Pueblo Viejo Expansion Project

FIELD MATERIAL REQUEST / RETURN (FMR) - SOLICITUD / RETORNO DE MATERIALES EN TERRENO

Type Request Requested by – Solicitado por Contract Name & N° - Contratista Date - Fecha
Tipo ✘ Solicitud PO 4500309509- PV EXP Electrical/
Return Instrumentation Abril 6th 2022
Retorno Ivan Ariel Suero Medina

Deliver to – Entregar a Required Date – Fecha Req. 03 Rev

Ivan Suero Abril 6th 2022 0
Area CWP DRAWING / BOM NUMBER Discipline / Disciplina Page - Página
Oxigen Plant
N/A Electrical/Instrumentation 1-1

ITEM CODE SIZE MATERIAL DESCRIPTION REQUIRED / RETURNED QTY

9144-982 PARARRAYO OPR60 ABB 107MT RADIO

10 N/A 1

20 N/A 9144-982 MASTIL P/PULSAR 2.3 MTS ROSCA 1

9144-982 MASTIL P/PULSAR 3 MTS ROSCA

30 N/A 1

9144-982 KIT TORNILLOS P/MASTIL 35/42 MM

40 N/A 1

9144-982 SOPORTE OFFSET SUST . HPS2705

50 N/A 2
9144-982 SOPORTE OFFSET SUST . HPS2709
60 N/A 2

SIGNATURE
Requested by Approved by (PVE Construction Received by Field Material Management
Supervisor)

Date: Abril 6th 2022 Date: Date:

Field Material Management