Document No.

: PSS-ADM-AF-03
PT. Prima Subsea Services Revision No. : 03
Document Date : 01 August 2022
Dispatch Manifest & Advise Note

Document Reference : PSS-L/SJ.031/VII/2023 Dispatch Address :

PSS Sorowako Warehouse
Project ID : UWS031
Jl. Pongkia no.9 Sorowako, Kel. Nikkel, Kec.
Dispatched By : Supriyatna Nuha, Luwu Timur, South Sulawesi 92983
Approving Officer : Jaka Oktamawiria
Dispatch Status : Demobilization

Asset Mass Dispatch Inspection

No. Q/U Description Remarks
Category @KG Yes No Function Test
1 AF 1/3 2 unit KMDSI KMB-18 Diving Mask √
Outland Technology Color Console
2 AI7 1 set √
CON-3300/dc
3 AM 4/5 2 unit Outland Diving Camera UWC-325P/E √
4 AM 1/11 2 unit Outland Diving Light UWL-401L √
5 1 unit Marsmarine Rubber Connector FS-5PIN √
Marsmarine Rubber Connector MP FS-
6 1 unit √
4PIN
7 1 unit Marsmarine Rubber Connector FS-3PIN √
RX.20.Pro-RX Octopus Console 2
8 AP 1/2 2 set √
Diving Regulator
9 1 unit Nikon Camera Underwater √
10 AM 10 1 unit DJI Osmo Action Underwater Camera √
11 2 unit HT iCOM Marine Walkie-Talkie √
KMDSI Part #515-033 Communication
12 1 unit √
Kit for KMB-18
13
14
15
16
17
18
19
20

Means of Transport : Air Transported By Delivery / Ship Address

Transport Carrier ID : PSS Warehouse
Jl. Perjuangan Raya No.12, Tugu Selatan
Transported By : Supriyatna Koja, Jakarta Utara 14260
Transport Date : 12/7/2023

Checked by Approved By Dispatched By Received By

Supriyatna Jaka Oktamawiria Supriyatna David Kristianto

Technician Project Spv Technician Comm. Mgr