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FIELD INSPECTION REPORT

INSPECTION TYPE: REPORT NO :


ITEM NO :
EQUIPMENT ACCESSORIES INSTALLATION INSPECTION
AREA/LOCATION :

ITEM No. DESCRIPTION : SIGNATURE

SSIE INSPECTOR PERTAMINA CONTRACTOR


PE INSPECTOR : SSIE ECLC GTA
CONTRACTOR'S INSPECTOR :

NO INSTALLATION INSPECTION
ACC REJ ACC REJ ACC REJ

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Comments :

LEGEND ACC : ACCEPT N.A. : Not Applicable REJ : REJECT

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