BENTUK/FORM KAI-PT.TSI 6 ‘SERAH TERIMA LOKOMOTIF TSO HAND OVER OF TSO LOCOMOTIVE NomorSerah Terima 1315-0057/KAL-PT.TS16/SDT/Vill/2019 Number of Hand Over : 1315-0057/KAL-PT.TS16/SOT/Vil/2019 Nama/Name Hari Arbianto Jabatan/ Tile KOT DIPO LoKOMOTIF siDoTOPO Mewaklirepresent : PT.Kereta Api Indonesia (Persero) Nama/Name Kuwat Budi Santoso Jabatan/ Tile ™” Mewakil/represent : PT. TSI SPemeiharaan | NOMORSER! ] TANGGAL] Jamawalmulel] pemelinarean ] pemelharaan bdak == Ae astitaain toomonr/ | oiserankan | Tso(wis) | terjadwal terjadwal Cee smtenance tocotion |2C0metive seria] Date of Hand | TSOSterting | Schedule Unschedule oe Aenea umber Over Timewne) | maintenance | Maintenance oa 1 sor c206 1315 | 27-08-2019 | 08:00 rans / 6 o M184 / 6, Surabaya, 27 Agus 2039 Penyerh/oever renege Dr KERETA AP INDONESIA 75 Krie Catatar/Note “7 clibuat dalam 2 lembar / made in 2 copies ema ke-1 untuk PTAY/Copy 3 for PT KAI . Jembar ke-2 untuk PT-TSI/Copy 2 for PT. TS! Untuk TSO tiak terjadwal, KOT wajlb menghubungl TA PT. TS sebelum ditetapkan jas TSO For TSO Unschedule, XOT must contact PT.TS TA before time of TSO decidedomer Serah Terma Number of Hand Over Nama/Name Jabatan/ Title Mewakli/epresent BENTUK/FORM KAL-PT.TS17 ‘SERAH TERIMA LOKOMOTIF SO HAND OVER OF SO LOCOMOTIVE 1315-0057, KA\-PT.TS17/SOT/ViN/2019 1315-0057/KAL-PT.TS17/SOT/VIN/2019 Hari arbianto KOT 01PO LoKoMOTIF siDoTOPO PI.Kereta Apl indonesia (Persero) ‘Nama/Name Kuwat Budi Santoso Jabatan/ Title ™ Mewakilrepresent : PT.TSt Toss pematnoraan | NOMORSERI sarrs0] #2917051 [scans go] Bawa mul eure | toxomoney |TANESALTSO) so una |" sqm |UMAT#ORD SO) ernie ‘Maoicenance | tacomotve seit oe 1505tar9 | sore gy 50) |S0Starting Time] Time TSO unt ae Location number | 82/750 | Fine is) e wn 50. a 6 jam 1 sor ce2613is | 27062019 | 080 | 27.08-2019| 1600 anae 75 O meni surabaya, 27 Agustus 2019 |a.n PTKERETA API INDONESIA PERSERO) : KOTDIPO LoKOMoTIFsiDoTOPO Hart arbianto catatan/note Glioatealam 2lembar/ made in 2 cop lemar kel untuk PKAI/Copy 3 fr PT KAI lembarke2 untuk PLTSY/Copy 2for PT. TI ‘Untuk TsO tik terjawa, KOT wai renghubung TA PT. TSI sebelum attapkan jam TSO» For TS0 Unscheule, DT mus contact PTSITA before time of TSO decided