INSPECTION RELEASE NOTE

IRN No.: Vendor: BERKAT SYNERGY SDN. BHD Date: 05-DECEMBER-2019

4400016917.IRN.001
Sub-Vendor: N/A
PO Number: Description: BULL PLUG FOR JACKET FLOODING, VENTING & GROUTING SYSTEM
4400016917

QTY RELEASED

COMPLETE (P/C)
OWL/PUNCHLIST

PARTIAL OR
PO PO PO REFERENCE
PO
REV. ITEM QTY TAG NUMBER DESCRIPTION / SCOPE OF WORK NUMBER
NO. NO. QTY
UOM
Cat. A Cat. B

HALF COUPLING NPT 2" MATERIAL

0 0010 4 4 HN: K740 4 C 0 0
GRADE : $A105N/A105N
BULL PLUG 2' NPT 3000# MATERIAL
0 0010 4 4 HN: 2310 4 C 0 0
GRADE : $A105N/A105N

PARTIAL OR

ASSAI
COMPLETE
RELEASEDQTY

DOCUMENTS
PO PO PO STATUS
PO TAG
REV. ITEM QTY DESCRIPTION / SCOPE OF WORK
QTY NUMBER
NO. NO. UOM Non
AFC
(P/C)

AFC

HN: K740 HALF COUPLING NPT 2" C/W BULL

0 0010 4 4 PLUG 2' NPT 3000# MATERIAL 4 C 0 0
HN: 2310 GRADE : $A105N/A105N

Note:

Name of SFSB Name of Vendor Name of SFSB SFSB PROJECT DIRECTOR:

Representative: Representative: SIC: Signature:
Position: Position: Position: SFSB SIC

Signature: Signature: Signature:

This inspection release note does not relieve the vendor or manufacturer from any responsibility, or any contractual obligations or guarantees, nor shall
it be interpreted in any way so as to imply acceptance of the goods. Inspection is performed to the best of our ability, knowledge and belief but
inspection personnel shall not be held responsible in any way whatsoever for the content of / or technical accuracy of the purchase order.

Appendix 8 Rev 01 Page 1 of 1 SOURCE INSPECTION PLAN - PGGA-QM-PLN-0-002