DOC.

NO FM-QCC-004

CHECK SHEET INSPECTION

REV. NO 01
REV. DATE 17 January, 2019

PT. DFFI PAGE of

Customer : PT. PERTAMINA HULU ROKAN Part No. : 10 & 20 Inspection by : Firman Ibnu / Sofyan Doni
Job No. : 4500007641 Dwg No. : - Inspection Report : Final Inspection
Total Qty : 130 pcs Material : ASTM A105/N Heat Number : 723R9
Qty Insp. : 8 pcs Inspection Level
: Gen. 1-D - 1,5
(ISO 2859-1:1999)
Part Name : Standard
Meas. Actual Dimension
REDUCER BUSHING 4" X 3" 3M/6M Item No. Position Remark
Device Nominal Tol
(ASME B16.11)
Drawing / Sketch : MTC No V
Visual V

F Nominal Width Flats VC 117,48mm -

G Hex Heigth VC Min 13mm -

Q1

A Length VC Min 32mm -

Q1 NPT Thread Female Mal 3" NPT -

Q2
Q2 NPT Thread Male Mal 4" NPT -

NOTE :
Measuring tool used : Inspected by Reviewed by
-V = Visual - HG = Height Gauge -SR = Steel Ruller
- VC = Vernier Caliper - BP = Bevel Protactor
- UT = Ultrasonic Thickness
Date : Date :