CV.

MUSTIKA BAHANA MARINE SAFETY

LIFERAFTI FIRE EXTINGUISHER SERVICE & RE-C RTIFICATION
SAFETY EQUIPMENT SERVICE & GENERAL TRADING
Samarinda Telp. (0541) 271 250 Fax (0541) 273 261 Email: mustikasmd@gmail.com
AHAN Balikpapan Telp. (0542) 8820103 Fax (0542) 8820104 Email: mustikabpn@gmail.com
Surabaya Telp. (031) 353 5115 Fax (031) 3579532 Email: mustikasby@gmail.com

RE-INSPECTTON CERIFICATTON
INFLATABLE LIFERAFT

Name OfShip Owner Date Of Inspection Certificate No.

Nama Kapal Pemilik Tg. Pemeriksaan No. Sertificate
TB. TTB-2009
PT. KARTIKA SAMUDRRA DECEMBER 13, 20220961/ILR-MBM/XII-22
ADIJAYA

Inflatable Liferaft Mark Type/ Capacity ILRSerial No. Date Of Manufacture

Liferaft Merek Tipe/ kapasitas_ No. Seri Liferaft Tahun Pembuatan
JIANGSU HAINING HNF-A10/10 PERSON 03166 OCT-2003
Dengan menyatakan Inflatable Liferaft tersebut di atas telah diperiksa dan ditest sesuai permintaan dari
pabrik pembuat dan telah memenuhi persyaratan Internasional Safety Of Lifc At Sea (SOLAS-1996).

This is to Certify that the above mentioned Inflatable Liferaft has been Inspected, Serviced and tested in
accordance to the requirement of manufacture and complying fully to the International Safety Of Liferat
At Sea (SOLAS-1996).

Lco2 CyL S/N Vol.OfC02 Vol.OfN2Cy.WeightGross WeightDikemas: FBER CAPSUL

Berat seluruhnya Packed in CONTAINER FRP
No. tabung CO2 Isi CO2 IsiN2 Berat tabung
1. 093741L 1,700 Kg 0,160 Kg 5,510 Kg 7,370 Kg Perlengkapandaruratpenuh
2.0937155 1,700 Kg 0.160Kg 5,510Kg_ 7370 Kg
Modification Cary Out:ANTI SEA SICKNESS, BATTERY SPARE, FIRST AID KIT, RENEWED.
Dengan perubahan
Red Hand Smoke Anti Sea First Aid REMARK
Ration Water |Parachute Catatan
Exp, Date Exp, DateExp, Date Exp, Date Exp, Date Sickness Exp. Date
LPack Pack 4 Pos 6 Pcs 2 Pcs Tab 1 Set
09-2024 09-2024|09-202409-2024 09-2024 12-2023 12-2023
REMARK / CATATAN: RAFT INGOOD CONDITION NEXT INSPECTION: DECEMBER 12, 2023

UB.
KEPALA KANTOR
KESAHRANDARAN DAN OTORITAS PELABUHAN
ENTE AS I SAMARINDA Cv. MUSTIKA BAHANA MARINE SAFETY
Rasi StatusHamSertifikasi Kapal
A
KANTOR

KESYAREADA ANAS
0TORTAS
KMARINDA

RHUUANTKDAMANG, SH.M.A.P.
NIP. 19701221 199312 1 001
MAKKAWARUDAKNG
SURVEYOR
NGALLE

0961
 CV. MUSTIKA BAHANA MARINE SAFETY
LIFERAFT/ FIRE EXTINGUISHER
SAFETY EQUIPMENT SERVICE & SERVICE& RE-CERTIFICATION GENERAL TRADING
Samarinda Telp. (0541) 271 250 Fax(0541) 273 261 Email: mustikasmd@gmail.com
Balikpapan Telp. (0542) 8820103 Fax
(0542) 8820104 Email :
Surabaya Telp. (031) 353 5115 Fax (031) 3579532 Email: mustikabpn@gmail.com
mustikasby@gmail.com

SURVEY AND TEST REPORT

Sertifikat No. : 0961 /LR-MBM/XII-22
LIFERAFT MARK : JIANGSU HAINING TYPE : HNF- A10 MFG. DATE : OCT - 2003
SERIAL NUMBER :03166 SIZE : 10 Person
NAME OF SHIP :TB.TTB-2009 CUST: PT. KARTIKA
SAMUDRA ADIJAYA
RAFT INSPECTIONS
OBJECT REMARKS OBJECT REMARKS OBJECT REMARKS
CONTAINER SHELL OK Inflation Valve, Hose Repair Kitt
Labels/ Markings RN TIY Piece Connector Leak Stoppers
OK
Handling Beckets OK Protection Pads
Gasket/ Strap / Packing List OK Sponges
Painter Line_ CO Cylinder (s) OF Bailers
DK Operating Cable& Condult OK
ID Container Spare Sea Anchor
Operating Head OK Torch, Signalling_
Valise Fabric
Eyelets Sparc Batteries
Pockets SURVEY OF INTERIOR Whistle
Bouyancies Fabric K Fishing Kit_
Bursting Band | Safety Relief Valves
Weak Link Can Opener (S)_
RN Grabline & Patches // Loops Paddles
Thwart, Fabric Spare Bulb for Torch
SURVEY OF EXTERIOR | Deflation Plugs/ Valves Drinking Vessel _
Bouyancies, Fabric Arches, Fabric Seasickness Bags
Inlet Valves Center Column Fabric Signal Mimor
Deflation Plugs / Valves Light Battery
Safety Relief Valve Manual Survival Book
Interior Lighting System Rescue Signal Table
Boarding Ramp_ Topping Up Valves Thermal Protective Aids
Boarding Ladders | Inner Canopy, Fabric Radar Reflector
Towing Bridle/ patch An waer Catchment Dye Marker
Lifeline and Patches Viewing Port (s) |EMERGENY PACK
Outer Canopy Fabric Acrial Sleeve 10 Food Ration OK
Rectro Reglective Tape Inner Floor, Fabric Exp. Date:09-2024 | SURYA SEGARA
Seam and Taping Topping Up Valves 30 Drinking Water OK
Rain Water Catchment | Deflation Up Valves
Exterior Lighting System Exp. Date:09-2024 SURYA SEGARA
|Emergency Pack Loop / Patch_ 4 Parachute Flares OK
Arch Detlation System Aerial Sockets/ Tic -Tapes Exp. Date: 09-2024
Entrance Sleeves CHINA
| Floor Reeds 6 Red Hand Flares OK
Outer Floor, Fabric Rescue Linc and Quoit_
Righting Strap | Knife Sheath
Exp. Datc:09 -2024 CHINA
2 Smoke Signal OK
Stabilishing Pockets Sea Anchor OK EXp. Date : 09-2024 CHINA
Cylinder Pockets (s) OK
1 First Aid Kit_ RN
Sca-CellL ACCESSORY BAG Exp. Date:12-2023 LOKAL
Painter Lashing/ Stowage | Bellows or Pump 60 Anti Sea-sickness Tablets RN
| Glucfor RepairKit_ RN Exp. Date: 12-2023 ANTIMO
RAFT AND CYLINDER TEST
Start Finish
PRESSURE TEST PRESSURE SAFETY VALVES
Time Pressure Iime Pressure DROP Blow Off Rescat
Temp. C
mm Hg Temp. C
mm Hg mm mmH mmHg
Upper Bouyancy_ 09,00 10,00
Lower Bouyancy 09,15 30 110 10,15
| Floor 09,30 20 10,30
Canopy
GAS CYLINDER TEST Cyl. No Mfg. Date Change Weight Of Weight Of|Weight Of Total W. Kg8 Hydr. Release Unit
Date Oyl. Kg_ CO. Kg NP.Kg
Cylinder No. 1 093741 5,510 1,700 0,160 7,370 Nomor
Cylinder No. 2 093715 5,510 1,700I 0,160 7,370 Test Bar

RES A.761 (18) REMARK DATE SIGN MARINE SURVEYOR:

INSPECTOR MAKKAWARU DAENG NGALLE STAMP
WP -TEST YES 13-12-2022

GI-TEST
FS TESTr

NAP TEST zINALABIDINM.Mar.EMM

NIP. 19740826|200812 1002 DATE:DECEMBR 13,20b2