Doc. No.

: GBP-QA-FM-23
Revision : 0
RADIOGRAPHY EXAMINATION REPORT Date : March 5, 2016
Page : 1 of 3

Client : Medco E&P Grissik Ltd. Contractor : GBP Report No. : 080/1100169687/RT/GBP-MEDCO/SB/VI/2023
Project Name : Smallbore Pipe Inspection 2023 Location : SUBAN PLANT STATION Date of Report June 27, 06,2016
: Januari 2023
Pmo : 1100169687

Material Specification : C/S Radiation Source : Ir 192 Screen Type : LEAD Film Type : FUJI IX 100
Application Code : - F/S Source Size : 3 mm x 2mm Back / Front Thick : 0.125 mm RT Tech : DWSI
Radiographic Procedure : GBP-RTP-02 Rev.0,ASME 31.3 Activity : 28 Ci Double / Single Load : S/L IQI Type : ASTM 1B

Type of Discontinuity
Material Size

Range Density
Incomp. Pen.
Incomp. Fus.

Sensitivity

Judgment
Thick

Under Cut
Inclusion
Max

Porosity

Others
Calculated Exp Time Welder Location

Crack
Identification Joint No. Date of Radiograph Min SOD DSSOF Ug. Remarks
from (MNT) Stamp Marker
(MM)
Radiography
(mm)

SB 623-3 June 27, 2023 5.57 5 Minute 20" 508 0.5 - A - - - - - - - 2% 2 -3.5 Acc No Found Anomaly
2-GL-230-113-
CA1

Technician : ANTON / DWI YUDITIYO RADIOGRAPER BY Witnessed and reviewed BY Reviewed and Approval BY ;
Total Welds/Film Used Comments : Medco E&P Grissik Ltd.
PT. Gamma Buana Persada
Asset Integrity Lead Inspector

: 1 Joints
( 4" x 10" ): - Sheets
( 4" x 15" ): - Sheets
( 7" x 17" ): 1 Sheets Name : Anton Eko P. Name : Furqon Anjalis
( 14'' x 17" ): - Sheets Date : June 27, 2023 Date : June 27, 2023
 Doc. No. : GBP-QA-FM-23

RADIOGRAPHY REPORT Revision : 0

IN SERVICE CORROSION SURVEY Date : September 27, 2017
Page : 2 of 3
Database Name : Piping Inspection
Project Name : Smallbore Pipe Inspection 2023 Client : Medco E&P Grissik Ltd.
Item/ Line No. : 2-GL-230-113-CA1 Report Number : 080/1100169687/RT/GBP-MEDCO/SB/VI/2023
Location (Stasion-P/F) : SUBAN PLANT STATION Survey Date : June 27, 2023
Ball Diameter Minimum
Calculated Thickness Measured Thickness Using
Diameter Measured
Test Point Orientation Nominal Measured From Radiography Ultrasonic Remarks
(inch) Thickness On
(mm) (mm) (mm) (mm) (mm)

SB 623-3 A 3/4" 18.00 21.00 6.50 5.57 N/A

Measurement Minimum Actual BALL Thickness

Calculated Thickness = X
Thickness on Radiography Measurement BALL Thickness

Reported By : Reviewed & witnessed by : Reviewed by :

PT. Gamma Buana Persada Medco E&P Grissik Ltd.
Radiography Level II Asset Integrity Lead Inspector

Name : Anton EP Name : Furqon Anjalis

Date : June 27, 2023 Date : June 27, 2023
 Doc. No. : GBP-QA-FM-23
Revision : 0
PHOTO AND RADIOGRAPHY LOCATION Date : September 27, 2017
Page : 3 of 3

SB 623-3
No Found Anomaly

2-GL-230-113-CA1
Line Section From : 230-V-101
Line Section To : LINE GL-203-108-CA3-C
Report No. : 080/1100169687/RT/GBP-MEDCO/SB/VI/2023
Date of Inspection : June 27, 2023
P&ID Number : ST-27-0001
Location : SUBAN PLANT STATION