Project : ATI PLANT RENOVATION PROJECT

Address : Jl. Raya Surabaya - Malang No. 352, Pasuruan

Client : PT ATOMIZATION TECHNOLOGY INDONESIA
Consultant Management: BUREAU VERITAS INDONESIA
Contractor : PT. SUKSES KARYA ABADI

APPROVAL FORM
DESCRIPTION OF APPROVAL : Ref. Approval No. :

Shop drawing for foundation pit excavation area 1 (1-3/D-J axis), ATI-SKA-CIV-DWG-SD-001
area 2 (1-3/C-D axis), area 3 (1-3/A-C axis) Date : September 04, 2023

EQUIPMENT: MATERIAL: DRAWING:

Maker/Brand Name: Maker/Brand Name: Shop Drawing: √

Model: Model: Detail Drawing:

Origin: Origin: As- Built Drawing:

TECHNICAL DATA :
1. 1-3/D-J Depth 1.5, excavation volume: (20.5+26.5)*23÷2*1.5 = 810.75 m3
2. 1-3/C-D Depth 2 excavation volume : 10.3*23*2 = 473.8 m3
3. 1-3/A-C Depth 3.5 excavation volume : 22*23*3.5 = 1771 m3

ENCLOSED DOCUMENTS :

TECHNICAL CATALOGUE TEST REPORT/CERTIFICATE

SPECIFICATION √ AS PER SAMPLE

FOR REVIEW AND COMMENTS BY THE CLIENT/CONSULTANT ONLY:

APPROVAL STATUS :

APPROVED RESUBMIT AS PER COMENTS

APPROVED with COMMENTS REJECTED

COMMENTS :

Contractor's Project Manager Review By : Approved By :

PT. Sukses Karya Mandiri PT. Bureau Veritas Indonesia Atomization Technology Indonesia

Signature : Signature : Signature :

Name : Su Wen Name : Name :

Date : September 04, 2023 Date : Date :

ILPM SF 29 Approval Form Rev. 0