GENERAL SUMMARY SUBGRADE

LOCATION VIP APRON

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
0+055 - 0+221.22 L2 6-Feb-23 6-Feb-23 - 6-Feb-23 6-Feb-23 6-Feb-23

LOCATION RUNWAY SHOULDER D

Accepted Criteria
STA Field Density Smoothness Test
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
112+120 - 112+220 L 6-Feb-23 6-Feb-23 6-Feb-23 6-Feb-23 - -

LOCATION VIP APRON

Accepted Criteria
STA Field Density Smoothness Test
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
0+042.97 - 0+055 L2 - R3 - - - - 8-Feb-23 8-Feb-23

,Prepared by ,Checked by ,Approved by ,Reviewed by

PT Mitra Gunung Makmur PT Eskapindo Matra PT Jagat Tribuana Sakti PT Surbana Jurong

_____________________ _____________________ ______________________ _____________________

 GENERAL SUMMARY BASE COURSE
LOCATION VIP APRON
LAYER TOP BASE COURSE

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
0+055 - 0+221.22 R1-L1 4-Feb-23 4-Feb-23 4-Feb-23 4-Feb-23 4-Feb-23 4-Feb-23
0+055 - 0+221.22 R2 6-Feb-23 6-Feb-23 6-Feb-23 6-Feb-23 6-Feb-23 6-Feb-23

LOCATION TAXIWAY A SHOULDER

LAYER TOP BASE COURSE

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
0+095 - 0+220 R 8-Feb-23 8-Feb-23 - - 7-Feb-23 7-Feb-23

LOCATION COMMERCIAL APRON 3A

LAYER TOP BASE COURSE

Accepted Criteria
STA Field Density Smoothness Test
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
0+360 - 0+490 L5-L6 - - - - 10-Feb-23 10-Feb-23

LOCATION RUNWAY SHOULDER D

LAYER 1

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
112+800 - 113+040 R - - 5-Feb-23 5-Feb-23 - -

,Prepared by ,Checked by ,Approved by ,Reviewed by

PT Mitra Gunung Makmur PT Eskapindo Matra PT Jagat Tribuana Sakti PT Surbana Jurong

_____________________ _____________________ ______________________ _____________________

 GENERAL SUMMARY
LOCATION RUNWAY SHOULDER B2.2
LAYER TOP SUBBASE COURSE

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal
110+870 - 111+040 R - - - - 8-Feb-23 8-Feb-23

LOCATION RUNWAY SHOULDER B2.2

LAYER TOP SUBBASE COURSE

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal

LOCATION RUNWAY SHOULDER B2.2

LAYER TOP SUBBASE COURSE

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal

LOCATION RUNWAY SHOULDER B2.2

LAYER TOP SUBBASE COURSE

Accepted Criteria
STA Field Density Smoothness Test Remarks
Quality Clearing Proof Rolling Field CBR Test
Test Transversal Longitudinal

,Prepared by ,Witnessed / Approved by ,Approved by ,Reviewed by

PT Mitra Gunung Makmur PT Eskapindo Matra PT Jagat Tribuana Sakti PT Surbana Jurong

_____________________ _____________________ ______________________ _____________________

 SUBGRADE PREPARATION REPORT

REFERENCE DOCUMENTS:

Today Date Location STA A Top Subgrade Work has

been carried out which was witnessed by PT. Mitra Gunung Makmur and CM PT. Eskapindo Matra. Photo documentation attached,
that’s how the minutes we made are actually true to be used as they should.

Item Result Approval

ACCEPTANCE CRITERIA Remarks
No. Accepted Reject MGM EM
1 Quality of Clearing Before Spreading Documentation
Attachment (Bukti
2 Proofrolling Test with Truck load min 20 tons
Timbangan)
Attachment (Report
3 CBR Field and Density Field
Test by MGM)
4 Smoothness 12mm with straight edge 3,7m Top Subgrade Attachment
Attachment (Data
5 Grade 15 mm with interval 5 m
Ukur dan Gambar)
Remarks:

,Prepared by ,Checked by ,Approved by ,Reviewed by

PT Mitra Gunung Makmur PT Eskapindo Matra PT Jagat Tribuana Sakti PT Surbana Jurong

_____________________ _____________________ ______________________ _____________________

 BASECOURSE PREPARATION REPORT

REFERENCE DOCUMENTS:

Today Date Location STA A Top Basecourse Work has

been carried out which was witnessed by PT. Mitra Gunung Makmur and CM PT. Eskapindo Matra. Photo documentation attached,
that’s how the minutes we made are actually true to be used as they should.

Item Result Approval

ACCEPTANCE CRITERIA Remarks
No. Accepted Reject MGM EM
1 Quality of Clearing Before Spreading Documentation
Attachment (Bukti
2 Proofrolling Test with Truck load min 20 tons
Timbangan)
Attachment (Report
3 CBR Field and Density Field
Test by MGM)
4 Smoothness 12mm with straight edge 3,7m Top Basecourse Attachment
Attachment (Data
5 Grade 15 mm with interval 5 m
Ukur dan Gambar)
Remarks:

,Prepared by ,Checked by ,Approved by ,Reviewed by

PT Mitra Gunung Makmur PT Eskapindo Matra PT Jagat Tribuana Sakti PT Surbana Jurong

_____________________ _____________________ ______________________ _____________________

 INSPECTION REPORT TEST

REFERENCE DOCUMENTS:

Today Date Location STA A (Top

Subgrade / Top Subbase / Top Basecourse / Top Aggregate A / Top Aggregate B) Work has been carried out which was witnessed
by PT. Mitra Gunung Makmur and CM PT. Eskapindo Matra. Photo documentation attached, that’s how the minutes we made are
actually true to be used as they should.

Item Result Approval

ACCEPTANCE CRITERIA Remarks
No. Accepted Reject MGM EM
1 Quality of Clearing Before Spreading Documentation
Attachment (Bukti
2 Proofrolling Test with Truck load min 20 tons
Timbangan)
Attachment (Report
3 CBR Field and Density Field
Test by MGM)
4 Smoothness 12mm with straight edge 3,7m Attachment
Attachment (Berita
5 Grade 15 mm with interval 5 m
Acara JS)
Remarks:

,Prepared by ,Witnessed / Approvedby ,Approved by ,Reviewed by

PT Mitra Gunung Makmur PT Eskapindo Matra PTJagat Tribuana Sakti PTSurbana Jurong

_____________________ _____________________ ______________________ _____________________