‘SITE NONCONFORMANCE REPORT. ‘DOCUMENT TYPE : NCR TOCATION: COAL HAUL ROAD EMPLOYER: PT. FAIARSAKTIPRIMA | RecA: cH 04000 ~ CH 304000 PT. BERKARYA ABADI SELALU | NCR issued during :c Site Clearance © Culverts & Bridges c Earthworks Road Surfacing qpther @ Reference documents : ‘2. MOM_Update Re Discussion Kick Off Meeting (27/08/2020) es ‘@bescription of the Non-conformance: ‘PT. BAS mengirimkan weekly report tanggal 2/11/2020 dianggap bisa mewakili daily report yang seharusnya dikirim sejak ‘tanggal 25/10/2020, namun sejak tanggal 3/11/2020 PT. BAS belum mengirimkan daily report sampal sekarang tanggal 22/31/2020. Root Causes analysis: «tote file by contractor on page) ‘Written by EMPAO YER Technical Team Representative: ised by EMPLOYER Project ig Date: 22-Nov-2020 ‘ame Fannwel Bao Stature Issue Oste: 22-Now 2020 | @ 1-Treatment proposed by CONTRACTOR: Justification: «10 be ied by Contractor on page 2) Ciconcession (accept as it is) GiRepair as per attached procedure DRework *tto be filed by Contactor on page 2) 2 Recommendations for corrective ac tion plan to avoid recurrence by CONTRACTOR Action to be carried out by : PT. BERKARYA ABADI SELALU Expected date of completion : By CONTRACTOR. Namea Date ‘Slenature: ‘@ 1- EMPLOYER decision on treatment proposal Recommendations / comments : 1D Accepted as proposed 1 Accepted but subject to incorporation of recommendations indicated Rejected ‘2 EMPLOYER review of corrective action plan : “Granting of Concesion / Special Repair bby EMPLOYER Project Managerfwhen appieable): ‘Concession request/atached pede repair procedure _accepted by EMPLOYER By EMPLOYER Fanon, Name eSigratur Name Sigrature ‘Tae ow ‘by EMPLOYER Project Manager Name e, Signature “CORRECTIVE ACTION PROPOSAL FOR NCR Date of Compliant : EMPLOYER Compliant Ref: FSP-XI-20-BAS-NCR-001 EMPLOYER Letter Ref. : Project Reference NCR Title Root Cause Analysis by CONTRACTOR ‘Treatment proposal by CONTRACTOR Treatment proposal : Recommendations for Corrective action plan to avoid recurrence Prepared by, PT BERKARYA ABADI SELALULAMPIRAN Update Re Discussion Kick -Off Meeting (27/08/2020) Project: FSP 10004 CHR, onstruction OF The 101.5 km Ha Road (rem Muar abu ort CHOToCH30) Jerse sony ansy RUHR fame ee lca cee cen ao oe = = wanes ane ‘astwe [sans | ome 1 women [ret | as tea rrgrinin srs guerra eran eon |esvoren ree fons Sosoemeeeaniaias TEP renarian BS unr ne ne Ga ADU OE 2 promot cons laren No.7 ferrgonn abe cou, arena da ge eon gs [ore no [enc cirerrginanjinshrapam jugs pinsere | mae z frie _ersapen adres /seritat- PROGRESS — [sr rain pass tS menecinan wroeteaiapain Sra ictus Js oe ae rapes ne |- 150 mein tapade tA menacian mes /pengrapan apn 38 | IAN} Aton ean, ana pect BW te ag | 24 aria rergrmean read venenwak eip pean ang ea Lent 4 fn ctr = RHE ee [pore | eas dininararghinean etod sent ptsan argon | 28/200) fom 1a- cH. Se cen emer, ce | ise ag Siuatn ars ag canal nae erp] 6 eos cane ae [rere * Imari yng tan cpt koran cer ri a yao] Aton aa yg a at ‘mea | 50 [gute wascampuanoren les a7 [2S hie mag spews plan doers ra [ [ro late tegen CseD oes [anes ranger ra ptr 18 frosispecton tom and rport 7° |e san mergirtan cay report wey port montey sonst | aga) Aton fern pa 0-130 re Da aor rs a go co Tig ein gen 5 fsssrpon [er Nene re nt tn nn. ‘ate eon eon sentra sonar ‘asaya, | nse set OFX aa JSA ra sis por [Wet egportty ere au bel comets wer nc lowe ering. od sep ata sappy. sioner 20 lorry ot teal comm 7 | Comm etre ropa fr ra a comes ston oe pony otal coms wrt ann et weer sala [nacromaor [#8 san spo fm epee BP omar raIRa SRS a raperno 1 fos Tyg ia OA rg pn TP a oo tees sitios [x Se ese oe reso |2 tat ay Soe: us