OCEANCARE CORPORATION SDN. BHD.

(561916-T)
2nd Floor, Wisma Yong Lung, Lot 698, Pelita Commercial Centre
P.O.Box 1355, 98008 Miri, Sarawak
Tel:+6085-423825 Fax:+6085-422825
Email: info@oceancare.com.my Website: www.oceancare.com.my
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FORM REF. NO. : OC/QMS-15/OP-05/F-02 TEST EQUIPMENT BORROWING FORM REVISION. NO. : 1

A. BORROW OF TEST EQUIPMENT

Form Ref. No. : OCSB P/EQP B/ / 21 - ICMS Project / Job Location : BARONIA
Borrower Name : WAHYU DIN Form Ref. No. : OCSB / RF - I / EQP / 210 /2021-SKO

No. Description Tag ID / Serial No. Taken Return

1 WELDING GAUGE OCSB - 05 - 212 - 2013 1

2 PIT GAUGE OCSB - 05 - 195 - 2013 1

3 BRASS CHIPPING HAMMER 1

4 INSP. MIRROW & PICK-UP STICK 1

Condition of Test Equipment

i. Visual Checks General Condition Accs. / Probe Cable Cleanliness

ii. Operational Checks Switch on / Start-up Gauge / Reading

Remarks: #MEMO 115/15 APPLIED

# Borrower Custodian

Name: WAHYU DIN Name: KHO PS

10 Jun 2021 10 Jun 2021
Date:

# By my signature, I acknowledge that i have read, understand, and agree to follow the Terms and Conditions stated in MEMO 115/15.

B. RETURN OF TEST EQUIPMENT

Form Ref. No. : OCSB P/EQP R / /2021-ICMS

Condition of Test Equipment

Condition same as above (A)? YES / NO If NO or in other condition, please state in remarks section below.

Remarks:

Borrower Custodian

Name: WAHYU DIN NORDIN Name:

Date:
10 Jun 2021 Date: