ats La titis sampurna inspection BERITA ACARA SERAH TERIMA PEKERIAAN Pada hari ini Senin, tanggal Dua puluh delapan bulan Nopember tahun Dua ribu dua puluh dua (28/11/2022) kami laporkan bahwa kami telah menyelesaikan sebagai berikut: Pekerjaan : Technical Services For Quality And inspection (Pekerjaan Radiography dan Dye Penetrant PHE WMO modif line gas out V710 for lowering pressure PHE 12 dan PHE WMO replacement of flow line A7 PHE 54 di ORF PHE, Gresik) Tanggal (Periode) a he somes fesae'fesas"| _orr/wer 3 | a7 November 2022 a 2 2 [20 november 2022 2 E 3 [25 November 2022 3 oe te Klien/User : PT. Pertamina Hulu Energi WMO Perincian 8 ‘Team Radiography (Onshore) 3 hari x Rp 3.000.000 = Ap 9.000.000 Equipment Gamma Ray 3 hari x Rp 1.500.000 = Rp 4.500.000 = Film 4 x10 72 lembar x Rp 60.000 = Rp 4.320.000 Film 4" x 15" 18 lembar x Rp 70.000 = Rp 1.260.000, ~Team DPT (Onshore) 1 hai =x Rp 2.000.000 = Rp 2.000.000 Chemical PT 3 kaleng x Rp 200.000 _=_Rp 600.000 sus TOTAL Rp 77i.680.000 PPNI1% = a 2.384.800 GRAND TOTAL = RP 4.064.600 Nilai Pekerjaan + Rp 24,064,800 (Dua puluh empat juta enam puluh empat ribu delapan ratus rupiah) . PO/WO/SPK + $044521006B —Tanggal__ 25 April 2022 Demikian Berita Acara Selesai Pekerjaan ini dibuat dengan sebenarnya untuk dapat dipergunakan sebagaimana mestinya. Perusahaan Inspeksi, Pemberi Kerja, Titis Sampurna Inspection PT Pertamina Hulu Energi WMO No. IPC : 006 IPC-VC-S/QA-08.22 PT. Titis Sampurna Insp Heed offs: Sovereign Pate 10° Flow, TB Sat Operational Ofc ; Witma MRA 11” Flor, I. TB Smatupa ‘¥; 8221 27081902 /F; +6221 27681923 femal: contacts tssampurra. coldepogiuoneoyiiend) Tae | woRpadsyy : om 2 on wes euindwes siia : O97 gna ow Taira 3 te nN] a: sare z Tey 7 wp sewer Le Y [ 6 renee ari A | 7 TA DS Pee Ti ae. b272er ‘Aepror | seinbons ig) woo a Peon 00 samo] |e g owen oN — ee ‘SHOM Jo uondyoseq i faypereoU ee co | i i I [ IXKA wy, eos eee { i 1 re EAS | | 1 { f g a I a | st } a eas a zi) at = u 77 [ yee 4 n tr | { iz : wy DaeP |2 AVA Aoi pewoO srowoey | x | {7 Se, ave Zz eT it ZL DP 2 u CI C 5 we RNEAL AS e IL | a vopedeu Lal Ww | 2 sopedsuj in | |7 lé | | QD Srey opodsuy RyseaBopey ° a _ 2000084 Ad] € _ - aaa 1 = ya eda man I au—RO 158) ees aoe sino} Jo oNNUNSIC al | [| ysi aa t eis ve] 06] 62) ez |zz | se] sz| vel ez [ze | ve] oz| or] | a1] orev [eer lalulolelelz|els |r| ele|e 8261628 16 29+ 4 2662 120+ aia efegeuns - veBunteg ‘nu, uesbunieD Ip Sv r0vas3g¢or| Nod ree 70 ‘quoyy whe SAS SS | wpe 12 ON G yoIg HesBunKeD eu, ora RE oo ee Oe) wt DAS a quad uonsadsu pers Soo] euinduies $13!) zv | tv | epogeeay yeays owl ee avTr eteg 0: ONC on wo, 7 uolpedsul euinduwies sijy sawo 222 180 Era EZ) Leta yee ZI AG ATOCE, iz) we) <1 ‘0M J0 uoRduDseq wwe AS] awen, STAB PFE aA gL | ree Veet VAP NAN VIED IPP oe EZIZ ae quewdinbS NS xia xo wemIPEL ASA sopedsui LdGiidi reipedtu in| DORE aR KO 2opsésu Aa sarod eure] ened Bu apogmuonedyienD a MW reo, ve| oe | 6] az) vz] oz| ei} as] Zt] oi] st] ol er ain ‘sino Jo uoRNgUNsiG ofetelzte[s iv felets F990 72S Shop [Ao.ww /r-21--20/— 920 ON Od ON Odi are Wee 70Ar a d Ls ee Tro! F¥e | woe001 Orns Se 7) wag Ly | 9pog eary JOYS OWL] eusndwies si3!) wa SavTam | YoRmedsy won on wos eusnaues sizz ova [YH 0 eg I g Buen 7 | Y Wl t VoyZTe (Glew a2 we eer | [a ee FPF Zeoion | sro z oa 2 mona [ma | | Eg auen on a 4 ‘SOM JO UORdUOSeg fq pewset OL “eo T T t wey AE 5 7 29-72, ms 5 =| a t m ’ 2 tt -_ —— ees —— ie u { 2 0) el a + ie jee | a eee a aaa T ot L zy [ t _ Le 1 2 ez @ & ae ae [ +—}_} | ¢ f. z 6 +r IZ © g W [ 3 2 3 S FREE E EEE 5 é St = fe eae = - v nok | Eo ‘skeq i: - i aeinbey. ul t +} eur ig] SuNOH JO uoRnausiq e104 : | ves veo | ez| ez |zz| sz] sz | vel ez [zz] vz] oz] orl er] Z| er] St] m/e [er ofe[z)e{s feels 326/628 16 20+ 4 8LOLECE LE ZO+ 1 eG a |] efegeing - uebuntes ‘snuay uessunien in “el Gora 77GAACP | ONOd| Wz 78H | ‘tquoyy] Onn 3A eH TOHROT| 1 on ayo posture a 1p 7 aa-ae -9e0| on dal 7 1 eRe or 2 ‘| (30a /P 24-20-92) ON Dall - ~7 | vasa Owed 947 cf wand] euinduies siti zy | tv | epog ery ia 9 © yous ow re