REQUEST FOR INSPECTION

PRE POURING

To : QAQC TPE Contract No : SPHR00306A

Project Title : CTI Well Facility Location : CTI Well_26
SPK No. : CCMSPHR/SPK/3700132661 Area : Petani Area

Gentlement : Your presence is required for the bellow mentioned inspection activity

Discipline : CIVIL √ MECH PIPING COATING

INSTR ELECT ELECT INSULT

Inspection Items : PRE POURING CONCRETE SUPPORT

Location : CTI Well_26

Quadrant : −
Time : Approx Duration:
Date :

Remarks :

Note : 1. Company reserved the right to waive witness/inspection at items/works described

above on condition that sign-off for involved item where inspection witness was waive
shall be done as actual inspection was carried out.
2. This inspection request must be issued 24 hours or more before actual date/time of
inspection.

Prepared by: Checked & Reviewed by:

PT. ADHI KARYA PT. TRIPATRA ENGINEERING

Yazit Albas Tomi #13137

DATE: DATE:
 REQUEST FOR INSPECTION
POURING CONCRETE

To : QAQC TPE Contract No : SPHR00306A

Project Title : CTI Well Facility Location : CTI Well_26
SPK No. : CCMSPHR/SPK/3700132661 Area : Petani Area

Gentlement : Your presence is required for the bellow mentioned inspection activity

Discipline : CIVIL √ MECH PIPING COATING

INSTR ELECT ELECT INSULT

Inspection Items : POURING CONCRETE SUPPORT K225 SITE MIX

Location : CTI Well_26

Quadrant : −
Time : Approx Duration:
Date :

Remarks :

Note : 1. Company reserved the right to waive witness/inspection at items/works described

above on condition that sign-off for involved item where inspection witness was waive
shall be done as actual inspection was carried out.
2. This inspection request must be issued 24 hours or more before actual date/time of
inspection.

Prepared by: Checked & Reviewed by:

PT. ADHI KARYA PT. TRIPATRA ENGINEERING

Yazit Albas Tomi #13137

DATE: DATE: