Doc. no.

PTD-GEN-TPT9750-BPN-3003-FORM

client( EMILY-1 PROJECT FUEL TERMINAL AND JETTY Rev. A

)logo subcon(
Date
)logo SURVEY REPORT
Page. of

Project Title : Emily -1 Project Fuel Terminal & Jetty

Job No : 9750

Client : INTERPORT Date : 8/26/2019

Main Contractor : PT. TRIPATRA Engineers & Constructors Report No. : 9750-QC-MRR-BCI-0001

Sub-Contractor : PT. Bahana Cipta Internusa Page : of

REFERENCES :

Item Name : Elevation Top Subgrade Location : Control Room & MCC Building

Drawing No. : 9750-CVL-DWG-0186

Revision : C

Sheet :

Coordinate Elevation
No. DESCRIPTION Remarks
Plan Actual Difference Plan Actual Difference

E 476979.480 476979.480 0.000

1 F1 (A3) +24.750 +24.775 +0.025
N 9868692.901 9868692.901 0.000

E 476979.480 476979.480 0.000

2 F1 (A'3) +24.750 +24.725 -0.025
N 986869.2901 986869.2901 0.000

E 476978.980 476978.980 0.000

3 F1(B3) +24.750 +24.720 -0.030
N 9868692.901 9868692.901 0.000

E 476979.980 476979.980 0.000

4 F1 (A4) +24.750 +24.775 +0.025
N 9868690.401 9868690.401 0.000

E 476979.480 476979.480 0.000

5 F1 (A4') +24.750 +24.740 -0.010
N 9868690.401 9868690.401 0.000

E 476979.980 476979.980 0.000

6 F1 (B4') +24.750 +24.730 -0.020
N 9868687.151 9868687.151 0.000

E 476979.980 476979.980 0.000

7 F1 (B4) +24.750 +24.735 -0.015
N 9868690.401 9868690.401 0.000

E 476979.980 476979.980 0.000

8 F1 (B5) +24.750 +24.730 -0.020
N 9868683.901 9868683.901 0.000

E = East

N = North

Prepared by, Witnessed/Reviewed by, Acknowledged by,

Bahana Cipta Internusa TRIPATRA Engineers & Constructors INTERPORT

Date Date Date

 Doc. no. PTD-GEN-TPT9750-BPN-30005-FORM
EMILY-1 PROJECT FUEL TERMINAL AND JETTY
client( Rev. A
subcon(
)logo Date
)logo EXCAVATION INSPECTION REPORT Page. of

Project Title : Emily -1 Project Fuel Terminal & Jetty

Job No : 9750

Client : INTERPORT Date : 8/26/2019

Main Contractor : PT. TRIPATRA Engineers & Constructors Report No. : 9750-QC-MRR-BCI-0001

Sub-Contractor : PT. Bahana Cipta Internusa Page : of

REFERENCES :

Drawing No. : 9750-CVL-DWG-0186 Location : MCC Building

F1 (B3, B4, B4', B5, A'3, A'4,
Revision : D A3, A4)
Sheet : 001
Result Approval Acknowledged
Item of Inspection Remarks
Accepted Rejected BCI TPEC INTERPORT

Demolition or Protection of Existing Facility

Investigation of Existing under-ground Facilities

Setout location, based on shop drawing and endorsed

Benchmark

Line, Slope and Grades according to approved drawing

Depth of Excavation, confirmed

Safety regarding excavation works, confirmed and

Protection of Slope

Dewatering

Quality Cleaning of Bottom Surface

COMMENT

Attached CBR Results (DCP Test)

Prepared by, Witnessed/Reviewed by, Acknowledged by,

Bahana Cipta Internusa TRIPATRA Engineers & Constructors INTERPORT

M Saoki
 Doc. no. PTD-GEN-TPT9750-BPN-3007-FORM
EMILY-1 PROJECT FUEL TERMINAL AND JETTY
client( Rev. A
subcon(
)logo Date
)logo COMPACTION INSPECTION REPORT Page. of

Project Title : Emily -1 Project Fuel Terminal & Jetty

Job No : 9750

Client : INTERPORT Date : 8/26/2019

Main Contractor : PT. TRIPATRA Engineers & Constructors Report No. : 9750-QC-MRR-BCI-0001

Sub-Contractor : PT. Bahana Cipta Internusa Page : of

REFERENCES :

Drawing No. : 9750-CVL-DWG-0186 Location : Control Room & MCC Building

F1 (B3, B4, B4', B5, A'3, A'4,
Revision : C A3, A4)
Sheet :
RESULT APPROVAL ACKNOWLEDGED
NO INSPECTION ITEMS REMARKS
Accepted Rejected BCI TPEC INTERPORT

1 Fill material quality

Area location marking for layer

2
thickness

3 Soil spreading methods

4 Thickness of loose soil

5 Water spreading methods

6 Optimum water content

7 Compactor trip number

Compaction test number for

8
covered area

EQUIPMENT
Total Unit : 1 pc(s)

Stamper Compactors Running Unit : 1 pc(s) Water Source Check

Stand Unit : 1 pc(s) Accepted Rejected

Total Unit : pc(s)
Water Quantity Due to Wet Compaction
Vibratory Compactors Running Unit : pc(s)
Check
Stand Unit : pc(s) Accepted Rejected
COMMENT

Attached CBR Results (DCP Test)

Prepared by, Witnessed/Reviewed by, Acknowledged by,

Bahana Cipta Internusa TRIPATRA Engineers & Constructors INTERPORT

M Saoki
QC Inspector Date Date Date

Doc. ref. FORM-WI-COR-QA-009-001-008 rev.0

 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0001
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (A3)
Coordinate X : 476979.480 Elevation : ± 24.275
Y : 9868692.901

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 100 100 20.0 10.2 0 10 20 30 40 50 60 70 80 90 100
3 5 254 254 30.8 6.3 0
4 5 326 326 14.4 14.7 50
5 5 403 403 15.4 13.7 100
6 5 542 542 27.8 7.0 150
7 5 630 630 17.6 11.8 200
8 5 659 659 5.8 40.8 250
9 5 676 676 3.4 74.2 Deepth (mm)
300
10 5 690 690 2.8 92.2
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 30.1

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0002
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (A'3)
Coordinate X : 476979.480 Elevation : ± 24.725
Y : 986869.2901

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 112 112 22.4 9.0 0 2 4 6 8 10 12 14 16
3 5 292 292 36.0 5.3 0
4 5 418 418 25.2 7.9 50
5 5 492 492 14.8 14.3 100
6 5 571 571 15.8 13.3 150
7 5 648 648 15.4 13.7 200
8 5 768 768 24.0 8.3 250
9 5 859 859 18.2 11.3 Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 10.4

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 Doc No. PTD-GEN-TPT9750-BPN-3005-FORM
EMILY-1 PROJECT FUEL TERMINAL & JETTY
Rev.
DYNAMIC CONE PENETROMETER TEST
Date
( ASTM D 6951 )
Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0003
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (B3)
Coordinate X : 476978.980 Elevation : ± 24.720
Y : 9868692.901

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 126 126 25.2 7.9 10800.9 0 5 10 15 20 25
3 5 230 230 20.8 9.8 0
4 5 354 354 24.8 8.0 50
5 5 529 529 35.0 5.4 100
6 5 613 613 16.8 12.4 150
7 5 672 672 11.8 18.4 200
8 5 721 721 9.8 22.7 250
9 5 807 807 17.2 12.1 Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 12.1

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0005
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (A4)
Coordinate X : 476979.980 Elevation : ± 24.275
Y : 9868690.401

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 129 129 25.8 7.7 0 2 4 6 8 10 12 14
3 5 317 317 37.6 5.0 0
4 5 400 400 16.6 12.6 50
5 5 555 555 31.0 6.2 100
6 5 683 683 25.6 7.7 150
7 5 825 825 28.4 6.9 200
8 5 958 958 26.6 7.4 250
Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
A4 900
950
1000
Average 7.6

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0006
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (A4')
Coordinate X : 476979.480 Elevation : ± 24.275
Y : 9868690.401

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 157 157 31.4 6.1 0 1 2 3 4 5 6 7 8 9 10
3 5 307 307 30.0 6.5 0
4 5 461 461 30.8 6.3 50
5 5 621 621 32.0 6.0 100
6 5 780 780 31.8 6.1 150
7 5 890 890 22.0 9.2 200
250
Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
A4 900
950
1000
Average 6.7

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0004
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (B4')
Coordinate X : 476979.980 Elevation : ± 24.275
Y : 9868687.151

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 123 123 24.6 8.1 0 2 4 6 8 10 12
3 5 295 295 34.4 5.6 0
4 5 398 398 20.6 9.9 50
5 5 490 490 18.4 11.2 100
6 5 661 661 34.2 5.6 150
7 5 832 832 34.2 5.6 200
8 5 958 958 25.2 7.9 250
Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
A4 900
950
1000
Average 7.7

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0007
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (B4)
Coordinate X : 476979.980 Elevation : ± 24.275
Y : 9868690.401

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 120 120 24.0 8.3 0 5 10 15 20 25
3 5 314 314 38.8 4.9 0
4 5 467 467 30.6 6.3 50
5 5 575 575 21.6 9.3 100
6 5 638 638 12.6 17.1 150
7 5 692 692 10.8 20.3 200
8 5 767 767 15.0 14.1 250
5 869 869 20.4 10.0 Deepth (mm)
300
5 986 986 23.4 8.5
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 11.0

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector
 EMILY-1 PROJECT FUEL TERMINAL & Doc No. PTD-GEN-TPT9750-BPN-30007-FORM

JETTY Rev.
DYNAMIC CONE PENETROMETER TEST Date
( ASTM D 6951 ) Page

Project Title : EMILY-1 PROJECT FUEL TERMINAL & JETTY

Job No : 9750
Client : INTERPORT Date : 26/08/2019
Main Contractor : PT. Tripatra Engineers & Constructors Report No. : 9750-QC-DCP-0008
Sub-Contractor : Bahana Cipta Internusa Page : of

Location : Foundation MCC Building No. Layer:

Work Item : Density Soil Test (DCP) Testing No : F1 (B5)
Coordinate X : 476979.980 Elevation : ± 24.275
Y : 9,868,683,901

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 150 150 30.0 6.5 0 2 4 6 8 10 12 14
3 5 337 337 37.4 5.1 0
4 5 502 502 33.0 5.8 50
5 5 628 628 25.2 7.9 100
6 5 713 713 17.0 12.2 150
7 5 817 817 20.8 9.8 200
8 5 924 924 21.4 9.4 250
Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 8.1

Remarks:
Minimum Requirement CBR ≥ 5 %
Acceptance:
Allow contractor to implement proceeding construction works ok Not ok

Prepared by, Witnessed/Reviewed by, Acknowledged by,

PT. Bahana Cipta Internusa PT. Tripatra Engineers & Constructors Interport

Muhammad Saoki
QC Inspector