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REQUEST FOR INSPECTION

NAMA PROJECT :
CLIENT :
NOMOR KONTRAK :
LOKASI :

ACTIVITY INFORMATION TYPE OF INSPECTION

Hari/Tanggal : MATERIAL VERFIKIASI


Waktu :
Tempat : WITNESS PENGUJIAN

JOIN SURVEY
PERSON IN- CHARGE : PUCHENG PURBA, ST
JOIN INSPEKSI
ITEM INSPEKSI
CONCRETE MIXER TRUCK INSPEKSI FINAL

LAIN-LAIN

LAMPIRAN: REPORT TO BE SUBMITED

List Inspeksi Dokumentasi

INSPEKSI / HASIL TEST: NOTE:

Satisfactory/Approved …………………………………………………………………..

Unsatisfactory/Not Approved …………………………………………………………………..

Re-Inspection/Test …………………………………………………………………..

…………………………………………………………………...

PT HUTAMA KARYA PT HUTAMA KARYA PT PERTAMINA PT PERTAMINA

IMAM DIANI HARIYADI SUJATMIKA

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