xR ee MADHANI [He Fi den ¢ EQUIPMENT : a SRT a a ‘COMPONENT REQUESTEI D [_}reontinue” vite CaponertNare eng Conporen Pat Naber (ROME Conporent Rovabe ie [0 yeu [ TINSNTO evenae ‘SCOPE OF WORK REQUEST : ‘Scheduled lother Transfer to other ste v/ | Unscheduled Machine Breakdown IDENTIFICATION = Detail problem : engine high blowby gasket cy head pos 3.45 leak coll engine mixed up coolant REQUEST BY: Yoshi Purnomo S. Sian Positen Plant Superintendent [bate 20-Sep-23 INameFORMULR aor RSPEI mR esazl eb Jot ava 2016 om REQUEST FORM es E TEQUETFORN ae ae 567278 PROJECT CODE: O43e provecrvane | Up asserjunT cove | [Eq OZ DESCRIPTIONS / he ro some’ [SO Bim Brey i ala WORK ORDER NUMBER cosrenour [13 SAolyy ESTIMATED COST ery r INFORMATION NEEDED 4 7 ART WuEER ~_OescRPTON aw | ww TEMAS t ra a 1 S 7 ane AECONIENDATION VENDOR FEAST BY CxEKING 3 Ne Selected must be based onthe Priory faa POSITION: SUPERINTENDENT / SUPERVISOR Class sted n he SOP Note: laze cle your pein and oss oa hat is not our poson! “Atestionlll"* Approval must be made and sign bythe Superintendent evel he superntndent evel dows not exit LeavalRR, Sik, Permit, ‘tthe highest evel of department only Supervisor), then ts represented by the Supervisor. [Andi there are no Superintendent & Supervisor Lave (Leave, Sick Perm) then approval must goto the Project Managed © For requests related to HSENSL, plese compl’ vith requests for completaness of what data information is needed Diarbaten (9 MSDS, 15, Data specications, ot) ‘Wite/Oigal Path) = Warehouse Pa Werah Mia) User Supertandont! Superior Green (Hau Mode) User