INSPECTION CLOSED-OUT FORM

Ships Name GAS SUASA

(Nama Kapal)
Ship Owner/Operator SUASA BENUA SUKSES
(Pemilik/Pengelola Kapal)
Date | Port of Inspection 20 September 2021 SEMARANG
(Tanggal | Pelabuhan Inspeksi)

VIQ / SSSCL Ref. Observation

(Temuan)
Engine Room bilge tank high level alarm was found not working properly at the time of
inspection.
10.30
Bilge Tank High Level Alarm Kamar Mesin ditemukan tidak berfungsi dengan baik saat
pemeriksaan.

Root Cause Metal corrosive

(Akar Masalah)

Logam berkarat.
Corrective Action Repair Micro Switch for the Bilge Tank High Level Alarm, after repair the result is
(Tindakan Perbaikan) working properly.

Memperbaiki saklar mikro untuk Bailge Tank High Level Alarm, setelah perbaikan
hasilnya dapat berfungsi dengan baik.

Preventive Action Put sealant seal to the cover of micro switch.

(Tindakan Pencegahan)

Memasang seal penutup pada pelindung micro switch.

Close-Out evidence might be; documents, procedures, photos, certificate, service report, delivery order, etc.)
(Bukti tindak lanjut dapat berupa; dokumen, prosedur, poto, sertifikat, laporan kerja, bukti pengiriman, dll.)

BEFORE

Page 1 of 3
 INSPECTION CLOSED-OUT FORM
Ships Name GAS SUASA
(Nama Kapal)
Ship Owner/Operator SUASA BENUA SUKSES
(Pemilik/Pengelola Kapal)
Date | Port of Inspection 20 September 2021 SEMARANG
(Tanggal | Pelabuhan Inspeksi)

AFTER

CLOSED

Page 2 of 3
 INSPECTION CLOSED-OUT FORM
Ships Name GAS SUASA
(Nama Kapal)
Ship Owner/Operator SUASA BENUA SUKSES
(Pemilik/Pengelola Kapal)
Date | Port of Inspection 20 September 2021 SEMARANG
(Tanggal | Pelabuhan Inspeksi)

SERVICE REPORT

CLOSED

Page 3 of 3