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 : 8/24/2019

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

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

REFERENCES :

Item Name : DRAWING MCC ROOM BUILDING FOUNDATION PLAN Location : MCC Building

Drawing No. : 9750-CVL-DWG-0186

Revision : D

Sheet : 001

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

E 476979.480 476979.480 0.000

F1 (A1) +25.450 +25.440 -0.010
N 9868701.901 9868701.901 0.000

E 476,979,480 476,979,480 0.000

F1 (A'1) +25.450 +25.450 -0.000
N 9868701.901 9868701.901 0.000

E 476974.980 476974.980 0.000

F1(B1) +25.450 +25.425 -0.025
N 9868701.901 9868701.901 0.000

E 476979.480 476979.480 0.000

F1 (A2) +25.450 +25.450 -0.000
N 9868697.401 9868697.401 0.000

E 476979.480 476979.480 0.000

F1 (A'2) +25.450 +25.455 +0.005
N 9868697.401 9868697.401 0.000

E 476974.980 476974.980 0.000

F1 (B2) +25.450 +25.455 +0.005
N 9868697.401 9868697.401 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-3005-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 : 8/23/2019

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

Revision : D

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

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 : 8/23/2019

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

Revision : D

Sheet : 001
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 : pc(s)

Sheep Foot Compactors Running Unit : pc(s) Water Source Check

Stand Unit : 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

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

 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 : 23/08/2019
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 (A1)
Coordinate X : 2910.4541 Elevation : ± 25.440
Y : 3282.0015

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 10226.6 0 2 4 6 8 10 12 14 16 18
3 5 201 201 16.2 12.9 0
4 5 400 400 39.8 4.7 50
5 5 570 570 34.0 5.6 100
6 5 792 792 44.4 4.2 150
7 5 892 892 20.0 10.2 200
8 5 955 955 12.6 17.1 250
Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 9.0

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
 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 : 23/08/2019
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 (A'1)
Coordinate X : 2910.4541 Elevation : ± 25.450
Y : 3282.0015

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 71 71 14.2 15.0 0 2 4 6 8 10 12 14 16
3 5 175 175 20.8 9.8 0
4 5 275 275 20.0 10.2 50
5 5 430 430 31.0 6.2 100
6 5 588 588 31.6 6.1 150
7 5 720 720 26.4 7.5 200
8 5 825 825 21.0 9.6 250
9 5 990 990 33.0 5.8 Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 8.8

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

Performed by, Witnessed/Reviewed by, Acknowledged by,

CV. Sigma PT. Tripatra Engineers & Constructors Interport
 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 : 23/08/2019
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 (B1)
Coordinate X : 2910.4541 Elevation : ± 25.425
Y : 3282.0015

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 95 95 19.0 10.8 0 2 4 6 8 10 12 14
3 5 212 212 23.4 8.5 0
4 5 300 300 17.6 11.8 50
5 5 380 380 16.0 13.1 100
6 5 478 478 19.6 10.4 150
7 5 572 572 18.8 10.9 200
8 5 768 768 39.2 4.8 250
9 5 883 883 23.0 8.7 Deepth (mm)
300
10 5 979 979 19.2 10.7
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 10.0

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

Performed by, Witnessed/Reviewed by, Acknowledged by,

CV. Sigma PT. Tripatra Engineers & Constructors Interport
 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 : 23/08/2019
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 (A2)
Coordinate X : 2910.4541 Elevation : ± 25.450
Y : 3282.0015

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 143 143 28.6 6.8 0 2 4 6 8 10 12 14
3 5 325 325 36.4 5.2 0
4 5 440 440 23.0 8.7 50
5 5 520 520 16.0 13.1 100
6 5 625 625 21.0 9.6 150
7 5 710 710 17.0 12.2 200
8 5 805 805 19.0 10.8 250
9 5 955 955 30.0 6.5 Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 9.1

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

Performed by, Witnessed/Reviewed by, Acknowledged by,

CV. Sigma PT. Tripatra Engineers & Constructors Interport
 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 : 23/08/2019
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 (A'2)
Coordinate X : 2910.4541 Elevation : ± 25.455
Y : 3282.0015

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 110 110 22.0 9.2 0 2 4 6 8 10 12 14 16
3 5 282 282 34.4 5.6 0
4 5 362 362 16.0 13.1 50
5 5 433 433 14.2 15.0 100
6 5 510 510 15.4 13.7 150
7 5 583 583 14.6 14.5 200
8 5 655 655 14.4 14.7 250
9 5 761 761 21.2 9.5 Deepth (mm)
300
5 900 900 27.8 7.0
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 11.4

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

Performed by, Witnessed/Reviewed by, Acknowledged by,

CV. Sigma PT. Tripatra Engineers & Constructors Interport
 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 : 23/08/2019
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 (B2)
Coordinate X : 2910.4541 Elevation : ± 25.455
Y : 3282.0015

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)
1 0 0 0 0 0 CBR
2 5 95 95 19.0 10.8 0 2 4 6 8 10 12 14
3 5 214 214 23.8 8.4 0
4 5 338 338 24.8 8.0 50
5 5 437 437 19.8 10.3 100
6 5 531 531 18.8 10.9 150
7 5 616 616 17.0 12.2 200
8 5 743 743 25.4 7.8 250
9 5 878 878 27.0 7.3 Deepth (mm)
300
350
400
450
500
550
600
650
700
750
800
850
900
950
1000
Average 9.5

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

Performed by, Witnessed/Reviewed by, Acknowledged by,

CV. Sigma PT. Tripatra Engineers & Constructors Interport
 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 : 23/08/2019
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 :
Coordinate X: Elevation :
Y:

Number of Depth DCP CBR

No. Reading Remarks Chart
blow (mm) (mm/blow) (%)

Average #DIV/0!

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

Performed by, Witnessed/Reviewed by, Acknowledged by,

CV. Sigma PT. Tripatra Engineers & Constructors Interport