Form List: No. Description Responsibility

FORM LIST
No. Description Responsibility

1 Daily Schedule
2 Request Work
3 Daily Report
4 Joint Inspection Report
5 Weekly Progress Report
6 Weekly Material and Equipment Report
7 Weekly Activity and Man Power Report
8 Monthly Progress Report
9 Monthly Material and Equipment Report
10 Monthly Activity and Man Power Report
11 Check List For Stone Masonry Work
12 Check List For Concrete Work
13 Deflect Work Report
14 Weekly Weather Report
15 Monthly Weather Report
Form No.
01
02
03
04
05-1 - 05-9
06
07
08-1 - 08-9
09
10
11
12-1 - 12-2
13
14
15
Form: 01
SATUAN KERJA NON VERTIKAL TERTENTU
PENGENDALIAN BANJIR LAHAR GUNUNG KELUD DAILY SCHEDULE
CONSULTANT: PROJECT : CONTRACTION/REPAIR OF SABO DAMS FOR
REHABILITATION OF MT. KELUD URGENT
NIPPON KOEI CO., LTD SABO PROJECT
AND ASSOCIATION
CONTRACT : Package 5
CONTRACTOR: LOCATION :
WASKITA NINDYA WEEKS : DATE:
Joint Operation
DATE : SHEETS:
(JO)
TO ENGINEER TO CONSULTANT
- Ass. Manager for Technical SNVT :
- Laboratorium : 1
- Survey : 2
- Planning : 3
- Ass. Manager for Construction and Program : 4
- Sub Project Manager for Package 5 :
APPROXIMATE
NO KIND OF ACTIVITY LOCATION REQUEST
QUANTITY
Approved by: Checked by: Prepared by:

SATUAN KERJA NON VERTIKAL TERTENTU Supervision Consultant Contractor
PENGENDALIAN BANJIR GUNUNG KELUD NIPPON KOEI CO.,LTD And Ass. Waskita - Nindya JO
-------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

NIP : Construction Engineer Project Manager
REQUEST AND APPROVAL
SATUAN KERJA PENGEMBANGAN INFRASTRUKTUR PERSAMPAHAN PROYEK : PEMBUATAN BANGUNAN SARINGAN SA

DAN SANITASI GERBANGKERTOSUSILO (TRASHRACK), MEKANIKAL ELEKTRIKA
KONSULTAN : PENGADAAN GENZET & PEK. SIPIL LAIN
PT. WAHANA ADYA DI KAWASAN TAMBAK WEDI
Engineering Consultant
KONTRAKTOR : LOKASI : Kenjeran - Surabaya

MINGGU : 3
WASKITA KARYA (Persero) :
TANGGAL 20 - 9 - 2007
No. IJIN KERJA :
Item Pekerjaan : No. Item Pekerjaan: II.B.1Tiang Pancang f 45 dan Pemancangannya
Volume:
Tiang Pancang f 45 dan Pemancangannya 660 m'
Daftar
Peralatan Tenaga Kerja Bahan - Bahan
No. Uraian Jumlah No. Jabatan Jumlah No. Bahan
1 Ponton 1 Unit 1 Operator Pancang 2 Orang 1 Tiang Pancang

2 Gantry Crane 1 Unit 2 Pembantu Pancang 4 Orang incl. tip plate &
3 Electric Hammer 1 Unit 3 Mekanik 2 Orang joint plate
4 Mesin Las 1 Unit 4 Welder 2 Orang 2
5 5 3
6 6 4
Catatan :
Menyetujui : Diperiksa :
Satker PIPS Gerbangkertosusilo Konsultan Supervisi
PENGAWAS LAPANGAN PT. WAHANA ADYA
Danu Wahyudi, BE Mulyadi, ST

Koordinator Inspektor Stuktur
REQUEST AND APPROVAL
PEMBUATAN BANGUNAN SARINGAN SAMPAH

(TRASHRACK), MEKANIKAL ELEKTRIKAL,
PENGADAAN GENZET & PEK. SIPIL LAINNYA
DI KAWASAN TAMBAK WEDI
HALAMAN:
II.B.1Tiang Pancang f 45 dan Pemancangannya
Daftar
Bahan - Bahan
Volume
22 Bottom
44 Middle
Dibuat oleh :
Kontraktor
WASKITA KARYA
Deny Adi Irawan,ST

Katek
Form: 02
PEJABAT PEMBUAT KOMITMEN
REQUEST FOR AUTHORIZATION TO COMMENCE
KEGIATAN PENGENDALIAN LAHAR GUNUNG KELUD
CONSULTANT: PROJECT : CONTRACTION/REPAIR OF SABO
NIPPON KOEI CO.,LTD., DAMS FOR REHABILITATION OF
AND ASSOCIATION MT. KELUD URGENT SABO PROJECT
CONTRACTOR: LOCATION :
WEEKS : DATE :
WASKITA NINDYA :
DATE SHEETS:
Joint Operation (JO)
No. REQUEST :
Description of Works: Payment item:
Volume with unit:
Proposed date of Commencement: Name of Field Representative:

Position Date Signature
Requested by:
Input Equipment/ Work Force/ Materials

Equipment Man Power Material to be Used
No. Description Nos No. Description/Position Person No. Materials Volume
1 1 1
2 2 2
3 3 3
4 4 4
5 5 5
6 6 6
INSPECTION BY THE PROJECT

Inspected in accordance with: Date of Inspection: / /
Inpector Project Consultant
Position
Name
Signature
Inspection Result
Approved Not Approved
The Works should be commenced on:

Reason of "Not Approved" or Comments by Inspector:

KOORDINATOR PENGAWAS Supervision Consultant Contractor
KEGIATAN PENGENDALIAN LAHAR G. KELUD NIPPON KOEI CO.,LTD And Ass Waskita-Nindya JO
Wilopo, Sp.1 Ananto Dibyo Agus A

NIP. 110 032 327 Construction Engineer Field Supervisor
Form: 02
REQUEST FOR AUTHORIZATION TO COMMENCE
CONSULTANT: PROJECT : CONTRACTION/REPAIR OF SABO
NIPPON KOEI CO.,LTD., DAMS FOR REHABILITATION OF
AND ASSOCIATION MT. KELUD URGENT SABO PROJECT
CONTRACTOR: LOCATION : LECD-8
WEEKS : 40 DATE : 23-8-2007
WASKITA NINDYA :
DATE SHEETS:
No. REQUEST :
Description of Works: Payment item:
Concrete K-175 Apron Left Side Volume with unit:
between Maindam and Subdam
Proposed date of Commencement: Name of Field Representative:

Position Date Signature
Requested by:
Supervisor
Input Equipment/ Work Force/ Materials
Equipment Man Power Material to be Used
No. Description Nos No. Description/Position Person No. Materials Volume
1 Concrete Mixer 1 Foreman 1 Cement (50 kg)

2 Concrete Vibrator 2 Skilled Labour 2 Crushed Stone
3 Alat bantu 3 Common Labour 3 Fine Aggregate
4 4 4
5 5 5
6 6 6
INSPECTION BY THE PROJECT

Inspected in accordance with: Date of Inspection: / /
Inpector Project Consultant
Position
Name
Signature
Inspection Result
Approved Not Approved
The Works should be commenced on:

Reason of "Not Approved" or Comments by Inspector:

COORDINATOR INSPECTOR Supervision Consultant Contractor
KEGIATAN PENGENDALIAN LAHAR G. KELUD NIPPON KOEI CO.,LTD And Ass Waskita-Nindya JO
Riyanto, ST Syamsul Bachri Harjono

NIP: 110 042 229 Construction Engineer Supervisor
Form: 03
PENGENDALIAN BANJIR LAHAR GUNUNG KELUD

DAILY REPORT
NIPPON KOEI CO.,LTD., PROJECT : : Contraction/Repair of sabo dam for rehabilitation of mt. kelud urgent sabo project
CONSULTANT :
AND ASSOCIATION CONTRACT : Package 5
LOCATION :
WASKITA NINDYA
CONTRACTOR : DATE :
WEATHER : Bright. Cloudy. Rainy
MAN POWER MATERIAL EQUIPMENT

POSITION PERSONS KINDS IN USE KIND/TYPE NUMBERS
ACTIVITY
CONSULTANT NOTES OTHERS

- VISIT
- ACCIDENT
ENGINEER NOTES OTHERS
- VISIT
- ACCIDENT
Approved by Checked by Prepared by

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD NIPPON KOEI CO,. LTD. And ASS. Waskita - Nindya JO
( ………………………………………………………… ) ( ………………………………………………………… ) ( ………………………………………………… )

Assistant Engineer Technical Manager
Form : 04

JOINT INSPECTION REPORT
KONSULTAN : WAHANA ADYA KONSULTAN PROYEK : Construction/Repair of Sabo Dam for Rehabilitation
of Mt. Kelud Urgent Sabo Project

PAKET : SBY KA-2
KONTRAKTOR : LOKASI : Kenjeran - Surabaya
WASKITA KARYA (Persero)
DATE : /09/2007
SHEET : of
ATTENDANTS:
INSPECTOR CONSULTANT CONTRACTOR

1 Sulistyono Aribowo 1 Ananto Dibyo 1 Supriyono
2 Misdo 2 Rois 2 Yoyok
3 3 3
4 4 4
5 5 5
1. KIND OF WORK : Wet Masonry Type-B (1 pc : 4 sand)
2. LOCATION : Sidewall 3nd Side Left
3. STATION :
4. ELEVATION : +596,250 ~ +601,000
STATEMENT:

KEGIATAN PENGENDALIAN LAHAR GUNUNG KELUD NIPPON KOEI CO., LTD. And Ass. Waskita - Nindya JO
Sulistyono Aribowo, ST Ananto Dibyo Supriyono

NIP. 110 049 082 Construction Engineer Supervisor
Form : 04
Form : 04

JOINT INSPECTION REPORT
CONSULTANT : NIPPON KOEI CO., LTD., PROJECT : Construction/Repair of Sabo Dam for Rehabilitation
AND ASSOCIATION of Mt. Kelud Urgent Sabo Project

CONTRACTOR : LOCATION : LECD-8 (Ds. Tulungrejo, Gandusari)
WASKITA NINDYA
DATE : 8/23/2007
SHEET : of
ATTENDANTS:
INSPECTOR CONSULTANT CONTRACTOR

1 Riyanto, ST 1 Syamsul Bachri 1 Harjono
2 2 Hizbul 2
3 3 3
4 4 4
5 5 5
1. KIND OF WORK : Concrete K-175
2. LOCATION : Apron between Maindam and Subdam Left Side
3. STATION :
4. ELEVATION : El.+516.057
STATEMENT:

Riyanto, ST. Syamsul Bachri Harjono

Form : 04
Form : 06
SATUAN KERJA NON VERTIKAL TERTENTU WEEKLY REPORT

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD MATERIAL and EQUIPMENT
PROJECT : CONTRATION/REPAIR OF SABO DAMS FOR REHABILITATION
NIPPON KOEI CO.,LTD.,
CONSULTANT : OF MT. KELUD URGENT SABO PROJECT
AND ASSOCIATION
CONTRACT : Package 5 ,
LOCATION :
WASKITA NINDYA
CONTRACTOR : WEEKS : DATE. : -
DATE : SHEETS :
NUMBERS EQUIPMENT
No. KINDS
IN USE KIND/TYPE NUMBER
I Material
II Equipment
Approved by : Checked by: Prepared by

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD NIPPON KOEI CO.,LTD And Ass. Waskita - Nindya JO
------------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

NIP : -------------------------- Construction Engineer Project Manager
Form : 07
SATUAN KERJA NON VERTIKAL TERTENTU WEEKLY REPORT

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD ACTIVITY and MAN POWER
PROJECT CONTRATION/REPAIR OF SABO DAMS FOR
REHABILITATION OF MT. KELUD URGENT SABO
CONSULTANT : NIPPON KOEI CO.,LTD.,AND ASSOCIATION PROJECT
LOCATION :
CONTRACTOR : WASKITA NINDYA Joint Operation (JO) WEEKS : DATE. : -

DATE : SHEETS :
MAN POWER
No. KIND OF USE MATERIAL REMAKS
POSITION PERSONS


Form : 09
SATUAN KERJA NON VERTIKAL TERTENTU MONTHLY REPORT

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD MATERIAL and EQUIPMENT
PROJECT : CONTRATION/REPAIR OF SABO DAMS FOR REHABILITATION
CONSULTANT : OF MT. KELUD URGENT SABO PROJECT
AND ASSOCIATION
LOCATION :
WASKITA NINDYA
CONTRACTOR : MONTHS : DATE. : -
DATE : SHEETS :
NUMBERS EQUIPMENT
No. KINDS
IN USE KIND/TYPE NUMBER
I Material
II Equipment


Form : 10
SATUAN KERJA NON VERTIKAL TERTENTU MONTHLY REPORT

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD ACTIVITY and MAN POWER
PROJECT : CONTRATION/REPAIR OF SABO DAMS FOR
REHABILITATION OF MT. KELUD URGENT SABO
CONSULTANT : NIPPON KOEI CO.,LTD., AND ASSOCIATION PROJECT
LOCATION :
CONTRACTOR : WASKITA NINDYA Joint Operation (JO) MONTHS : DATE. : -

DATE : SHEETS :
MAN POWER
No. KIND OF USE MATERIAL REMAKS
POSITION PERSONS


Form : 11
PEJABAT PEMBUAT KOMITMEN CHECK LIST FOR STONE MASONRY

KEGIATAN PENGENDALIAN LAHAR GUNUNG KELUD WORKS
: NIPPON KOEI CO., LTD., PROJECT : Constraction/Repair of Sabo Dam for Rehabilitation

CONTRACTOR : LOCATION : BACD-6 (Ds. Penataran-Nglegok)
WASKITA NINDYA
DATE :
WEATHER : Bright Cloudly Rainly
Yes No N/A
1. Water
Free from impurities
2. Sand
a) Washed before use
b) Free from organic matters and other contamination
c) Sieved by 5 mm sieve before use
3. Stone
a) Free from crack/seam
b) Appropiate max. stone size (30 cm and 2/3 of wall thickness)
c) Angular stone
4. Placing of Masonry
a) Proper cement/sand mix proportion for joint mortar
b) Moistened stone before use
c) Hitting and consolidation of stone by steel hammer
d) Width of joints in face stone not exceeding 3 cm
5. Pointing
a) Chipped joint mortar to a depth of 3 cm
b) Proper cement/sand mix proportion ( 1 : 2 )
c) Cleaned surface of joint mortar using wire brush
d) Sufficient filling of surface joint mortar
6. Plastering
a) The depth of plastering is proper with technical spesification
b) Proper cement/sand mix proportion ( 1 : 3 )
c) Width of list plastering is 15 cm
7. Wooden separator for Lining Works

a) Appropiate min. board thickness is 1 cm
b) Materials shall be non wrapping and non wrinkling
c) Uniform dimension
8. Remarks
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
Approved by : Checked by : Prepared by :


NIP.110 049 082 Construction Engineer Supervisor
Form : 11
PEJABAT PEMBUAT KOMITMEN CHECK LIST FOR STONE MASONRY

KEGIATAN PENGENDALIAN LAHAR GUNUNG KELUD WORKS
: NIPPON KOEI CO., LTD., PROJECT : Constraction/Repair of Sabo Dam for Rehabilitation

CONTRACTOR : LOCATION : LEKD-14 (Ds. Jambewangi-Selopuro)
WASKITA NINDYA
DATE :
Yes No N/A
1. Check elevation dig to be attached foundation.
2. Check bouwplank / profile of elevasi to be attached.
3. Check condition material's :

a) River Stone
b) Sand
c) Cement
d) Watering
4. Equipment :
a) Concrete Mixer
b) Dolak mixer / sand
c) Water pump
5. Man Power
a) Foreman
b) Skilled Labour
c) Common Labour
6. Application Assits
a) Roof gutter
b) Protector ratch
7. Check straightness of installation of stone and adapted for bouwplank
8. Remarks
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
Approved by : Checked by : Prepared by :

Co. Inspector Supervision Consultant Contractor
Wilopo, Sp. 1 Ananto Dibyo Supriyono

Form : 12-1
PEJABAT PEMBUAT KOMITMEN CHECK LIST FOR CONCRETE WORKS:

KEGIATAN PENGENDALIAN LAHAR GUNUNG KELUD DURING PLACEMENT OF STRUCTURAL CONCRETE
CONSULTANT : NIPPON KOEI CO., LTD., PROJECT : Constraction/Repair of Sabo Dam for Rehabilitation

CONTRACTOR : LOCATION : LECD-8 (Ds. Tulungrejo-Gandusari)

WASKITA NINDYA
Joint Operation DATE :
(JO)
Yes No N/A
1. Concrete Test
a) Slump within tolerance
b) Time Limitation (1.5 hrs. from mixing plant)
c) Air contents within limits ( 6% ± 2% )
d) Concrete temperature (below 320C)
e) Cylinders/cubes taken ( min. 3 nos.)
2. Concrete Placement
a) Means of placing
- Crane & bucket - Chute
- Pumping - Conveyor belt
- Buggy - Other
b) Distance of free fall of concrete

- Limited to 1.2 m max. from truck
- Seggregation occuring due to free fall
c) Concrete vibration
- Backup vibrator on site
- No horizontal movement on concrete
- Sufficient vibrating for consolidation
- Vibrate around rebar and embedments
- Penetrate into previous layer by 15 cm
- Vibrating in one position for no more than 15 sec.
d) Finish
- Brooming - Trowel
- Rough - Float finish
e) Concrete placed :……………………………………………………………………………… m3
f) Minimum time before removal of form : …….……….……………………………………… days
g) Minimum time of curing : ………………………..…………………………………………… days
3. Remarks
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….

Riyanto, ST Syamsul Bachri Harjono

Form : 12-2
PEJABAT PEMBUAT KOMITMEN CHECK LIST FOR CONCRETE WORKS:

KEGIATAN PENGENDALIAN LAHAR GUNUNG KELUD PRIOR TO PLACEMENT OF STRUCTURAL CONCRETE
Constraction/Repair of Sabo Dam for
CONSULTANT : NIPPON KOEI CO., LTD., PROJECT :
Rehabilitation

CONTRACTOR : LOCATION : BACD-6 (Ds.Penataran - Nglegok)
WASKITA NINDYA DATE :
Yes No N/A
1. Formwork Preparation
a) Form at proper position
b) Forms brace properly
c) Forms clean
d) Approved coating materials of forms
e) Construction joint clean
f) Forms sufficiently tight to prevent leakage
g) Work quatity calculated
2. Reinforcement Bar Placing
a) Bars placed in accordance with approved re-bar drawing with proper

spacing blocks
b) Lap joint length sufficient
c) Bars fastened together properly
d) Bars free of mud, oil, grease or other contamination
e) Have all embedded items been placed
f) Work quantity calculated
3. Vibrator equipment available
4. Concrete plant Inspector's report received and properly filled out
3. Remarks
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….


Form : 13

DEFLECT WORK REPORT
PROJECT : : Contraction/Repair of sabo dam for rehabilitation of mt. kelud
CONSULTANT : urgent sabo project
AND ASSOCIATION
CONTRACT : : Package 5 ,
LOCATION :
WASKITA NINDYA
CONTRACTOR : DATE :
SHEET : Of
STATUS
No. Description Remarks Finished Targets
Approved Repaired Reject
ACTIVITY
CONSULTANT NOTES OTHERS

- VISIT
- ACCIDENT
ENGINEER NOTES OTHERS
- VISIT
- ACCIDENT
Approved by Checked by Prepared by

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD NIPPON KOEI CO,. LTD. And ASS. Waskita - Nindya JO
( ………………………………………………………… () ………………………………………………………… ) ( ………………………………………………… )

Assistant Engineer Technical Manager
Form : 14

WEEKLY WEATHER REPORT
PROJECT CONTRATION/REPAIR OF SABO DAMS FOR
NIPPON KOEI CO.,LTD., REHABILITATION OF MT. KELUD URGENT SABO
CONSULTANT : PROJECT
AND ASSOCIATION
LOCATION :
WASKITA NINDYA
CONTRACTOR : WEEKS : DATE. : -
JOINT OPERATION (JO)
DATE : SHEETS :
TIME ……………………. 200………

(HOUR 1 2 3 4 5 6 7
)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

……………………………………… Syamsul Bachri Ir. Ibnu Nouval

Form : 15

MONTHLY WEATHER REPORT
PROJECT : CONTRATION/REPAIR OF SABO DAMS FOR REHABILITATION OF MT.
CONSULTANT : NIPPON KOEI CO.,LTD., AND ASSOCIATION KELUD URGENT SABO PROJECT
LOCATION :
CONTRACTOR : WASKITA NINDYA JOINT OPERATION (JO) MONTHS : DATE. : -

DATE : SHEETS :
TIME ……………………. 200………

(HOUR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

……………………………………… Syamsul Bachri Ir. Ibnu Nouval

MONTHLY SERTIFICATE OF PAYMENT ( SUMMARY )
NAME OF PACKAGE: Package 5

CONTRACTOR : WASKITA NINDYA Joint Operation (JO)
CONTRAC no. : 16 / PKK/Aa.13.43/ LN/2006
Form : 16
NET PAYMENT RECEIVED
TOTAL PROGRESS PAYMENT ( in Rupiah )
No. DESCRIPTION ( in Rupiah ) REMAINING DATE OF
RATE DEDUCTION CONTRACT
MONTH / INVOICE (%) REFUND OF THIS RATE AMOUNT PAYMENT PAYMENT
AMOUNT COMMULATIVE COMMULATIVE
No. ADVANCE RETENTION TOTAL COMMULATIVE PERIOD (%) ( Rp) REQUEST RECEIVED
PAYMENT
1 2 3 4 5 6 = 20% x 3 7 = 5% x 3 8 = 6+ 7 9 10 = 3 - 8 11 12 13= (D17) - 10 14 15
ORIGINAL CONTRACT
1 Advance payment

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FORM LIST

No. Description Responsibility

Approved by: Checked by: Prepared by:

-------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

SATUAN KERJA PENGEMBANGAN INFRASTRUKTUR PERSAMPAHAN PROYEK : PEMBUATAN BANGUNAN SARINGAN SA

KONTRAKTOR : LOKASI : Kenjeran - Surabaya

1 Ponton 1 Unit 1 Operator Pancang 2 Orang 1 Tiang Pancang

Danu Wahyudi, BE Mulyadi, ST

PEMBUATAN BANGUNAN SARINGAN SAMPAH

II.B.1Tiang Pancang f 45 dan Pemancangannya

Deny Adi Irawan,ST

Proposed date of Commencement: Name of Field Representative:

Input Equipment/ Work Force/ Materials

INSPECTION BY THE PROJECT

Approved Not Approved

The Works should be commenced on:

Approved by: Checked by: Prepared by:

Wilopo, Sp.1 Ananto Dibyo Agus A

Proposed date of Commencement: Name of Field Representative:

1 Concrete Mixer 1 Foreman 1 Cement (50 kg)

3 Alat bantu 3 Common Labour 3 Fine Aggregate

INSPECTION BY THE PROJECT

Approved Not Approved

The Works should be commenced on:

Approved by: Checked by: Prepared by:

Riyanto, ST Syamsul Bachri Harjono

SATUAN KERJA NON VERTIKAL TERTENTU

PENGENDALIAN BANJIR LAHAR GUNUNG KELUD

MAN POWER MATERIAL EQUIPMENT

CONSULTANT NOTES OTHERS

Approved by Checked by Prepared by

( ………………………………………………………… ) ( ………………………………………………………… ) ( ………………………………………………… )

PEJABAT PEMBUAT KOMITMEN

of Mt. Kelud Urgent Sabo Project

INSPECTOR CONSULTANT CONTRACTOR

1. KIND OF WORK : Wet Masonry Type-B (1 pc : 4 sand)

2. LOCATION : Sidewall 3nd Side Left

4. ELEVATION : +596,250 ~ +601,000

Approved by: Checked by: Prepared by:

Sulistyono Aribowo, ST Ananto Dibyo Supriyono

PEJABAT PEMBUAT KOMITMEN

AND ASSOCIATION of Mt. Kelud Urgent Sabo Project

INSPECTOR CONSULTANT CONTRACTOR

1. KIND OF WORK : Concrete K-175

2. LOCATION : Apron between Maindam and Subdam Left Side

Approved by: Checked by: Prepared by:

Riyanto, ST. Syamsul Bachri Harjono

SATUAN KERJA NON VERTIKAL TERTENTU WEEKLY REPORT

Approved by : Checked by: Prepared by

------------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

SATUAN KERJA NON VERTIKAL TERTENTU WEEKLY REPORT

CONTRACTOR : WASKITA NINDYA Joint Operation (JO) WEEKS : DATE. : -

Approved by : Checked by: Prepared by

------------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

SATUAN KERJA NON VERTIKAL TERTENTU MONTHLY REPORT

Approved by : Checked by: Prepared by

------------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

SATUAN KERJA NON VERTIKAL TERTENTU MONTHLY REPORT

CONTRACTOR : WASKITA NINDYA Joint Operation (JO) MONTHS : DATE. : -

Approved by : Checked by: Prepared by

------------------------------------------- Syamsul Bachri Ir. Ibnu Nouval

PEJABAT PEMBUAT KOMITMEN CHECK LIST FOR STONE MASONRY