WORK ORDER FORM

Technical Operation Department

Customer Technical Support Installation
PT. Eka Mas Republik
Graha FIM, Jl. Teuku Cik Ditiro No. 37
Menteng, Jakarta Pusat 10310

Work Order Information Customer Information

No. WO 3554471 Customer ID C2070888

BAST Number Name Abhib Hardhian
WO Date 02 November 2023 SA Date 02 November 2023
Appt. Date 02 November 2023 Service Status Pending
Service Aging Installation 0 PIC Abhib Hardhian
Appt. Type Installation Address JAWA TIMUR JEMBER (68124)
KALIURANG GREEN GARDEN JLN.
General Retail [RFS]
Project Name KALIURANG GREEN GARDEN BLOK
[JBR.100.0102/KGG.037/A06]
H8 Number 6 Kode Pos : 68124
Installation Type AERIAL
Class Type Customer Regular
Ticket Date 02 November 2023
Package/Plan ONT (4 Port) V2 - Jet20 Internet New -
Initiate Ticket Category
Billing Cycle Date
Value Account state 0
Mobile 085335970695
Phone 085335970695
Email ianpalopa@gmail.com

Device Information
No Item ID Descriptions Serial Number Mac Address
1 ONTHW.001 HUAWEI OPTICAL NETWORK TERMINAL (ONT)
2

Main Material Information

Device
No Item ID Descriptions Serial Number Mac Address Remark Status
Model
1 ONTHW.001 HUAWEI OPTICAL NETWORK TERMINAL (ONT) ONT
2

Accessories Material Information

Material Material
No. Material Name Unit QTY No. Material Name Unit QTY
Code Code
1 200000083 Cable A/V 3m pcs 10 200000242 Terminal Box + adapter SC-APC pcs
2 11 Cable pathcord single mode 20 m (SC-
200000101 Cable duct/protector TC2 pcs 200000243 pcs
APC to SC-APC)
3 12 Cable pathcord single mode 50 m (SC-
200000102 Pipa PVC/Conduit 20 mm pcs 200000244 pcs
APC to SC-APC)
4 200000105 Clamp pipa conduit 20 mm pcs 13 200000245 Flexible 20mm (1m) meter
5 200000111 Sock pipa conduit 20 mm pcs 14 200000247 Adapter SC-APC to SC-APC pcs

6 200000117 Cable drop FO G657 dual core ( non mess ) meter 15 200000516 Splice-on Connector APC pcs
7 Cable drop FO G657 dual core With 16
200000118 meter 200000517 Splice-on Connector UPC pcs
Messenger
8 200000142 Pig Tail SC APC (2m) pcs 17 300000209 Fast Connector SC/APC pcs
9 Cable pathcord single mode 30 m (SC-APC 18
200000240 pcs 300000210 Fast Connector SC/UPC pcs
to SC-APC)

Free of charge: 150 meter note : Additional charge Rp 2500/ meter up to 100 meter
Remark to Contractor

Category Problem/Root Cause Analysis

Comments by Contractor
Appointment delayed on 2023-11-03

Technician Information Solution & Finishing

Area Jember Installer Arrival Time
Contractor Anugerah Terang Persada PT Work Completed TIme
Installer Name Anassul Malik Appt. Status/Work Order Successful
Installer Contact No. 085708778102 St Unsuccessful
Slot Time 5pm to 7pm

Dengan menandatangani lembar kerja ini saya menyetujui semua hasil kerja dan perbaikan yang sudah dilakukan dengan hasil baik
Jember, ...................................................

Cust. Technical Support Signature Customer Signature & Name