 Condition Appraisal

(formerly known as Pantai Medivest Sdn

 Technical Report
Bhd)

Facility
Hospital : Hospital Sultanah Aminah, Johor Engineering
Equipment Description: HSA-FCBLD09-0119
Ref No : MSB/HSA/FEMS/RPT/0244/2013
Maintenance
Date : 2 / 09 / 2013 Services
(FEMS)
Contents

1. Objective. ...............................................................................................................................3
2. Asset Details. ........................................................................................................................3
3. Current Condition of the Asset. .............................................................................................4
4. Root Cause. ...........................................................................................................................5
5. Technical Advise and Proposal. ............................................................................................6
6. List of Attachments. ...............................................................................................................7
7. Photo. ...................................................................................................................................8
8. Verification. ............................................................................................................................9
9. Recommendation. .................................................................................................................9
10. Conclusion. ............................................................................................................................9

Facility Engineering Maintenance Services Page 2 of 9

1. Objective. (Tujuan laporan ini disediakan)

Objective Statement:
 For General Status / Condition
(Untuk makluman status semasa)
 Consideration for Exemption
(Untuk pertimbangan Pengecualian)
 Testing & Commissioning
( Ujian & Pentauliahan)
 Others (lain-lain):
 Proposal for Upgrading Works
(Cadangan kerja Naiktaraf )
 Replacement
(Penggantian)
 Proposal for Decommissioning
(Cadangan untuk dihentitugas)

Remarks (if any):

Laporan Teknikal ini disediakan adalah untuk memaklumkan mengenai status semasa mangkuk tandas yang pecah
dan seterusnya menggantikan mangkuk tandas yang pecah tersebut di cafeteria balai pelawat, Hospital Sultanah
Aminah Johor agar tidak memberi masalah kepada pengguna/orang awam untuk kegunaan seharian.

2. Asset Details. (Maklumat aset)

Asset Number** HSA – FCBLD09-0119

Description BUILDING, ROOMS

Model & Brand: TIDAK BERKENAAN

Manufacturer: MALAYSIA

Make (country of origin) MALAYSIA

Chasis No. TIDAK BERKENAAN

Registration No. TIDAK BERKENAAN

Engine No. TIDAK BERKENAAN

Serial No. TIDAK BERKENAAN

Software Version TIDAK BERKENAAN

User Department BALAI PELAWAT

Location TANDAS AWAM PEREMPUAN

Purchase Date 23/7/2008

Purchase Cost (RM) TIDAK BERKENAAN

Warranty Start 26/3/2009

Warranty Expired 27/3/2009

Supplier TASJA SDN.BHD

Facility Engineering Maintenance Services Page 3 of 9

Total Count of breakdown TIDAK BERKENAAN

Accumulated Maintenance Cost (RM) TIDAK BERKENAAN

List of accessories TIDAK BERKENAAN

** Note1 Attach list of asset if more than one (1) unit.

3. Current Condition of the Asset. (Penjelasan keadaan terkini dan masalah berkaitan aset)

 Good & Functioning  Frequent breakdown/ unreliable

(Berfungsi dengan baik) (Kerap rosak / Keupayaan Diragukan)

 Functioning but Not Satisfactory  Not in use

(Tidak berfungsi dengan baik) (Tidak digunakan)

 Performance Not to Specification.  Operating At Maximum Capacity

Does not comply to specification (Beroperasi pada kapasiti maksima)
(Tidak mengikut spesifikasi)

 Not Functioning  Not safe

(Rosak & Tidak Berfungsi) (Tidak selamat digunakan)

 Legal requirement (Please specified)  Environmental effect

Remarks (if any):

1. “ Mangkuk Tandas ”
- Mangkuk tandas awam perempuan pecah di kafeteria balai pelawat.

1. Root Cause. (Punca masalah)

 Wear & Tear  Accident

(Kadar pengunaan) (Kerosakan akibat kemalangan)

Facility Engineering Maintenance Services Page 4 of 9

  Outdated technology/software  Obsolescence
(Teknologi/perisian luput) (Pengeluaran alat/alat ganti/aksesori ditamatkan dan tiada di pasaran)

 Mishandling  Environmental
(Penyalahgunaan) (Faktor persekitaran)

 Others (Please specify)  Exceed Capacity

(Lain-lain – sila nyatakan)

 Installation defects

Further explanation (penerangan lanjut):

1) Daripada pemerhatian yang di buat di dapati mangkuk tandas awam (P) pecah di kafeteria balai
pelawat semasa pemeriksaan dilakukan.

2) Pihak MSB mendapati berkemungkinan mangkuk tandas yang pecah ini daripada kecuaian dari pihak
ketiga.

3) Mangkuk tandas ini pecah disebabkan terdapat kesan hentakan dari objek keras di
dalam lubang tersebut.

4) Lampiran bergambar menunjukkan keadaan mangkuk tandas yang pecah.

2. Technical Advice and Proposal (Nasihat teknikal dan cadangan)

 Safety Scope Description (Cadangan Skop Kerja):

(Keselamatan)

 Service Interruption 1. Pihak MSB menyediakan laporan ini untuk pemberitahuan kepada
(Gangguan perkhidmatan)
Pihak Hospital dan Jurutera yang berkaitan.

Facility Engineering Maintenance Services Page 5 of 9

  Upgrading
(Naiktaraf) 2. Pihak MSB memerlukan masa untuk melakukan kerja-kerja

 Replacement penggantian kerana pihak kami sedang menunggu barangan dari

(Penggantian) pembekal.

 Others (Lain-lain)
3. Pembaikpulihan perlu di lakukan kerana ia memberi masalah
kepada pengguna untuk menjalankan aktiviti seharian.

3. List of Attachments. (Senarai dokumen sokongan yang disertakan)

No Document Name
1  KEW PA3 from User
2  Log Card (Asset Details and Maintenance History) from CMIS or User
3  Service Request
4  Obsolete or any discontinuation (Service/Parts) letter from Supplier /Authorised Agent
5  Quotation
6  Letter from User (Request from User)
7  Estimated Useful Lives of Depreciable Hospital Assets – American Hospital Association

Facility Engineering Maintenance Services Page 6 of 9

 8  Operating data (log sheet) / Relevant Job Sheet / PPM Job Sheet
9  Defect list / Work Order Form
10  Facilities Acceptance Certificate.
11  BER 1

Facility Engineering Maintenance Services Page 7 of 9

 4. Photo. (Gambar menunjukkan keadaan asset)
oto

Keadaan mangkuk tandas yang pecah

Facility Engineering Maintenance Services Page 8 of 9

 5. Verification. (Pengesahan maklumat laporan)

Prepared by: Checked by: Approved by:

Prepared By Check By Customer Service Manager
Signature & Official Stamp: Signature & Official Stamp: Signature & Official Stamp:

Name: Syida Syahira Bt Mohd Name:Mohammad Nasrul B

Name: Safridah Bt Osman
Yusoff Othman
Designation: Civil Engineer Designation: Engineer (RW) Designation:

Date: 2/ 09 / 2013 Date: 2 / 09 / 2013 Date: 3 / 09 / 2013

6. Recommendation. (Sokongan / pandangan dari pihak JOHN)

Remarks (if any):

Signature: Official Stamp:

Name:
Designation:
Date:

Conclusion. (Keputusan dari pihak Pengarah atau Pegawai yang diberi kuasa)
7.
 Acknowledged  Approved for Reimbursable Works
 Approved for Exemption  Approved for Decommissioning
Remarks (if any):

Signature: Official Stamp:

Name:
Designation:
Date:

Facility Engineering Maintenance Services Page 9 of 9