HMMI Inspection and Test Plan Rev - 0

ITP FOR HMMI PROJECT (Mechanical Works) _ REV0
Flow Chart Inspection Item Inspection Point

Remark
Level 1 Level 2 Sub-con HEIN HMC
Material Onsite 1. Material Approval & Mock up I W/R SW As required
Common 2. Material Onsite Inspection I W/R SW Random Check
Inspection 3. Sleeve I n s t a l l a t i o n works I W/R SW

Fail Pass
4. Piping Works (Underground) I W/R SW
Shop Drawing
 Leak Test I/T W/R W
5. Piping Works (Above Ground) I W/R SW

Piping works
- Utility  Leak Test I/T W/R W
Review - GAS and Oil `
- HVAC 6. Plumbing Works (Underground) I W/R SW
- Fire Fighting
Fail  Leak Test I/T W/R W
Pass
7. Plumbing Works (Above Ground) I W/R SW

Installation
 Leak Test I/T W/R W
8. Duct Works I W/R SW

HVAC works
Daily Field Check
Filed Observation 9. EHP Works I/T W/R SW
Defect NCR
Insulation 10. Insulation work I W/R SW
11. Automatic Control Works I/T W/R SW
Inspection Control and

T&C 12. Equipment Test I/T W/R W
13. Commissioning I/T W/R W

Fail
Pass 14. T.A.B I/T W/R W
Record and Special Work 15. Tank Farm I/T W/R SW

Next Step
16. WWTP I/T W/R W
Field Observation Daily Inspection SI /R
Legend:
I: SI : T: W: SW : R:
Inspection Spot Inspection Test Witness Spot Witness Record Check

ITP NO. HMMI - Q - ME - 01
HMMI Project in Indonesia.
INSPECTION & TEST PLAN
PAGE 1 OF 8
REV No 0
WORK ITEM : MECHANICAL WORK
REV Date 01-MAY-20
INSPECTION POINT
ACTIVITY FREQUENCY INSPECTION STANDARD REPORT
ITEM INSPECTION ITEM REMARK
TO BE VERIFIED SUB-
HEIN HMC
CON
Common Before Each Main work Material approval Document Material submittal I W/R SW/R
1. Material Approval & Mock up Mock up Report by sub
SNI & Industrial Standard
1) Material approval All material submittal shall SI/R

be submitted by
- Specification.
Subcontractor
2) Mock up
- Material approval
- Quality of installation
Material on arrival. Shop Drawing Inspection Report by sub I W/R SW/R

2. Material Inspection Random Check asked By
SNI & Industrial Standard
Check list Hein
1) Material Receiving Inspection During the installation Field Observation by GC SI/R
- Field Observation NCR by GC
- Material approval document
- Packing condition
- Quality of product
- Brand new Product
- Any damage during the transportation
- Storage condition at the filed
After Sleeve installation Shop Drawing Inspection Report by sub I W/R SW/R
3. Sleeve I n s t a l l a t i o n works Before Concrete Casting SNI & Industrial Standard
Check list
1) Sleeve installation During the installation Field Observation by GC SI/R
- Material Condition
- Installation Location / Height
- Fixed Status.
PAGE 2 OF 8
REV No 0
REV Date 01-MAY-20
INSPECTION POINT
TO BE VERIFIED SUB-
HEIN HMC
CON
After Piping Installation Shop Drawing Inspection Report by sub I W/R SW/R
Mechanical 4. Piping Works (Underground) Before Backfilling SNI & Industrial Standard
Works Check list
1) Underground Piping works During the installation Field Observation by GC SI/R
- Stored and Installed material condition - Field Observation NCR by GC
- Pipe alignment (level, route, space)

- Piping bedding and back fill soil condition
- Support Interval (span) and alignment
- Pipe and fitting welding Status
- Anti-corrosion tapping condition
- Electrofusion welding condition.
5. Piping Works (Above Ground) Before Backfilling SNI & Industrial Standard
Check list
1) Utility Piping Works During the installation Field Observation by GC SI/R
- Stored and Installed Material condition - Field Observation NCR by GC
- Pipe alinement (level, route, space)

- Clearance for Insulation and other work
- Pipe supports interval per pipe size
- Correct fittings (Tee, Reducer, Weldolet, Etc)
- Support bolt, nut plate fixing condition
- Bolting appropriate length, diameter
- Branch location and connection method.
- Shoe & Anchor Installation condition
- Valve, A.A.V location and Installation.
- No STS touch the Carbon steel
- Any damage of paint
2) Welding / Groove Joint
- Treatment of cutting faces (V-cutting)
- The width/height of the bead
- Check Over/Under cut, etc.
- Cracks, deformation
- Distortion in weldments
- Grooving condition per manual
- Level of each installed pipe
- Bolt nut fixing condition
INSPECTION & TEST PLAN PAGE
REV No
3 OF 8
0
REV Date 01-MAY-20
INSPECTION POINT
TIMING / FREQUENCY INSPECTION STANDARD REPORT
SUB-
HEIN HMC
CON
Mechanical 6. Plumbing Works (Underground) Before Backfilling SNI & Industrial Standard
Works Check list
1) Pipe Installation During the Installation Field Observation by GC SI/R
- Stored and Installed Material condition
- Pipe alinement (slope, level, route, space)
- Proper supporting and anchoring maintain
pipe alignment.
- Each stub up location per shop drawing
- F.D location is not located at path of user.
- Trap installation condition
- Finishing condition of each sleeve.
- Vent line size and branch location
- Waste pipe from fixture shall be equal or
greater in diameter to that of the fixture
outlet.
After piping Installation Shop Drawing Inspection Report by sub I W/R SW/R
7. Plumbing Works (Above Ground) Before Ceiling or Insulation SNI & Industrial Standard
Check list
During the Installation Field Observation by GC SI/R
1) Pipe Installation
- Stored and Installed Material condition
- Pipe alinement (level, route, space)
Pipe alignment.
pipe alignment.
- Hot and cold water connection
- Height of water for plumbing equipment
- Finish of the water pipe for tile work.
- Block vale location and access door location
REV No
4 OF 8
0
REV Date 01-MAY-20
INSPECTION POINT
SUB-
HEC PMC
CON
After Duct Installation Shop Drawing Inspection Report by sub I W/R SW/R
Mechanical 8.Duct Works SNI & Industrial Standard
Works Check list
1) Duct Work During the Installation Field Observation by GC SI/R
- Duct Arrangement & Branch Condition
- Fixing & Supporting for Duct
- Duct Connection / Sealing
- Flexible duct & canvas connection
- Touch-up painting for all cut edges
2) Duct Insulation
- Damage on duct insulation
- Cleanliness(rust,dust,grease,etc)
3) Duct Accessory
- Fire dampers, Volume Damper
(Suitability of damper to control)
- Louvers, Back draft dampers
9. EHP Works SNI & Industrial Standard
Check list
1) EHP Installation Works During the Installation Field Observation by GC SI/R
- Installation of Split Units
- Refrigerant Pipe Connection
- Drain Pipe Connection
(Slope of the drain pipe)
- Leakage
2) EHP Installation Works
- Installation of Split Units
- Refrigerant Pipe Connection
- Drain Pipe Connection
(Slope of the drain pipe)
- Running Test
PAGE 5 OF 8
REV No 0
REV Date 01-MAY-20
INSPECTION POINT
TO BE VERIFIED SUB-
HEIN HMC
CON
After Insulation Shop Drawing Inspection Report by sub I W/R SW/R
Insulation 10. Insulation Work SNI & Industrial Standard
Works Check list
1) Surface Preparation During the installation Field Observation by GC SI/R

- Leak test report.
- Cleanliness (rust, dust, grease, etc)
1) Insulation Works
- Stored and Installed material condition
- Installation means and method
- Insulation material thickness
- Check Insulation layer (Plastic wrapping)
- Insulation status of valve and fitting
- Any damage of insulation material
3) Jacketing Work
- Cladding thickness and type
- Overlap of sheet min 2”
- Strapping and screwing
- Check expansion joint or movable device.
- Removable type work for valve/flange
- Weather protection at joint.
4) Final Visual Inspection

- Any damage or contamination of insulation
- Closing conditions around sleeve
- Insulation shall be extended through sleeves
PAGE 6 OF 8
REV No 0
REV Date 01-MAY-20
INSPECTION POINT
SUB-
HEC PMC
CON
After Shop Drawing Inspection Report by sub I W/R SW/R
BMS 11. Automatic Control works BMS installation SNI & Industrial Standard
Check list
1) Material During the Installation Field Observation by GC SI/R
- Pipe and Wiring Material
Control Cable
Rigid Steel Electrical Conduit and Hardware
- Instrument
2) Panel Construction
- Arrangement and Interface with Other
Monitor Panel of Central Monitor Panel
- Interface with Local Panel
- Implementing Function of Monitor Panel
- Finishing Condition of Local Panel
(Painting, Thickness)
3) Installation
- Arrangement of Conduit, Bending
Connection.
- Location and Fixing Condition of Pull Box
- Prohibiting Mixing Conduit and Signal Line
- Location, Direction and Insertion Depth
of Sensor
- Finishing around Connection Area
and Arranging Wire
PAGE 7OF 8
REV No 0
REV Date 01-MAY-20
INSPECTION POINT
SUB-
HEC PMC
CON
After Equipment Start up Maker Standard Startup Report by sub I SW/R
W/R
T&C 12. Equipment Procedure
1) Air compressor During the Installation 1) Equipment Submittal shall Field Observation by GC SI/R
- Field Observation be approved by HEIN prior to NCR by GC
2) AHU
start manufacturing.
3) Chiller
4) Cooling tower 2) Equipment installation
5) Steam boiler procedure shall be approved
6) Rotating Equipment before equipment shipping.
7) etc. equipment 3) Start up Procedure
shall be submitted by maker
for review.
After Equipment Start up Commissioning Procedure Report by sub I W/R

W/R
13. Commissioning Check list
1) General Installation Check SI/R
2) Valve, Piping and Coils Installation Check

3) Fan, Duct Work (Near Unit)
4) Electrical Controls Installation Check
REV No
8 OF 8
0
REV Date 01-MAY-20
INSPECTION POINT
SUB-
HEC PMC
CON
After Equipment Start up TAB Procedure. TAB Report by sub I SW/R
W/R
Special 14. T.A.B
Works
1) TAB Wet and Dry During the Installation TAB Procedure shall be Field Observation by GC SI/R
1) TAB Wet and Dry
- Field Observation submitted for approval. NCR by GC
After Shop Drawing Inspection Report by I W/R SW/R

15. Tank Farm TANK Farm installation SNI & Industrial Standard sub
Check list-Mechanical
During the Installation T&C Procedure shall be Field Observation by GC I SW/R

1) Civil Work W/R
- Field Observation submitted for approval. NCR by GC
2) Mechanical work
3) Electrical work
4) Auto Control installation
Inspection based on
General mechanical work
After Shop Drawing Inspection Report by I W/R SW/R
WWTP installation SNI & Industrial Standard sub
16. WWTP
Check list-Mechanical
During the Installation T&C Procedure shall be Field Observation by GC SI/R

1) Mechanical work - Field Observation submitted for approval. NCR by GC
2) Electrical work
3) Auto Control installation
Inspection based on
General mechanical work
MATERIAL RECEIVING INSPECTION
REPORT
PROJECT : HMMI PROJECT IN INDONESIA.. REPORT NO. : HMMI_QC_ME_SUBNAME_001
PO NO. : TK-01-30 DATE : 2020.05.10
SUBCON NAME : P.T Takenaka Indonesia VENDOR NAME : P.T ABED Indonesia
USE LOCATION : Utility Center VENDOR CONTTAC : + 62 - 1234-1234
ITEM DESCRIPTION : Piping for Utility and Fire fighting
CHECHK POINTS. RESULTS REMARKS
1. Equipment/Material Approval Condition □ ACCEPT □ REJECT
2. Identification of equipment/material □ ACCEPT □ REJECT
3. Packing condition □ ACCEPT □ REJECT
4. Unloading condition □ ACCEPT □ REJECT
5. Ensure all materials are new and not damaged □ ACCEPT □ REJECT
6. Others ( ) □ ACCEPT □ REJECT
ATTACHEMENTS. ATTACHED
1. Packing list and invoice. □ YES □ NO
2. Photo Report □ YES □ NO
3. Others ( ) □ YES □ NO
CONCLUSION OF INSPECTION. RESULTS REMARKS
□ ACCEPT □ CONDITONALLY ACCEPT □ REJECT
ACTION TO BE TAKEN (IF NOT ACCEPTED) :
Sub-CONTRACTOR NAME: HEIN INCHARGE: HMC INCHARGE:
DATE: DATE: DATE:
SIGEND BY SIGEND BY SIGEND BY

PHOTO REPORT
PHOTO OF : DATE :
PHOTO OF : DATE :
Mock up Report
PROJECT : HMMI PROJECT IN INDONESIA.. REPORT NO. : HMMI_QC_ME_SUBNAME_001
PO NO. : TK-01-30 DATE : 2020.05.10
SUBCON NAME : P.T Takenaka Indonesia
MOCKUP FOR : Utility Piping
Comment :
CHECHK POINTS. RESULTS REMARKS
1. Material Approved □ ACCEPT □ REJECT
2. Shop Drawing □ ACCEPT □ REJECT
3. Acceptance criteria SNI & Industrial Standard. □ ACCEPT □ REJECT
4. Installation condition □ ACCEPT □ REJECT
5. Check with client. □ ACCEPT □ REJECT
6. Others ( ) □ ACCEPT □ REJECT
ATTACHEMENTS. ATTACHED
1. Photo Report □ YES □ NO
2. Others ( □ YES □ NO
)
CONCLUSION OF INSPECTION. RESULTS REMARKS
□ ACCEPT □ CONDITONALLY ACCEPT □ REJECT
ACTION TO BE TAKEN (IF NOT ACCEPTED) :
Sub-CONTRACTOR NAME: HEIN INCHARGE: HMC INCHARGE:
DATE: DATE: DATE:
SIGEND BY SIGEND BY SIGEND BY

PHOTO REPORT
PHOTO OF : DATE :
PHOTO OF : DATE :
SLEEVE INSTALLATION
PROJECT: HMMI INDONESIA PROJECT HMMI_QC_ME_SUBNAME_001
Location (Building Name) : Paint shop Restroom Drawing Attached : _____ Page
Sleeve for : Paint Shop Restroom Drainage Subcon. Name : P.T Takenaka Indonesia
Acceptance criteria Check

No. Description of Inspection or Test SNI & Industrial Comment
Standard. Accept N/A
The sleeve material is the same as specification

1 Material Approval.
and Material approval.
Shop Drawing
2 Sleeve installed per approved shop drawings.
Sleeve size selected considering the insulation Shop Drawing

3
space.
Sleeve installed securely with proper Shop Drawing

4
reinforcement of rebar
Sleeve penetrated the external wall has a water Shop Drawing

5
stop.
The sleeves finish level higher than the floor Shop Drawing
6
level. (For the staircase and pit)
The end of the sleeve has protection for Shop Drawing

7
concrete.
Inspection By Sub-con HEIN HMC
Name
Signature
Date
PIPING INSTALLATION (Underground)
Location (Building Name) : Paint Shop to R&D center Drawing Attached : _____ Page
Utility for : IW,FF Subcon. Name : P.T Takenaka Indonesia

.
Piping includes fittings and valves installed per
material approval.
Piping installed as per approved shop drawing.

2 Shop Drawing
(level, size, route)
Underground pipe bedding prepared per shop Shop Drawing

3
drawing details.
All pipe connections are completed accordingly. Shop Drawing

4
(Electro welding bid, Welding Bid)
The trust blocks are installed at the right location Shop Drawing
5
and direction.
Corrosion protection tape installed without Shop Drawing

6
damage or any missing point.
Washed sand is clean and enough to protect the Shop Drawing

7
pipe. (Bottom and Top)
8  Leak Test Report Per Area and System Per area
Name
Signature
Date
PIPING INSTALLATION (Above Ground)
Location (Building Name) : Assembly Shop A~B x 7~8 Drawing Attached : _____ Page
Piping Insulation For : IW,CW,CHW,NG,STEAM Subcon. Name :

Piping includes fittings and valves installed

per material approval.

2 Shop Drawing
(Level, Size, Route)
Pipe supports, hangers are installed per shop Shop Drawing

3
drawing details. (Interval, level, mockup)
Installed pipe considered insulation clearance, Shop Drawing

4
steel beam, pipes, and supports.
Welding connections are completed per WPS.

Shop Drawing
5 All joints connection completed in accordance
With grove installation manual.
Installed pipe had a proper drain point and slope. Shop Drawing
6
(Drain point and slope of the pipe)
All bolt and nut are installed securely and Shop Drawing
7
checking any missing point.
Guide/Anchor supports are installed per shop

8 Shop Drawing
drawings
Valves, including other devices, installed

9 Shop Drawing
considering operation and repair.
Flange Alignment (Pump, Equipment, etc.)

10 Shop Drawing
Check Valve type, direction, and location.
Valve flow direction and valve steam and handle Shop Drawing
11
direction, Check H.P.V / L.P.D locations.
Before doing insulation work, the pipe shall be Shop Drawing

12
clean thoroughly.
Name
Signature
Date
PLUMBING WORKS (Underground)
Plumbing for : Assembly Restroom Subcon. Name :

No. Description of Inspection or Test SNI & Industrial
Piping includes fittings and valves installed


2 Shop Drawing
(level, Size, Route)

3
Each pipe support shall be stable, and all Shop Drawing

4
hangers must hold the pipe tightly.
Gravity Sewage drain pipes are installed with Shop Drawing

5
proper slope. not less than 1mm per 1 m.
Vent branches are made at the right location and Shop Drawing
6
size.
Elevation of main outlet form the building has

Shop Drawing
7 checked with an elevation of the civil main pipe
line
F.D, C.O installed considering future Shop Drawing

8
maintenance and any obstruction.
Pipe stub up location has checked with the finish Shop Drawing
9
of the fixture location.
The trap is installed before connecting with civil

10 Shop Drawing
line.
Name
Signature
Date
PLUMBING WORKS (Above Ground)
Plumbing for : Assembly Restroom Subcon. Name :

Piping includes fittings and valves installed per

material approval.

2 Shop Drawing
(level, Size, Route)

3
Each pipe support shall be stable and all hangers Shop Drawing
4
must hold the pipe tightly.
Elevation of pipe finish for the sanitary fixture Shop Drawing

5
check with fixture’s connection.
Pipe insulation space for hot water line shall be Shop Drawing
6
considered.
The main water line for the restroom had the Shop Drawing
7
block valve for the maintenance.
The pipes to be reclaimed must be protected Shop Drawing

8
appropriately.
Vent finish avoided HVAC unit, window, and Shop Drawing

9
louver.
10 Bird screen installed at each vent line on the roof. Shop Drawing
Name
Signature
Date
DUCT WORK
Duct Work for For : Assembly Office Area. Subcon. Name :

All the material, including duct, fittings, and

dampers, are installed per material approval.
Duct fabrications are made per approved

2 Shop Drawing
drawing. (thickness, dimension, finish)
Duct installed right elevation, size, and route per

Shop Drawing
3 approved drawing. (Any Obstruction for other
work)
Each duct supports are installed stably. All Shop Drawing

4
hangers must hold the duct tightly
Duct joint connections are installed tightly with Shop Drawing

5
the correct type of gasket.
Duct brackets, hangers, and supports are Shop Drawing

6
installed per shop drawing detail.
All flexible had proper support and enough Shop Drawing

7
length.
Fire dampers, Manual damper are installed Shop Drawing

8
correct location.
Shop Drawing
9 All damper positions are adjusted right position.
Shop Drawing
10 Identification label for each Duct and Pipeline
Access doors for damper location are considered Shop Drawing

11
correctly.
Name
Signature
Date
DUCT ACCESSORY
Utility for : Assembly Office Area Subcon. Name :

All the materials are installed per material

approval. (diffuser, grille, and register)
The number and type of duct accessories are

2 Shop Drawing
installed per drawing. (T-bar, Line, General)
Flexible duct and duct accessory shall be Shop Drawing

3
connected securely.
Grill, Register, Louver are installed properly Shop Drawing

4
considering architectural finishing.
Grille, diffuser, and register are correctly aligned Shop Drawing

5
and fitted at the ceiling panel.
The diffuser, grille, and register are clean and Shop Drawing
6
installed without any damages.
Grilles/registers necks are fitted to the duct Shop Drawing

7
opening to avoid air leak.
The duct line above the ceiling shall have

Shop Drawing
8 adequate insulation for preventing dew
condensation.
Shop Drawing
9
Shop Drawing
10
Shop Drawing
11
12  Per area
Name
Signature
Date
EHP INSTALLATION
Duct work : Assembly Office Area Subcon. Name :

Piping, the conduit, includes fittings installed per

material approval.
Piping installed with a correct arrangement as per

2 Shop Drawing
approved shop drawing. (Level, Size, Route)

3
Installed pipe considered other obstruction such Shop Drawing

4
as other utilities, duct, and lighting.
All refrigerant pipe and drain pipe connections Shop Drawing

5
are completed
All bolt and nut are installed securely and Shop Drawing
6
checking any missing point.
The support for an indoor unit installed securely

Shop Drawing
7 at the right location, considering ceiling
arrangement.
Refrigerant pipe and drain for equipment
Shop Drawing
8 connection are located at the correct equipment
location.
The condensate drain pipe had a proper slop Shop Drawing

9
without water tied up.
Insulation installed per shop drawing and had Shop Drawing

10
proper support to protect the insulation.
Insulation installed with joint and completed the

11 Shop Drawing
joint after leak test.
Per area
12  Leak Test Report Per area
Name
Signature
Date
INSULATION (PIPE)
Utility for : IW,CW,CHW,NG,STEAM Subcon. Name :

No. Description of Inspection or Test SNI & Industrial
Standard. Accept
Insulation material and size shall installed

Proper insulation method shall be applied for the

2 Shop Drawing
system.
Material shall be selected considering Shop Drawing

3
maintenance or future expansion work.
Each Insulation material shall be connected Shop Drawing

4
tightly to bear the pipe expansion and vibration.
Each Insulation connected point shall be Shop Drawing

5
completely isolated from atmosphere.
Check refrigerant pipe insulation and jacketing if Shop Drawing

6
it is free from any damage.
Check pipe insulation if it is tightly fixed to Shop Drawing

7
refrigerant pipes.
Before doing insulation work, pipe shall be clean Shop Drawing

8
completely.
Check approved construction details for Shop Drawing

9
refrigerant pipe jacket upon installation.
10
11
12
Name
Signature
Date
INSULATION (DUCT)
Duct Insulation for For : Assembly Office Area. Subcon. Name :

Insulation materials are installed per material

approval. (Type of Insulation material)
Correct insulation method has applied to each

2 Shop Drawing
piping system. (Layer, Thickness)
Each Insulation connect points are completely Shop Drawing

3
isolated from the atmosphere. (Overwrap)
Each insulation is connected tightly to bear the Shop Drawing

4
pipe expansion and vibration.
Insulation works completed considering Shop Drawing

5
maintenance or future expansion work.
Name
Signature
Date
BMS INSTALLATION
Utility for : IW,CW,CHW,NG,STEAM Subcon. Name :

The tray or conduit includes fittings, and instruments

are installed per material approval.
2 The tray or conduit and control panels are installed

Shop Drawing
per shop drawing. (Level, Size, Route)
The instruments are installed each requirement. Shop Drawing

3
(required distance, location, support)
All the sensors for the automatic system are installed Shop Drawing
4
at correct locations without damage.
The control panel shall have a proper support Shop Drawing

5
method and grounding system
Installed panel and instrument located proper Shop Drawing

6
operation and maintenance access.
The cable connections at the panel or instruments Shop Drawing

7
are made without any losing point.
The control panel finished with clean conditions Shop Drawing

8
inside and outside.
Name
Signature
Date
LEAK TEST
Test for : IW Subcon. Name :
SCOPE OF TEST : ATTACEHED MARKED-UP P&ID OR DRWAING
APPLICABLE COD : Specification / Project Requirement
DESING PRESSURE : ________ Kg/Cm2
METHOD USED FOR TEST :
HYDROSTATIC 　 PNEUMATIC 　 SERVICE 　
REQUIRED TEST PRESSURE : ________ Kg/Cm2
INSPECTION TEST PRESSURE ________ Kg/Cm2
REQUIRED TIME TEST PRESSURE HELD : ________ HR
TIME TEST STARTED : ___________________ / TIMETEST COMPLETED : ___________________
ACTUAL LEAKAGE : ________ Kg/Cm2
TEST ACCEPTED :
YES 　 NO 　
IF NO, WHY?
Name
Signature
Date
LEAK TEST PHOTO
Test for : IW Subcon. Name :
BEFORE TEST : DATE AND TIME :
AFTER TEST : DATE AND TIME :

LEAK TEST DRAWING
EQUIPMENT
Location (Building Name) : UTILITY BUILDING Drawing Attached : _____ Page
EQUIPMENT INSTALLATION Subcon. Name :

Equipment level in good condition and remove

1
temporary supports.
2 All rotating parts are aligned and free of condition.
3 All equipment completed correct lubrication or Oil.
4 Equipment and pipe or duct system connected

tightly without leak
5 Proper electric power source confirmed with

electrician.
6 Electric power connections are tight and good

condition.
7 All valves are right position filled with water.
8 Safety valves and safety relief valves shall be

located.
 Equipment's test report, O&M manual

9
submitted
Name
Signature
Date
Commissioning
Location (Building Name) : Utility Center Drawing Attached : _____ Page
Installation and Operational Checks Subcon. Name :
General Installation Check Accept N/A Comment

Permanent labels affixed, including for equipment
Each equipment pre functional test check list has been completed
Clean up of equipment completed per contract documents
Connection between Pipe/duct and unit tight, without leaks and in

good condition
Maintenance access acceptable for unit and components locks
Vibration isolation equipment installed & released from shipping

(minimum deflection 2”)
Final filter installed with replacement type and construction filters removed)
Valve, Piping and Coils Installation Check (near unit) Accept N/A Comment
Pipe fittings complete
Pipes labeled & insulated
Safety/Relief valve are installed set up
Strainers in place and clean
Piping system leak tested & flushed
Condensate drain pans clean and slope to drain
All drain is connected and aby obstructions.
All control valves installed correctly.
Valves installed in proper direction, valve tags attached
P/T plugs installed per drawings
Fan, Duct Work (Near Unit) Accept N/A Comment

Supply fan and motor alignment correct
Supply fan and motor bearings lubricated
Supply fan area & blower wheel clean
Dampers close tightly & move freely without binding
Ducts cleaned
Electrical Controls Installation Check Accept N/A Comment

Power connects in place and labeled
Electric connections tight
Power to light fixtures and Out let
Proper grounding installed for components and unit
Overload breakers installed and correct size
Control system interlocks hooked up and functional
Control devices and wiring complete
Connection to DDC complete
Point to point checkout complete

HMMI Inspection and Test Plan Rev - 0

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HMMI Inspection and Test Plan Rev - 0

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ITP FOR HMMI PROJECT (Mechanical Works) _ REV0

Flow Chart Inspection Item Inspection Point

Material Onsite 1. Material Approval & Mock up I W/R SW As required

Common 2. Material Onsite Inspection I W/R SW Random Check

Inspection 3. Sleeve I n s t a l l a t i o n works I W/R SW

4. Piping Works (Underground) I W/R SW

5. Piping Works (Above Ground) I W/R SW

7. Plumbing Works (Above Ground) I W/R SW

 Leak Test I/T W/R W

8. Duct Works I W/R SW

Insulation 10. Insulation work I W/R SW

11. Automatic Control Works I/T W/R SW

Inspection Control and

13. Commissioning I/T W/R W

Record and Special Work 15. Tank Farm I/T W/R SW

16. WWTP I/T W/R W

Field Observation Daily Inspection SI /R

Inspection Spot Inspection Test Witness Spot Witness Record Check

1) Material approval All material submittal shall SI/R

Material on arrival. Shop Drawing Inspection Report by sub I W/R SW/R

- Pipe alignment (level, route, space)

- Pipe alinement (level, route, space)

1) Surface Preparation During the installation Field Observation by GC SI/R

4) Final Visual Inspection

After Equipment Start up Commissioning Procedure Report by sub I W/R

1) General Installation Check SI/R

2) Valve, Piping and Coils Installation Check

After Shop Drawing Inspection Report by I W/R SW/R

During the Installation T&C Procedure shall be Field Observation by GC I SW/R

4) Auto Control installation

During the Installation T&C Procedure shall be Field Observation by GC SI/R

3) Auto Control installation

PROJECT : HMMI PROJECT IN INDONESIA.. REPORT NO. : HMMI_QC_ME_SUBNAME_001

PO NO. : TK-01-30 DATE : 2020.05.10

USE LOCATION : Utility Center VENDOR CONTTAC : + 62 - 1234-1234

ITEM DESCRIPTION : Piping for Utility and Fire fighting

CHECHK POINTS. RESULTS REMARKS

1. Equipment/Material Approval Condition □ ACCEPT □ REJECT

2. Identification of equipment/material □ ACCEPT □ REJECT

3. Packing condition □ ACCEPT □ REJECT

4. Unloading condition □ ACCEPT □ REJECT

6. Others ( ) □ ACCEPT □ REJECT

1. Packing list and invoice. □ YES □ NO

2. Photo Report □ YES □ NO

CONCLUSION OF INSPECTION. RESULTS REMARKS

□ ACCEPT □ CONDITONALLY ACCEPT □ REJECT

ACTION TO BE TAKEN (IF NOT ACCEPTED) :

Sub-CONTRACTOR NAME: HEIN INCHARGE: HMC INCHARGE:

DATE: DATE: DATE:

SIGEND BY SIGEND BY SIGEND BY

PROJECT : HMMI PROJECT IN INDONESIA.. REPORT NO. : HMMI_QC_ME_SUBNAME_001

PO NO. : TK-01-30 DATE : 2020.05.10

SUBCON NAME : P.T Takenaka Indonesia

MOCKUP FOR : Utility Piping

CHECHK POINTS. RESULTS REMARKS

1. Material Approved □ ACCEPT □ REJECT

2. Shop Drawing □ ACCEPT □ REJECT

3. Acceptance criteria SNI & Industrial Standard. □ ACCEPT □ REJECT

4. Installation condition □ ACCEPT □ REJECT

5. Check with client. □ ACCEPT □ REJECT

6. Others ( ) □ ACCEPT □ REJECT

1. Photo Report □ YES □ NO

CONCLUSION OF INSPECTION. RESULTS REMARKS