Project Name: Grasberg Kasuang Copper Cleaner Project ( CuCL)

Project No: C0JV

Contractor: FPJO

PRE - POURING CONCRETE INSPECTION CHECKLIST

Description: Column Pedestal P6 & P7 Location: Air Receiver
IWP: A2480A1FCC00 CWP: A2480A1FCC00
As Built Dwg: Instrument: TS Leica MS-60-SN-890372
Report Number: C208 Survey Date: 18-Oct-2023

Design Actual Deviation Actual VS Design

Point ID Coordinate Coordinate Deviation Point Description
E N Z E N Z ΔE ΔN ΔZ
Formwork
P6
A 734672.697 9547265.853 2815.400 734672.701 9547265.853 2815.400 0.004 0.000 0.000 Marking TOC
B 734673.464 9547266.496 2815.400 734673.462 9547266.493 2815.400 -0.002 -0.003 0.000 Marking TOC
C 734674.106 9547265.730 2815.400 734674.105 9547265.727 2815.400 -0.001 -0.003 0.000 Marking TOC
D 734673.340 9547265.087 2815.400 734673.339 9547265.083 2815.400 -0.001 -0.004 0.000 Marking TOC
P6
E 734677.102 9547269.549 2815.400 734677.107 9547269.548 2815.400 0.005 -0.001 0.000 Marking TOC
F 734677.868 9547270.192 2815.400 734677.869 9547270.196 2815.400 0.001 0.004 0.000 Marking TOC
G 734678.511 9547269.426 2815.400 734678.515 9547269.432 2815.400 0.004 0.006 0.000 Marking TOC
H 734677.745 9547268.783 2815.400 734677.753 9547268.785 2815.400 0.008 0.002 0.000 Marking TOC
P6
I 734678.773 9547267.557 2815.400 734678.772 9547267.550 2815.400 -0.001 -0.007 0.000 Marking TOC
J 734679.540 9547268.200 2815.400 734679.533 9547268.199 2815.400 -0.007 -0.001 0.000 Marking TOC
K 734680.182 9547267.434 2815.400 734680.179 9547267.435 2815.400 -0.003 0.001 0.000 Marking TOC
L 734679.416 9547266.791 2815.400 734679.418 9547266.786 2815.400 0.002 -0.005 0.000 Marking TOC
P7
M 734674.369 9547263.861 2815.400 734674.368 9547263.858 2815.400 -0.001 -0.003 0.000 Marking TOC
N 734675.135 9547264.504 2815.400 734675.134 9547264.501 2815.400 -0.001 -0.003 0.000 Marking TOC
O 734675.739 9547263.784 2815.400 734675.743 9547263.784 2815.400 0.004 0.000 0.000 Marking TOC
P 734674.973 9547263.141 2815.400 734674.976 9547263.142 2815.400 0.003 0.001 0.000 Marking TOC

Rebar Column
P6
1 734672.769 9547265.846 2815.350 734672.805 9547265.843 2815.350 0.036 -0.003 0.000 Marking TOR
2 734673.458 9547266.424 2815.350 734673.425 9547266.377 2815.350 -0.033 -0.047 0.000 Marking TOR
3 734674.036 9547265.736 2815.350 734674.002 9547265.736 2815.350 -0.034 0.000 0.000 Marking TOR
4 734673.346 9547265.158 2815.350 734673.356 9547265.222 2815.350 0.010 0.064 0.000 Marking TOR
P6
5 734677.173 9547269.543 2815.350 734677.212 9547269.554 2815.350 0.039 0.011 0.000 Marking TOR
6 734677.862 9547270.121 2815.350 734677.858 9547270.077 2815.350 -0.004 -0.044 0.000 Marking TOR
7 734678.440 9547269.433 2815.350 734678.421 9547269.434 2815.350 -0.019 0.001 0.000 Marking TOR
8 734677.751 9547268.854 2815.350 734677.772 9547268.907 2815.350 0.021 0.053 0.000 Marking TOR
P6
9 734678.844 9547267.551 2815.350 734678.885 9547267.505 2815.350 0.041 -0.046 0.000 Marking TOR
10 734679.533 9547268.130 2815.350 734679.525 9547268.076 2815.350 -0.008 -0.054 0.000 Marking TOR
11 734680.112 9547267.440 2815.350 734680.082 9547267.449 2815.350 -0.030 0.009 0.000 Marking TOR
12 734679.422 9547266.862 2815.350 734679.440 9547266.909 2815.350 0.018 0.047 0.000 Marking TOR
P7
13 734674.439 9547263.855 2815.350 734674.491 9547263.882 2815.350 0.052 0.027 0.000 Marking TOR
14 734675.129 9547264.434 2815.350 734675.117 9547264.399 2815.350 -0.012 -0.035 0.000 Marking TOR
15 734675.669 9547263.790 2815.350 734675.648 9547263.818 2815.350 -0.021 0.028 0.000 Marking TOR
16 734674.979 9547263.212 2815.350 734675.007 9547263.288 2815.350 0.028 0.076 0.000 Marking TOR

BM Reference
1 734614.3714 9547274.726 2814.384 Pole-3
2 734658.234 9547347.715 2824.279 Pole-7
3 734651.0215 9547191.166 2816.327 Pole-9

Page 1 of 3
Project Name: Grasberg Kasuang Copper Cleaner Project ( CuCL)
Project No: C0JV
Contractor: FPJO

PRE - POURING CONCRETE INSPECTION CHECKLIST

Description: Column Pedestal P6 & P7 Location: Air Receiver
IWP: A2480A1FCC00 CWP: A2480A1FCC00
As Built Dwg: Instrument: TS Leica MS-60-SN-890372
Report Number: C208 Survey Date: 18-Oct-2023
SKETCH DRAWING
Note:
- Drawing Reference: 02021916-GC-24803300_Rev1
02021916-GC-24803305_Rev_0
-- All deviation for elevation are zero, because actual elevation using design elevation for marking top elevation on site

Page 2 of 3
Project Name: Grasberg Kasuang Copper Cleaner Project ( CuCL)
Project No: C0JV
Contractor: FPJO

PRE - POURING CONCRETE INSPECTION CHECKLIST

Description: Column Pedestal P6 & P7 Location: Air Receiver
IWP: A2480A1FCC00 CWP: A2480A1FCC00
As Built Dwg: Instrument: TS Leica MS-60-SN-890372
Report Number: C208 Survey Date: 18-Oct-2023
FPJO Surveyor FPJO Quality FMI/PTFI
Name : Herman Sinaga

Signature :

Date : 18-Oct-2023

Page 3 of 3