QC-FRM-GEN-E1 (REV.

6A)

Client
Contractor
Area / Plant
Date

WILMAR PROJECT GRESIK

:PT.WILMAR NABATI INDONESIA

:PT.PRIMA DUTA KARYA
: ISBL UTILITY
: 12-DESEMBER-2015

NDT REQUEST
FORM
NUMBER *

Page : 1 of 1

RQ-002 / PDK ISBL UTILITY / NDT / 15 / 12

NDT Team

RT JOINTS

RT
FILMS

NDT Service

Radiographic Test

Vacuum Test

Other:

Location

Pipe / Coil

Tank

Other:

WELDING DETAILS

S/
N

Line / Item No.

Joint

10-TOH-001-C12B100A

1B

(SHEET 1 OF 1)

3B

Process

Size

Sch.

Mat.

GTAW

10

40

A53

GTAW

10

GTAW

10

GTAW

10

GTAW

10

GTAW

10

1B

GTAW

14

2B

GTAW

14

4B

6B

7B

10B
14-TOH-001-C12B100A
(SHEET 1 OF 1)

Position

Requested by:
Name
Dept.

MATERIAL

FARID
Contractor

Welder

W2057
W0958
W0958
W2023
W2024
W2057

Acknowledged by:
HERU A W
Project Construction

Signatur
e
Telp.

081233760334

Kontraktor& NDT Company harapmemastikanpersiapan di

lapangansebelumpelaksanaan NDT.

Alokasi Budget :
Note:

40
40
40
40
40

40
40

18

Remarks

A53
A53
A53
A53
A53

A53
A53

Verified by:
M FIRMAN
QC Inspector

QC-FRM-GEN-E1 (REV.6A)

Client
Contractor
Area / Plant
Date

WILMAR PROJECT GRESIK

:PT.WILMAR NABATI INDONESIA

:PT.PRIMA DUTA KARYA
: ISBL UTILITY
: 12-DESEMBER-2015

NDT REQUEST

FORM NUMBER *

Page : 1 of 1

RQ-003 / PDK ISBL BDL #2 / NDT / 15 / 02

NDT Team

RT
JOINTS

RT
FILMS

11

NDT Service

Radiographic Test

Vacuum Test

Other:

Location

Pipe / Coil

Tank

Other:

S/
N

WELDING DETAILS
Line / Item No.

Joint

80-MO-1021-S12A25ST

(SHEET 1 OF 1)

14

19

80-MO-1024-S12A25ST

(SHEET 1 OF 1)

10

20

80-MO-1065-S12A25ST

(SHEET 1 OF 1)

10

15

11

17

12

80-MO-1029-S12A25PP

13

(SHEET 1 OF 1)

14
15

Position

MATERIAL
Welder

W0157
W0157
W0157
W0157
W0157
W0157
W0157
W0157
W0157
W0157
W0157
W2024
W2024
W2024
W2024

Process

Size

Sch.

Mat.

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

16
18

80-MO-1038-S12A25PP

19

(SHEET 1 OF 1)

20
21

W2024
W2024
W2024
W2024

33

Remarks

QC-FRM-GEN-E1 (REV.6A)

Client
Contractor
Area / Plant
Date

WILMAR PROJECT GRESIK

:PT.WILMAR NABATI INDONESIA

:PT.PRIMA DUTA KARYA
: ISBL UTILITY
: 12-DESEMBER-2015

NDT REQUEST

Page : 1 of 1
W2024

22
Requested by:

Acknowledged by:

KHULAFAUR
Contractor

Name
Dept.

GTAW

10

A312

Verified by:

RUSDI SAAD
Project Construction

AGUNG PRAMONO
QC Inspector

Signatur
e
Telp.

081230474243 / 085314329717

Kontraktor& NDT Company harapmemastikanpersiapan di

lapangansebelumpelaksanaan NDT.

FORM NUMBER *

Alokasi Budget :
Note:

RQ-004 / PDK ISBL BDL #2 / NDT / 15 / 02

NDT Team

RT
JOINTS

RT
FILMS

21

NDT Service

Radiographic Test

Vacuum Test

Other:

Location

Pipe / Coil

Tank

Other:

S/
N

WELDING DETAILS
Line / Item No.

Joint

150-PME-1521-S12A25PP

(SHEET 1 OF 1)

5A

15

19

26

29

33

10

36

11

40

12

43

13
14

100-RPO-0002-S12A25ST
(SHEET 3 OF 5)

3
7

Position

MATERIAL
Welder

W2024
W2024
W2024
W2024
W2222
W2024
W2024
W2024
W2024
W2024
W2024
W2024
W0157
W-

Process

Size

Sch.

Mat.

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

63

Remarks

QC-FRM-GEN-E1 (REV.6A)

Client
Contractor
Area / Plant
Date

WILMAR PROJECT GRESIK

:PT.WILMAR NABATI INDONESIA

:PT.PRIMA DUTA KARYA
: ISBL UTILITY
: 12-DESEMBER-2015

NDT REQUEST

Page : 1 of 1
0157

15

100-RPO-0002-S12A25ST

1A

16

(SHEET 4 OF 5)

17

W2222
W2222
W2222

18

80-MO-1026-S12A25ST

19

(SHEET 1 OF 1)

20

14

21

18

W0157
W0157
W0157
W0157

Requested by:

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

GTAW

10

A312

Acknowledged by:

KHULAFAUR
Contractor

Name
Dept.

GTAW

Verified by:

RUSDI SAAD
Project Construction

AGUNG PRAMONO
QC Inspector

Signatur
e
Telp.

081230474243 / 085314329717

Kontraktor& NDT Company harapmemastikanpersiapan di

lapangansebelumpelaksanaan NDT.

FORM NUMBER *

Alokasi Budget :
Note:

RQ-003 / PDK ISBL BDL #2 / NDT / 15 / 02

NDT Team

RT
JOINTS

RT
FILMS

NDT Service

Radiographic Test

Vacuum Test

Other:

Location

Pipe / Coil

Tank

Other:

S/
N

3
4

WELDING DETAILS
Line / Item No.

100-MO-1005-S12A25ST
(SHEET 1 OF 1)
150-MO-1007-S12A25ST
(SHEET 1 OF 1)
100-PME-1510-S12A25ST
(SHEET 1 OF 1)

MATERIAL

Joint

Position

Welder

Process

Size

Sch.

Mat.

15

(4-8)(80)

W0157

GTAW

10

A312

(R-1) 8

(7-14)

W2024

GTAW

10

A312

(R-1) 3

(0-5)

GTAW

10

A312

(R-1) 8

(0-5)

GTAW

10

A312

W2024
W-

11

Remarks

RESHOOT

QC-FRM-GEN-E1 (REV.6A)

Client
Contractor
Area / Plant
Date

WILMAR PROJECT GRESIK

:PT.WILMAR NABATI INDONESIA

:PT.PRIMA DUTA KARYA
: ISBL UTILITY
: 12-DESEMBER-2015

NDT REQUEST
(10-0)
5

100-PME-1517-S12A25ST

(R-1) 7

All

(SHEET 1 OF 1)

(R-1) 9

(14-0)

(R-1) 6

(4-8)

80-V-2415-S12AOONA
(SHEET 1 OF 1)

Requested by:
Name
Dept.

KHULAFAUR
Contractor

Page : 1 of 1
2024
W2222
W0157
W2222

081230474243 / 085314329717

Kontraktor& NDT Company harapmemastikanpersiapan di

lapangansebelumpelaksanaan NDT.

10

A312

GTAW

10

A312

GTAW

10

A312

Acknowledged by:
RUSDI SAAD
Project Construction

Signatur
e
Telp.

GTAW

Alokasi Budget :
Note:

Verified by:
AGUNG PRAMONO
QC Inspector