F2820-F0092-04 Attachment-2 Page 28 of 29Procedure No.

F2820-P0043-01

No Dokumen Form-HSE-TMR-010
GERINDA INSPECTION STANDARD Tanggal Efektif 1/13/2022
PT PP(Persero)Tbk, Div.EPC - CFSPP TIMOR-1 (2x50 MW) No Revisi 1
(PP/No.50/2012)
Halaman 1/1

Inspection Date : _____________________________

Owner : _____________________________

Register Number : _____________________________

INSPECTION METHOD INSPECTION RESULT REASON FOR NOT

No INSPECTION ITEM STANDARDS
VISUAL FUNCTION GOOD NOT GOOD COMPLY

1 Side handle Availlable (tersedia)

2 Wheel guard Not crack (tidak retak)
3 Wheel lock Nut not crack,tight (baut tidak retak,rapat)
4 Wrench Availlable (tersedia)
5 Spidle lock button Work (berfungsi)
6 Switch Work (berfungsi)
As manufacturing standard, not expired (sesuai
7 Wheel
dengan standar pabrikan, tidak kadaluarsa)
8 Body machine Not greased,oil (tidak ada grease,oli)

9 Power cord Not scratch,insullated (tidak sobek,terisolasi)

10 Motor No spark (tidak ada percikan)

INSPECTION STATUS

PASSED Stiker Number

REJECT Stiker Number

HOLD Stiker Number

INSPECTION DATE DURATION :

To

SPECIAL NOTE :

SPESIFIKASI
Diameter ............................
INSPECTION BY APPROVED BY ACKNOWLEDGE BY RPM.....................................

Merk...................................

HSE Inspector Site Manager HSE Site Manager EPC

Name and Signature Name and Signature Name and Signature