M16 Minor
4 M12 Minor

C VERTICALITY CHECK
1 Verticality If tower not usable or safe If tower functional

D FOUNDATION & BASE FRAME (Outdoor Equipment)

1 Type of Foundation 2G / 2G & 3G * if not usable If suitable rectification possible
afterwards
2 Base Frame If structure not stable or ifStructure stable and rectification
Foundation rectification not possible possible afterwards
3 Cable Tray Under Base Frame Minor
4 Base Frame If replacement of major element If suitable rectification possible
required afterwards
5 Pole ACPDB if not usable If suitable rectification possible
afterwards

E FOUNDATION & BASE FRAME (Outdoor Equipment)

1 Cable Runway If installation not possible If fixable
2 Wall-mounted Cable Tray If installation not possible If fixable

F SUB DISTRIBUTION PANEL (SDP)

I VISUAL CHECK
1 Panel Dimensions Minor
2 Painting Minor
3 Panel Component If not functional if fixable
4 Wiring Diagram at the back of the Panel Door Minor
5 Connections between cables and components, using Cable Shoes If not functional if fixable
6 Cable for RST alarm (enva) is provided to DDF if not provided
II FUNCTIONAL CHECK
1 Voltages Measurements from KWh to SDP Normally Major
2 MCB Function Normally Major
3 KWh Meter Function Normally Major
4 Relay RST alarm in acpdb is working If not functional
5 RST Voltage if out of 10% tolerance
G VISUAL & FUNCTIONAL CHECK KWH METER
1 KWh Meter Pole if not usable If suitable rectification possible
afterwards
2 KWh Meter Box Minor
3 PLN Capacity If operation effected If operation not effected
H VISUAL CHECK OF AERIAL INSTALLATION
1 Daya PLN If operation effected If operation not effected
2 Cable Route / Position Minor
3 Groud Level Clearance Minor
4 Pole Distance (span) Minor
5 Stay Wire/ Over Head Guy Minor
6 Placement of Pole Minor
7 Painting Minor
8 Cable Sag Minor
9 Pole Bracket. Turn Buckle Minor
10 Pole Strap with Dist. Ring Minor
11 Miscellaneous Minor
I VISUAL CHECK of TRAFO & ACCESSORIES
1 Daya PLN If operation effected If operation not effected
2 Trafo If operation effected If operation not effected
3 Pole and Support for Trafo Minor
4 Trafo Frame Minor
5 Panel for 3 Phase Trafo If operation effected If operation not effected
6 Isolator If operation effected
7 Piping Minor
8 Cabling & Connecting If operation effected
9 Grounding Resistance If operation effected
10 Accessories Minor
11 Protection Assembly If cannot be made secure If can be made secure
12 Miscellaneous Minor
J GROUNDING CHECK
1 Control Pit Minor
2 Control Box Minor
3 Grounding System Normally Major
4 Grounding Resistance Normally Major
K VISUAL CHECK OF FENCE & LANDSCAPE
1 Fence and Gate If site can not be made secure if site can be made secure
2 Landscape If major settlement with if minor isolated areas of
possibility of structural damage settlement
3 Access Road If BTS Installation effected If BTS Installation not effected
4 Cleanness and Tidiness Minor
L FIRE ALARM PROTECTION
I VISUAL CHECK
1 Control Panel Minor
2 Electrical Installation Minor
3 Detectors Minor
4 Bell/ Horn Minor
5 Portable Extinguisher Minor
6 Cabling and Labels Minor
II FUNCTIONAL CHECK
1 Control Panel If operation effected If operation not effected
2 Zone Detector If operation effected If operation not effected
M KEYS FUNCTION
1 ACPDB Provision Post ATP
2 KWh Meter Provision Post ATP
3 Fence/Gate Provision Post ATP
N POWER GENERATOR
I VISUAL CHECK
1 Genset Data Minor
2 Capacity Minor
3 Area Around The Generator Ventilated Minor
4 Genset Installation Minor
5 Genset Capacity Minor
6 Genset Base Frame Minor
7 Exhaust Pipe (knalpot) System Minor
8 Oil Level Minor
9 Genset Body Grounding Minor
10 External Tank Minor
11 Genset Leakage Test Minor
12 Fuel Indicator Minor
13 Doors of Generator Set Minor
14 Main Fuel Tank Leakage Test Minor
15 Grounding Minor
16 Tag Labelling Minor
17 Site Keys Minor
18 Cleanness and Tidiness Minor
II FUNCTION TEST
1 MCB PLN Normally Major If fixable/replaceable
2 MCB Genset Normally Major If fixable/replaceable
3 Genset Functional Test - Manual Starting Normally Major
4 Genset Measurement If genset not functional
5 AMF (Automatic Main Failure) - Automatic Genset Starting Normally Major
6 Genset Shutdown System Normally Major
7 Turn off the genset by using starter key Normally Major
8 Genset Grounding Resistance Normally Major
O SHELTER CHECKLIST (Indoor Equipment)
1 Shelter Dimensions If not fit for use If compatible
2 Shelter Floor Major if not done Minor if small defects can be
rectified afterwards
3 Shelter Inner and Outer Wall If rectification not possible If minor defects that can be
afterwards corrected afterwards
4 Shelter Plafond and Roof Minor
5 Awning above The Shelter Door Minor
6 Shelter Doors (Indoor and Outdoor) If door cannot be locked If door can be locked and
replacement possible later
7 Shelter Bonding Major if water ingress likely Normally minor
8 Shelter Painting Minor
9 Shelter Illumination Minor
10 Outlets within Shelter Major changes effecting use or Minor changes not effecting use
stability of stability
11 Switches within Shelter Major changes effecting use or Minor changes not effecting use
stability of stability
12 Cable Installation within Shelter Major changes effecting use or Minor changes not effecting use
stability of stability
13 Shelter Exhaust Fan (DC) Major changes effecting use or Minor changes not effecting use
stability of stability
14 Shelter Thermostat Major changes effecting use or Minor changes not effecting use
stability of stability
15 Shelter Drainage Minor
16 All Environment Alarm (MGW/MSC/BSC ONLY) If not functional
P AIR CONDITIONER
I VISUAL CHECK
1 Placement If not functional If minor defects that can be
corrected later
2Appearance of Indoor Cabinet/Fins & Outdoor Unit Minor
3aTechnical Data Indoor Unit Minor
3bTechnical Data Outdoor Unit Minor
4Electricity and Piping Installation If deemed unsafe If functional
5Switches If not functional If compatible
6Remote Control & Its Fitting Minor
7Refrigerant Pipes Insulation if effect AC function if not effect AC function
8Condensation-Water Drainage System If draiange from shelter not workin If drainage is effective
II TRIAL OPERATIONS TESTS
1 Air Flow Adjusting Button If not functional Compatible/replaceable
2 Room Temperature Adjusting button If not functional Compatible/replaceable
3 Input Voltage Major changes effecting use or Minor changes not effecting use
stability of stability
4 Temperature Major
III FUNCTION TEST
1 On/Off Button If not functional If minor defects that can be
corrected later
2 Auto Restart Major
3 Timer Minor

RESULT OF INSPECTION NOTE

Site approved for Conditional Acceptance. Accepted on condition:
Major Deficiency = …………… items. 1) No major deficiency items
Minor Deficiency = …………… items. 2) No more than 20 minor deficiency items
Agreed Punch List is Attached. 3) Punch List Completed

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

PT. TOWER BERSAMA: PT. BACH MULTI GLOBAL: MANAGED SERVICE :

Name

Date

Signature
 Keys Function

Function
Keys Amount
OK NOT OK

1 ACPDB

2 KWH meter

3 Fence

PT. TOWER BERSAMA : PT BACH MULTI MANAGED SERVICE :

GLOBAL:
Name

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

1 Type of Foundation 2G / 2G & 3G * Conform

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

PT. TOWER BERSAMA : PT BACH MULTI GLOBAL: MANAGED SERVICE :

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

1 KWH Meter Pole

a. KWH Meter Pole properly installed Diameter 3" , 6 m long

b. Foundation of KWH Meter Pole, does't have cracks or settlement Firmly fixed / Conform

c. The position is correct Conform

d. Wiring Diagram at the back of the Panel Door Provided

2 KWH Meter Box

a. KWH Meter Box at correct position

b. The earthing cable is properly connected and has right size

c. KWH Meter Panel in good condition (no obvious scratches,cracks)

d. Outgoing Cables to sub-meters NYY/NYFGBY 4x16 mm2, in duct)

e. KWH Meter is sealed by PLN Properly

3 PLN Capacity

a. PLN Power capacity (10.5 / 13.2 / 16.5 / 23.1*) KVA

b. All 220 VAC cables are properly connected

Notes :

ACC : ACCEPTED
AWR : ACCEPTED WITH REMARKS
RJT : REJECTED

* : Choose the suitable one

PT. TOWER BERSAMA: PT. BACH MULTI GLOBAL: MANAGED SERVICE :

Name

Date

Signature