Rev 0 DE14(02/03)

PSS STORES REQUISITION

A/C Code :
Ship's Name : FC. STRAITS PHOENIX Requisition No. PHOENIX/STE/091/10/2022
Port : TABONEO Stores Required at ETA

NO. ITEMS IMPA QUANTITY QUANTITY QUANTITY QUANTITY PART

NO. ON HAND REQUIRED APPROVED RECEIVED NUMBER
1 NON - SPARK CHAIN HOIST (CHAIN BLOCK) PR Number
- 3 TON 615024 2 PCS 22-0223
- 5 TON 615025 2 PCS
- 2 TON 615023 2 PCS 22-0223
2 SLIM BELT BELT TYPE 50x2 meter 232191 4 PCS
3 GASOLINE AND OIL FINDING PASTE 650891 5 PCS

4 STEEL EQUAL ANGLES ( BESI SIKU) 670607 30 PCS

5 PLAIN STYLE GRATINGS 673802 3 PCS

6 MAJUN ( C0TTON RACK) 100 KG 22-0230

FILTER BULDOZER KOMATSU D31PX

1 FILTER CATRIDGE 1 5 PCS 11Y-60-28712

2 OIL FILTER / CATRIDGE 0 5 PCS 600-211-2111

3 PRE FILTER / FUEL FILTER 0 5 PCS 600-3195-612
4 FILTER CATRIDGE 1 5 PCS 11Y-60-51310
5 FUEL FILTER 1 5 PCS 600-311-3870
6 ELEMENT 0 5 PCS 600-185-2510
7 PRE- CLEANER ASSEMBLY 0 5 PCS 600-181-2630
8 CAP 0 2 PCS 17A-04-41411

BY Signature : Name: YULIUS BURANNA Department: Master DATE: 16-10-2022

Ch.Engineer

Rank : ENGINE BAHARUDDIN

Stores Received at : Date :

Received By: Signature QUANTITY

Name: Rank: APPROVED

BY
Satisfactory? YES/NO* If not, indicate your reasons on back page. Initials/Date
Note: 1. *-Delete as appropriate.
2. Requisitions should be raised at least 4 weeks before arrival at the intended port of delivery.
3. Use separate forms for paints, lubes, gases, chemicals, & deck/engine/radio/catering stores.
4. Quantity shall be approved by the office.
5. Give reason if urgently required.

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