DOC.

NO FM-QCC-004

CHECK SHEET INSPECTION

REV. NO 01
REV. DATE 17 January, 2019

PT. DFFI PAGE of

Customer : PT. CHEVRON PACIFIC INDONESIA Part No. : 5 Inspection by : Firman Ibnu / Sofyan Doni
Job No. : 90471 R2WHDRI Dwg No. : - Inspection Report : Final Inspection
Total Qty : 215 pcs Material : ASTM A105 Heat Number : D19112
Qty Insp. : 13 pcs Inspection Level
: GEN II-E, 1.0
(ISO 2859-1:1999)
Part Name : Standard
Meas. Actual Dimension
BL 3" 300# RF Item No. Position Remark
Device Nominal Tol
(ASME B16.5)
Drawing / Sketch : MTC No V
Visual V

ft D Outside Diameter OF Flange VC 210mm -

K Diameter of Bolt Circle VC 168,3mm ±1,5mm

G Facing Diameter VC 127mm ±1,0mm

L Diameter of Bolt Holes VC 22,22mm -

+3.0mm
B Flange Thickness VC 27mm
-0.0mm

ft Facing Thickness VC 2mm -

- Number of Bolt Holes V 8 -

NOTE :
Measuring tool used : Inspected by Reviewed by
-V = Visual - HG = Height Gauge -SR = Steel Ruller
- VC = Vernier Caliper - BP = Bevel Protactor
- UT = Ultrasonic Thickness
Date : Date :