INSPECTION FORM Doe. No Form Horizontal Lifeline Date 06-Jan-2022 Rev. No 09 Horizontal Lifeline (for construction processes) Tiang lifeline terpasang dalam kondisi baik dan tidak beng! Dynabolts on lifeline must fully installed Dynabolt pada tiang lifeline terpasang pent Th turnbuckle installed and working pi | Turnbuckle terpasang dan dapat ber ‘Anchor point are available on each lifel Titik. angkur ‘tersedia pada setiap tiang | bend of the wire slings, Itis | Pada setiap tekukan wire sling wajib t Wire clips/clamps must be install (min. 3 pes) “a Wire clip/clamp horus terpasang ¢ (min. 3 pcs) 4 Inspect Project Name: Nestle Batik and Spark Project Rotating Day/Date: On Me (6-0) tot 1 6 Le al Uo 3 Ending Point No. ITEMS CHECK YES. NO REMARKS 1 | Wire Sings have been inspected and the wite slings in good condition | Wire sling telah dilokukan pemeriksaan dan dalam kondisi yang baik 2, | The lifeline post installed in good condition and there are not bent |__/ | Scanned with CamScanner