03/MAU-M

CHECK LIST INSTRUKSI KERJA

(WORK INSTRUCTIONS CHECK LIST) Nomor Urut
:
SESUDAH PEMBESIAN DINDING BETON (Serial Number)
(AFTER IRONING OF CONCRETE WALL)
Nomor Referensi Gambar
PROYEK [ Kode ] : (Drawings Reference number) :

LOKASI (LOCATION): : Revisi (Revision) :

Beri tanda (Mark) √ yang sesuai (Appropriate) Inspeksi I (Inspection I) Inspeksi II* (Inspection II) Inspeksi III* (Inspection
ITEM PEMERIKSAAN Ya Tidak Tidak disyaratkan Ya Tidak Tidak disyaratkan Ya Tidak
No
(WORK ITEM) (Yes) (No) (Not Required) (Yes) (No) (Not Required) (Yes) (No)
Shop drawing tersedia
1
(Shop drawing is available)

Jumlah & diameter tulangan utama terpasang sesuai shop drawing

2 (The number and size of
main reinforcement are installed accordance with shop drawing)

Diameter & Jarak pembesian sengkang

3
(The diameter and distance of stirrup ironing)
Kuat ikatan pembesian
4
(The strongness of ironing ties)
Besi sambungan/stek/overlap terpasang min 40 D
5
(Iron connecting / cuttings / overlap is installed min 40 D
Beton deking terpasang
6
(Sherlter concrete is installed)
Sepatu dinding terpasang
7
(Wall shoes is installed)
Sparing sudah terpasang sesuai shop drawing
8 (Sparing has been installed in accordance with
shop drawing)
Tidak ada insident yang terjadi akibat pekerjaan tersebut
9
(No insident is caused by such work)

Lokasi Inspeksi (Inspection Location) : Tanggal inspeksi (Date of Inspection) Tanggal inspeksi (Date of Inspection) Tanggal inspeksi (Date of Inspe

Yang membuat (Created by) Yang membuat (Created by) Yang membuat (Created b

Supervisor Supervisor Supervisor

Alat Inspeksi (Inspection Tools) : Mengetahui (Approved by) Mengetahui (Approved by) Mengetahui (Approved by

Quality Control Quality Control Quality Control

Catatan (Note) : Rekomendasi (Recommendation) Rekomendasi (Recommendation) Rekomendasi (Recommen

Perhatian (Attention):
Utamakan Keselamatan Kerja (Safety First) Penanggung jawab
1 (Responsible person)
2 Pakailah safety helmet (Used Safety Helmet)
3 Pakailah safety shoes (Used Safety Shoes)
4 Pakailah safety belt (Used Safety Belt)
5 Jagalah kebersihan lingkungan (Keep it Clean) Production Manager

*) Kolom Inspeksi II dan III digunakan apabila ada pekerjaan yang tidak memenuhi syarat ( ada Ketidaksesuaian Produk)
(Inspection columns II and III are used when there are work that do not qualify (there Incompatibility Products))
 03/MAU-MR/R0

Inspeksi III* (Inspection III)

Tidak disyaratkan
(Not Required)

Tanggal inspeksi (Date of Inspection)

Yang membuat (Created by)

Supervisor
Mengetahui (Approved by)

Quality Control
Rekomendasi (Recommendation)
 03/MAU-MR/R0
CHECK LIST INSTRUKSI KERJA
(WORK INSTRUCTIONS CHECK LIST) Nomor Urut :
SESUDAH BEKISTING DINDING BETON (Serial Number)
(AFTER FORMWORK OF CONCRETE WALL)
Nomor Referensi Gambar
PROYEK [ Kode ] : (Drawings Reference number) :

LOKASI (LOCATION): : Revisi (Revision) :

Beri tanda (Mark) √ yang sesuai (Appropriate) Inspeksi I (Inspection I) Inspeksi II* (Inspection II) Inspeksi III* (Inspection III)

ITEM PEMERIKSAAN Ya Tidak Tidak disyaratkan Ya Tidak Tidak disyaratkan Ya Tidak

No
(WORK ITEM) (Yes) (No) (Not Required) (Yes) (No) (Not Required) (Yes) (No)
Shop drawing tersedia
1 (Shop drawing is available)
Vertikalitas bekisting
2 (Formwork verticality)
Kelurusan bekisting kolom beton
3 (Straightness of concrete column formwork)
Kerapatan sambungan bekisting
4 (Formwork connection density)
Jarak klem/support bekisting
5 (Clamp distance/formwork support)
Kuat klem/sabuk kolom
6 Clamp strongness/belt column)
Marking elevasi top cor kolom
7 (Marking of top cast column elevation)
Pipa pendukung
8 (Pipe support)
Tidak ada insident yang terjadi akibat pekerjaan tersebut
9 (No insident is caused by such work)

Lokasi Inspeksi (Inspection Location) : Tanggal inspeksi (Date of Inspection) Tanggal inspeksi (Date of Inspection) Tanggal inspeksi (Date of Inspection)

Yang membuat (Created by) Yang membuat (Created by) Yang membuat (Created by)

Supervisor Supervisor Supervisor

Alat Inspeksi (Inspection Tools) : Mengetahui (Approved by) Mengetahui (Approved by) Mengetahui (Approved by)

Quality Control Quality Control Quality Control

Catatan (Note) : Rekomendasi (Recommendation) Rekomendasi (Recommendation) Rekomendasi (Recommendation)

Perhatian (Attention): Penanggung jawab

1 Utamakan Keselamatan Kerja (Safety First) (Responsible person)
2 Pakailah safety helmet (Used Safety Helmet)
3 Pakailah safety shoes (Used Safety Shoes)
4 Pakailah safety belt (Used Safety Belt)
5 Jagalah kebersihan lingkungan (Keep it Clean) Production Manager
*) Kolom Inspeksi II dan III digunakan apabila ada pekerjaan yang tidak memenuhi syarat ( ada Ketidaksesuaian Produk)
 03/MAU-MR/R0

Inspeksi III* (Inspection III)

Tidak disyaratkan
(Not Required)

Tanggal inspeksi (Date of Inspection)

Yang membuat (Created by)

Supervisor
Mengetahui (Approved by)

Quality Control
Rekomendasi (Recommendation)
 03/MAU-MR/
CHECK LIST INSTRUKSI KERJA
(WORK INSTRUCTIONS CHECK LIST) Nomor Urut :
SESUDAH PENGECORAN DINDING BETON (Serial Number)
(AFTER CONCRETE WALL CASTING)
Nomor Referensi Gambar
PROYEK [ Kode ] : (Drawings Reference number) :

LOKASI (LOCATION): : Revisi (Revision) :

Beri tanda (Mark) √ yang sesuai (Appropriate) Inspeksi I (Inspection I) Inspeksi II* (Inspection II) Inspeksi III* (Inspection III
ITEM PEMERIKSAAN Ya Tidak Tidak disyaratkan Ya Tidak Tidak disyaratkan Ya Tidak
No
(WORK ITEM) (Yes) (No) (Not Required) (Yes) (No) (Not Required) (Yes) (No)
Shop drawing tersedia
1
(Shop drawing is available)
Elevasi top cor dinding
2
(Elevation of casting top wall)
Dinding beton yang sudah dicor harus dicuring
3 (Concrete wall that
had been casted must be curing)
Vertikalitas kolom beton
4
(Concrete column verticality)
Kelurusan kolom beton
5
(Straightness of concrete column)
Hasil pengecoran tidak keropos
6
(Cast result does not porous)
Tidak ada insident yang terjadi akibat pekerjaan tersebut
7
(No insident is caused by such work)

Lokasi Inspeksi (Inspection Location) : Tanggal inspeksi (Date of Inspection) Tanggal inspeksi (Date of Inspection) Tanggal inspeksi (Date of Inspection

Yang membuat (Created by) Yang membuat (Created by) Yang membuat (Created by)

Supervisor Supervisor Supervisor

Alat Inspeksi (Inspection Tools) : Mengetahui (Approved by) Mengetahui (Approved by) Mengetahui (Approved by)

Quality Control Quality Control Quality Control

Catatan (Note) : Rekomendasi (Recommendation) Rekomendasi (Recommendation) Rekomendasi (Recommendati

Perhatian (Attention): Penanggung jawab

1 Utamakan Keselamatan Kerja (Safety First) (Responsible person)
2 Pakailah safety helmet (Used Safety Helmet)
3 Pakailah safety shoes (Used Safety Shoes)
4 Pakailah safety belt (Used Safety Belt)
5 Jagalah kebersihan lingkungan (Keep it Clean) Production Manager

*) Kolom Inspeksi II dan III digunakan apabila ada pekerjaan yang tidak memenuhi syarat ( ada Ketidaksesuaian Produk)
 03/MAU-MR/R0

Inspeksi III* (Inspection III)

Tidak disyaratkan
(Not Required)

Tanggal inspeksi (Date of Inspection)

Yang membuat (Created by)

Supervisor
Mengetahui (Approved by)

Quality Control
Rekomendasi (Recommendation)