REQUEST FORM

Request No : Request Date : Jumat,14 Januari 2022

Location :: Project Rsup Dr. Sardjito Yogyakarta Request By : Riyadh

NO ITEM NAME QTY SATUAN PRICE Total

1 10 Dus
Dynabolt M8
2 5 Dus
Mur Baut M6
3 10 Dus
Baut Roofing
4
Meteran 2 Bh
5 5 Pcs
Mata Roofing
6 8 Btg
Shock Tembaga 1 1/8
7 4 Btg
Shock Tembaga 5/8
Pipa Tembaga 2 Mtr
Elbow Tembaga 5/8 11 Btg
BJLS 0,8 4 Roll
BJLLS 0,6 8 Roll
Flexibel 12" 10 Roll

Flexibel 5" (Non Isolasi) 10 Roll

Flexibel 20" 2 Roll
Flexibel 10" 6 Roll
RAG 1000x200 10 Unit
RAG 1200 X200 1 Unit
Lem Aibon 5 Can
Therbreak 15 Dus
Thermaflex 25 7 Roll
Kawat Las 3 Dus
Kabel NYY 4x50 42 Mtr
Kabel NYA 1x50 42 Mtr
Kabel AWG 18 1 Roll
Stang Sealant 3 Buah
Sarung tangan 10 Pack
Water Pass 1 Pcs
HT 2 Bh
Penguat Sinyal HT 1 Bh
Wearmes Stainles 5 Roll
Mata Cutting WD 4" 5 Dus
Mata Cutting WD 14" 2 Pcs
SKUN Y Kuning 16 6 Pcs
SKUN Merah 16 6 Pcs
SKUN Y Item 16 6 pcs
SKUN Y Biru 16 6 pcs
SKUN Y Kuning 50 2 Pcs
SKUN Merah 50 2 Pcs
SKUN Y Item 50 2 pcs
SKUN Y Biru 50 2 pcs
Thermaflex 1 3/8 4 Btg
U Bolt 3" 20 Pcs
Reducer 2"x1 1 Pcs
Tee pvc 2"x 1" 1 Pcs
Tee pvc 2" 1 pCS
Elbow PVC 2" 3 Pcs
Pipa PVC 2" 6 Btg

Prepared By Approved By
Riyadh
REQUEST FORM

ITEM DESCRIPTION