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‘SCR PROCEDURE ~ CONSTRUCTION SECURITY MANAGEMENT PLAN ‘J910-DD08-POZEN-070015 Appendix 6. Equipment and Materials Gate Pass In and Out Q woorsnremnon | f EQUIPMENT / MATERIAL GATE PASS FORM. | JAWA 9&10 (2 X 1000 MW) COAL FIRED STEAM POWER PLANT, BANTEN “Please checklist and fill the form in correctly data [_]wasningBay Passed our times | NAMEOF COMPANY : pT. Qogsan Das 2 sep 22 VEHICLE NUMBER Req No 8 2099 @2 t& DATE ARRIVAL / ETA “a Rett | 22 Septemver 2022 Goods/ Equipment enumerated below has been permitted to be taken out from the Site of Consortium Contractor Doosan ~ HutamaKaryaJawa 9&10 CFSPP 2 X 1000 MW. (References: EHS Procedure Security Management Plan / J910-DD08-POZEN-070016) Item Descriptio uar Boner Header £ Tubes (PL-19¢), Gaeaeeteron Senyscoed a Saar moon Seunire | ; a E, rane Mato (oat Fi | OFFICER of CONSORTIUM DOOSAN HII - HUTAMA KARYA. Authorized EHS OFFICER of CONSORTIUM DOOSAN HII HUTAMA KARYA ‘Authorized Signature 2 Signature he Name nga Soe Name SURAT 1430-9612-000310 . MARYONO JAKARTA, 29-12-1996 O2PRIA .. PAGERBARANG RT.03/04 KEC. PAGERBARANG KABUPATEN TEGAL 5. SWASTA 6. JATENG ape 05-11-2026 “Scanned with CamScanner HX XHK XK, 7, B00. Bo 000. 37500 wer. canned with CamScanner Bc a OUay ma DUA P ‘SCR PROCEDURE ~ CONSTRUCTION SECURITY MANAGEMENT PLAN 4J910-0008-POZEN-070016 Appendix 6, Equipment and Materials Gate Pass In and Out Qu me EQUIPMENT / MATERIAL GATE PASS FORM JAWA 9&10 (2 X 1000 MW) COAL FIRED STEAM POWER PLANT, BANTEN | *Please checklist and fll the form in correctly data w[_] Time [__] washing Bay Passed NAME OF COMPANY : ft. Qogson Dae: a8 sep 22 VEHICLE NUMBER eee ut tee ea No DATEARRIVAL/ETA : 99 Septemvet 2022 ~ Rett Goods/ Equipment enumerated below has been permitted to be taken out from the Site of | Consortium Contractor Doosan ~ HutamaKaryaJawa 9&10 CFSPP 2 X 1000 MW. (References: EHS Procedure Security Management Plan / J910-DD08-POZEN-070016) | SUB CONTRACTOR SECURITY of CONSORTIUM | { DOOSAN HII —-HUTAMA KARYA | Authorined Authorized | Signature Signature s os ON | Name L qhal FH | | OFFICER of CONSORTIUM [HS OFFICER of CONSORTIUM, } | DOOSAN Hl - HUTAMAKARYA DOSAN Hl HUTAMA KARYA | | Authorized ‘Authorized | Signature Signature ae al Name Name i ‘ } “we Bilumum | 1320-6510-00001 4. KASIM Zip SERANG §N240-1965 3. BePRIN 4. GENGGONG ,RTIRW 21 WILAN ne ‘Scanned with CamScanner {7s MOONS ITERATION sr20n00 732048 [verre seanuarn 13 EK (47 428/NOOEL TRACTOR HEAD TA rama ey aS eee ania nee eye noes ne PT SANKYU INDONESIA wee | —UTERNATIONg ‘Scanned with CamScanner [SCR PROCEDURE - CONSTRUCTION SECURITY MANAGEMENT PLAN -4910-D008-POZEN-070016 Appendix 6. Equipment and Materials Gate Pass In and Out Q voor semen EQUIPMENT / MATERIAL GATE PASS FORM. JAWA 9&10 (2 X 1000 MW) COAL FIRED STEAM POWER PLANT, BANTEN *Please checklist and fill the form in correctly data 1] Tine: [J washing bay Passed our _]tine NAME OF COMPANY Date 2 sep 20 VEHICLE NUMBER Req No B 9300 sey — DATE ARRIVAL/ETA : 96 Septemust 2022 biel \ipment enumerated below has been permitted to be taken out from the Site of ‘Consortium Contractor Doosan — HutamaKaryaJawa 9&10 CFSPP 2 X 1000 MW (References: EHS Procedure Security Management Plan / J910-DD08-POZEN-070016) [ S.LNo| Item Description Quantity Baver Header £ Tubes (PL-IA0) | SUB CONTRACTOR SECURITY of CONSORTIUM | DOOSAN HIl- HUTAMA KARYA | Authorized ‘Authorized | signature Signature p | | Naroe Material Document Controllor (aba 4 - ~ | | OFFICER of CONSORTIUM lS OFFICER of CONSORTIUM | DOOSAN BI - HUTAMA KARYA )SAN Hl - HUTAMA KARYA Authorized Signature ~ AS ame ft SP 1322-6807 -000098 4 |. ENJEN / 2: MALINGRING, 02-07-1960 Scanned with CamScanr DINAS PE RHURUNGAN PROVING! 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Qggsomny Dae 28 Sep 20 | Eee | VEHICLE NUMBER: gga@ @M e Req No DATE ARRIVAL/ETA : 99 coptemvet 2022, a Rett Goods/ Equipment enumerated below has been permitted to be taken out from the Site of Consortium Contractor Doosan — HutamaKaryaJawa 9&10 CFSPP 2 X 1000 MW (References: EHS Procedure Security Management Plan / J910-DD08-POZEN-070016) No Item Description 1 Boner Header 2 Toes LPL-19¢) | SUB CONTRACTOR SECURITY of CONSORTIUM | DOOSAN HII - HUTAMA KARYA, Authorized Authorized | Signature | Putrt Name OFFICER of CONSORTIUM t DOOSAN HII -HUTAMA KARYA DOSAN HIT ~ HUTAMA KARYA | Authorized ae “S Authorized | fists Maret § t Name | lovee | ‘Scanned with CamScanner Ak VS 410.0924 / SHOMAL aN : DIRWNd TION © 2zszeol lose, weorsey ‘Aug wobr3 40 Koueby uonzedsuy jeapoued 919A NOS3I19 VLOW

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