SR Doddy Ir 2024
Uploaded by
Ubed FananiSR Doddy Ir 2024
Uploaded by
Ubed FananiRekindWorleyParsons Quality Management System
Contract Number: C822444
Date: SR No#:
SURVEILLANCE REPORT
DISCIPLINE : WR NO : LOCATION CONTRACTORS PROJECT AREA :
Piping & Mechanical □SLN □SLO □HO □PG&T-HCT
WORK DESCRIPTION : ISSUE DATE COMPLETED WORK
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
□YES □NO
INSPECTION CHECKLIST:
Preparation : Y N Qty Non Destructive Testing Y N Qty
Drawing Radiography Testing
WPS / PQR Liquid Penetrant Testing
Certified Welders / Pipe Fitter Magnetic Particel Testing
Form Welding Record Hardness Testing
Materials ID and Surface Quality Post Weld Heat Treatment
Materials Receiving and Storage
Welding Electrode Oven Dryer Portable Dryer Traceability ( Including Welding Comsumables Record )
Grinding & Brushing Bolting and Gasket
Welding Cap, Apron and Glove Bolt Tightening
Plastic Wind Shield Line Check
Inspection Tools Line Layout
Existence Contractors Piping Inspector Size and Rating
Valve, Fitting, Vent and Drain Arrangements
Joints Fit Up Pipe Internal cleaning by Pigging
Beveling Mechine & Cleaning Hydro Test Package
Cutting and Edge Preparation Pressure Test
Root Opening Flushing, Cleanout, and Purge
Joining, Leveling and Alignment
Comsumables Filler Metal & Flux Under Ground Piping
Blast and Coar prior to Installation
Welding Placement of pipe in Trench
Ampere and Voltage present Wire brush and wrap closure pipe
Tranfer Head Number Holiday Test Coating
Tack Welding Back Fill Trench
Preheat Flush / Test System
Visual Inspection of Weldments During Application Work
Surface Under Cut / Other Defect Weather Condition
Wide & High of welding surface Insulation, Jacket Thickness, and Num of Layer
Surface Cleaning ( Welding Slag & Tack ) Finals Inspection and Punch List
High / Low Others
Weld Repair
Note
Number of items inspected Number of Items accepted
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: __ Date: 01/03/13 Signature:
Person Notified of Deficiency:
Name: _____________________ Date: ________ Signature:
Reviewed by RWP - CM Manager:
Name: _____________________ Date: ________ Signature:
KPI No Inspection NC/ Finding open NC close NC
Preparation :
Joints Fit Up
Welding
Visual Inspection of Weldments
Non Destructive Examination
Traceability ( Welding Comsumables Record )
Under Ground Piping
During Application Work
RekindWorleyParsons Quality Management System
Contract Number: C822444
Page __ of __
Date: __________ SR No#: SLN/IM-REM CMT/13/001
SURVEILLANCE PHOTOS
RekindWorleyParsons Quality Management System
Contract Number: C822444
Date: SR No#: ______________________
SURVEILLANCE REPORT
DISCIPLINE : WR NO : LOCATION CONTRACTORS PROJECT AREA :
Piping □SLN □SLO □HO □PG&T-HCT
WORK DESCRIPTION : ISSUE DATE COMPLETED WORK
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE: □YES □NO
INSPECTION CHECKLIST:
PREPARATION Y N N/A Traceability ( Including Welding Comsumables Record ) Y N N/A
Drawing (latest revision) Bolting and Gasket
Approve WPS / PQR Bolt Tightening
Approve ITP that related to jobs 1. Anti Seized Compound
Certified Welders / Pipe Fitter 2. Alignment of flange centers and paralellness
Material Surface Quality (free from
scale/lamitation/grease/paint) of flange faces
Materials Handling and Storage 3. Tightening Sequence
Welding consumable (E-7018)put in dryer and plug in 4. All bolts extend completely through their nuts
Welding machine is good condition Line Check
Alignment and straighteness Line Layout
Install wind sheild properly Size and Rating
Valve, Fitting, Vent and Drain Arrangements
Joints Fit Up Pipe Internal cleaning by Pigging
Bevelling meet with WPS/PQR Hydro Test Package
Cutting and Edge Preparation Review Test Package
Cleanliness (free from oil, grease, scale, paint) Pressure Test
Root Opening meet with WPS/PQR 1. Warning sign and barricade
Joining, Leveling and Alignment 2. Bolt Completely and tightening properly
3. Pressurized as per steps
Welding 4. Holding time as per procedure
Ampere and Voltage meet with WPS/PQR 5. Release pressure as per steps
Tranfer Head Number 6. De-watering
Preheat (if any) Flushing, Cleanout, and Purge
Visual Inspection of Weldments Under Ground Piping
Surface Under Cut / Other Defect Blast and Coar prior to Installation
Wide & High of welding surface Placement of pipe in Trench
Surface Cleaning ( Welding Slag & Tack ) Wire brush and wrap closure pipe
High / Low Holiday Test Coating
Weld Repair (if any visual failed) Back Fill Trench
Flush / Test System
Non Destructive Testing
Radiography Testing During Application Work
Liquid Penetrant Testing Weather Condition
Magnetic Particel Testing Insulation, Jacket Thickness, and Num of Layer
Hardness Testing Finals Inspection and Punch List
Post Weld Heat Treatment (if any)
Others
Note :
Number of items inspected Number of Items accepted
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: _____________________ Date: 01/03/13 Signature:
Person Notified of Deficiency:
Name: _____________________ Date: ________ Signature:
Reviewed by RWP - CM Manager:
Name: _____________________ Date: ________ Signature:
KPI No Inspection NC/ Finding open NC close NC
Preparation :
Joints Fit Up
Welding
Visual Inspection of Weldments
Non Destructive Examination
Traceability ( Welding Comsumables Record )
Under Ground Piping
During Application Work
RekindWorleyParsons Quality Management System
Contract Number: C822444
Page __ of __
Date: __________ SR No#: ______________________
SURVEILLANCE PHOTOS
Singgar Mulia Brown & Root Quality Management System
Contract Number: C1368255
Date : ________________________ SR No#: ________________________
SURVEILLANCE REPORT
DISCIPLINE : WR NO : LOCATION CONTRACTORS PROJECT AREA :
□OU-1 □OU-2 □OU-3
Piping □ARC □EPS
□HIS □ARC □EPS
WORK DESCRIPTION : ISSUE DATE COMPLETED WORK
□YES □NO
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
INSPECTION CHECKLIST:
Preparation Y N N/A Intallation Y N N/A
Drawing (latest revision) Install Gasket and Bolt-nuts
Approved WPS / PQR available Install anti seize coumpound
Approved ITP available and implemented All bolts extend completely through their nuts
Certified Welders Line Check
Materials Handling and Storage
Welding consumable (E-7018) put in dryer and plug in Hydrotesting
Welding machine is good condition Pipe Internal cleaning by Pigging
Install wind sheild properly Review Test Package
1. Warning sign and barricade
Joints Fit Up 2. Bolt Completely and tightening properly
Tranfer Head Number 3. Pressurized as per steps
Cutting and Edge Preparation 4. Holding time as per procedure
Bevelling meet with WPS/PQR 5. Release pressure as per steps
Alignment and straightness 6. De-watering
Root Opening meet with WPS/PQR
Cleanliness (free from oil, grease, scale, paint) Under Ground Piping
Placement of pipe in Trench
Welding Back Fill Trench
Ampere and Voltage meet with WPS/PQR
Punch-list
Finals Inspection and Punch List
Visual Inspection of Weldments
Surface Under Cut / Other Defect Others
Wide & High of welding surface
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any)
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
Observation :
Number of items inspected Number of Items accepted
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: _____________________ Date: ________ Signature:
Person Notified of Deficiency:
Name: _____________________ Date: ________ Signature:
Reviewed by SMBR - QAQC Superintendent:
Date: ________ Signature:
Name: _____________________
Singgar Mulia Brown & Root Quality Management System
Contract Number: C1368255
Page __ of __
Date: __________ SR No#: ________________________
SURVEILLANCE PHOTOS
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/1/2023 SR No#: ___SOUTH/DDY/001
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_1E-
72,Fabrication and install pipe Ø 4" ADK
Piping 3700107409 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 1E - 72 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
2/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) used poly pig secondhand √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check pipe internal cleaning by Pigging
Number of items inspected 9 Number of Items accepted 8
FINDING / NON COMPLY WORK:
Cleaning internal pipe used Poly Pig secondhand
CORRECTIVE ACTION :
Used new polypig while cleaning internal pipe ( Closes)
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/1/2023 SR No#: ___SOUTH/DDY/001
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/1/2023 SR No#: ___SOUTH/DDY/002
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_1E-
72,Fabrication and install pipe Ø 4" ADK
Piping 3700107409 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 1E - 72 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Painting joint welding √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Testing pipe with Hydrotesting
Number of items inspected 16 Number of Items accepted 15
FINDING / NON COMPLY WORK:
Painting all Joint welding before doing Hydrotest
CORRECTIVE ACTION :
Remove paint to all joint welding ( Closes)
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/1/2023 SR No#: ___SOUTH/DDY/002
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/1/2023 SR No#: ___SOUTH/DDY/003
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_5C-
58N Ø 4" (Existing 5D-42) EFK
Piping 3700098450 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 5D-42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
4/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Preparation install spooll
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/1/2023 SR No#: ___SOUTH/DDY/003
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/1/2023 SR No#: ___SOUTH/DDY/004
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_5C-
58N Ø 4" (Existing 5D-42) EFK
Piping 3700098450 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 5D-42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
5/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/1/2023 SR No#: ___SOUTH/DDY/004
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/1/2023 SR No#: ___SOUTH/DDY/005
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_5C-
58N Ø 4" (Existing 5D-42) EFK
Piping 3700098450 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 5D-42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check Visual welding
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/1/2023 SR No#: ___SOUTH/DDY/005
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/1/2023 SR No#: ___SOUTH/DDY/006
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_7C -
91 Ø 4" (Existing 7C - 88) EFK
Piping 3700094853 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 7C - 91 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Testing pipe with Hydrotesting
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/1/2023 SR No#: ___SOUTH/DDY/006
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/1/2023 SR No#: ___SOUTH/DDY/007
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
9/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Preparation moving from loc 7 C - 91
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/1/2023 SR No#: ___SOUTH/DDY/007
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/1/2023 SR No#: ___SOUTH/DDY/008
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_5C-
58N Ø 4" (Existing 5D-42) EFK
Piping 3700098450 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Minas 5D-42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/1/2023 SR No#: ___SOUTH/DDY/008
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/1/2023 SR No#: ___SOUTH/DDY/009
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/1/2023 SR No#: ___SOUTH/DDY/009
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/1/2023 SR No#: ___SOUTH/DDY/010
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Fab Matting Board and Rebar Fabrication BY ADK.
At Shop of Jaya Glassindo
Piping 76107 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Shop of Jaya Glassindo C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
11/1/2023 E ✘
O
Fabrication Matting Board S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Under Fill √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Visual welding
Number of items inspected 2 Number of Items accepted 0
FINDING / NON COMPLY WORK:
Visual welding repair Under cut and Under Fill
CORRECTIVE ACTION :
Repair all welding
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/1/2023 SR No#: ___SOUTH/DDY/010
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/1/2023 SR No#: ___SOUTH/DDY/011
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
11/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/1/2023 SR No#: ___SOUTH/DDY/011
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/1/2023 SR No#: ___SOUTH/DDY/012
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check visual welding
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/1/2023 SR No#: ___SOUTH/DDY/012
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/1/2023 SR No#: ___SOUTH/DDY/013
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Recolation New Facility for new wells P_6D - 53 N
Fabrication and install pipe Ø 4" Hydrotest by PT.
Piping 3700097765 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D - 53 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check Testing pipe with use Hydrotesting
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Hydrotest pipe Under ground and flow line Ø 4" result Fail because weather rain
CORRECTIVE ACTION :
Re Hydrotest pipe Under ground and flow line Ø 4"
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/1/2023 SR No#: ___SOUTH/DDY/013
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/1/2023 SR No#: ___SOUTH/DDY/014
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Recolation New Facility for new wells P_6D - 53 N
Fabrication and install pipe Ø 4" Hydrotest by PT.
Piping 3700097765 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D - 53 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check Testing pipe with use Hydrotesting
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
Re Hydrotest pipe Under ground and flow line Ø 4" result OK ( NO leak )
CORRECTIVE ACTION :
Hydrotest pipe Under ground and flow line Ø 4" ( Closed )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/1/2023 SR No#: ___SOUTH/DDY/014
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/1/2023 SR No#: ___SOUTH/DDY/015
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7C-
37E Fabrication and Install Ø 4" by PT. ADK
Piping 3700106509 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7 C - 37E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/1/2023 SR No#: ___SOUTH/DDY/015
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/1/2023 SR No#: ___SOUTH/DDY/016
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7C-
37E Fabrication and Install Ø 4" by PT. ADK
Piping 3700106509 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7 C - 37E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check visual welding
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/1/2023 SR No#: ___SOUTH/DDY/016
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/1/2023 SR No#: ___SOUTH/DDY/017
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7C-
37E Fabrication and Install Ø 4" by PT. ADK
Piping 3700106509 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7 C - 37E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Install Material Flange no match with drawing √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
Crew install flange 4 # 300 to under ground for line water injection, which should flange 4" # 600 (Reject)
CORRECTIVE ACTION :
because in drawing for line water injection must used flange 4" # 600 ( closed )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/1/2023 SR No#: ___SOUTH/DDY/017
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/1/2023 SR No#: ___SOUTH/DDY/018
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Recolation New Facility for new wells P_6D - 53 N
Fabrication and install pipe Ø 4" Pigging by PT. EFK
Piping 3700097765 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D - 53 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check cleaning internal pipe
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/1/2023 SR No#: ___SOUTH/DDY/018
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/1/2023 SR No#: ___SOUTH/DDY/019
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
14E (Existing 3C-98N) Tie - In and Review Film by
Piping 3700098482 PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 98N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check visual welding
Check Film RT
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/1/2023 SR No#: ___SOUTH/DDY/019
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/1/2023 SR No#: ___SOUTH/DDY/020
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/1/2023 SR No#: ___SOUTH/DDY/020
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/1/2023 SR No#: ___SOUTH/DDY/021
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
18/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check Visual welding
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/1/2023 SR No#: ___SOUTH/DDY/021
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/1/2023 SR No#: ___SOUTH/DDY/022
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Preparation fab & install flow line
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/1/2023 SR No#: ___SOUTH/DDY/022
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/1/2023 SR No#: ___SOUTH/DDY/023
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/1/2023 SR No#: ___SOUTH/DDY/023
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/1/2023 SR No#: ___SOUTH/DDY/024
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/1/2023 SR No#: ___SOUTH/DDY/024
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/1/2023 SR No#: ___SOUTH/DDY/025
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700097787 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area gelatik minas C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/1/2023 E ✘
O
Fabrication and install Flow line 4" & 6" and Pipe Support S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check Visual welding
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/1/2023 SR No#: ___SOUTH/DDY/025
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/1/2023 SR No#: ___SOUTH/DDY/026
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/1/2023 SR No#: ___SOUTH/DDY/026
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/1/2023 SR No#: ___SOUTH/DDY/027
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/1/2023 SR No#: ___SOUTH/DDY/027
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/1/2023 SR No#: ___SOUTH/DDY/028
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Preparation fab & install flow line
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/1/2023 SR No#: ___SOUTH/DDY/028
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/1/2023 SR No#: ___SOUTH/DDY/029
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/1/2023 SR No#: ___SOUTH/DDY/029
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/1/2023 SR No#: ___SOUTH/DDY/030
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/1/2023 SR No#: ___SOUTH/DDY/030
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/1/2023 SR No#: ___SOUTH/DDY/031
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
26/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/1/2023 SR No#: ___SOUTH/DDY/031
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/1/2023 SR No#: ___SOUTH/DDY/032
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
26/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check during welding
Check Visual welding
Review RT welding
Number of items inspected 19 Number of Items accepted 18
FINDING / NON COMPLY WORK:
Joint welding pipe Under ground FW : 5 Repair Radiography ( Porosity ) 2.3 mm
CORRECTIVE ACTION :
Re welding pipe under ground ( Closes ) tgl 27 /1/23
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/1/2023 SR No#: ___SOUTH/DDY/032
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/1/2023 SR No#: ___SOUTH/DDY/033
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/1/2023 SR No#: ___SOUTH/DDY/033
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/1/2023 SR No#: ___SOUTH/DDY/034
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Hot Tap √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Review RT for pipe loc 4C - 24E
Witness pigging U/G Ø 4"
Witness Hydrotest U/G Ø 4"
Witness Hot Tap flow line Ø 4" for header Ø 8"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/1/2023 SR No#: ___SOUTH/DDY/034
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/1/2023 SR No#: ___SOUTH/DDY/035
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
28/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Check Visual welding
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/1/2023 SR No#: ___SOUTH/DDY/035
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/1/2023 SR No#: ___SOUTH/DDY/036
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Check Visual welding
Review film joint welding
Number of items inspected 19 Number of Items accepted 18
FINDING / NON COMPLY WORK:
finding defect Quality film ( foging , scatter , Chemical mark dll ) because process film not procedure
CORRECTIVE ACTION :
Re shoot X - ray ( radiography ) for welding joint reshoot ( closed)
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/1/2023 SR No#: ___SOUTH/DDY/036
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/1/2023 SR No#: ___SOUTH/DDY/037
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/1/2023 SR No#: ___SOUTH/DDY/037
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/1/2023 SR No#: ___SOUTH/DDY/038
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
25N2 (Existing 4C-26N1) Fabrication and install Ø
Piping 3700102811 4" PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 C - 26 N1 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
31/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Hot Tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/1/2023 SR No#: ___SOUTH/DDY/038
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/1/2023 SR No#: ___SOUTH/DDY/039
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
31/1/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/1/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/1/2023 SR No#: ___SOUTH/DDY/039
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/2/2023 SR No#: ___SOUTH/DDY/040
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
1/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check Visual welding
Number of items inspected 18 Number of Items accepted 17
FINDING / NON COMPLY WORK:
The base pipe after joint welding not yet
CORRECTIVE ACTION :
The base used sand bag ( closed )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/2/2023 SR No#: ___SOUTH/DDY/040
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/2/2023 SR No#: ___SOUTH/DDY/041
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
25N2 (Existing 4C-26N1) Fabrication and install Ø
Piping 3700102811 4" PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 C - 26 N1 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
1/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/2/2023 SR No#: ___SOUTH/DDY/041
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/2/2023 SR No#: ___SOUTH/DDY/042
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
2/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check Hydrotest pipe Under ground 4"
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/2/2023 SR No#: ___SOUTH/DDY/042
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/2/2023 SR No#: ___SOUTH/DDY/043
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
25N2 (Existing 4C-26N1) Fabrication and install Ø
Piping 3700102811 4" PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 C - 26 N1 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
2/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Check Review film
Check Hydrotest pipe under ground 4"
Number of items inspected 28 Number of Items accepted 28
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/2/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/2/2023 SR No#: ___SOUTH/DDY/043
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/2/2023 SR No#: ___SOUTH/DDY/044
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
25N2 (Existing 4C-26N1) Fabrication and install Ø
Piping 3700102811 4" PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 C - 26 N1 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Check Pigging inner pipe Under Ground 4"
Check Hot Tap
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/2/2023 SR No#: ___SOUTH/DDY/044
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/2/2023 SR No#: ___SOUTH/DDY/045
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check Pigging inner pipe under ground 4'
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/2/2023 SR No#: ___SOUTH/DDY/045
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/2/2023 SR No#: ___SOUTH/DDY/046
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location new wells P_5B-77E Fab and
Piping 3700109834 Install RSS (Existing 5B-79E) PT. ADK PT. ADK
M
C W A E
FI T HI
Location : Minas P_5B - 79E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
6/2/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Visual welding
Number of items inspected 8 Number of Items accepted 8
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/2/2023 SR No#: ___SOUTH/DDY/046
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/2/2023 SR No#: ___SOUTH/DDY/047
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check Visual welding
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/2/2023 SR No#: ___SOUTH/DDY/047
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/2/2023 SR No#: ___SOUTH/DDY/048
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
25N2 (Existing 4C-26N1) Fabrication and install Ø
Piping 3700102811 4" PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 C - 26 N1 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
7/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding
Check during welding
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/2/2023 SR No#: ___SOUTH/DDY/048
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/2/2023 SR No#: ___SOUTH/DDY/049
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
New Facility for new wells P_3D - 79 N
Fabrication and install pipe Ø 4" by PT. EFK
Piping 3700107407 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
7/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check Visual welding
Review RT FILM Flow line 4"
Hydrotest flow line 4"
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/2/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/2/2023 SR No#: ___SOUTH/DDY/049
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/2/2023 SR No#: ___SOUTH/DDY/050
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Recolation New Facility for new wells P_6D - 53 N
Fabrication and install pipe Ø 4" Pigging by PT. EFK
Piping 3700097765 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 42 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
8/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts √
Approved ITP available and implemented Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP ( Put of Production ) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Line Check Bolting
POP ( Put of Production )
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/2/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/2/2023 SR No#: ___SOUTH/DDY/050
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/2/2023 SR No#: ___SOUTH/DDY/051
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_1E-
72, Install and Fabrication PT. ADK
Piping 3700107409 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 1E - 72 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
9/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Preparation POP ( Put of Production)
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/2/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/2/2023 SR No#: ___SOUTH/DDY/051
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/2/2023 SR No#: ___SOUTH/DDY/052
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
24E Fabrication and install Ø 4" (Existing ) by PT.
Piping 3700097787 EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 24E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
9/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch - list
Number of items inspected 1 Number of Items accepted 0
FINDING / NON COMPLY WORK:
Finding Install plug 1/2 " at Manyfold
CORRECTIVE ACTION :
Install plug 1/2" at manyfold
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/2/2023 SR No#: ___SOUTH/DDY/052
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/2/2023 SR No#: ___SOUTH/DDY/053
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-
14E (Existing 3C-98N) Tie - In and Review Film by
Piping 3700098482 PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 98N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
9/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Re Punch list
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/2/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/2/2023 SR No#: ___SOUTH/DDY/053
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/2/2023 SR No#: ___SOUTH/DDY/054
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_1E-
72, Install and Fabrication PT. ADK
Piping 3700107409 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 1E - 72 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check Visual welding
Review RT FILM Flow line 4"
Check install gasket
Number of items inspected 23 Number of Items accepted 21
FINDING / NON COMPLY WORK:
NDT ( Radiography ) wing line 4" FW 2A result Repair ( porosity 3 mm )
Intallation for flange line tester 4" used gasket rating # 150
CORRECTIVE ACTION :
Re welding after repair wing line 4" and re NDT ( radiography ) result ACC ( Closes)
Re install gasket rating # 300 ( closes )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/2/2023 SR No#: ___SOUTH/DDY/054
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/2/2023 SR No#: ___SOUTH/DDY/055
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install for
new wells P_5E-96N (existing 5E-84E) PT. ADK
Piping 3700106565 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5E - 84E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check visual welding flow line Ø 4"
Number of items inspected 8 Number of Items accepted 8
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/2/2023 SR No#: ___SOUTH/DDY/055
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/2/2023 SR No#: ___SOUTH/DDY/056
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Fab and Install RSS for new wells P_5E-96N
Piping (existing 5E-84E) PT. VI PT. VI
M
C W A E
FI T HI
Location : Minas P_5B - 79E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/2/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check During welding H - Beam ( RSS)
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/2/2023 SR No#: ___SOUTH/DDY/056
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/2/2023 SR No#: ___SOUTH/DDY/057
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/2/2023 SR No#: ___SOUTH/DDY/057
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/2/2023 SR No#: ___SOUTH/DDY/058
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Install pipe pilling for new wells P_ 5C - 95 N PT. VI
Piping PT. VI
M
C W A E
FI T HI
Location : Minas P_5C- 95N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/2/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check During welding H - Beam ( RSS)
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/2/2023 SR No#: ___SOUTH/DDY/058
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/2/2023 SR No#: ___SOUTH/DDY/059
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Pipe Support 4"
Check during welding Pipe Support 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/2/2023 SR No#: ___SOUTH/DDY/059
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/2/2023 SR No#: ___SOUTH/DDY/060
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fab and Install Ø 6" &
4" for new wells P_4D-71E (4D-81N) PT.EFK
Piping 3700105020 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4D - 81N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pipe Under ground 4"
Check during welding pipe Under ground 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/2/2023 SR No#: ___SOUTH/DDY/060
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/2/2023 SR No#: ___SOUTH/DDY/062
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Manyfold 4"
Check during welding Manyfold 4"
Check Visual welding Manyfold 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/2/2023 SR No#: ___SOUTH/DDY/062
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/2/2023 SR No#: ___SOUTH/DDY/062
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fab and Install Ø 6" &
4" for new wells P_4D-71E (4D-81N) PT.EFK
Piping 3700105020 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4D - 81N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review RT FILM Under ground 4"
Pigging Under ground 4"
Hydrotest Under ground 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/2/2023 SR No#: ___SOUTH/DDY/062
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/2/2023 SR No#: ___SOUTH/DDY/063
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check during welding flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/2/2023 SR No#: ___SOUTH/DDY/063
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/2/2023 SR No#: ___SOUTH/DDY/064
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fab and Install Ø 6" &
4" for new wells P_4D-71E (4D-81N) PT.EFK
Piping 3700105020 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4D - 81N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Wing line 4"
Check during welding Wing line 4"
Check Visual welding Wing line 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/2/2023 SR No#: ___SOUTH/DDY/064
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/2/2023 SR No#: ___SOUTH/DDY/065
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fab and Install Ø 6" &
4" for new wells P_4D-71E (4D-81N) PT.EFK
Piping 3700105020 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4D - 81N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
18/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Bolting flange
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/2/2023 SR No#: ___SOUTH/DDY/065
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2023 SR No#: ___SOUTH/DDY/066
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Fab and Install RSS for new wells P_5E-96N
Piping (existing 5E-84E) PT. VI PT. VI
M
C W A E
FI T HI
Location : Minas P_5B - 79E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/2/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check During welding H - Beam ( RSS)
Check Visual welding H - Beam ( RSS)
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2023 SR No#: ___SOUTH/DDY/066
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2023 SR No#: ___SOUTH/DDY/067
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install 4"
for new wells P_5E - 96N (Existing 5E - 84E)
Piping 3700106565 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5E - 84 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC welding √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line and Pipe support 4"
Check during welding flow line and Pipe support 4"
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
Welding Inspector Contractor Not on site
CORRECTIVE ACTION :
Welding Inspector contractor done improve with Coordinator , because Quality Control allways a field every day based on ITP ( witness)
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2023 SR No#: ___SOUTH/DDY/067
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2023 SR No#: ___SOUTH/DDY/068
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC welding √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check during welding flow line 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding Inspector Contractor Not on site
CORRECTIVE ACTION :
Welding Inspector contractor done improve with Coordinator , because Quality Control allways a field every day based on ITP ( witness)
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2023 SR No#: ___SOUTH/DDY/068
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/2/2023 SR No#: ___SOUTH/DDY/069
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground and Many fold 4"
Check during welding Under ground and Many fold 4"
Check Visual welding Under ground and Many fold 4"
Number of items inspected 16 Number of Items accepted 15
FINDING / NON COMPLY WORK:
Visual welding joint under ground ( under Cut ) depth 2 mm.
CORRECTIVE ACTION :
Repair welding to joint welding under ground
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/2/2023 SR No#: ___SOUTH/DDY/069
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/2/2023 SR No#: ___SOUTH/DDY/070
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fab and Install Ø 6" &
4" for new wells P_4D-71E (4D-81N) PT.EFK
Piping 3700105020 PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4D - 81N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
21/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Finals Punch list
Number of items inspected 1 Number of Items accepted
FINDING / NON COMPLY WORK:
finding ; ( bolting short , flow line not contact to pipe support, pressure gauge not yet )
CORRECTIVE ACTION :
Contractor must close finding punch list
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/2/2023 SR No#: ___SOUTH/DDY/070
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/2/2023 SR No#: ___SOUTH/DDY/071
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
21/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line and Many fold 4"
Check during welding Flow line and Many fold 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/2/2023 SR No#: ___SOUTH/DDY/071
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/2/2023 SR No#: ___SOUTH/DDY/072
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location new wells P_5C-95N PT. ADK
Piping 3700109091 PT. ADK
M
C W A E
FI T HI
Location : Minas P_5C - 95 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/2/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check During welding H - Beam ( RSS)
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/2/2023 SR No#: ___SOUTH/DDY/072
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/2/2023 SR No#: ___SOUTH/DDY/073
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
22/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Flow line not match with Drawing √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding spooll weldolet 6" X 4"
Check during welding spooll weldolet 6" X 4"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
Install Tie - In flow line for well head ( 5B - 79 E ) it is not in accordance with Drawing
CORRECTIVE ACTION :
Re Install tie - In flow line used Flange to flange to pipe new with pipe existing
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/2/2023 SR No#: ___SOUTH/DDY/073
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/2/2023 SR No#: ___SOUTH/DDY/074
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location new wells P_5C-95N PT. ADK
Piping 3700109091 PT. ADK
M
C W A E
FI T HI
Location : Minas P_5C - 95 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
22/2/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Visual welding H - Beam ( RSS)
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/2/2023 SR No#: ___SOUTH/DDY/074
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/2/2023 SR No#: ___SOUTH/DDY/075
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6F-82
and P_7E-14 Fabrication and install pipe Ø 4" &
Piping 3700105246 6"(Gelatik Complex)by PT. EFK PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area Gelatik C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film radiography pipe under ground 4"
Check Pigging pipe under ground 4"
Check Hydrotest pipe under ground 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/2/2023 SR No#: ___SOUTH/DDY/075
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/2/2023 SR No#: ___SOUTH/DDY/076
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check install bolting many fold 4"
Number of items inspected 8 Number of Items accepted 7
FINDING / NON COMPLY WORK:
Install bolting not used anti seize coumpound
CORRECTIVE ACTION :
Re Install bolting must use anti seize coumpond
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/2/2023 SR No#: ___SOUTH/DDY/076
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/2/2023 SR No#: ___SOUTH/DDY/077
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding road crossing 4" for loc 5 B - 77 E
Check during welding road crossing 4" for loc 5 B - 77 E
Check Pigging U/G and Flow line loc 5B- 79 E
Check Pigging U/G loc 5B- 77 E
Review Film after repair ( R1) pipe U/G loc 5B-79E
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
welding after repair ( R1 ) pipe under ground 4" FW : 6 for loc 5 B - 79 E , welding repair ( R2)
CORRECTIVE ACTION :
welding joint repair (R2) have to CUT OFF, re joint welding with initial FW : 6 C/O
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/2/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/2/2023 SR No#: ___SOUTH/DDY/077
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/2/2023 SR No#: ___SOUTH/DDY/078
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding ( CO ) Under ground 4" for loc 5 B - 79 E
Check Pigging Flow line loc 5B- 77 E
Review Film after repair ( CO ) pipe U/G loc 5B-79E
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/2/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/2/2023 SR No#: ___SOUTH/DDY/078
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/2/2023 SR No#: ___SOUTH/DDY/079
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install Ø
4" for new wells P_5B-77E (Existing 5B-79E)
Piping 3700110628 PT.ADK PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/2/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Witness Hydrotest Under ground 4" loc 5B - 77 N and 5B - 79 E
Witness Hydrotest Flow line 4" loc 5B - 77 N and 5B - 79 E
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/2/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/2/2023 SR No#: ___SOUTH/DDY/079
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/3/2023 SR No#: ___SOUTH/DDY/080
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Site Com √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Site COM
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/3/2023 SR No#: ___SOUTH/DDY/080
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/3/2023 SR No#: ___SOUTH/DDY/081
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
25N1 Fab and install pipe Ø 4" (Existing 3C-99N)
Piping 3700099189 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 99N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/3/2023 SR No#: ___SOUTH/DDY/081
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/3/2023 SR No#: ___SOUTH/DDY/082
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
"Relocation and New Facility for new wells P_1E-
72,Fabrication and install pipe Ø 4" ADK
Piping 3700107409 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 1E - 72 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Number of items inspected Number of Items accepted 1
FINDING / NON COMPLY WORK:
Install ball valve 1/2" at under ground
CORRECTIVE ACTION :
Re Install ball valve 1/2"
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/3/2023 SR No#: ___SOUTH/DDY/082
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/3/2023 SR No#: ___SOUTH/DDY/083
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
25N1 Fab and install pipe Ø 4" (Existing 3C-99N)
Piping 3700099189 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 99N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding spooll hoop Up 4"
Check during welding spooll hoop Up 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/3/2023 SR No#: ___SOUTH/DDY/083
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/3/2023 SR No#: ___SOUTH/DDY/084
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4C-
25N1 Fab and install pipe Ø 4" (Existing 3C-99N)
Piping 3700099189 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 99N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding spooll hoop Up 4"
Check during welding spooll hoop Up 4"
Check Visual welding wing line 4"
Review film tie - In 4"
check all bolting flow line 4"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/3/2023 SR No#: ___SOUTH/DDY/084
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/3/2023 SR No#: ___SOUTH/DDY/085
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4A - 23E & P_ 4A -
Piping 83729 22 PT. ADK PT. ADK
M
C W A E
FI T HI
Location : Minas 4A - 23 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
5/3/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding H - Beam ( RSS)
Check during welding H - Beam ( RSS)
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/3/2023 SR No#: ___SOUTH/DDY/085
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/3/2023 SR No#: ___SOUTH/DDY/086
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3C - 99N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground 4"
Check During welding under ground 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/3/2023 SR No#: ___SOUTH/DDY/086
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/3/2023 SR No#: ___SOUTH/DDY/087
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " & 6 " for New Well P_6D - 64 N ( Ext 6D - 64 )
Piping 82287 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 6D - 64 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground 4" & 6"
Check During welding under ground 4" & 6"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/3/2023 SR No#: ___SOUTH/DDY/087
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/3/2023 SR No#: ___SOUTH/DDY/088
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4A - 23E & P_ 4A -
Piping 83729 22 PT. ADK PT. ADK
M
C W A E
FI T HI
Location : Minas 4A - 23 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
6/3/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding H - Beam ( RSS)
Check during welding H - Beam ( RSS)
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/3/2023 SR No#: ___SOUTH/DDY/088
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/3/2023 SR No#: ___SOUTH/DDY/089
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab member support 4"
Check before welding fab member support 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/3/2023 SR No#: ___SOUTH/DDY/089
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/3/2023 SR No#: ___SOUTH/DDY/090
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line and many fold 4"
Check before welding fab Flow line and many fold 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/3/2023 SR No#: ___SOUTH/DDY/090
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/3/2023 SR No#: ___SOUTH/DDY/091
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4A - 23E & P_ 4A -
Piping 83729 22 PT. ADK PT. ADK
M
C W A E
FI T HI
Location : Minas 4A - 23 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
7/3/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Visual welding H - Beam ( RSS)
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/3/2023 SR No#: ___SOUTH/DDY/091
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/3/2023 SR No#: ___SOUTH/DDY/092
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check before welding fab Flow line 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/3/2023 SR No#: ___SOUTH/DDY/092
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/3/2023 SR No#: ___SOUTH/DDY/093
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Check Visual welding fab Flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/3/2023 SR No#: ___SOUTH/DDY/093
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/3/2023 SR No#: ___SOUTH/DDY/094
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check before welding fab Flow line 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/3/2023 SR No#: ___SOUTH/DDY/094
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/3/2023 SR No#: ___SOUTH/DDY/095
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding threaded 1/2 "
Check During welding threaded 1/2 "
Check Visual welding threaded 1/2 "
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/3/2023 SR No#: ___SOUTH/DDY/095
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/3/2023 SR No#: ___SOUTH/DDY/096
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Witness Pigging Under ground 4"
Witness Hydrotest Under ground 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/3/2023 SR No#: ___SOUTH/DDY/096
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/3/2023 SR No#: ___SOUTH/DDY/097
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Check Visual welding fab Flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/3/2023 SR No#: ___SOUTH/DDY/097
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/3/2023 SR No#: ___SOUTH/DDY/098
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4A - 23E & P_ 4A -
Piping 83729 22 PT. ADK PT. ADK
M
C W A E
FI T HI
Location : Minas 4A - 23 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
10/3/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pilling 8"
Check During welding install pilling 8"
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/3/2023 SR No#: ___SOUTH/DDY/098
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/3/2023 SR No#: ___SOUTH/DDY/099
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
10/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) Hot tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Check Visual welding fab Flow line 4"
Check Hot - Tap Ø 4" X 8"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/3/2023 SR No#: ___SOUTH/DDY/099
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/3/2023 SR No#: ___SOUTH/DDY/100
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install 4"
for new wells P_5E-96N (existing 5E-84E) PT. ADK
Piping 3700106565 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5E - 84E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Hot tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Execution HOT TAP ( Cancelled )
Number of items inspected 1 Number of Items accepted 0
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/3/2023 SR No#: ___SOUTH/DDY/100
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/3/2023 SR No#: ___SOUTH/DDY/101
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Hot Tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Execution HOT TAP ( Cancelled )
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/3/2023 SR No#: ___SOUTH/DDY/101
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/3/2023 SR No#: ___SOUTH/DDY/100
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install 4"
for new wells P_5E-96N (existing 5E-84E) PT. ADK
Piping 3700106565 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5E - 84E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Hot tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Execution HOT TAP result OK
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/3/2023 SR No#: ___SOUTH/DDY/100
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/3/2023 SR No#: ___SOUTH/DDY/103
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Under ground 4"
Check During welding fab Under Ground 4"
Check Visual welding fab Under ground 4"
Execution HOT TAP result OK
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/3/2023 SR No#: ___SOUTH/DDY/103
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/3/2023 SR No#: ___SOUTH/DDY/104
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4A - 23E & P_ 4A -
Piping 83729 22 PT. ADK PT. ADK
M
C W A E
FI T HI
Location : Minas 4A - 23 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
15/3/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Visual welding install pilling 8"
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/3/2023 SR No#: ___SOUTH/DDY/104
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/3/2023 SR No#: ___SOUTH/DDY/105
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/3/2023 SR No#: ___SOUTH/DDY/105
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/3/2023 SR No#: ___SOUTH/DDY/106
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - IN line tester 4"
Check During welding Tie - IN line tester 4"
Check Visual welding Tie - IN line tester 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/3/2023 SR No#: ___SOUTH/DDY/106
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/3/2023 SR No#: ___SOUTH/DDY/107
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Check Visual welding fab Flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/3/2023 SR No#: ___SOUTH/DDY/107
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/3/2023 SR No#: ___SOUTH/DDY/108
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Check Visual welding fab Flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/3/2023 SR No#: ___SOUTH/DDY/108
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/3/2023 SR No#: ___SOUTH/DDY/109
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install 4"
for new wells P_8C - 66 E (existing 8C - 66) PT. EFK
Piping 87087 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 8 C - 66 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab Flow line 4"
Check Visual welding fab Flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/3/2023 SR No#: ___SOUTH/DDY/109
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/3/2023 SR No#: ___SOUTH/DDY/110
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__8 C - 66 E PT. VDI
Piping 85655 PT. VDI
M
C W A E
FI T HI
Location : Minas 8 C - 66 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/3/2023 E ✘
O
Fabrication and install Pipe pilling RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pilling 8"
Check During welding install pilling 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/3/2023 SR No#: ___SOUTH/DDY/110
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/3/2023 SR No#: ___SOUTH/DDY/111
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
26N (Existing 3A - 26) pipe Ø 4" & 6", by PT. EFK
Piping 3700105246 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3 A - 26 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Wing line 4" loc 3A - 26
Check During welding fab Wing line 4" loc 3A - 26
Check Visual welding fab Wing line 4" loc 3A - 26
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/3/2023 SR No#: ___SOUTH/DDY/111
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/3/2023 SR No#: ___SOUTH/DDY/112
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
26N (Existing 3A - 26) pipe Ø 4" & 6", by PT. EFK
Piping 3700105246 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 3 A - 26 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Repair Wing line 4" loc 3A - 26
Check During welding Repair Wing line 4" loc 3A - 26
Check Visual welding Repair Wing line 4" loc 3A - 26
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/3/2023 SR No#: ___SOUTH/DDY/112
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/3/2023 SR No#: ___SOUTH/DDY/113
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation Production Facility for Minas P_9E-21N
Piping 85655 & P_9E-11N PT. ADK PT. ADK MD
M
C W A E
FI T HI
Location : Minas P_ 9E - 21N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/3/2023 E ✘
O
Install power pole S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Line Check
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/3/2023 SR No#: ___SOUTH/DDY/113
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/3/2023 SR No#: ___SOUTH/DDY/114
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Under ground 4"
Check During welding fab Under ground 4"
Check Visual welding fab Under ground 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/3/2023 SR No#: ___SOUTH/DDY/114
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/3/2023 SR No#: ___SOUTH/DDY/115
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Under ground 4"
Check During welding fab Under ground 4"
Check Visual welding fab Under ground 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/3/2023 SR No#: ___SOUTH/DDY/115
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/3/2023 SR No#: ___SOUTH/DDY/116
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N (Existing 5D-42) Fab and Install pipe Ø 4"
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5 D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Site Preparation
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/3/2023 SR No#: ___SOUTH/DDY/116
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/3/2023 SR No#: ___SOUTH/DDY/117
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Review film radiography under ground 4"
Hydrotest under ground 4"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/3/2023 SR No#: ___SOUTH/DDY/117
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/3/2023 SR No#: ___SOUTH/DDY/117
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Review film radiography under ground 4"
Hydrotest under ground 4"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/3/2023 SR No#: ___SOUTH/DDY/117
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/3/2023 SR No#: ___SOUTH/DDY/119
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
31/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Witness Pigging under ground 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/3/2023 SR No#: ___SOUTH/DDY/119
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/3/2023 SR No#: ___SOUTH/DDY/120
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N (Existing 5D-42) Fab and Install pipe Ø 4"
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5 D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
31/3/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Under ground 4" and Pipe support
Check During welding fab Under ground 4" and pipe support
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/3/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/3/2023 SR No#: ___SOUTH/DDY/120
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/3/2023 SR No#: ___SOUTH/DDY/121
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation Road and Location new wells P_5C-57N
Piping 85655 PT, HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5C - 57N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
31/3/2023 E ✘
O
Install power pole S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Pipe pilling 8"
Check During welding pipe pilling 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/3/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/3/2023 SR No#: ___SOUTH/DDY/121
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/4/2023 SR No#: ___SOUTH/DDY/122
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B -
21N (Existing 4B - 94 A) Fab and Install pipe Ø 4"
Piping 86848 PT. EFK 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4B - 94 A C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Under ground 4"
Check During welding fab Under ground 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/4/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/4/2023 SR No#: ___SOUTH/DDY/122
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/4/2023 SR No#: ___SOUTH/DDY/123
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install for
new wells P_5B-77E (Existing 5B-79E) PT.ADK
Piping 3700110628 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding repair welding under ground 4 " 5B - 79E
Check During welding repair welding under ground 4 " 5B - 79E
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/4/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/4/2023 SR No#: ___SOUTH/DDY/123
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/4/2024 SR No#: ___SOUTH/DDY/124
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install for
new wells P_5B-77E (Existing 5B-79E) PT.ADK
Piping 3700110628 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install wing line Ø 4 " 5B - 79E
Check During install wing line Ø 4 " 5B - 79E
Check Visual install wing line Ø 4 " 5B - 79E
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/4/2024 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/4/2024 SR No#: ___SOUTH/DDY/124
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/4/2023 SR No#: ___SOUTH/DDY/125
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Witness Hydrotest Road Crossing 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/4/2023 SR No#: ___SOUTH/DDY/125
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/4/2024 SR No#: ___SOUTH/DDY/126
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install for
new wells P_5B-77E (Existing 5B-79E) PT.ADK
Piping 3700110628 PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5B - 79E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install wing line Ø 4 " 5B - 79E
Check During install wing line Ø 4 " 5B - 79E
Check Visual install wing line Ø 4 " 5B - 79E
Check all bolting completed
Review film Tie - In wing line Ø 4 " 5B - 79E
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/4/2024 SR No#: ___SOUTH/DDY/126
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/4/2024 SR No#: ___SOUTH/DDY/127
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B -
21N (Existing 4B - 94 A) Fab and Install pipe Ø 4"
Piping 86848 PT. EFK 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4B - 94 A C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install Under ground Ø 4 "
Check During install Under ground Ø 4 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/4/2024 SR No#: ___SOUTH/DDY/127
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/4/2023 SR No#: ___SOUTH/DDY/128
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/4/2023 SR No#: ___SOUTH/DDY/128
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/4/2023 SR No#: ___SOUTH/DDY/129
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Check Visual welding fab flow line 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/4/2023 SR No#: ___SOUTH/DDY/129
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/4/2023 SR No#: ___SOUTH/DDY/131
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Check Visual welding fab flow line 4"
Number of items inspected 16 Number of Items accepted 15
FINDING / NON COMPLY WORK:
Defect visual welding at flow line pipe to pipe Ø 4 " result High & low more than 5 mm,
based on procedure max high & low 1,6 mm
CORRECTIVE ACTION :
Cut off to welding joint pipe to pipe and Re welding joint flow line 4 "
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/4/2023 SR No#: ___SOUTH/DDY/131
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/4/2023 SR No#: ___SOUTH/DDY/132
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4"
Piping 85967 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4 A - 23 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
10/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Check Visual welding fab flow line 4"
Number of items inspected 16 Number of Items accepted 15
FINDING / NON COMPLY WORK:
Defect visual welding at flow line pipe to ellbow Ø 4 " result High & low more than 8 mm,
based on procedure max high & low 1,6 mm
CORRECTIVE ACTION :
Cut off to welding joint pipe to Ellbow and Re welding joint flow line 4 "
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/4/2023 SR No#: ___SOUTH/DDY/132
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/4/2023 SR No#: ___SOUTH/DDY/133
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__5B - 21N PT.
Piping ADK PT. ADK
M
C W A E
FI T HI
Location : Minas P_ 5B - 21 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
11/4/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/4/2023 SR No#: ___SOUTH/DDY/133
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/4/2023 SR No#: ___SOUTH/DDY/134
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-78
(Existing 5D - 71) Fabrication & Install pipe 4" &
Piping 79907 6", by PT. EFK 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R ✘ P
Location : Area 5D - 71 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
12/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab Flow line 4"
Check During welding fab flow line 4"
Check Visual welding fab flow line 4"
Review RT film wing line 4 "
Check install all Bolting to line 4"
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/4/2023 SR No#: ___SOUTH/DDY/134
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/4/2023 SR No#: ___SOUTH/DDY/134
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__5B - 21N PT.
Piping ADK PT. ADK
M
C W A E
FI T HI
Location : Minas P_ 5B - 21 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/4/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/4/2023 SR No#: ___SOUTH/DDY/134
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/4/2023 SR No#: ___SOUTH/DDY/136
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B -
21N (Existing 4B - 94 A) Fab and Install pipe Ø 4"
Piping 86848 PT. EFK 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R ✘ P
Location : Area 5D - 71 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding fab U/G 4"
Check During welding fab U/G 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/4/2023 SR No#: ___SOUTH/DDY/136
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/4/2023 SR No#: ___SOUTH/DDY/137
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R ✘ P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film Ndt radiography road crossing and Under ground 4"
Witness hydrotest road crossing and Under ground 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/4/2023 SR No#: ___SOUTH/DDY/137
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/4/2023 SR No#: ___SOUTH/DDY/138
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__5C - 59 PT. HKI
Piping 87787 PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5C - 69 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
27/4/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/4/2023 SR No#: ___SOUTH/DDY/138
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/4/2023 SR No#: ___SOUTH/DDY/139
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
✘ P ✘ D R ✘ P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Under ground piping
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/4/2023 SR No#: ___SOUTH/DDY/139
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/4/2023 SR No#: ___SOUTH/DDY/140
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__5C - 59 PT. HKI
Piping 87787 PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5C - 69 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
28/4/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Check visual welding install RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/4/2023 SR No#: ___SOUTH/DDY/140
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/4/2023 SR No#: ___SOUTH/DDY/141
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
✘ P ✘ D R ✘ P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/4/2023 SR No#: ___SOUTH/DDY/141
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/4/2023 SR No#: ___SOUTH/DDY/142
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__5C - 59 PT. HKI
Piping 87787 PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5C - 69 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/4/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Check visual welding install RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/4/2023 SR No#: ___SOUTH/DDY/142
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/5/2023 SR No#: ___SOUTH/DDY/143
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P D ✘ R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/5/2023 SR No#: ___SOUTH/DDY/143
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/4/2023 SR No#: ___SOUTH/DDY/144
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/4/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/4/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/4/2023 SR No#: ___SOUTH/DDY/144
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/5/2023 SR No#: ___SOUTH/DDY/145
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P D ✘ R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Check Visual welding Under ground Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/5/2023 SR No#: ___SOUTH/DDY/145
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/5/2023 SR No#: ___SOUTH/DDY/146
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Check Visual welding Under ground Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/5/2023 SR No#: ___SOUTH/DDY/146
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/5/2023 SR No#: ___SOUTH/DDY/147
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding threaded Ø 1/2" for under ground piping
Check during welding threaded Ø 1/2" for under ground piping
Check Visual welding threaded Ø 1/2" for under ground piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/5/2023 SR No#: ___SOUTH/DDY/147
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/5/2023 SR No#: ___SOUTH/DDY/148
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Jumper line Ø 4" piping
Check during welding Jumper line Ø 4" piping
Check Visual welding Jumper line Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/5/2023 SR No#: ___SOUTH/DDY/148
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/5/2023 SR No#: ___SOUTH/DDY/149
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility Fabrication and Install
Ø 4 " for New Well P_5C - 95 N
Piping 86430 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
POP ( Put On Production )
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/5/2023 SR No#: ___SOUTH/DDY/149
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/5/2023 SR No#: ___SOUTH/DDY/150
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7E-
94N & P_8D-19E Ø 4" & 6" (Existing Well 7E-94E)
Piping 18236 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 7E - 94E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Check Pigging Under ground Ø 4" 4 Ea
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/5/2023 SR No#: ___SOUTH/DDY/150
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/5/2023 SR No#: ___SOUTH/DDY/151
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N Ø 4 " (Existing 5D-42)
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding weldolet Ø 4" piping
Check during welding weldolet Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/5/2023 SR No#: ___SOUTH/DDY/151
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/5/2023 SR No#: ___SOUTH/DDY/152
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells Ø 4"
'P_4C-25N2
Piping 86008 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Wing line Ø 4" piping
Check during welding wing line Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/5/2023 SR No#: ___SOUTH/DDY/152
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/5/2023 SR No#: ___SOUTH/DDY/153
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N Ø 4 " (Existing 5D-42)
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground to flow line Ø 4" piping
Check during welding under ground to flow line Ø 4" piping
Check Visual welding under ground to flow line Ø 4" piping
Review Film wing line Ø 4"
Hydrostating piping Ø 4"
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/5/2023 SR No#: ___SOUTH/DDY/153
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/5/2023 SR No#: ___SOUTH/DDY/154
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N Ø 4 " (Existing 5D-42)
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground to flow line Ø 4" piping
Check during welding under ground to flow line Ø 4" piping
Review Film wing line Ø 4"
Hydrostating piping Ø 4"
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/5/2023 SR No#: ___SOUTH/DDY/154
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/5/2023 SR No#: ___SOUTH/DDY/155
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N Ø 4 " (Existing 5D-42)
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
10/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding re pad hot tap Ø 4" piping
Check during welding Re pad hot tap Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/5/2023 SR No#: ___SOUTH/DDY/155
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/5/2023 SR No#: ___SOUTH/DDY/156
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__5C - 59 PT. HKI
Piping 87787 PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5C - 69 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
11/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/5/2023 SR No#: ___SOUTH/DDY/156
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/5/2023 SR No#: ___SOUTH/DDY/157
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
57N Ø 4 " (Existing 5D-42)
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5D - 42 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
11/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold Ø 4" piping
Check during welding manyfold Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/5/2023 SR No#: ___SOUTH/DDY/157
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/5/2023 SR No#: ___SOUTH/DDY/158
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C-59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold Ø 4" piping
Check during welding manyfold Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/5/2023 SR No#: ___SOUTH/DDY/158
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/5/2023 SR No#: ___SOUTH/DDY/159
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping 82267 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install spooll Hot tap welding Ø 4" for main line Ø 6" piping
Check during install spooll Hot tap welding Ø 4" for main line Ø 6" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/5/2023 SR No#: ___SOUTH/DDY/159
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/5/2023 SR No#: ___SOUTH/DDY/160
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping 82267 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install pipe support
Check during install pipe support
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/5/2023 SR No#: ___SOUTH/DDY/160
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/5/2023 SR No#: ___SOUTH/DDY/161
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before fab manyfold Ø 4" Piping
Check during fab manyfold Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/5/2023 SR No#: ___SOUTH/DDY/161
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/5/2023 SR No#: ___SOUTH/DDY/162
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7C-
17S Ø 4 " PT. EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7C - 17S C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install wing line Ø 4" Piping
Check during install wing line Ø 4" Piping
Check Visual install wing line Ø 4" Piping
Review Film wing line Ø 4"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/5/2023 SR No#: ___SOUTH/DDY/162
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/5/2023 SR No#: ___SOUTH/DDY/163
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7C-
17S Ø 4 " PT. EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7C - 17S C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Fabrication line tester Ø 4" Piping
Check during Fabrication line tester Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/5/2023 SR No#: ___SOUTH/DDY/163
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/5/2023 SR No#: ___SOUTH/DDY/164
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__7E - 94 N PT.
Piping HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 7E - 94 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
18/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/5/2023 SR No#: ___SOUTH/DDY/164
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/5/2023 SR No#: ___SOUTH/DDY/165
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C-59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold Ø 4" piping
Check during welding manyfold Ø 4" piping
Check visual welding manyfold Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/5/2023 SR No#: ___SOUTH/DDY/165
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/5/2023 SR No#: ___SOUTH/DDY/166
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/5/2023 SR No#: ___SOUTH/DDY/166
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/5/2023 SR No#: ___SOUTH/DDY/167
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7C-
17S Ø 4 " PT. EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7C - 17S C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install pipe pilling Ø 8" Piping
Check during Install pipe pilling Ø 8" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/5/2023 SR No#: ___SOUTH/DDY/167
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/5/2023 SR No#: ___SOUTH/DDY/168
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film QC MK √
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install Flow line Ø 4" Piping
Check during Install Flow line Ø 4" Piping
Check Hot Tap Ø 4"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/5/2023 SR No#: ___SOUTH/DDY/168
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/5/2023 SR No#: ___SOUTH/DDY/169
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC MK √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/5/2023 SR No#: ___SOUTH/DDY/169
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/5/2023 SR No#: ___SOUTH/DDY/170
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC MK √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before fab Under ground Ø 4" Piping
Check during fab Under ground Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/5/2023 SR No#: ___SOUTH/DDY/170
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/5/2023 SR No#: ___SOUTH/DDY/172
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Hole bolting alignment √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Fab under ground Ø 4" Piping
Check during Fab under ground Ø 4" Piping
Number of items inspected 14 Number of Items accepted 13
FINDING / NON COMPLY WORK:
repair hole Bolting flange flow line alignment with hole bolting flange under ground Ø 4"
CORRECTIVE ACTION :
Re welding flange flow line Ø 4" ( close) 23-05-2023
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/5/2023 SR No#: ___SOUTH/DDY/172
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/5/2023 SR No#: ___SOUTH/DDY/173
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Line tester Bending √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before fab Line tester Ø 4" Piping
Check during fab line tester Ø 4" Piping
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
Line tester Ø 4" bending
CORRECTIVE ACTION :
Re welding line tester ( closes) 23 - 05 - 23
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/5/2023 SR No#: ___SOUTH/DDY/173
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/5/2023 SR No#: ___SOUTH/DDY/174
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Fab pipe support Ø 4" Piping
Check during Fab pipe support Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/5/2023 SR No#: ___SOUTH/DDY/174
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/5/2023 SR No#: ___SOUTH/DDY/175
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P__7E - 94 N PT.
Piping HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 7E - 94 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
23/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC MK √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe Ø 8" pilling
Check During welding install pipe Ø 8" pilling
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/5/2023 SR No#: ___SOUTH/DDY/175
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/5/2023 SR No#: ___SOUTH/DDY/176
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before fab Line tester Ø 4" Piping
Check during fab line tester Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/5/2023 SR No#: ___SOUTH/DDY/176
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/5/2023 SR No#: ___SOUTH/DDY/177
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Tie - In line tester Ø 4" Piping
Check during Tie - In line tester Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/5/2023 SR No#: ___SOUTH/DDY/177
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/5/2023 SR No#: ___SOUTH/DDY/178
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before fab Jumper line Ø 8" Piping
Check during fab Jumper line Ø 8" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/5/2023 SR No#: ___SOUTH/DDY/178
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/5/2023 SR No#: ___SOUTH/DDY/179
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4C - 35E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 7E - 94 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
25/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe Ø 8" pilling
Check During welding install pipe Ø 8" pilling
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/5/2023 SR No#: ___SOUTH/DDY/179
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/5/2023 SR No#: ___SOUTH/DDY/180
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C-59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Flow line Ø 4" piping
Check during welding Install Flow line Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/5/2023 SR No#: ___SOUTH/DDY/180
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/5/2023 SR No#: ___SOUTH/DDY/181
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C-59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Flow line Ø 4" piping
Check during welding Install Flow line Ø 4" piping
Check visual welding Install Flow line Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/5/2023 SR No#: ___SOUTH/DDY/181
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/5/2023 SR No#: ___SOUTH/DDY/182
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab Flow line Ø 4" piping
Check during welding Fab Flow line Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/5/2023 SR No#: ___SOUTH/DDY/182
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/5/2023 SR No#: ___SOUTH/DDY/183
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_3D - 33 E PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 3D - 33 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe Ø 8" pilling
Check During welding install pipe Ø 8" pilling
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/5/2023 SR No#: ___SOUTH/DDY/183
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/5/2023 SR No#: ___SOUTH/DDY/184
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping 86887 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C-59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/5/2023 ✘ E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Flow line Ø 4" piping
Check during welding Install Flow line Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/5/2023 SR No#: ___SOUTH/DDY/184
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/5/2023 SR No#: ___SOUTH/DDY/185
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab Flow line Ø 4" piping
Check during welding Fab Flow line Ø 4" piping
Check Visual welding Fab Flow line Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/5/2023 SR No#: ___SOUTH/DDY/185
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/5/2023 SR No#: ___SOUTH/DDY/178
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before fab pipe support Ø 4" Piping
Check during fab pipe support Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/5/2023 SR No#: ___SOUTH/DDY/178
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/5/2023 SR No#: ___SOUTH/DDY/187
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4D - 38 E PT. VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
27/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe Ø 8" pilling
Check During welding install pipe Ø 8" pilling
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/5/2023 SR No#: ___SOUTH/DDY/187
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/5/2023 SR No#: ___SOUTH/DDY/188
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Pigging flow line & under ground Ø 4" Piping
Check Hydrotest flow line & under ground Ø 4" Piping
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/5/2023 SR No#: ___SOUTH/DDY/188
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/5/2023 SR No#: ___SOUTH/DDY/189
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4D - 38 E PT. VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/5/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe Ø 8" pilling
Check During welding install pipe Ø 8" pilling
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/5/2023 SR No#: ___SOUTH/DDY/189
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/5/2023 SR No#: ___SOUTH/DDY/190
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4" PT. EFK
Piping 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 22 & 4A - 23E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check during flow line Ø 4" piping
Check Visual flow line Ø 4" piping
Check Pigging flow line Ø 4" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/5/2023 SR No#: ___SOUTH/DDY/190
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/5/2023 SR No#: ___SOUTH/DDY/191
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for New Well P_4A -
23E & P_ 4A - 22 Fab and install pipe Ø 4" PT. EFK
Piping 2 PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 22 & 4A - 23E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
31/5/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before wing line Ø 4" piping
Check during wing line Ø 4" piping
Check Visual flow line Ø 4" piping
Check Pigging flow line Ø 4" Piping
Check hydrotest flow line Ø 4" piping
Check review Film flow line Ø 4" piping
Check Put On Production result OK
Number of items inspected 25 Number of Items accepted 25
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/5/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/5/2023 SR No#: ___SOUTH/DDY/191
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/6/2023 SR No#: ___SOUTH/DDY/192
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) Hot Tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Check Hot - tap Result OK
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/6/2023 SR No#: ___SOUTH/DDY/192
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/6/2023 SR No#: ___SOUTH/DDY/193
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping 83747 PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 5C - 63 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) Hot Tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4" piping
Check during welding Under ground Ø 4" piping
Check Hot - tap Result OK
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/6/2023 SR No#: ___SOUTH/DDY/193
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/6/2023 SR No#: ___SOUTH/DDY/194
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation New Facility Fabrication and Install
flow line Ø 4" for new wells P_5C - 63 PT.ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 63 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
2/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before wing line Ø 4" piping
Check during wing line Ø 4" piping
Check Visual flow line Ø 4" piping
Check Pigging flow line Ø 4" Piping
Check hydrotest flow line Ø 4" piping
Check review Film flow line Ø 4" piping
Check Put On Production result OK
Number of items inspected 25 Number of Items accepted 25
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/6/2023 SR No#: ___SOUTH/DDY/194
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/6/2023 SR No#: ___SOUTH/DDY/195
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install flow line Ø 6" Piping
Check during install flow line Ø 6" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/6/2023 SR No#: ___SOUTH/DDY/195
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/6/2023 SR No#: ___SOUTH/DDY/196
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5E -
64 Ø 4 " , 6" & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install flow line Ø 8" Piping
Check during install flow line Ø 8" Piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/6/2023 SR No#: ___SOUTH/DDY/196
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/6/2023 SR No#: ___SOUTH/DDY/197
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
5/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before flow line Ø 6" piping
Check during flow line Ø 6" piping
Check Visual flow line Ø 6" piping
Check Pigging flow line & under ground Ø 4"& 6" Piping
Check hydrotest Under ground Ø 4" piping
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/6/2023 SR No#: ___SOUTH/DDY/197
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/6/2023 SR No#: ___SOUTH/DDY/198
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before tie - in flow line Ø 6" and fab line tester Ø 4" piping
Check during flow line Ø 6" piping
Check Visual flow line Ø 6" piping
Check Review Film flow line Ø 6" and Tie - In Ø 6"
Check hydrotest Flow line Ø 6" piping
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/6/2023 SR No#: ___SOUTH/DDY/198
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/6/2023 SR No#: ___SOUTH/DDY/199
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
7/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Review Film Tie - In Ø 6"
Check line check bolting Ø 4" & 6"
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/6/2023 SR No#: ___SOUTH/DDY/199
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/6/2023 SR No#: ___SOUTH/DDY/200
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check line check all pipe Ø 4" & 6"
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/6/2023 SR No#: ___SOUTH/DDY/200
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/6/2023 SR No#: ___SOUTH/DDY/201
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before flow line Ø 4" piping
Check during flow line Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/6/2023 SR No#: ___SOUTH/DDY/201
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/6/2023 SR No#: ___SOUTH/DDY/202
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 33 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
9/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before tie - in wing line Ø 4" piping
Check during tie - in wing line Ø 4" piping
Check Visual tie - in wing line Ø 4" piping
Check Review Film tie - in wing line Ø 4" piping
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/6/2023 SR No#: ___SOUTH/DDY/202
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/6/2023 SR No#: ___SOUTH/DDY/203
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before flow line Ø 4" piping
Check during flow line Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/6/2023 SR No#: ___SOUTH/DDY/203
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/6/2023 SR No#: ___SOUTH/DDY/204
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
12/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before Fab pipe support Ø 4" piping
Check during Fab pipe support Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/6/2023 SR No#: ___SOUTH/DDY/204
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/6/2023 SR No#: ___SOUTH/DDY/205
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Jumper line Ø 8" piping
Check during Jumper line Ø 8" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/6/2023 SR No#: ___SOUTH/DDY/205
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/6/2023 SR No#: ___SOUTH/DDY/206
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4D -
38 E N Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4D - 38 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before tie - in wing line Ø 4" piping
Check during tie - in wing line Ø 4" piping
Check Visual tie - in wing line Ø 4" piping
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/6/2023 SR No#: ___SOUTH/DDY/206
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/6/2023 SR No#: ___SOUTH/DDY/207
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4D - 38 E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/6/2023 SR No#: ___SOUTH/DDY/207
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/6/2023 SR No#: ___SOUTH/DDY/208
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Jumper line Ø 8" piping
Check during Jumper line Ø 8" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/6/2023 SR No#: ___SOUTH/DDY/208
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/6/2023 SR No#: ___SOUTH/DDY/209
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4D - 38 E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/6/2023 SR No#: ___SOUTH/DDY/209
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/6/2023 SR No#: ___SOUTH/DDY/210
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install pipe support for Jumper line Ø 8" piping
Check during install pipe support for Jumper line Ø 8" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/6/2023 SR No#: ___SOUTH/DDY/210
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/6/2023 SR No#: ___SOUTH/DDY/211
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before Fab pipe support Ø 4" piping
Check during Fab pipe support Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/6/2023 SR No#: ___SOUTH/DDY/211
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/6/2023 SR No#: ___SOUTH/DDY/212
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C -
57 Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before install spooll Weldolet Ø 4" piping
Check during install spooll Weldolet Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/6/2023 SR No#: ___SOUTH/DDY/212
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/6/2023 SR No#: ___SOUTH/DDY/213
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C -
57 Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before install spooll Weldolet and spooll line tester Ø 4" piping
Check duringinstall spooll Weldolet and spooll line tester Ø 4" piping
Check Visual install spooll Weldolet and spooll line tester Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/6/2023 SR No#: ___SOUTH/DDY/213
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/6/2023 SR No#: ___SOUTH/DDY/214
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install pipe flow line Ø 8" install under ground Ø 4" piping
Check during install pipe flow line Ø 8" install under ground Ø 4" piping
Check Visual install pipe flow line Ø 8" install under ground Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/6/2023 SR No#: ___SOUTH/DDY/214
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/6/2023 SR No#: ___SOUTH/DDY/215
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4C - 35 E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
17/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/6/2023 SR No#: ___SOUTH/DDY/215
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/6/2023 SR No#: ___SOUTH/DDY/216
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C -
57 Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Hot Tap spooll Ø 4"
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/6/2023 SR No#: ___SOUTH/DDY/216
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/6/2023 SR No#: ___SOUTH/DDY/217
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-59
Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 59 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before Install Ø 8" power pole
Check during Install Ø 8" power pole
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/6/2023 SR No#: ___SOUTH/DDY/217
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/6/2023 SR No#: ___SOUTH/DDY/219
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C -
57 Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film U/G Ø 4"
Check Pigging U/G Ø 4"
Check Hydrotest U/G Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/6/2023 SR No#: ___SOUTH/DDY/219
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/6/2023 SR No#: ___SOUTH/DDY/220
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install pipe flow line Ø 8" install under ground Ø 4" piping
Check during install pipe flow line Ø 8" install under ground Ø 4" piping
Check Visual install pipe flow line Ø 8" install under ground Ø 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/6/2023 SR No#: ___SOUTH/DDY/220
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/6/2023 SR No#: ___SOUTH/DDY/221
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4C - 35 E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Check Visual welding Fab RSS
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/6/2023 SR No#: ___SOUTH/DDY/221
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/6/2023 SR No#: ___SOUTH/DDY/222
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C -
57 Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Visual welding line tester Ø 4"
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/6/2023 SR No#: ___SOUTH/DDY/222
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/6/2023 SR No#: ___SOUTH/DDY/223
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4C - 35 E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
20/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/6/2023 SR No#: ___SOUTH/DDY/223
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/6/2023 SR No#: ___SOUTH/DDY/224
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Pipe support
Check during Pipe support
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/6/2023 SR No#: ___SOUTH/DDY/224
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/6/2023 SR No#: ___SOUTH/DDY/225
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4C - 35 E PT. ADK
Piping EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/6/2023 SR No#: ___SOUTH/DDY/225
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/6/2023 SR No#: ___SOUTH/DDY/226
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
21/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install weldolet Ø 8"X10" hot tap
Check during Install weldolet Ø 8"X10" hot tap
Check Visual Install weldolet Ø 8"X10" hot tap
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/6/2023 SR No#: ___SOUTH/DDY/226
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/6/2023 SR No#: ___SOUTH/DDY/227
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C -
57 Ø 4 " PT. EFK
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check during Rewelding wing line Ø 4"
Check Visual Rewelding wing line Ø 4"
Check Review film RE welding
Check Install all Bolting
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/6/2023 SR No#: ___SOUTH/DDY/227
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/6/2023 SR No#: ___SOUTH/DDY/228
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_4C - 35 E, 4C- 45&
Piping 4C- 46 PT. ADK EW PT. ADK EW
M
C W A E
FI T HI
Location : Minas P_ 4D - 38 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
22/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Check Visual welding RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/6/2023 SR No#: ___SOUTH/DDY/228
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/6/2023 SR No#: ___SOUTH/DDY/229
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E, 4C-45 N1 & 4C-46 Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Pigging U/G Ø 4"
Check Hydrotest U/G Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/6/2023 SR No#: ___SOUTH/DDY/229
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/6/2023 SR No#: ___SOUTH/DDY/230
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5B - 87 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding U/G Ø 4"
Check During welding U/G Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/6/2023 SR No#: ___SOUTH/DDY/230
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/6/2023 SR No#: ___SOUTH/DDY/231
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Fab Road Crossing 8" and under ground 4" piping
Check during Fab Road Crossing 8" and under ground 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/6/2023 SR No#: ___SOUTH/DDY/231
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/6/2023 SR No#: ___SOUTH/DDY/232
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5B - 87 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding spooll hot tap Ø 4"
Check During welding spooll hot tap Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/6/2023 SR No#: ___SOUTH/DDY/232
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/6/2023 SR No#: ___SOUTH/DDY/233
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5B - 87E PT. VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 5 B - 87 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
25/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/6/2023 SR No#: ___SOUTH/DDY/233
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/6/2023 SR No#: ___SOUTH/DDY/234
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
26/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before install under ground 4" piping
Check during Install under ground 4" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/6/2023 SR No#: ___SOUTH/DDY/234
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/6/2023 SR No#: ___SOUTH/DDY/235
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5B - 87 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Before welding Fab Many Fold Ø 4"
Check During welding Fab Many Fold Ø 4"
Check Visual welding Fab Under ground Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/6/2023 SR No#: ___SOUTH/DDY/235
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/6/2023 SR No#: ___SOUTH/DDY/236
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5B - 87E PT. VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 5 B - 87 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/6/2023 SR No#: ___SOUTH/DDY/236
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/6/2023 SR No#: ___SOUTH/DDY/237
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Fab Hook UP 4" piping
Check during Fab Hook UP 4" piping
Check Visual Fab Hook UP 4" piping
Check HOT TAP 8" X 10
Number of items inspected 19 Number of Items accepted 18
FINDING / NON COMPLY WORK:
Execution HOT TAP 8" X 10 , drill pilot blunt ( Fail )
CORRECTIVE ACTION :
RE HOT TAP change drill pilot
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/6/2023 SR No#: ___SOUTH/DDY/237
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/6/2023 SR No#: ___SOUTH/DDY/238
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5B - 87E PT. VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 5 B - 87 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
28/6/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/6/2023 SR No#: ___SOUTH/DDY/238
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/6/2023 SR No#: ___SOUTH/DDY/239
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
28/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install R/C Ø 8" piping
Check during Install R/C Ø 8" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/6/2023 SR No#: ___SOUTH/DDY/239
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/6/2023 SR No#: ___SOUTH/DDY/240
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/6/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Fab line tester Ø 4" & R/ C Ø 8" piping
Check during Fab line tester Ø 4" & R/ C Ø 8" piping
Check HOT TAP 8" X 10
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/6/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/6/2023 SR No#: ___SOUTH/DDY/240
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/7/2023 SR No#: ___SOUTH/DDY/241
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
1/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before FAB Under ground Ø 4" piping
Check during FAB Under ground Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/7/2023 SR No#: ___SOUTH/DDY/241
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/7/2023 SR No#: ___SOUTH/DDY/241
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install Re welding Under ground Ø 4" piping
Check during Install Re welding Under ground Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/7/2023 SR No#: ___SOUTH/DDY/241
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/7/2023 SR No#: ___SOUTH/DDY/243
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 20 & P_ 21 PT.
Piping HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 20 & P_21 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
2/7/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Check Visual welding Fab RSS
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/7/2023 SR No#: ___SOUTH/DDY/243
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/7/2023 SR No#: ___SOUTH/DDY/244
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Pipe Bending √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before FAB Under ground & line Tester Ø 4" piping
Check during FAB Under ground & line Tester Ø 4" piping
Visual pipe spooll manyfold ( flow line Ø 6" & line Tester Ø 4" ) bending result (Repair)
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
visual pipe spooll manyfold ( flow line Ø 6" & line Tester Ø 4" ) bending ( reject ),
Because treatment welding 3 spot weldolet un procedure welding
CORRECTIVE ACTION :
Re fabrication spooll manyfold ( flow line Ø 6" & line Tester Ø 4" )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/7/2023 SR No#: ___SOUTH/DDY/244
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/7/2023 SR No#: ___SOUTH/DDY/245
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
4/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before FAB Under ground Ø 4" and Flow line Ø 6" piping
Check during FAB Under ground Ø 4" and Flow line Ø 6" piping
Visual welding under ground Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/7/2023 SR No#: ___SOUTH/DDY/245
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/7/2023 SR No#: ___SOUTH/DDY/246
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
5/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before FAB Under ground Ø 4" and Flow line Ø 6" piping
Check during FAB Under ground Ø 4" and Flow line Ø 6" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/7/2023 SR No#: ___SOUTH/DDY/246
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/7/2023 SR No#: ___SOUTH/DDY/247
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before FAB Flow line Ø 6" piping
Check during FAB Flow line Ø 6" piping
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/7/2023 SR No#: ___SOUTH/DDY/247
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/7/2023 SR No#: ___SOUTH/DDY/248
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Tie - In Flow line Ø 6" piping
Check during Tie - IN Flow line Ø 6" piping
Check Visual Tie - IN Flow line Ø 6" piping
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/7/2023 SR No#: ___SOUTH/DDY/248
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/7/2023 SR No#: ___SOUTH/DDY/249
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5B -
21N Ø 4 " PT EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5B-21N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Tie - In wing line Ø 4" piping
Check during Tie - In wing line Ø 4" piping
Check Visual Tie - In wing line Ø 4" piping
Check Pigging flow line and U/G Ø 4" result OK
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/7/2023 SR No#: ___SOUTH/DDY/249
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/7/2023 SR No#: ___SOUTH/DDY/250
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5B -
21N Ø 4 " PT EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5B-21N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
11/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation √
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film Tie - In wing line Ø 4"
Check bolting and gasket Ø 4" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/7/2023 SR No#: ___SOUTH/DDY/250
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/7/2023 SR No#: ___SOUTH/DDY/251
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B-34 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/7/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation √
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film Tie - In wing line Ø 4" & 6"
Check bolting and gasket Ø 4" & 6" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/7/2023 SR No#: ___SOUTH/DDY/251
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/7/2023 SR No#: ___SOUTH/DDY/252
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3B-34 PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 3B-34 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
12/7/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab pipe pilling
Check During welding Fab pipe pilling
Check Visual welding Fab pipe pilling
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/7/2023 SR No#: ___SOUTH/DDY/252
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/7/2023 SR No#: ___SOUTH/DDY/253
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B-34 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/7/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation √
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install Wing line Ø 4"
Check During welding install Wing line Ø 4"
Check bolting and gasket Ø 4" & 6" piping
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/7/2023 SR No#: ___SOUTH/DDY/253
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/7/2023 SR No#: ___SOUTH/DDY/254
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3B-34 PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 3B-34 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/7/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/7/2023 SR No#: ___SOUTH/DDY/254
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/7/2023 SR No#: ___SOUTH/DDY/255
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3B-34 PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 3B-34 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/7/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install conductor pipe Ø 16"
Check During welding install conductor pipe Ø 16"
Check Visual welding install conductor pipe Ø 16"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/7/2023 SR No#: ___SOUTH/DDY/255
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/7/2023 SR No#: ___SOUTH/DDY/256
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_6D-
84E Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D - 84E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/7/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab under ground line Ø 4"
Check During welding Fab under ground line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/7/2023 SR No#: ___SOUTH/DDY/256
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/7/2023 SR No#: ___SOUTH/DDY/257
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_6D-
11E 1 Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D - 11 E 1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/7/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab Many fold line Ø 4"
Check During welding Fab many fold line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/7/2023 SR No#: ___SOUTH/DDY/257
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/7/2023 SR No#: ___SOUTH/DDY/258
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Fab power pole for all location Minas area
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area At seven yard C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/7/2023 E ✘
O
Fabrication and install Power pole S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab power pole
Check During welding Fab power pole
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/7/2023 SR No#: ___SOUTH/DDY/258
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/7/2023 SR No#: ___SOUTH/DDY/259
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Fab power pole for all location Minas area
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area At seven yard C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/7/2023 E ✘
O
Fabrication and install Power pole S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab power pole
Check During welding Fab power pole
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/7/2023 SR No#: ___SOUTH/DDY/259
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/7/2023 SR No#: ___SOUTH/DDY/260
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4A -
29 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/7/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/7/2023 SR No#: ___SOUTH/DDY/260
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/7/2023 SR No#: ___SOUTH/DDY/261
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_5B - 87 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab wing line Ø 4"
Check During welding Fab wing line Ø 4"
Check Visual welding Fab wing line Ø 4"
Check HOT TAP Ø 4" B56:ADB56:AD106
Check pigging to U/G pipe Ø 4"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/7/2023 SR No#: ___SOUTH/DDY/261
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/7/2023 SR No#: ___SOUTH/DDY/261
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5D -
14E1 Ø 4 " PT. ADK MD
Piping PT. EFK 2
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_5D-14E1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/7/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) HOT TAP
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab line tester Ø 4"
Check During welding Fab line tester Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/7/2023 SR No#: ___SOUTH/DDY/261
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/7/2023 SR No#: ___SOUTH/DDY/263
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_5B - 87 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install tie - in line tester Ø 4"
Check During welding install tie - in line tester Ø 4"
Check Visual welding install tie - in line tester Ø 4"
Check Hydrotest U/G & manyfold Ø 4"
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/7/2023 SR No#: ___SOUTH/DDY/263
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/7/2023 SR No#: ___SOUTH/DDY/264
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_5B - 87 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/7/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install tie - in wing line Ø 4"
Check During welding install tie - in wing line Ø 4"
Check Visual welding install tie - in wing line Ø 4"
Review film tie - in wing line Ø 4"
Number of items inspected 18 Number of Items accepted 17
FINDING / NON COMPLY WORK:
Contion Film reshoot
CORRECTIVE ACTION :
Change developer chemical, change hided film and change cassette film
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/7/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/7/2023 SR No#: ___SOUTH/DDY/264
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/8/2023 SR No#: ___SOUTH/DDY/269
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D-79 PT. VDI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 3D-79 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
2/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding modyfication RSS
Check During welding modyfication RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/8/2023 SR No#: ___SOUTH/DDY/269
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/8/2023 SR No#: ___SOUTH/DDY/270
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6B-24
E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_6B-24 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab under ground line Ø 4"
Check During welding Fab under ground line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/8/2023 SR No#: ___SOUTH/DDY/270
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/8/2023 SR No#: ___SOUTH/DDY/271
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6B-24
E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_6B-24 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Hot tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab under ground line Ø 4"
Check During welding Fab under ground line Ø 4"
Check Hot Tap Ø 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/8/2023 SR No#: ___SOUTH/DDY/271
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/8/2023 SR No#: ___SOUTH/DDY/272
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 6B-24 E PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
3/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe pilling Ø 8"
Check During welding install pipe pilling Ø 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/8/2023 SR No#: ___SOUTH/DDY/272
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/8/2023 SR No#: ___SOUTH/DDY/273
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6B-24
E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_6B-24 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install TIE - IN tester line Ø 4"
Check During welding Install TIE - IN tester line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/8/2023 SR No#: ___SOUTH/DDY/273
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/8/2023 SR No#: ___SOUTH/DDY/274
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Weldolet Ø 4"
Check During welding Install Weldolet Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/8/2023 SR No#: ___SOUTH/DDY/274
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/8/2023 SR No#: ___SOUTH/DDY/275
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 3B-
34 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3B-34 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Install Well head √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install well head
Check During Install well head
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/8/2023 SR No#: ___SOUTH/DDY/275
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/8/2023 SR No#: ___SOUTH/DDY/276
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Weldolet Ø 4"
Check During welding Install Weldolet Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/8/2023 SR No#: ___SOUTH/DDY/276
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/8/2023 SR No#: ___SOUTH/DDY/277
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6B-24
E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_6B-24 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install flow line Ø 4"
Check During welding Install flow line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/8/2023 SR No#: ___SOUTH/DDY/277
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/8/2023 SR No#: ___SOUTH/DDY/278
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 6B-24 E PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
5/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe pilling conductor pipe Ø 16"
Check During welding install pipe pilling conductor pipe Ø 16"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/8/2023 SR No#: ___SOUTH/DDY/278
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/8/2023 SR No#: ___SOUTH/DDY/279
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 3B-
34 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3B-34 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install Tie - IN wing line Ø 4"
Check During Install Tie - IN wing line Ø 4"
Check after Install Tie - IN wing line Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/8/2023 SR No#: ___SOUTH/DDY/279
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/8/2023 SR No#: ___SOUTH/DDY/280
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab Manyfold Ø 4"
Check During welding Fab Manyfold Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/8/2023 SR No#: ___SOUTH/DDY/280
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/8/2023 SR No#: ___SOUTH/DDY/281
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4"
Check During welding Under ground Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/8/2023 SR No#: ___SOUTH/DDY/281
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/8/2023 SR No#: ___SOUTH/DDY/282
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 6B-24 E PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
7/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/8/2023 SR No#: ___SOUTH/DDY/282
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/8/2023 SR No#: ___SOUTH/DDY/283
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 6B-24 E PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
8/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/8/2023 SR No#: ___SOUTH/DDY/283
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/8/2023 SR No#: ___SOUTH/DDY/284
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Preparation pilling pipe support √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation pilling pipe support
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/8/2023 SR No#: ___SOUTH/DDY/284
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/8/2023 SR No#: ___SOUTH/DDY/285
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 5D -
14 E 1 Ø 4 " & 6" PT. EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5D - 14 E 1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Preparation pilling pipe support √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Hydrotest Flow line and line tester Ø 4" & 6"
Number of items inspected 8 Number of Items accepted 7
FINDING / NON COMPLY WORK:
Hydrotest Consist decrease Pressure 600 Psi ( 540 Psi ) during holding time 1 hour.
CORRECTIVE ACTION :
RE hydrotest flow line and line tester Ø 4" & 6" ( Close ) tgl 10-8-23
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/8/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/8/2023 SR No#: ___SOUTH/DDY/285
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/8/2023 SR No#: ___SOUTH/DDY/286
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe support
Check during welding install pipe support
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/8/2023 SR No#: ___SOUTH/DDY/286
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/8/2023 SR No#: ___SOUTH/DDY/287
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
10/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe support
Check during welding install pipe support
Check Film radiography U/G Ø 4"
Check Pigging and Hydrotest U/G Ø 4"
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/8/2023 SR No#: ___SOUTH/DDY/287
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/8/2023 SR No#: ___SOUTH/DDY/288
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
11/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe support
Check during welding install pipe support
Check Visual welding flow line Ø 6"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/8/2023 SR No#: ___SOUTH/DDY/288
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/8/2023 SR No#: ___SOUTH/DDY/289
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 4A - 29 PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/8/2023 SR No#: ___SOUTH/DDY/289
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/8/2023 SR No#: ___SOUTH/DDY/290
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 4A - 29 PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
15/8/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/8/2023 SR No#: ___SOUTH/DDY/290
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/8/2023 SR No#: ___SOUTH/DDY/291
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install flow line Ø 4" & 6"
Check during welding install flow line Ø 4" & 6"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/8/2023 SR No#: ___SOUTH/DDY/291
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/8/2023 SR No#: ___SOUTH/DDY/292
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install flow line Ø 4" & 6"
Check during welding install flow line Ø 4" & 6"
Check visual welding flow line Ø 4" & 6"
Review film Radiography.
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/8/2023 SR No#: ___SOUTH/DDY/292
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/8/2023 SR No#: ___SOUTH/DDY/293
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A-29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Hydrotest Flow line and line tester Ø 4" & 6"
Number of items inspected 7 Number of Items accepted 6
FINDING / NON COMPLY WORK:
Hydrotest Consist decrease Pressure 600 Psi ( 540 Psi ) during holding time 1 hour.
CORRECTIVE ACTION :
RE hydrotest flow line and line tester Ø 4" & 6" ( Close ) tgl 10-8-23
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/8/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/8/2023 SR No#: ___SOUTH/DDY/293
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/8/2023 SR No#: ___SOUTH/DDY/285
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 5D -
14 E 1 Ø 4 " & 6" PT. EFK
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5D - 14 E 1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/8/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch_list Piping
Number of items inspected 1 Number of Items accepted 0
FINDING / NON COMPLY WORK:
There Still are Finding Punchlist
CORRECTIVE ACTION :
Re Punchlist
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/8/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/8/2023 SR No#: ___SOUTH/DDY/285
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/8/2023 SR No#: ___SOUTH/DDY/295
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3B -
34 Ø 4 " & 6 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C - 35E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Visual welding under ground Ø 4"
Number of items inspected 4 Number of Items accepted 4
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/8/2023 SR No#: ___SOUTH/DDY/295
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/8/2023 SR No#: ___SOUTH/DDY/296
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/8/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install under ground Ø 4"
Check during welding install under ground Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/8/2023 SR No#: ___SOUTH/DDY/296
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/8/2023 SR No#: ___SOUTH/DDY/297
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5B-
87 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D ✘ R P
Location : Area P_ 5B-87E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch_list Piping
Number of items inspected 0 Number of Items accepted 1
FINDING / NON COMPLY WORK:
There Still are Finding Punchlist
CORRECTIVE ACTION :
Re Punchlist
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/8/2023 SR No#: ___SOUTH/DDY/297
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/8/2023 SR No#: ___SOUTH/DDY/298
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4D -
38 E Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D ✘ R P
Location : Area P_ 4D-38 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch_list Piping
Number of items inspected 0 Number of Items accepted 1
FINDING / NON COMPLY WORK:
There Still are Finding Punchlist
CORRECTIVE ACTION :
Re Punchlist
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/8/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/8/2023 SR No#: ___SOUTH/DDY/298
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/8/2023 SR No#: ___SOUTH/DDY/299
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
33 E N Ø 4 " & 6" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D ✘ R P
Location : Area P_ 3D-33 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch_list Piping
Number of items inspected 0 Number of Items accepted 1
FINDING / NON COMPLY WORK:
There Still are Finding Punchlist
CORRECTIVE ACTION :
Re Punchlist
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/8/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/8/2023 SR No#: ___SOUTH/DDY/299
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/8/2023 SR No#: ___SOUTH/DDY/300
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
79N Ø 4"
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D - 79 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/8/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Wing line Ø 4"
Check during welding install wing line Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/8/2023 SR No#: ___SOUTH/DDY/300
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/8/2023 SR No#: ___SOUTH/DDY/301
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_03 Ø
8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_03 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/8/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check pigging Road crossing Ø 8"
Check Hydrotest Road crossing Ø 8"
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/8/2023 Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/8/2023 SR No#: ___SOUTH/DDY/301
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/8/2023 SR No#: ___SOUTH/DDY/302
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
79N Ø 4"
Piping PT. EFK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 79N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/8/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Wing line Ø 4"
Check during welding install wing line Ø 4"
Check all Bolting completed
Review Film Tie in radiography.
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/8/2023 SR No#: ___SOUTH/DDY/302
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/8/2023 SR No#: ___SOUTH/DDY/303
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6D -
84E Ø 4" PT ADK MD
Piping PT. ADKMD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D-84E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install Wing line and Under ground Ø 4"
Check during welding Install Wing line and Under ground Ø 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/8/2023 SR No#: ___SOUTH/DDY/303
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/8/2023 SR No#: ___SOUTH/DDY/304
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6D -
84E Ø 4" PT ADK MD
Piping PT. ADKMD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D-84E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/8/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts √
Approved ITP available and implemented Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Pigging flow line Ø 4" result Clean
Check Hydrotest Flow line Ø 4" result ok ( no leak )
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/8/2023 SR No#: ___SOUTH/DDY/304
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/8/2023 SR No#: ___SOUTH/DDY/305
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
31/8/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install Wing line Ø 4"
Check during welding install wing line Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/8/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/8/2023 SR No#: ___SOUTH/DDY/305
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/9/2023 SR No#: ___SOUTH/DDY/306
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5C-
63 Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/9/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist Piping
Number of items inspected 1 Number of Items accepted 0
FINDING / NON COMPLY WORK:
There Still are Finding Punchlist
CORRECTIVE ACTION :
Re Punchlist
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/9/2023 SR No#: ___SOUTH/DDY/306
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/9/2023 SR No#: ___SOUTH/DDY/307
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/9/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install Wing line Ø 4"
Check during welding install wing line Ø 4"
Check Visual welding install wing line Ø 4"
Number of items inspected 15 Number of Items accepted 11
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/9/2023 SR No#: ___SOUTH/DDY/307
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/9/2023 SR No#: ___SOUTH/DDY/308
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/9/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check install bolting to Flange
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/9/2023 SR No#: ___SOUTH/DDY/308
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/9/2023 SR No#: ___SOUTH/DDY/309
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6B -
24 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_6B - 24 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check install bolting to Flange
Check before welding Fab Wing line Ø 4"
Check during welding Fab wing line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/9/2023 SR No#: ___SOUTH/DDY/309
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/9/2023 SR No#: ___SOUTH/DDY/310
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6B -
24 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_6B - 24 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab under ground Ø 4"
Check during welding Fab under ground Ø 4"
Check Visual welding Fab under ground Ø 4"
Check Pigging flow line Ø 4" result Clean
Check Hydrotest Flow line Ø 4" result ok ( no leak )
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/9/2023 SR No#: ___SOUTH/DDY/310
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/9/2023 SR No#: ___SOUTH/DDY/311
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/9/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Filling water √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Hydrotest Flow line and line tester Ø 4" & 8"
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/9/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/9/2023 SR No#: ___SOUTH/DDY/311
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/9/2023 SR No#: ___SOUTH/DDY/311
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C-35 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/9/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Filling water √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Hydrotest Flow line and line tester Ø 4" & 8"
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/9/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/9/2023 SR No#: ___SOUTH/DDY/311
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/9/2023 SR No#: ___SOUTH/DDY/313
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C -
35 E Ø 4 " & 8" PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4C-35 E C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
8/9/2023 E ✘
O
Fabrication and install Flow line 4" & 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Pigging flow line Ø 4" result Clean
Check Hydrotest Flow line Ø 4" result ok ( no leak )
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/9/2023 SR No#: ___SOUTH/DDY/313
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/9/2023 SR No#: ___SOUTH/DDY/314
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 11 PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B-24 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install RSS
Check During welding install RSS
Check Visual welding Install RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/9/2023 SR No#: ___SOUTH/DDY/314
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/09/2023 SR No#: ___SOUTH/DDY/315
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_6D -
11 Ø 4" & 6"
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6D - 11 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/09/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check all Bolting completed
Review Film Tie in radiography.
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/09/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/09/2023 SR No#: ___SOUTH/DDY/315
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/9/2023 SR No#: ___SOUTH/DDY/316
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
13N Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D - 13 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab under ground Ø 4"
Check during welding Fab under ground Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/9/2023 SR No#: ___SOUTH/DDY/316
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/9/2023 SR No#: ___SOUTH/DDY/317
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 13 N PT.
Piping ADK MD PT. ADK MD
M
C W A E
FI T HI
Location : Minas P_ 3D - 13 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
16/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install pipe pilling
Check During welding install pipe pilling
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/9/2023 SR No#: ___SOUTH/DDY/317
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/9/2023 SR No#: ___SOUTH/DDY/318
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7D -
Piping 32 E Ø 4 " PT ADK MD PT. ADK MD
M
C W A E
FI T HI
Location : Minas P_ 7D - 32 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
17/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install weldolet 4" and Fab under ground 4"
Check During welding Install weldolet 4" and Fab under ground 4"
Check Visual Welding Install weldolet 4" and Fab under ground 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/9/2023 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/9/2023 SR No#: ___SOUTH/DDY/318
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/9/2023 SR No#: ___SOUTH/DDY/319
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 13 N PT.
Piping ADK MD PT. ADK MD
M
C W A E
FI T HI
Location : Minas P_ 3D - 13 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
18/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab manyfold and under ground Ø 4"
Check During welding Fab manyfold and under ground Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/9/2023 SR No#: ___SOUTH/DDY/319
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/9/2023 SR No#: ___SOUTH/DDY/320
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 13 N PT.
Piping ADK MD PT. ADK MD
M
C W A E
FI T HI
Location : Minas P_ 3D - 13 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground Ø 4"
Check During welding under ground Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/9/2023 SR No#: ___SOUTH/DDY/320
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/9/2023 SR No#: ___SOUTH/DDY/321
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 13 N PT.
Piping VDI PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 3D - 13 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation fab RSS
Number of items inspected 4 Number of Items accepted 4
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/9/2023 SR No#: ___SOUTH/DDY/321
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/9/2023 SR No#: ___SOUTH/DDY/322
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
13N Ø 4 " PT ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D -13 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Pigging flow line Ø 4" result Clean
Check Hydrotest Flow line Ø 4" result ok ( no leak )
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/9/2023 SR No#: ___SOUTH/DDY/322
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/9/2023 SR No#: ___SOUTH/DDY/323
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
29 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4A- 29 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
POP
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/9/2023 SR No#: ___SOUTH/DDY/323
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/9/2023 SR No#: ___SOUTH/DDY/324
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_8D-
66N1 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_8D - 66 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install Flow line Ø 6"
Check during welding install Flow line Ø 6"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/9/2023 SR No#: ___SOUTH/DDY/324
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/9/2023 SR No#: ___SOUTH/DDY/325
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_8D-
66N1 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_8D - 66 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/9/2023 SR No#: ___SOUTH/DDY/325
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/9/2023 SR No#: ___SOUTH/DDY/326
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_8D-
66N1 Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_8D - 66 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground Ø 4"
Check during welding under ground Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/9/2023 SR No#: ___SOUTH/DDY/326
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/9/2023 SR No#: ___SOUTH/DDY/327
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D-
12N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D-12N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/9/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground anf Flow line Ø 4"
Check during welding under ground anf Flow line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/9/2023 SR No#: ___SOUTH/DDY/327
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/9/2023 SR No#: ___SOUTH/DDY/328
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 8D- 42 N PT. HKI
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 8D-42N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/9/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install pilling Ø 8"
check During welding install pilling Ø 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/9/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/9/2023 SR No#: ___SOUTH/DDY/328
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/10/2023 SR No#: ___SOUTH/DDY/329
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-35
Ø 4 " & 8" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/10/2023 SR No#: ___SOUTH/DDY/329
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/10/2023 SR No#: ___SOUTH/DDY/330
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D-
12N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D-12N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Filling Water √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check install bolting flange to flange Ø 4"
Check Filling water before Hydrotest
Review Film : 7 JT ,.. 5 JT result ACC and 2 JT result Repair
Number of items inspected 15 Number of Items accepted 13
FINDING / NON COMPLY WORK:
Repair Film : 1 jt and repair welding : 1 jt
CORRECTIVE ACTION :
Repair film : 1 jt ( Reshoot ) repair welding : 1 jt ( Rewelding ) ( closes )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/10/2023 SR No#: ___SOUTH/DDY/330
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/10/2023 SR No#: ___SOUTH/DDY/331
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4C-35
Ø 4 " & 8" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_4C-35 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding repair under ground 4"
Check During welding repair under ground 4"
Check Visual welding repair under ground 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/10/2023 SR No#: ___SOUTH/DDY/331
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/10/2023 SR No#: ___SOUTH/DDY/332
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D-
12N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D-12N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground and wing line 4" & flow line 6"
Check During welding under ground and wing line 4" & flow line 6"
Check Visual welding under ground and wing line 4" & flow line 6"
Check Pigging flow line Ø 6" result Clean
Check Hydrotest Flow line Ø 4" & 6" result ok ( no leak )
Check Install bolting
Number of items inspected 29 Number of Items accepted 29
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/10/2023 SR No#: ___SOUTH/DDY/332
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/10/2023 SR No#: ___SOUTH/DDY/333
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D-
12N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_3D-12N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Install bolting
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/10/2023 SR No#: ___SOUTH/DDY/333
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/10/2023 SR No#: ___SOUTH/DDY/334
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 12N PT VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 3D - 12 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
6/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install RSS
check During welding install RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/10/2023 SR No#: ___SOUTH/DDY/334
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/10/2023 SR No#: ___SOUTH/DDY/335
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7E -
67E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7E - 67 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab wing line Ø 4"
check Duringwelding Fab wing line Ø 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/10/2023 SR No#: ___SOUTH/DDY/335
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/10/2023 SR No#: ___SOUTH/DDY/336
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_11 Ø
4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_11 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground and wing line 4"
Check During welding under ground and wing line 4"
Check Visual welding under ground and wing line 4"
Check Pigging flow line & UG Ø 4" result Clean
Check Hydrotest Flow line & UG Ø 4" " result ok ( no leak )
Check Install bolting
Review Film
Number of items inspected 31 Number of Items accepted 31
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/10/2023 SR No#: ___SOUTH/DDY/336
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/10/2023 SR No#: ___SOUTH/DDY/337
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_7E -
67E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7E - 67 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
10/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G line Ø 4"
check Duringwelding Fab U/G line Ø 4"
Review Film R/C Ø 4"
Number of items inspected 14 Number of Items accepted 13
FINDING / NON COMPLY WORK:
Repair 1 joint ( Porosity )
CORRECTIVE ACTION :
Re welding joint (Close)
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/10/2023 SR No#: ___SOUTH/DDY/337
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/10/2023 SR No#: ___SOUTH/DDY/338
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
13 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 13N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
12/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install weldolet Ø 4" X 6"
check During welding install weldolet Ø 4" X 6"
check Visual welding install weldolet Ø 4" X 6"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/10/2023 SR No#: ___SOUTH/DDY/338
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/10/2023 SR No#: ___SOUTH/DDY/339
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
13 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 13N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) HOT - TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding line tester Ø 4"
check During welding line tester Ø 4"
check Visual welding line tester Ø 4"
HOT - TAP
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/10/2023 SR No#: ___SOUTH/DDY/339
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/10/2023 SR No#: ___SOUTH/DDY/340
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_11 Ø
4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_11 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check Pigging flow line & UG Ø 4" result Clean
Check Hydrotest Flow line Ø 4" " result ok ( no leak )
Check Install bolting
Review Film
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/10/2023 SR No#: ___SOUTH/DDY/340
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/10/2023 SR No#: ___SOUTH/DDY/341
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
13 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 13N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding wing line Ø 4"
check During welding wing line Ø 4"
check Visual welding wing line Ø 4"
Review Film
Number of items inspected 18 Number of Items accepted 17
FINDING / NON COMPLY WORK:
Repair 1 Joint ( Porosity )
CORRECTIVE ACTION :
Re welding joint ( close )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/10/2023 SR No#: ___SOUTH/DDY/341
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/10/2023 SR No#: ___SOUTH/DDY/342
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 2D - 85 N PT VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 2D - 85 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab RSS
check During welding Fab RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/10/2023 SR No#: ___SOUTH/DDY/342
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/10/2023 SR No#: ___SOUTH/DDY/343
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2 D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding power pole Ø 8"
check During welding power pole Ø 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/10/2023 SR No#: ___SOUTH/DDY/343
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/10/2023 SR No#: ___SOUTH/DDY/344
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 2D - 85 N PT VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 2D - 85 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
15/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab RSS
check During welding Fab RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/10/2023 SR No#: ___SOUTH/DDY/344
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/10/2023 SR No#: ___SOUTH/DDY/345
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2 D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding U/G Ø 4 "
check During welding U/G Ø 4 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/10/2023 SR No#: ___SOUTH/DDY/345
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/10/2023 SR No#: ___SOUTH/DDY/346
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
13 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 13N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding wing line Ø 4"
check During welding wing line Ø 4"
check Visual welding wing line Ø 4"
Review Repair Film
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/10/2023 SR No#: ___SOUTH/DDY/346
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/10/2023 SR No#: ___SOUTH/DDY/347
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 2D - 85 N PT VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 2D - 85 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
16/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab RSS
check During welding Fab RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/10/2023 SR No#: ___SOUTH/DDY/347
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/10/2023 SR No#: ___SOUTH/DDY/348
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2 D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding U/G Ø 4 "
check During welding U/G Ø 4 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/10/2023 SR No#: ___SOUTH/DDY/348
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/10/2023 SR No#: ___SOUTH/DDY/349
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 2D - 85 N PT VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 2D - 85 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
17/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab RSS
check During welding Fab RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/10/2023 SR No#: ___SOUTH/DDY/349
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/10/2023 SR No#: ___SOUTH/DDY/350
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2 D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding wing line Ø 4 "
check During welding Wing line Ø 4 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/10/2023 SR No#: ___SOUTH/DDY/350
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/10/2023 SR No#: ___SOUTH/DDY/351
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 2D - 85 N PT VDI
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 2D - 85 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
18/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab RSS
check During welding Fab RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/10/2023 SR No#: ___SOUTH/DDY/351
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/10/2023 SR No#: ___SOUTH/DDY/352
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2 D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/10/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Flow line Ø 4 "
check During welding Flow line Ø 4 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/10/2023 SR No#: ___SOUTH/DDY/352
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/10/2023 SR No#: ___SOUTH/DDY/353
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5D - 93 E
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5 D - 93 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation RSS
Number of items inspected 4 Number of Items accepted 4
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/10/2023 SR No#: ___SOUTH/DDY/353
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/10/2023 SR No#: ___SOUTH/DDY/354
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab Many fold Ø 4 "
check During welding Fab Many fold Ø 4 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/ A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/10/2023 SR No#: ___SOUTH/DDY/354
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/10/2023 SR No#: ___SOUTH/DDY/355
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab Many fold Ø 4 "
check During welding Fab Many fold Ø 4 "
Check visual welding Fab many fold Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/ A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/10/2023 SR No#: ___SOUTH/DDY/355
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/10/2023 SR No#: ___SOUTH/DDY/356
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5D - 93 E
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5 D - 93 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation RSS
Number of items inspected 4 Number of Items accepted 4
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/10/2023 SR No#: ___SOUTH/DDY/356
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/10/2023 SR No#: ___SOUTH/DDY/357
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4 "
check During welding Fab U/G Ø 4 "
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Repair 1 Joint ( Porosity )
CORRECTIVE ACTION :
Re welding joint ( close )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/10/2023 SR No#: ___SOUTH/DDY/357
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/10/2023 SR No#: ___SOUTH/DDY/358
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5D - 93 E
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5 D - 93 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
23/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/10/2023 SR No#: ___SOUTH/DDY/358
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/10/2023 SR No#: ___SOUTH/DDY/359
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G & T/L Ø 4 " and F/L Ø 6"
check During welding Fab U/G & T/L Ø 4 " and F/L Ø 6"
check Visual welding Fab U/G & T/L Ø 4 " and F/L Ø 6"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/10/2023 SR No#: ___SOUTH/DDY/359
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/10/2023 SR No#: ___SOUTH/DDY/360
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5D - 93 E
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5 D - 93 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
24/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/10/2023 SR No#: ___SOUTH/DDY/360
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/10/2023 SR No#: ___SOUTH/DDY/361
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab T/L Ø 4 "
check During welding Fab T/L Ø 4 "
Review Film Under ground Ø 4" Result Acc
Check Hydrotest Under ground Ø 4" " result ok ( no leak )
Number of items inspected 27 Number of Items accepted 27
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/10/2023 SR No#: ___SOUTH/DDY/361
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/10/2023 SR No#: ___SOUTH/DDY/362
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4 " and F/L Ø 6"
check During welding Fab U/G Ø 4 " and F/L Ø 6"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/10/2023 SR No#: ___SOUTH/DDY/362
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/10/2023 SR No#: ___SOUTH/DDY/363
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 4A - 43 E
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 4A - 43 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/10/2023 SR No#: ___SOUTH/DDY/363
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/10/2023 SR No#: ___SOUTH/DDY/364
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab F/L Ø 6"
check During welding Fab F/L Ø 6"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/10/2023 SR No#: ___SOUTH/DDY/364
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/10/2023 SR No#: ___SOUTH/DDY/365
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 4A - 43 E
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 4A - 43 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
27/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/10/2023 SR No#: ___SOUTH/DDY/365
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/10/2023 SR No#: ___SOUTH/DDY/366
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_4A -
43 E Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab T/L Ø 4 " and F/L Ø 6"
check During welding Fab T/L Ø 4 " and F/L Ø 6"
Review Film Under ground Ø 4" Result Acc
Check Hydrotest Under ground Ø 4" " result ok ( no leak )
Check Pigging U/G 4" and F/L 6" result ( Clean )
Number of items inspected 28 Number of Items accepted 28
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/10/2023 SR No#: ___SOUTH/DDY/366
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/10/2023 SR No#: ___SOUTH/DDY/367
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
31/10/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab T/L & manyfold Ø 4 "
check During welding Fab T/L & manyfold Ø 4 "
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/10/2023 SR No#: ___SOUTH/DDY/367
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/10/2023 SR No#: ___SOUTH/DDY/368
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3 D - 13 N
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 3D - 13 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
31/10/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/10/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/10/2023 SR No#: ___SOUTH/DDY/368
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/11/2023 SR No#: ___SOUTH/DDY/369
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3 D - 13 N
Piping PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 3D - 13 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
1/11/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/11/2023 SR No#: ___SOUTH/DDY/369
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/11/2023 SR No#: ___SOUTH/DDY/370
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/11/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab T/L Ø 4 "
check During welding Fab T/L Ø 4 "
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/11/2023 SR No#: ___SOUTH/DDY/370
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/11/2023 SR No#: ___SOUTH/DDY/371
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/11/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab J/L Ø 4 " and Pipe support Ø 4"
check During welding Fab J/L Ø 4 " and Pipe support Ø 4"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/11/2023 SR No#: ___SOUTH/DDY/371
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/11/2023 SR No#: ___SOUTH/DDY/372
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/11/2023 E ✘
O
Fabrication and install Flow line 4" & 6" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab J/L Ø 4 " , Pipe support Ø 4" and install pipe pilling Ø 8"
check During welding Fab J/L Ø 4 " , Pipe support Ø 4" and install pipe pilling Ø 8"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/11/2023 SR No#: ___SOUTH/DDY/372
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/11/2023 SR No#: ___SOUTH/DDY/373
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install pipe pilling Ø 8"
check During welding install pipe pilling Ø 8"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/11/2023 SR No#: ___SOUTH/DDY/373
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/11/2023 SR No#: ___SOUTH/DDY/374
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_8C -
79 Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8C - 79 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding fab U/G & W/L Ø 4"
check During welding fab U/G & W/L Ø 4"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/11/2023 SR No#: ___SOUTH/DDY/374
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/11/2023 SR No#: ___SOUTH/DDY/375
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 8D - 12 N 1
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 8D - 12 N 1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
4/11/2023 E ✘
O
Install Pilling 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pilling pipe Ø 8"
check During welding Install pilling pipe Ø 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/11/2023 SR No#: ___SOUTH/DDY/375
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/11/2023 SR No#: ___SOUTH/DDY/376
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2 D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding fab U/G Ø 4"
check During welding fab U/G Ø 4"
check Visual welding fab U/G Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/11/2023 SR No#: ___SOUTH/DDY/376
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/11/2023 SR No#: ___SOUTH/DDY/377
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_2 D -
85 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2D - 85 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install weldolet Ø 4" X 6"
check During welding Install weldolet Ø 4" X 6"
check Visual welding Install weldolet Ø 4" X 6"
Review film U/G & FL
Check Hydrotest U / G & F/L Ø 4" " result ok ( no leak )
Number of items inspected 27 Number of Items accepted 27
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/11/2023 SR No#: ___SOUTH/DDY/377
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/11/2023 SR No#: ___SOUTH/DDY/378
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding fab spooll line tester Ø 4"
check During welding fab spooll line tester Ø 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/11/2023 SR No#: ___SOUTH/DDY/378
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/11/2023 SR No#: ___SOUTH/DDY/379
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install flow line Ø 4"
check During welding install flow line Ø 4"
check after welding install flow line Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/11/2023 SR No#: ___SOUTH/DDY/379
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/11/2023 SR No#: ___SOUTH/DDY/380
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install pipe support Ø 4"
check During welding install pipe support Ø 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/11/2023 SR No#: ___SOUTH/DDY/380
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/11/2023 SR No#: ___SOUTH/DDY/381
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5C - 27 N
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5 C - 27 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/11/2023 E ✘
O
Install Pilling 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pilling pipe Ø 8"
check During welding Install pilling pipe Ø 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/11/2023 SR No#: ___SOUTH/DDY/381
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/11/2023 SR No#: ___SOUTH/DDY/382
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install flow line Ø 4"
check During welding install flow line Ø 4"
Review Film flow line Ø 4" result ACC
Hydrotest flow line Ø 4" result OK ( no leak )
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/11/2023 SR No#: ___SOUTH/DDY/382
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/11/2023 SR No#: ___SOUTH/DDY/383
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Road crossing Ø 4"
check During welding Road crossing Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/11/2023 SR No#: ___SOUTH/DDY/383
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/11/2023 SR No#: ___SOUTH/DDY/384
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 65
Piping PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3D - 65 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
17/11/2023 E ✘
O
Install Pilling Conductor pipe 24" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pilling conductor pipe Ø 24"
check During welding Install pilling conductor pipe Ø 24"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/11/2023 SR No#: ___SOUTH/DDY/384
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/11/2023 SR No#: ___SOUTH/DDY/385
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Road crossing Ø 4"
check During welding Road crossing Ø 4"
Number of items inspected 11 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/11/2023 SR No#: ___SOUTH/DDY/385
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/11/2023 SR No#: ___SOUTH/DDY/386
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 5C - 27 N
Piping PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5 C - 27 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/11/2023 E ✘
O
Install Pilling conductor pipe 24" and Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install Pilling conductor pipe 24" and Install RSS
check During welding Install Pilling conductor pipe 24" and Install RSS
check After welding Install Pilling conductor pipe 24" and Install RSS
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/11/2023 SR No#: ___SOUTH/DDY/386
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/11/2023 SR No#: ___SOUTH/DDY/387
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding U/G Ø 4"
check During welding U/G Ø 4"
Number of items inspected 11 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/11/2023 SR No#: ___SOUTH/DDY/387
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/11/2023 SR No#: ___SOUTH/DDY/388
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding flow line TIE - IN Ø 6"
check During welding flow line TIE - IN Ø 6"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/11/2023 SR No#: ___SOUTH/DDY/388
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/11/2023 SR No#: ___SOUTH/DDY/389
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding weldolet in service Ø 4" X 14 "
check During welding weldolet in service Ø 4" X 14 "
check After welding weldolet in service Ø 4" X 14 "
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/11/2023 SR No#: ___SOUTH/DDY/389
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/11/2023 SR No#: ___SOUTH/DDY/390
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4A -
43 E N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4"
check During welding Fab U/G Ø 4"
check After welding Fab U/G Ø 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/11/2023 SR No#: ___SOUTH/DDY/390
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/11/2023 SR No#: ___SOUTH/DDY/391
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab flow line Ø 6"
check During weldingFab flow line Ø 6"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/11/2023 SR No#: ___SOUTH/DDY/391
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/11/2023 SR No#: ___SOUTH/DDY/392
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location New wells P_ 3D - 65
Piping PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3D - 65 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
23/11/2023 E ✘
O
Install Pilling Conductor pipe 24" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/11/2023 SR No#: ___SOUTH/DDY/392
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/11/2023 SR No#: ___SOUTH/DDY/393
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install flow line Ø 6"
check During welding install flow line Ø 6"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/11/2023 SR No#: ___SOUTH/DDY/393
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/11/2023 SR No#: ___SOUTH/DDY/394
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4A -
43 E N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check Pigging U/ G 4"
check Hydrotest U/G 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/11/2023 SR No#: ___SOUTH/DDY/394
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/11/2023 SR No#: ___SOUTH/DDY/395
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install flow line Ø 6"
check During welding install flow line Ø 6"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/11/2023 SR No#: ___SOUTH/DDY/395
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/11/2023 SR No#: ___SOUTH/DDY/396
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab Manyfold line Ø 4"
check During welding Fab Manyfold line Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/11/2023 SR No#: ___SOUTH/DDY/396
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/11/2023 SR No#: ___SOUTH/DDY/397
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4A -
43 E N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 43 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install wing line Ø 4"
check During welding install wing line Ø 4"
check After welding install wing line Ø 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/11/2023 SR No#: ___SOUTH/DDY/397
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/11/2023 SR No#: ___SOUTH/DDY/398
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fabrication U/G Ø 4"
check During welding Fabrication U/G Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/11/2023 SR No#: ___SOUTH/DDY/398
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/11/2023 SR No#: ___SOUTH/DDY/399
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab Manyfold line Ø 4"
check During welding Fab Manyfold line Ø 4"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/11/2023 SR No#: ___SOUTH/DDY/399
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/11/2023 SR No#: ___SOUTH/DDY/400
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding line tester Ø 4"
check During welding line tester Ø 4"
check After welding line tester Ø 4"
Number of items inspected 18 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding spooll line tester Ø 4" finding defect Under Cut depth 2 mm with lenghth more than 3 inchi
CORRECTIVE ACTION :
Re welidng ( closes)
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/11/2023 SR No#: ___SOUTH/DDY/400
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/11/2023 SR No#: ___SOUTH/DDY/401
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab Manyfold line Ø 4"
check During welding Fab Manyfold line Ø 4"
check after welding Fab Manyfold line Ø 4"
Number of items inspected 18 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding spooll line tester Ø 4" finding defect spatter
CORRECTIVE ACTION :
Re welding ( Closes )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/11/2023 SR No#: ___SOUTH/DDY/401
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/11/2023 SR No#: ___SOUTH/DDY/402
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/11/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding flow line and manyfold Ø 4"
check During welding flow line and manyfold Ø 4"
Check after welding flow line and manyfold Ø 4"
Number of items inspected 18 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding spooll line tester Ø 4" finding defect Under Fill
CORRECTIVE ACTION :
Re welidng ( closes)
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/11/2023 SR No#: ___SOUTH/DDY/402
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/11/2023 SR No#: ___SOUTH/DDY/403
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/11/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab flow line Ø 6" and U/G Ø 4"
check During welding Fab flow line Ø 6" and U/G Ø 4"
check after welding Fab flow line Ø 6" and U/G Ø 4"
Number of items inspected 18 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding spooll line tester Ø 4" finding bending Pipe to TEE more than 3 degree
CORRECTIVE ACTION :
Re welding ( Closes )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/11/2023 SR No#: ___SOUTH/DDY/403
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/11/2023 SR No#: ___SOUTH/DDY/404
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D-
12N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3 D - 12 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/11/2023 E ✘
O
Fabrication and install Flow line 4" & 6 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install U/ G Ø 4" ( 3D-12 N)
check During welding install U/ G Ø 4" ( 3D-12 N)
Review Film U/G Ø 4" result ACC ( P_ 04 )
Hydrotest flow line Ø 4" result OK ( no leak ) ( P_04 )
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/11/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/11/2023 SR No#: ___SOUTH/DDY/404
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/12/2023 SR No#: ___SOUTH/DDY/405
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D-
12N Ø 4 " & 6" PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3 D - 12 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/12/2023 E ✘
O
Fabrication and install Flow line 4" & 6 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install U/ G Ø 4" ( 3D-12 N)
check During welding install U/ G Ø 4" ( 3D-12 N)
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/12/2023 SR No#: ___SOUTH/DDY/405
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/12/2023 SR No#: ___SOUTH/DDY/406
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install flow line Ø 6"
check During welding Install flow line Ø 6"
check after welding Install flow line Ø 6"
Number of items inspected 18 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding spooll flow line Ø 6" finding slag welding capping
CORRECTIVE ACTION :
Brushing ( Closes )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/12/2023 SR No#: ___SOUTH/DDY/406
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/12/2023 SR No#: ___SOUTH/DDY/407
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/12/2023 E ✘
O
Fabrication and install Flow line 4" S
Install pipe pilling Ø 8"
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding U/G Ø 4"
check During welding U/G Ø 4"
Check after welding U/G Ø 4"
Number of items inspected 18 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Welding spooll line tester Ø 4" finding defect Spatter
CORRECTIVE ACTION :
grinding ( closes)
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/12/2023 SR No#: ___SOUTH/DDY/407
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/12/2023 SR No#: ___SOUTH/DDY/408
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_3D - 55 N PT.
Piping RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3D - 55 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
2/12/2023 E ✘
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install RSS
check During welding Install RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/12/2023 SR No#: ___SOUTH/DDY/408
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/12/2023 SR No#: ___SOUTH/DDY/409
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install flow line Ø 6" and line tester Ø 4"
check During welding Install flow line Ø 6" and line tester Ø 4"
check after welding Install flow line Ø 6" and line tester Ø 4"
Hydrotest flow line Ø 4" result OK ( no leak )
Number of items inspected 25 Number of Items accepted 25
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/12/2023 SR No#: ___SOUTH/DDY/409
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/12/2023 SR No#: ___SOUTH/DDY/410
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts √
Approved ITP available and implemented Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Installation bolting
Number of items inspected 5 Number of Items accepted 2
FINDING / NON COMPLY WORK:
threaded not extend completely
CORRECTIVE ACTION :
Change bolt which is longer
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/12/2023 SR No#: ___SOUTH/DDY/410
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/12/2023 SR No#: ___SOUTH/DDY/411
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check Installation Bolting
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/12/2023 SR No#: ___SOUTH/DDY/411
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/12/2023 SR No#: ___SOUTH/DDY/412
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Hydrotest flow line Ø 6" and line tester Ø 4" result OK no leaking
Check Pigging Flow line Ø 4 " & 6" and U/G Ø 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/12/2023 SR No#: ___SOUTH/DDY/412
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/12/2023 SR No#: ___SOUTH/DDY/413
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
65 (MIBASA) Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts √
Approved ITP available and implemented Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
POP well existing
Number of items inspected 4 Number of Items accepted 4
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/12/2023 SR No#: ___SOUTH/DDY/413
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/12/2023 SR No#: ___SOUTH/DDY/414
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Filling water for hydrotest
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/12/2023 SR No#: ___SOUTH/DDY/414
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/12/2023 SR No#: ___SOUTH/DDY/415
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
11/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4"
check During welding Fab U/G Ø 4"
Check hydrotest R/C Ø 4"
Check install HOT TAP
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/12/2023 SR No#: ___SOUTH/DDY/415
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/12/2023 SR No#: ___SOUTH/DDY/416
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4"
check During welding Fab U/G Ø 4"
Check After welding Fab U/G Ø 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/12/2023 SR No#: ___SOUTH/DDY/416
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/12/2023 SR No#: ___SOUTH/DDY/417
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab R/C Ø 4"
check During welding Fab R/C Ø 4"
Check After welding Fab R/C Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/12/2023 SR No#: ___SOUTH/DDY/417
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/12/2023 SR No#: ___SOUTH/DDY/418
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8E -
42 E Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8E - 42 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install flow line Ø 4"
check During welding Install flow line Ø 4"
Number of items inspected 14 Number of Items accepted 13
FINDING / NON COMPLY WORK:
During welding used E 7018 not install a Wind sheild properly
CORRECTIVE ACTION :
Install a wind sheild properly during welding used E 70 18 ( CLOSES )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/12/2023 SR No#: ___SOUTH/DDY/418
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/12/2023 SR No#: ___SOUTH/DDY/419
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
23 N1 E Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Tack weld to Fit - Up √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab Manyfold Ø 4"
check During welding Fab Manyfold Ø 4"
Number of items inspected 15 Number of Items accepted 13
FINDING / NON COMPLY WORK:
During welding used E 7018 not install a Wind sheild properly
Tack weld will be done a Pipe fitter
CORRECTIVE ACTION :
Install a wind sheild properly during welding used E 70 18 ( CLOSES )
Tack weld only doing a welder sertified ( CLOSES )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/12/2023 SR No#: ___SOUTH/DDY/419
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/12/2023 SR No#: ___SOUTH/DDY/420
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
12 N 1 Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 12 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab pipe support Ø 4"
check During welding Fab pipe support Ø 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/12/2023 SR No#: ___SOUTH/DDY/420
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/12/2023 SR No#: ___SOUTH/DDY/421
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab wing line Ø 4"
check During welding Fab wing line Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/12/2023 SR No#: ___SOUTH/DDY/421
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/12/2023 SR No#: ___SOUTH/DDY/422
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_6B - 29 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 29 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
20/12/2023 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pipe pilling 8"
check During welding Install pipe pilling 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/12/2023 SR No#: ___SOUTH/DDY/422
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/12/2023 SR No#: ___SOUTH/DDY/423
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_6B - 29 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 29 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/12/2023 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pipe pilling 8"
check During welding Install pipe pilling 8"
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/12/2023 SR No#: ___SOUTH/DDY/423
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/12/2023 SR No#: ___SOUTH/DDY/424
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_6B - 29 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 29 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
22/12/2023 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab RSS
check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/12/2023 SR No#: ___SOUTH/DDY/424
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/12/2023 SR No#: ___SOUTH/DDY/425
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
12 N 1 Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 12 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install R/C Ø 4"
check During welding install R/C Ø 4"
Check Pigging U/G Ø 4"
Check hydrotest U/G Ø 4"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/12/2023 SR No#: ___SOUTH/DDY/425
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/12/2023 SR No#: ___SOUTH/DDY/426
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
23 N1 E Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pipe support Ø 4"
check During welding Install pipe support Ø 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/12/2023 SR No#: ___SOUTH/DDY/426
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/12/2023 SR No#: ___SOUTH/DDY/427
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_6B - 29 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 29 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
23/12/2023 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install conductor pipe Ø 24 "
check During welding Install conductor pipe Ø 24 "
check After welding Install conductor pipe Ø 24 "
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/12/2023 SR No#: ___SOUTH/DDY/427
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/12/2023 SR No#: ___SOUTH/DDY/428
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
23 N1 E Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Install pipe support Ø 4" & 6"
check During welding Install pipe support Ø 4" & 6"
check After welding Install pipe support Ø 4" & 6"
Review Film
Number of items inspected 20 Number of Items accepted 19
FINDING / NON COMPLY WORK:
Not install Wind shield during welding E 7018
CORRECTIVE ACTION :
Allways Install wind shield during welding E 7018 ( Closes )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/12/2023 SR No#: ___SOUTH/DDY/428
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/12/2023 SR No#: ___SOUTH/DDY/429
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
23 N1 E Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film
Check Pigging pipe Ø 4" & 6"
Check Hydrotest pipe Ø 4" & 6"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/12/2023 SR No#: ___SOUTH/DDY/429
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/12/2023 SR No#: ___SOUTH/DDY/430
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
23 N1 E Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Install Road Crossing and Under ground
Number of items inspected 7 Number of Items accepted 6
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/12/2023 SR No#: ___SOUTH/DDY/430
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/12/2023 SR No#: ___SOUTH/DDY/431
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
12 N 1 Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 12 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install U/G Ø 4"
check During welding install U/G Ø 4"
check After welding install U/G Ø 4"
Review RT film
Check Bolting
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/12/2023 SR No#: ___SOUTH/DDY/431
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/12/2023 SR No#: ___SOUTH/DDY/432
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8D -
23 N1 E Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/12/2023 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Install Road Crossing and Under ground
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/12/2023 SR No#: ___SOUTH/DDY/432
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/12/2023 SR No#: ___SOUTH/DDY/433
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_6B - 29 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 29 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
28/12/2023 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Line Check
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/12/2023 SR No#: ___SOUTH/DDY/433
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/12/2023 SR No#: ___SOUTH/DDY/434
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punchlist LOC : P_03 PT. ADK MD
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/12/2023 E ✘
O
'Punchlist S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist piping
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
Bolting at wing line short
CORRECTIVE ACTION :
Change with bolting based in accordance
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/12/2023 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/12/2023 SR No#: ___SOUTH/DDY/434
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/1/2024 SR No#: ___SOUTH/DDY/001
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_6B - 29 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 29 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
2/1/2024 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Line Check
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/1/2024 SR No#: ___SOUTH/DDY/001
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/1/2024 SR No#: ___SOUTH/DDY/002
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder test dilokasi BLK Pekan baru, PT Vadhana -
BRIJ
Piping PT. V - BRIJ
M
C W A E
FI T HI
P ✘ D R P
Location : BLK Pekan baru C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/1/2024 E ✘
O
S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Welder Test √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Welder Test
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/1/2024 SR No#: ___SOUTH/DDY/002
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/1/2024 SR No#: ___SOUTH/DDY/003
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-75
N1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Site KOM √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Site Kom Piping
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/1/2024 SR No#: ___SOUTH/DDY/003
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/1/2024 SR No#: ___SOUTH/DDY/004
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-
92 E Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 93E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/1/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Review Film wing line Ø 4"
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/1/2024 SR No#: ___SOUTH/DDY/004
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/1/2024 SR No#: ___SOUTH/DDY/005
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-75
N1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation manyfold 4"
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/1/2024 SR No#: ___SOUTH/DDY/005
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/1/2024 SR No#: ___SOUTH/DDY/006
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-75
N1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation manyfold 4"
Check Pigging U/G pipe Ø 4"
Check Hydrotest line Tester and Flow line Ø 4" & 6" used barthon chart 2000 approved by farep PHR.
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/1/2024 SR No#: ___SOUTH/DDY/006
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/1/2024 SR No#: ___SOUTH/DDY/007
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3A - 75 N1 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
15/1/2024 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before pipe pilling Ø 8"
Check During pipe pilling Ø 8"
Check After pipe pilling Ø 8"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/1/2024 SR No#: ___SOUTH/DDY/007
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/1/2024 SR No#: ___SOUTH/DDY/008
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-75
N1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install wing line Ø 4"
check During welding install wing line Ø 4"
check After welding install wing line Ø 4"
Check Pigging flow line Ø 6"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/1/2024 SR No#: ___SOUTH/DDY/008
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/1/2024 SR No#: ___SOUTH/DDY/009
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3A - 75 N1 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
16/1/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before pipe conductor pipe Ø 24"
Check During pipe conductor pipe Ø 24"
Check After pipepipe conductor pipe Ø 24"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/1/2024 SR No#: ___SOUTH/DDY/009
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/1/2024 SR No#: ___SOUTH/DDY/010
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-75
N1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding install Tie - IN flow line Ø 4"
check During welding install Tie - IN flow line Ø 4"
check After welding install Tie - IN flow line Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/1/2024 SR No#: ___SOUTH/DDY/010
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/1/2024 SR No#: ___SOUTH/DDY/011
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_ 2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) site Com √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Site com
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/1/2024 SR No#: ___SOUTH/DDY/011
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/1/2024 SR No#: ___SOUTH/DDY/012
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3A-75
N1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Review RT film
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/1/2024 SR No#: ___SOUTH/DDY/012
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/1/2024 SR No#: ___SOUTH/DDY/013
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_8C-
77 E Ø 4 " & 6 " PT. BKP MD
Piping PT. BKP MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8C - 77 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/1/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
check After welding flow line Ø 6" & many fold and line tester Ø 4"
Review film radiography. flow line Ø 6" & many fold and line tester Ø 4" ( repair 3 joint )
Number of items inspected 7 Number of Items accepted 6
FINDING / NON COMPLY WORK:
Finding Repair joint Defect Porosity
CORRECTIVE ACTION :
Re welding
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/1/2024 SR No#: ___SOUTH/DDY/013
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/1/2024 SR No#: ___SOUTH/DDY/014
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3A - 75 N1 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
22/1/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before RSS
Check During RSS
Check After RSS
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/1/2024 SR No#: ___SOUTH/DDY/014
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/1/2024 SR No#: ___SOUTH/DDY/015
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder Test at BLK pekan baru
Piping PT. RDP
M
C W A E
FI T HI
P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
24/1/2024 ✘ E ✘
O
Welder Test S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding test piece
Check During welding test piece
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/1/2024 SR No#: ___SOUTH/DDY/015
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/1/2024 SR No#: ___SOUTH/DDY/016
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder Test at BLK pekan baru
Piping PT. RDP
M
C W A E
FI T HI
P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
25/1/2024 ✘ E ✘
O
Welder Test S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding test piece
Check During welding test piece
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/1/2024 SR No#: ___SOUTH/DDY/016
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/1/2024 SR No#: ___SOUTH/DDY/017
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 2 D - 96 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/1/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before pipe pilling Ø 8"
Check During pipe pilling Ø 8"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/1/2024 SR No#: ___SOUTH/DDY/017
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/1/2024 SR No#: ___SOUTH/DDY/018
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3A - 75 N1 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/1/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Pilling Ø 8"
Check During Pilling Ø 8"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/1/2024 SR No#: ___SOUTH/DDY/018
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/1/2024 SR No#: ___SOUTH/DDY/019
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3A - 75 N1 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
30/1/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation install Conductor pipe 24"
Crane by PT RDP broken
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/1/2024 SR No#: ___SOUTH/DDY/019
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/1/2024 SR No#: ___SOUTH/DDY/020
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3A - 75 N1 N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3A - 75 N1 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
31/1/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation install Conductor pipe 24"
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/1/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/1/2024 SR No#: ___SOUTH/DDY/020
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/2/2024 SR No#: ___SOUTH/DDY/021
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 2D - 96N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 2D - 96 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
1/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before conductor Pipe 24 "
Check During conductor Pipe 24 "
Check after conductor Pipe 24 "
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/2/2024 SR No#: ___SOUTH/DDY/021
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/2/2024 SR No#: ___SOUTH/DDY/022
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4"
check During welding Fab U/G Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/2/2024 SR No#: ___SOUTH/DDY/022
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/2/2024 SR No#: ___SOUTH/DDY/023
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 2D - 96N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 2D - 96 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
5/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before RSS
Check During RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/2/2024 SR No#: ___SOUTH/DDY/023
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/2/2024 SR No#: ___SOUTH/DDY/024
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
check before welding Fab U/G Ø 4"
check During welding Fab U/G Ø 4"
Review film Radiography. U/G Ø 4"
Pigging U/G Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/2/2024 SR No#: ___SOUTH/DDY/024
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/2/2024 SR No#: ___SOUTH/DDY/025
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 2D - 96N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 2D - 96 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
6/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before RSS
Check During RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/2/2024 SR No#: ___SOUTH/DDY/025
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/2/2024 SR No#: ___SOUTH/DDY/026
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Hydrotest U/G 4"
Tie - In Wing line Ø 4"
Review Film Tie - IN
Number of items inspected 27 Number of Items accepted 27
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/2/2024 SR No#: ___SOUTH/DDY/026
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/2/2024 SR No#: ___SOUTH/DDY/027
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 2D - 96N
Piping Install RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 2D - 96 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
7/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before RSS
Check During RSS
Check after RSS
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/2/2024 SR No#: ___SOUTH/DDY/027
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/2/2024 SR No#: ___SOUTH/DDY/028
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts √
Approved ITP available and implemented Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
POP loc P_ 3D - 55 N
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/2/2024 SR No#: ___SOUTH/DDY/028
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/2/2024 SR No#: ___SOUTH/DDY/029
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility for new wells P_3D -
55 N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before weldolet 4" X 6"
Check During weldolet 4" X 6"
Check after weldolet 4" X 6"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/2/2024 SR No#: ___SOUTH/DDY/029
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/2/2024 SR No#: ___SOUTH/DDY/030
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 6E - 57
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6E - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
11/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before flow line and Under ground Ø 4"
Check During flow line and Under ground Ø 4"
Check after flow line and Under ground Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/2/2024 SR No#: ___SOUTH/DDY/030
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/2/2024 SR No#: ___SOUTH/DDY/031
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 6E - 57
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6E - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
12/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before flow line and Jumper line Ø 4"
Check During flow line and Jumper line Ø 4"
Check after flow line and Jumper line Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/2/2024 SR No#: ___SOUTH/DDY/031
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/2/2024 SR No#: ___SOUTH/DDY/032
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 6E - 57
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6E - 57 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
12/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before flow line and Jumper line Ø 4"
Check During flow line and Jumper line Ø 4"
Check after flow line and Jumper line Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/2/2024 SR No#: ___SOUTH/DDY/032
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/2/2024 SR No#: ___SOUTH/DDY/032
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 6E - 57
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6E - 57 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before wing line Ø 4"
Check During wing line Ø 4"
Check after wing line Ø 4"
Check review film Radiography
Check Install all bolting
Check Pigging flow line and U/G 4"
Check Hydrotest flow line and U/G 4"
Number of items inspected 32 Number of Items accepted 30
FINDING / NON COMPLY WORK:
shoot Film and repair 1 Joint ( Porosity ) more than 3 "
CORRECTIVE ACTION :
Re shoot and Re welding ( close )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/2/2024 SR No#: ___SOUTH/DDY/032
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/2/2024 SR No#: ___SOUTH/DDY/034
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Survey NCR SID for loc 5C - 63
Piping PT. ADK MD
M
C W A E
FI T HI
P D R P
Location : Area P_ 5C - 63 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/2/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
'Survey NCR SID
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/2/2024 SR No#: ___SOUTH/DDY/034
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/2/2024 SR No#: ___SOUTH/DDY/035
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/2/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/2/2024 SR No#: ___SOUTH/DDY/035
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/2/2024 SR No#: ___SOUTH/DDY/036
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 8C - 77 E Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI ✘ T HI
Location : Minas P_ 2D - 96 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
17/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/2/2024 SR No#: ___SOUTH/DDY/036
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/2/2024 SR No#: ___SOUTH/DDY/037
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/2/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/2/2024 SR No#: ___SOUTH/DDY/037
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2024 SR No#: ___SOUTH/DDY/038
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 8E - 55 N Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 8E - 55 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2024 SR No#: ___SOUTH/DDY/038
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2024 SR No#: ___SOUTH/DDY/039
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 6B-29 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before wing line Ø 4"
Check During wing line Ø 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2024 SR No#: ___SOUTH/DDY/039
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2024 SR No#: ___SOUTH/DDY/040
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" for new
well P_ 8E - 42E PT. BKP MD
Piping PT. BKP MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8E - 42 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Planning POP
Number of items inspected 1 Number of Items accepted
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2024 SR No#: ___SOUTH/DDY/040
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/2/2024 SR No#: ___SOUTH/DDY/041
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 3A - 75 N 1 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before wing line Ø 4"
Check During wing line Ø 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/2/2024 SR No#: ___SOUTH/DDY/041
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/2/2024 SR No#: ___SOUTH/DDY/042
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 8C - 77 E Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI ✘ T HI
Location : Minas P_ 2D - 96 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
20/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/2/2024 SR No#: ___SOUTH/DDY/042
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/2/2024 SR No#: ___SOUTH/DDY/043
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" for new
well P_ 8E - 42E PT. BKP MD
Piping PT. BKP MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8E - 42 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Planning POP
Number of items inspected 1 Number of Items accepted
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/2/2024 SR No#: ___SOUTH/DDY/043
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/2/2024 SR No#: ___SOUTH/DDY/044
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 3A - 75 N 1 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Hook Up Ø 4"
Check During Hook Up Ø 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/2/2024 SR No#: ___SOUTH/DDY/044
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/2/2024 SR No#: ___SOUTH/DDY/045
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 8E - 55 N Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 8E - 55 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding conductor pipe 24"
Check during welding conductor pipe 24"
Check After welding conductor pipe 24"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/2/2024 SR No#: ___SOUTH/DDY/045
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/2/2024 SR No#: ___SOUTH/DDY/046
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 3A - 75 N 1 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Manyfold Ø 4"
Check During Manyfold Ø 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/2/2024 SR No#: ___SOUTH/DDY/046
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/2/2024 SR No#: ___SOUTH/DDY/047
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Relocation and New Facility pipe Ø 4" & 6" for new
well P_ 3A - 75 N 1 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench √
Back Fill Trench √
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation POP
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/2/2024 SR No#: ___SOUTH/DDY/047
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/2/2024 SR No#: ___SOUTH/DDY/048
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 8E - 55 N Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 8E - 55 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
25/2/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding conductor pipe 24"
Check during welding conductor pipe 24"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/2/2024 SR No#: ___SOUTH/DDY/048
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/2/2024 SR No#: ___SOUTH/DDY/049
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD ( Shop ADK MD )
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/2/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/2/2024 SR No#: ___SOUTH/DDY/049
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/2/2024 SR No#: ___SOUTH/DDY/050
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/2/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/2/2024 SR No#: ___SOUTH/DDY/050
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/2/2024 SR No#: ___SOUTH/DDY/051
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
28/2/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/2/2024 SR No#: ___SOUTH/DDY/051
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/2/2024 SR No#: ___SOUTH/DDY/052
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
29/2/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/2/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/2/2024 SR No#: ___SOUTH/DDY/052
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/3/2024 SR No#: ___SOUTH/DDY/053
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD ( Shop ADK MD )
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Preparation welding weldolet In service
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/3/2024 SR No#: ___SOUTH/DDY/053
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/3/2024 SR No#: ___SOUTH/DDY/054
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
1/3/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/3/2024 SR No#: ___SOUTH/DDY/054
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/3/2024 SR No#: ___SOUTH/DDY/055
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_08 &
09 Ø 4 " PT. BKP MD
Piping PT. BKP MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 08& 09 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install weldolet Ø 4" X 6"
Check During Install weldolet Ø 4" X 6"
Check After Install weldolet Ø 4" X 6"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/3/2024 SR No#: ___SOUTH/DDY/055
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/3/2024 SR No#: ___SOUTH/DDY/056
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
29 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install weldolet Ø 4" X 6"
Check During Install weldolet Ø 4" X 6"
Check After Install weldolet Ø 4" X 6"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/3/2024 SR No#: ___SOUTH/DDY/056
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/3/2024 SR No#: ___SOUTH/DDY/057
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
29 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install flow line and jumper line Ø 4"
Check During Install flow line and jumper line Ø 4"
Check After Install flow line and jumper line Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/3/2024 SR No#: ___SOUTH/DDY/057
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/3/2024 SR No#: ___SOUTH/DDY/058
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
29 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install flow line and jumper line Ø 4"
Check During Install flow line and jumper line Ø 4"
Check After Install flow line and jumper line Ø 4"
Review Film piping Ø 4"
Check installation bolting
Witness Hydrotest piping ( U/G & flow line )
Number of items inspected 30 Number of Items accepted 30
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/3/2024 SR No#: ___SOUTH/DDY/058
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/3/2024 SR No#: ___SOUTH/DDY/059
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
29 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install under ground Ø 4"
Check During Install under ground Ø 4"
Check After Install under ground Ø 4"
Check installation bolting
Witness Pigging piping ( U/G & flow line )
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/3/2024 SR No#: ___SOUTH/DDY/059
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/3/2024 SR No#: ___SOUTH/DDY/060
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
29 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before Install wing line Ø 4"
Check During Install wing line Ø 4"
Check After Install wing line Ø 4"
Check installation bolting
Review film TIE - IN
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/3/2024 SR No#: ___SOUTH/DDY/060
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/3/2024 SR No#: ___SOUTH/DDY/061
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3 A -
75 N 1 Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 75 N1 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 2
FINDING / NON COMPLY WORK:
Bolting short 4 Ea pipe 6"
CORRECTIVE ACTION :
Change to bolting pipe 6"
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/3/2024 SR No#: ___SOUTH/DDY/061
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/3/2024 SR No#: ___SOUTH/DDY/062
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4A -
29N Ø 4 " & 6 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist OK no finding
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/3/2024 SR No#: ___SOUTH/DDY/062
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/3/2024 SR No#: ___SOUTH/DDY/063
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD ( Shop ADK MD )
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/3/2024 SR No#: ___SOUTH/DDY/063
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/3/2024 SR No#: ___SOUTH/DDY/064
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder test at BKL pekan baru
Piping PT. MPS
M
C W A E
FI T HI
P ✘ D R P
Location : BLK pekan baru C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/3/2024 E ✘
O
Welder TEST S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Welder Test
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/3/2024 SR No#: ___SOUTH/DDY/064
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/3/2024 SR No#: ___SOUTH/DDY/065
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD ( Shop ADK MD )
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
12/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/3/2024 SR No#: ___SOUTH/DDY/065
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/3/2024 SR No#: ___SOUTH/DDY/066
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/3/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/3/2024 SR No#: ___SOUTH/DDY/066
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/3/2024 SR No#: ___SOUTH/DDY/067
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/3/2024 SR No#: ___SOUTH/DDY/067
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/3/2024 SR No#: ___SOUTH/DDY/068
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_04 Ø
4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 04 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
13/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/3/2024 SR No#: ___SOUTH/DDY/068
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/3/2024 SR No#: ___SOUTH/DDY/069
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N ( shop ADK MD ) C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
14/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/3/2024 SR No#: ___SOUTH/DDY/069
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/3/2024 SR No#: ___SOUTH/DDY/070
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/3/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding
Check during welding
Check After welding
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/3/2024 SR No#: ___SOUTH/DDY/070
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/3/2024 SR No#: ___SOUTH/DDY/071
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
15/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Before welding weldolet 4 X 6 " and Fab Under ground 4"
During welding weldolet 4 X 6 " and Fab Under ground 4"
After welding weldolet 4 X 6 " and Fab Under ground 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/3/2024 SR No#: ___SOUTH/DDY/071
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/3/2024 SR No#: ___SOUTH/DDY/072
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
16/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Before welding Fab Under ground 4"
During welding Fab Under ground 4"
After welding Fab Under ground 4"
Witness HOT TAP
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/3/2024 SR No#: ___SOUTH/DDY/072
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/3/2024 SR No#: ___SOUTH/DDY/073
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Install Bolting
Witness Pigging U/G and F/L Ø 4"
Witness hydrotest U/G and F/L Ø 4"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/3/2024 SR No#: ___SOUTH/DDY/073
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/3/2024 SR No#: ___SOUTH/DDY/074
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line Ø 4"
Check during welding wing line Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/3/2024 SR No#: ___SOUTH/DDY/074
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/3/2024 SR No#: ___SOUTH/DDY/075
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder test at BKL pekan baru
Piping PT. MPS
M
C W A E
FI T HI
P ✘ D R P
Location : BLK pekan baru C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/3/2024 E ✘
O
Welder TEST S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Welder Test
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/3/2024 SR No#: ___SOUTH/DDY/075
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/3/2024 SR No#: ___SOUTH/DDY/076
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5 C -
27 N Ø 4 " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Review film TIE - IN
POP ( Put On Production ) result OK
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/3/2024 SR No#: ___SOUTH/DDY/076
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/3/2024 SR No#: ___SOUTH/DDY/077
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3 A -
92 E Ø 4 " " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3A - 92 E C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/3/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/3/2024 SR No#: ___SOUTH/DDY/077
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/3/2024 SR No#: ___SOUTH/DDY/078
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
29 N Ø 4 " " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 29 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/3/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/3/2024 SR No#: ___SOUTH/DDY/078
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/3/2024 SR No#: ___SOUTH/DDY/079
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 5C -
27 N Ø 4 " " PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 27 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/3/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 3
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/3/2024 SR No#: ___SOUTH/DDY/079
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/3/2024 SR No#: ___SOUTH/DDY/080
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 08 & 09 Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI ✘ T HI
Location : Minas P_ 8E - 55 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/3/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pillingr pipe 8"
Check during welding pillingr pipe 8"
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/3/2024 SR No#: ___SOUTH/DDY/080
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/3/2024 SR No#: ___SOUTH/DDY/081
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitoring
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/3/2024 SR No#: ___SOUTH/DDY/081
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/3/2024 SR No#: ___SOUTH/DDY/082
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
22/3/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitoring
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/3/2024 SR No#: ___SOUTH/DDY/082
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/3/2024 SR No#: ___SOUTH/DDY/083
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding power pole Ø 8"
Check during welding power pole Ø 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/3/2024 SR No#: ___SOUTH/DDY/083
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/3/2024 SR No#: ___SOUTH/DDY/084
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Inspection Fab Matting Board at Shop Wahana
Rumbai Jln patria sari
Piping PT. BKE
M
C W A E
FI T HI
P D R P
Location : Area Rumbai C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/3/2024 E ✘
O
Fabrication SID S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitoring
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/3/2024 SR No#: ___SOUTH/DDY/084
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/3/2024 SR No#: ___SOUTH/DDY/084
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
25/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Pipe support
Check during welding pipe support
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/3/2024 SR No#: ___SOUTH/DDY/084
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/3/2024 SR No#: ___SOUTH/DDY/085
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Manyfold Ø 4"
Check during welding manyfold Ø 4"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/3/2024 SR No#: ___SOUTH/DDY/085
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/3/2024 SR No#: ___SOUTH/DDY/086
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding line tester Ø 4" and flow line Ø 6"
Check during welding line tester Ø 4" and flow line Ø 6"
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/3/2024 SR No#: ___SOUTH/DDY/086
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/3/2024 SR No#: ___SOUTH/DDY/087
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/3/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) √ QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding line tester Ø 4"
Check during welding line tester Ø 4"
Check Visual welding line tester Ø 4"
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/3/2024 SR No#: ___SOUTH/DDY/087
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/3/2024 SR No#: ___SOUTH/DDY/088
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 08 & 09 Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI ✘ T HI
Location : Minas P_ 08 & 09 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
30/3/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pillingr pipe 8"
Check during welding pillingr pipe 8"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/3/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/3/2024 SR No#: ___SOUTH/DDY/088
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/4/2024 SR No#: ___SOUTH/DDY/089
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
96 N Ø 4 " & 6 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P D R P
Location : Area P_ 2D - 96 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Line Check
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/4/2024 SR No#: ___SOUTH/DDY/089
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/4/2024 SR No#: ___SOUTH/DDY/086
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground Ø 4"
Check during welding under ground Ø 4"
Number of items inspected 16 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/4/2024 SR No#: ___SOUTH/DDY/086
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/4/2024 SR No#: ___SOUTH/DDY/091
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 08 & 09 Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI ✘ T HI
Location : Minas P_ 08 & 09 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
6/4/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS
Check during welding RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/4/2024 SR No#: ___SOUTH/DDY/091
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/4/2024 SR No#: ___SOUTH/DDY/092
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 4E - 95 N Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI ✘ T HI
Location : Minas P_ 4E - 95 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
6/4/2024 ✘ E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pilling pipe 8"
Check during welding pilling pipe 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/4/2024 SR No#: ___SOUTH/DDY/092
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/4/2024 SR No#: ___SOUTH/DDY/093
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
17/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check Install Bolting 4"
Witness Pigging flow line and U/G 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/4/2024 SR No#: ___SOUTH/DDY/093
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/4/2024 SR No#: ___SOUTH/DDY/094
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
18/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line 4"
Check during welding wing line 4"
Check Install Bolting 4"
Hydrotest flow line and wing line 4"
Number of items inspected 30 Number of Items accepted 30
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/4/2024 SR No#: ___SOUTH/DDY/094
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/4/2024 SR No#: ___SOUTH/DDY/095
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold 4"
Check during welding manyfold 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/4/2024 SR No#: ___SOUTH/DDY/095
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/4/2024 SR No#: ___SOUTH/DDY/096
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 6B - 36 N Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 6B - 36 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/4/2024 E ✘
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring pilling 8 "
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/4/2024 SR No#: ___SOUTH/DDY/096
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/4/2024 SR No#: ___SOUTH/DDY/097
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold & line tester 4" and flow line 6"
Check during welding manyfold & line tester 4" and flow line 6"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/4/2024 SR No#: ___SOUTH/DDY/097
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/4/2024 SR No#: ___SOUTH/DDY/098
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 10C - 16 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 10 C - 16 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
20/4/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed)
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring pilling 8 "
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/4/2024 SR No#: ___SOUTH/DDY/098
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/4/2024 SR No#: ___SOUTH/DDY/099
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold & line tester 4" and flow line 6"
Check during welding manyfold & line tester 4" and flow line 6"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/4/2024 SR No#: ___SOUTH/DDY/099
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/4/2024 SR No#: ___SOUTH/DDY/100
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
23/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold & line tester 4" and flow line 6"
Check during welding manyfold & line tester 4" and flow line 6"
Check After welding manyfold & line tester 4" and flow line 6"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/4/2024 SR No#: ___SOUTH/DDY/100
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/4/2024 SR No#: ___SOUTH/DDY/101
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
24/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold & line tester 4" and flow line 6"
Check during welding manyfold & line tester 4" and flow line 6"
Review film U/G , line tester manyfold 4" and fow line 6"
Hydrotest U/G 4"
Number of items inspected 24 Number of Items accepted 24
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/4/2024 SR No#: ___SOUTH/DDY/101
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/4/2024 SR No#: ___SOUTH/DDY/102
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line , U/G and wing line
Check during welding flow line , U/G and wing line
Check all Bolting
Pigging U/G 4"
Hydrotest line tester , manyfold and flow line
Number of items inspected 31 Number of Items accepted 31
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/4/2024 SR No#: ___SOUTH/DDY/102
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/4/2024 SR No#: ___SOUTH/DDY/103
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 N Ø 4 " & 6 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4 E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
26/4/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
RE POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check all Bolting
Review film U/G , wing line 4" and fow line 6"
RE POP
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/4/2024 SR No#: ___SOUTH/DDY/103
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/4/2024 SR No#: ___SOUTH/DDY/104
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Shoot Radiography √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
witness Shoot Radiography
Number of items inspected 10 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/4/2024 SR No#: ___SOUTH/DDY/104
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/4/2024 SR No#: ___SOUTH/DDY/105
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8E -
55 N Ø 4 " PT. BKP MD
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8E - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
27/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pipe support
Check during welding pipe support
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/4/2024 SR No#: ___SOUTH/DDY/105
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/4/2024 SR No#: ___SOUTH/DDY/0106
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 10C - 16 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 10 C - 16 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
27/4/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS
Check During welding RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/4/2024 SR No#: ___SOUTH/DDY/0106
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/4/2024 SR No#: ___SOUTH/DDY/107
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_8E -
55 N Ø 4 " PT. BKP MD
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8E - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line & line tester
Check during welding flow line & line tester
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/4/2024 SR No#: ___SOUTH/DDY/107
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/4/2024 SR No#: ___SOUTH/DDY/0108
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 10C - 16 N
Piping Install RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 10 C - 16 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
28/4/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS
Check During welding RSS
Check after welding RSS
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/4/2024 SR No#: ___SOUTH/DDY/0108
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/4/2024 SR No#: ___SOUTH/DDY/109
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
29/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check During welding flow line 4"
Check after welding flow line 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/4/2024 SR No#: ___SOUTH/DDY/109
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/4/2024 SR No#: ___SOUTH/DDY/110
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
30/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film radiography
Pigging U/G 4"
Hydrotest U/G 4"
Number of items inspected 17 Number of Items accepted 16
FINDING / NON COMPLY WORK:
Defect Film ( water Mark , chemical , debris & light exposure )
CORRECTIVE ACTION :
RE shoot
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/4/2024 SR No#: ___SOUTH/DDY/110
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/4/2024 SR No#: ___SOUTH/DDY/111
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/4/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review Film radiography
Monitoring
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/4/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/4/2024 SR No#: ___SOUTH/DDY/111
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/5/2024 SR No#: ___SOUTH/DDY/112
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/5/2024 SR No#: ___SOUTH/DDY/112
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/5/2024 SR No#: ___SOUTH/DDY/113
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
3/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check During welding flow line 4"
Check after welding flow line 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/5/2024 SR No#: ___SOUTH/DDY/113
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/5/2024 SR No#: ___SOUTH/DDY/114
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/5/2024 SR No#: ___SOUTH/DDY/114
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/5/2024 SR No#: ___SOUTH/DDY/115
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells
P_MINA24_8E-55N/8E-63N PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8E - 55 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line 4"
Check During welding wing line 4"
Hydrotest U/G 4"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/5/2024 SR No#: ___SOUTH/DDY/115
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/5/2024 SR No#: ___SOUTH/DDY/116
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Road crossing 4"
Check During welding Road crossing 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/5/2024 SR No#: ___SOUTH/DDY/116
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/5/2024 SR No#: ___SOUTH/DDY/117
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Safety guard 6"
Check During welding Safety guard 6"
Check After welding Safety guard 6"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/5/2024 SR No#: ___SOUTH/DDY/117
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/5/2024 SR No#: ___SOUTH/DDY/118
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2E -
92 N Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
8/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Road Crossing 4"
Check During welding Road Crossing 4"
Check After welding Road Crossing 4"
Pigging R/C & F/L 4"
Hydrotest R/C & F/L 4"
POP
Number of items inspected 25 Number of Items accepted 25
FINDING / NON COMPLY WORK:
Defect Film ( water Mark , chemical , debris & light exposure )
CORRECTIVE ACTION :
RE shoot
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/5/2024 SR No#: ___SOUTH/DDY/118
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/5/2024 SR No#: ___SOUTH/DDY/0119
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3D - 91 N Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3D - 91 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/5/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pipe pilling 8 "
Check During welding welding pipe pilling 8 "
Check after welding welding pipe pilling 8 "
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/5/2024 SR No#: ___SOUTH/DDY/0119
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/5/2024 SR No#: ___SOUTH/DDY/0120
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3D - 91 N Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 3D - 91 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
14/5/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Conductor Pipe 24 "
Check During welding welding Conductor Pipe 24 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/5/2024 SR No#: ___SOUTH/DDY/0120
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/5/2024 SR No#: ___SOUTH/DDY/121
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab spooll manyfold 4"
Check During weldingFab spooll manyfold 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/5/2024 SR No#: ___SOUTH/DDY/121
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/5/2024 SR No#: ___SOUTH/DDY/123
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
63 Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5 C - 63 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding SID
Check During welding SID
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/5/2024 SR No#: ___SOUTH/DDY/123
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/5/2024 SR No#: ___SOUTH/DDY/122
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab spooll manyfold 4"
Check During weldingFab spooll manyfold 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/5/2024 SR No#: ___SOUTH/DDY/122
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/5/2024 SR No#: ___SOUTH/DDY/124
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
63 Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5 C - 63 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding SID
Check During welding SID
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/5/2024 SR No#: ___SOUTH/DDY/124
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/5/2024 SR No#: ___SOUTH/DDY/125
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
63 Ø 4 " PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5 C - 63 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Finals Inspection SID
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/5/2024 SR No#: ___SOUTH/DDY/125
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/5/2024 SR No#: ___SOUTH/DDY/126
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab spooll line Tester 4"
Check During welding Fab spooll line Tester 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/5/2024 SR No#: ___SOUTH/DDY/126
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/5/2024 SR No#: ___SOUTH/DDY/127
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab spooll flow line 6"
Check During welding Fab spooll Flow line 6"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/5/2024 SR No#: ___SOUTH/DDY/127
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/5/2024 SR No#: ___SOUTH/DDY/128
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
18/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab spooll road crossing water injection 6"
Check During welding Fab spooll road crossing water injection 6"
Check After welding Fab spooll road crossing water injection 6"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/5/2024 SR No#: ___SOUTH/DDY/128
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/5/2024 SR No#: ___SOUTH/DDY/129
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab spooll road crossing water injection and flow line 6"
Check During welding Fab spooll road crossing water injection and flow line 6"
Check After welding Fab spooll road crossing water injection and flow line 6"
Review Film
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/5/2024 SR No#: ___SOUTH/DDY/129
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/5/2024 SR No#: ___SOUTH/DDY/130
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - IN 6"
Check During welding Tie - IN 6"
Check After welding Tie - IN 6"
Review Film
Hydrotest pipe water Injection 6" and pipe U/G 4"
Pigging pipe water Injection 6" and pipe U/G 4"
Number of items inspected 29 Number of Items accepted 29
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/5/2024 SR No#: ___SOUTH/DDY/130
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/5/2024 SR No#: ___SOUTH/DDY/131
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
21/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Flow direction Check Valve √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Hydrotest pipe flow line 6" and line tester 4"
Pigging pipe flow line 6"
Install bolting all flange 4" & 6"
Inspection flow direction valve
Number of items inspected 22 Number of Items accepted 21
FINDING / NON COMPLY WORK:
finding Flow direction check valve not in accordance with drawing
CORRECTIVE ACTION :
Re install Check valve based on drawing
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/5/2024 SR No#: ___SOUTH/DDY/131
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/5/2024 SR No#: ___SOUTH/DDY/132
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
22/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation √
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Flow direction Check Valve √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - IN 6" Water Injection and Wing line 4"
Check During welding Tie - IN 6" Water Injection and Wing line 4"
Check After welding Tie - IN 6" Water Injection and Wing line 4"
Install bolting all flange 4" & 6"
Review Film tie - in water injection 6" aand wing line 4"
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
finding Flow direction check valve not in accordance with drawing
CORRECTIVE ACTION :
Re install Check valve based on drawing ( Close )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/5/2024 SR No#: ___SOUTH/DDY/132
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/5/2024 SR No#: ___SOUTH/DDY/133
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D-
91 N Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Power pole 12"
Check During welding Power pole 12"
Check After welding Power pole 12"
Number of items inspected 18 Number of Items accepted 17
FINDING / NON COMPLY WORK:
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/5/2024 SR No#: ___SOUTH/DDY/133
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/5/2024 SR No#: ___SOUTH/DDY/134
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Pumchlist ''Relocation and New Facility for new
wells P_ 2E - 92 N Ø 4 " PT. ADK MD
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2E - 92 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Finals Inspection Puchlist OK
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/5/2024 SR No#: ___SOUTH/DDY/134
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/5/2024 SR No#: ___SOUTH/DDY/134
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punchlist ''Relocation and New Facility for new
wells P_04 Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5 C - 63 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Finals Inspection Puchlist Finding
Number of items inspected 2 Number of Items accepted 1
FINDING / NON COMPLY WORK:
Install Pipe support broken
CORRECTIVE ACTION :
RE install Pipe support
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/5/2024 SR No#: ___SOUTH/DDY/134
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/5/2024 SR No#: ___SOUTH/DDY/136
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
26/5/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Road crossing 6" and Road crossing 4"
Check During welding Road crossing 6" and Road crossing 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/5/2024 SR No#: ___SOUTH/DDY/136
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/5/2024 SR No#: ___SOUTH/DDY/137
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/5/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding spooll Manyfold 4"
Check During welding spooll Manyfold 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/5/2024 SR No#: ___SOUTH/DDY/137
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/5/2024 SR No#: ___SOUTH/DDY/138
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
28/5/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Wall thickness √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding spooll Manyfold 4"
Check During welding spooll Manyfold 4"
Wall thickness water injection 6"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/5/2024 SR No#: ___SOUTH/DDY/138
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/5/2024 SR No#: ___SOUTH/DDY/139
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 10 C
- 16 Ø 4 " PT. ADK
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 10C - 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
28/5/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Wall thickness
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Cutting and Edge Preparation
Number of items inspected 9 Number of Items accepted 9
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/5/2024 SR No#: ___SOUTH/DDY/139
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/5/2024 SR No#: ___SOUTH/DDY/140
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
29/5/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pipe support 4"
Check During welding pipe support 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/5/2024 SR No#: ___SOUTH/DDY/140
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/5/2024 SR No#: ___SOUTH/DDY/0141
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 16 Install RSS PT.
Piping RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 16 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/5/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pilling Pipe 8 "
Check During welding pilling Pipe 8 "
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/5/2024 SR No#: ___SOUTH/DDY/0141
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/5/2024 SR No#: ___SOUTH/DDY/142
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/5/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install water injection 4"
Check During welding install water injection 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/5/2024 SR No#: ___SOUTH/DDY/142
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/5/2024 SR No#: ___SOUTH/DDY/0143
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 16 Install RSS PT.
Piping RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 16 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
30/5/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding pilling Pipe 8 "
Check During welding pilling Pipe 8 "
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/5/2024 SR No#: ___SOUTH/DDY/0143
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/5/2024 SR No#: ___SOUTH/DDY/144
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
31/5/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Hydrotest R/ C water injection 6" and R/C production line 4"
review film water injection
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/5/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/5/2024 SR No#: ___SOUTH/DDY/144
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/6/2024 SR No#: ___SOUTH/DDY/145
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
1/6/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - In water injection 6"
Check During welding Tie - In water injection 6"
Check After welding Tie - In water injection 6"
Review film Tie - IN 3 joint result 2 joint ( ACC) & 1 joint repair
Number of items inspected 21 Number of Items accepted 20
FINDING / NON COMPLY WORK:
Repair welding IC ( Internal Concavity )
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Re welding repair ( closes ) tgl 3 - 6 -2024
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/6/2024 SR No#: ___SOUTH/DDY/145
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/6/2024 SR No#: ___SOUTH/DDY/146
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/6/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - In water injection 6"
Check During welding Tie - In water injection 6"
Check After welding Tie - In water injection 6"
Review film Tie - IN 1 joint after repair result ACC
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/6/2024 SR No#: ___SOUTH/DDY/146
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/6/2024 SR No#: ___SOUTH/DDY/147
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4E -95 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
4/6/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground 4"
Check During welding under ground 4"
Check After welding under ground 4"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/6/2024 SR No#: ___SOUTH/DDY/147
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/6/2024 SR No#: ___SOUTH/DDY/148
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4E -95 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
5/6/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground & hook up 4"
Check During welding under ground & hook up 4"
Check After welding under ground & hook up 4"
Pigging pipe Under ground 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/6/2024 SR No#: ___SOUTH/DDY/148
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/6/2024 SR No#: ___SOUTH/DDY/149
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4E -95 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/6/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - IN wing line 4"
Check During welding Tie - IN wing line 4"
Check After welding Tie - IN wing line 4"
Hydrotest Under ground and wing line 4"
review RT film tie - IN wing line 4"
Install bolting 4"
Number of items inspected 32 Number of Items accepted 32
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/6/2024 SR No#: ___SOUTH/DDY/149
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/6/2024 SR No#: ___SOUTH/DDY/0150
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 16 Install RSS PT.
Piping RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 16 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
7/6/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS 8 "
Check During welding RSS 8 "
Check After welding RSS 8 "
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/6/2024 SR No#: ___SOUTH/DDY/0150
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/6/2024 SR No#: ___SOUTH/DDY/151
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_10 C -
16 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 10 C - 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
8/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Install bolting 4"
Number of items inspected 11 Number of Items accepted 10
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/6/2024 SR No#: ___SOUTH/DDY/151
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/6/2024 SR No#: ___SOUTH/DDY/152
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT
✘ ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
33 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5 C - 33 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/6/2024 E ✘
O
Fabrication and install Flow line 4" and power pole S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Power pole 8 "
Check During welding Power pole 8 "
Check After welding Power pole 8 "
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/6/2024 SR No#: ___SOUTH/DDY/152
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/6/2024 SR No#: ___SOUTH/DDY/0153
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 5C- 33 Install
Piping RSS PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 5C - 33 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
10/6/2024 ✘ E
O
Install Pilling pipe 8 " & 24" and RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS 8 "
Check During welding RSS 8 "
Check After welding RSS 8 "
Number of items inspected 16 Number of Items accepted 16
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/6/2024 SR No#: ___SOUTH/DDY/0153
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/6/2024 SR No#: ___SOUTH/DDY/154
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_2D -
32 N Ø 4 " PT. ADK ( RTP )
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 2D - 32 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold and wing line 4"
Check During welding manyfold and wing line 4"
Check After welding manyfold and wing line 4"
Pigging U/G 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/6/2024 SR No#: ___SOUTH/DDY/154
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/6/2024 SR No#: ___SOUTH/DDY/155
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_4E -
95 Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4E -95 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding manyfold 4"
Check During welding manyfold 4"
Hydrotest Under ground and wing line 4"
review RT film under ground 4"
Number of items inspected 24 Number of Items accepted 24
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/6/2024 SR No#: ___SOUTH/DDY/155
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/6/2024 SR No#: ___SOUTH/DDY/155
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_08 &
09 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 08 & 09 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding U/G 4"
Check During welding U/G 4"
Check After welding U/G 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/6/2024 SR No#: ___SOUTH/DDY/155
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/6/2024 SR No#: ___SOUTH/DDY/156
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_08 &
09 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 08 & 09 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding U/G and wing line 4"
Check During welding U/G and wing line 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/6/2024 SR No#: ___SOUTH/DDY/156
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/6/2024 SR No#: ___SOUTH/DDY/157
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_08 &
09 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 08 & 09 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Review film under ground 4" P_08 & 09
Hydrotest under ground 4" P _ 09
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/6/2024 SR No#: ___SOUTH/DDY/157
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/6/2024 SR No#: ___SOUTH/DDY/0158
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Install Retaining wall Location for new wells P_ 08 &
Piping 09 PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 08 & 09 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
20/6/2024 ✘ E
O
Install Pilling pipe 8 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding braching 4 " to pilling 8"
Check During welding braching 4 " to pilling 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/6/2024 SR No#: ___SOUTH/DDY/0158
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/6/2024 SR No#: ___SOUTH/DDY/157
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_08 &
09 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 08 & 09 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
20/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting √
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Pigging under ground 4" p_ 08 & 09
Hydrotest under ground 4" P _ 08
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/6/2024 SR No#: ___SOUTH/DDY/157
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/6/2024 SR No#: ___SOUTH/DDY/0160
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Install Retaining wall Location for new wells P_ 08 &
Piping 09 PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 08 & 09 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
22/6/2024 ✘ E
O
Install Pilling pipe 8 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding braching 4 " to pilling 8"
Check During welding braching 4 " to pilling 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/6/2024 SR No#: ___SOUTH/DDY/0160
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/6/2024 SR No#: ___SOUTH/DDY/0161
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Install Retaining wall Location for new wells P_ 08 &
Piping 09 PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 08 & 09 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
24/6/2024 ✘ E
O
Install Pilling pipe 8 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding braching 4 " to pilling 8"
Check During welding braching 4 " to pilling 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/6/2024 SR No#: ___SOUTH/DDY/0161
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/6/2024 SR No#: ___SOUTH/DDY/0162
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder Test
Piping RDP
M
C W A E
FI T HI
Location : BLK Pekanbaru P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
25/6/2024 ✘ E
O
Welder test PT. RDP S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Welder Test √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Welder Test
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/6/2024 SR No#: ___SOUTH/DDY/0162
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/6/2024 SR No#: ___SOUTH/DDY/0163
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder Test
Piping RDP
M
C W A E
FI T HI
Location : BLK Pekanbaru P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
26/6/2024 ✘ E
O
Welder test PT. RDP S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) Welder Test √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Welder Test
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/6/2024 SR No#: ___SOUTH/DDY/0163
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/6/2024 SR No#: ___SOUTH/DDY/164
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_08 &
09 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 08 & 09 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding U/G and wing line 4"
Check During welding U/G and wing line 4"
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
Install threaded Ø 3/4" not match with drawing
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Install threaded Ø 3/4" based on drawing ( closes )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/6/2024 SR No#: ___SOUTH/DDY/164
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/6/2024 SR No#: ___SOUTH/DDY/165
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
91N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
28/6/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting √
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Pigging under ground 4" P_ 3D - 91 N
Hydrotest under ground 4" P_ 3D - 91 N
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/6/2024 SR No#: ___SOUTH/DDY/165
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/6/2024 SR No#: ___SOUTH/DDY/0166
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 11 Install RSS PT.
Piping VDI PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 11 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/6/2024 ✘ E
O
Install Pilling pipe 8 " & 24" , RSS and cellar Box S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Install Cellar Box √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Install cellar Box
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/6/2024 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/6/2024 SR No#: ___SOUTH/DDY/0166
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/6/2024 SR No#: ___SOUTH/DDY/167
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_6F -
91 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6F - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
29/6/2024 E ✘
O
Fabrication and install Flow line 4" , fabrication power pole 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding power pole 8"
Check During welding power pole 8"
Check after welding power pole 8"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
Install threaded Ø 3/4" not match with drawing
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Install threaded Ø 3/4" based on drawing ( closes )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/6/2024 SR No#: ___SOUTH/DDY/167
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/6/2024 SR No#: ___SOUTH/DDY/168
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
91N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
29/6/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - IN wing line 4"
Check During welding Tie - IN wing line 4"
Check after welding Tie - IN wing line 4"
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
Install threaded Ø 3/4" not match with drawing
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Install threaded Ø 3/4" based on drawing ( closes )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/6/2024 SR No#: ___SOUTH/DDY/168
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/6/2024 SR No#: ___SOUTH/DDY/169
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_6F -
91 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6F - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/6/2024 E ✘
O
Fabrication and install Flow line 4" , fabrication power pole 8" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding power pole 8"
Check During welding power pole 8"
Check after welding power pole 8"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
Install threaded Ø 3/4" not match with drawing
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Install threaded Ø 3/4" based on drawing ( closes )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/6/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/6/2024 SR No#: ___SOUTH/DDY/169
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/6/2024 SR No#: ___SOUTH/DDY/0170
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 6D - 43 E Install
Piping RSS PT. RDP PT. RDP
M
C W A E
FI T HI
Location : Minas P_ 6D - 43 E P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
30/6/2024 ✘ E
O
Install Pilling pipe 8 " & 24" , RSS and cellar Box S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Install Pilling 8" √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Install Pilling 8"
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/6/2024 Signature: _____________________
Person Notified of Deficiency:
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/6/2024 SR No#: ___SOUTH/DDY/0170
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/7/2024 SR No#: ___SOUTH/DDY/171
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punch list P_ 3D - 55 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 55 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 2
FINDING / NON COMPLY WORK:
Pipe header Ø 6" bending ( broken ) and spooll line tester jump from pipe support because landslide
Bolting short 4 Ea pipe 6"
plug 3/4 " 2 Ea for well existing to threaded wing u/g 4" (not yet.)
CORRECTIVE ACTION :
repair location area header Ø 6"
Change to bolting pipe 6"
Install plug to threaded 3/4 " U/G 4"
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/7/2024 SR No#: ___SOUTH/DDY/171
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/7/2024 SR No#: ___SOUTH/DDY/172
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punch list P_ 3D - 65 PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 65 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
1/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 2
FINDING / NON COMPLY WORK:
flow line Ø 4" bending (broken )and pipe support ( Broken )because landslide
CORRECTIVE ACTION :
Repair flow line and pipe support
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/7/2024 SR No#: ___SOUTH/DDY/172
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/7/2024 SR No#: ___SOUTH/DDY/173
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_3D -
91N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
2/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
POP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Line check before POP
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/7/2024 SR No#: ___SOUTH/DDY/173
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/7/2024 SR No#: ___SOUTH/DDY/0174
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Install Retaining wall Location for new wells P_ 08 &
Piping 09 PT. HKI PT. HKI
M
C W A E
FI T HI
Location : Minas P_ 08 & 09 P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
3/7/2024 ✘ E
O
Install Pilling pipe 8 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding braching 4 " to pilling 8"
Check During welding braching 4 " to pilling 8"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/7/2024 SR No#: ___SOUTH/DDY/0174
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/7/2024 SR No#: ___SOUTH/DDY/175
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
33 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 33 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
4/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground 4"
Check During welding under ground 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/7/2024 SR No#: ___SOUTH/DDY/175
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/7/2024 SR No#: ___SOUTH/DDY/176
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_11 Ø
4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 11 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check During welding flow line 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/7/2024 SR No#: ___SOUTH/DDY/176
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/7/2024 SR No#: ___SOUTH/DDY/177
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
33 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 33 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding line tester 4"
Check During welding line tester 4"
Hydrotest U/ G 4"
Number of items inspected 23 Number of Items accepted 23
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/7/2024 SR No#: ___SOUTH/DDY/177
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/7/2024 SR No#: ___SOUTH/DDY/178
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_5C -
33 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 5C - 33 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
11/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
POP √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line 4"
Check During welding wing line 4"
Check After welding wing line 4"
Review Film Tie - In
Pigging U/G 4"
Installation Bolting
POP
Number of items inspected 27 Number of Items accepted 27
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/7/2024 SR No#: ___SOUTH/DDY/178
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/7/2024 SR No#: ___SOUTH/DDY/179
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Hot - Tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line 4"
Check During welding wing line 4"
Installation bolting 4"
Hot Tap
Number of items inspected 20 Number of Items accepted 20
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/7/2024 SR No#: ___SOUTH/DDY/179
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/7/2024 SR No#: ___SOUTH/DDY/0180
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 6B - 36 N Install
Piping RSS PT. VDI PT. VDI
M
C W A E
FI T HI
Location : Minas P_ 6B - 36 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
12/7/2024 ✘ E
O
Install RSS S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS
Check During welding RSS
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/7/2024 SR No#: ___SOUTH/DDY/0180
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/7/2024 SR No#: ___SOUTH/DDY/181
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check During welding flow line 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/7/2024 SR No#: ___SOUTH/DDY/181
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/7/2024 SR No#: ___SOUTH/DDY/0182
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3B - 24 N & P_3B
Piping - 14 Install conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 3B - 24 N P ✘ D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/7/2024 ✘ E
O
Install RSS & conductor 24" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Conductor 24 "
Check During welding Conductor 24 "
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/7/2024 SR No#: ___SOUTH/DDY/0182
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/7/2024 SR No#: ___SOUTH/DDY/0183
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 11 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 11 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
13/7/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Conductor 24 "
Check During welding Conductor 24 "
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/7/2024 SR No#: ___SOUTH/DDY/0183
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/7/2024 SR No#: ___SOUTH/DDY/184
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check During welding flow line 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/7/2024 SR No#: ___SOUTH/DDY/184
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/7/2024 SR No#: ___SOUTH/DDY/185
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check During welding flow line 4"
Hydrotest Road Crossing 4"
Number of items inspected 21 Number of Items accepted 21
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/7/2024 SR No#: ___SOUTH/DDY/185
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 17/7/2024 SR No#: ___SOUTH/DDY/186
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
17/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4" and pipe support 6"
Check before welding flow line 4" and pipe support 6"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 17/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 17/7/2024 SR No#: ___SOUTH/DDY/186
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 18/7/2024 SR No#: ___SOUTH/DDY/187
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
18/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 18/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 18/7/2024 SR No#: ___SOUTH/DDY/187
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/7/2024 SR No#: ___SOUTH/DDY/188
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punch list P_ 4E - 95 N PT. ADK MD
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4E - 95 N C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
19/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 2
FINDING / NON COMPLY WORK:
Bolting not balance 6 Ea pipe 6"
CORRECTIVE ACTION :
Balance to bolting pipe 6"
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/7/2024 SR No#: ___SOUTH/DDY/188
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/7/2024 SR No#: ___SOUTH/DDY/0189
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3B - 24 N & P_3B
Piping - 14 Install conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 3B - 24 N & P_3B - 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
19/7/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS
Check During welding RSS
Check After welding RSS
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/7/2024 SR No#: ___SOUTH/DDY/0189
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/7/2024 SR No#: ___SOUTH/DDY/190
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6"
Check During welding Flow line Ø 6"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/7/2024 SR No#: ___SOUTH/DDY/190
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/7/2024 SR No#: ___SOUTH/DDY/191
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 8D -
23 N1 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 8D - 23 N 1 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
21/7/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line Ø 4"
Check During welding wing line Ø 4"
Check After welding wing line Ø 4"
Install bolting all to flange
Pigging U/ G and Flow line Ø 4"
Hydrotest flow line Ø 4"
Review film Tie - in wing line
Number of items inspected 32 Number of Items accepted 31
FINDING / NON COMPLY WORK:
Repair welding joint radiography wing line ( Porosity )
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Re welding joint repair ( Closes)
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/7/2024 SR No#: ___SOUTH/DDY/191
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/7/2024 SR No#: ___SOUTH/DDY/192
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
21/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6"
Check During welding Flow line Ø 6"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/7/2024 SR No#: ___SOUTH/DDY/192
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/7/2024 SR No#: ___SOUTH/DDY/193
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
22/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6" and line tester 4"
Check During welding Flow line Ø 6" and line tester 4"
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/7/2024 SR No#: ___SOUTH/DDY/193
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/7/2024 SR No#: ___SOUTH/DDY/194
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6" and line tester 4"
Check During welding Flow line Ø 6" and line tester 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/7/2024 SR No#: ___SOUTH/DDY/194
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/7/2024 SR No#: ___SOUTH/DDY/195
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6" and line tester 4"
Check During welding Flow line Ø 6" and line tester 4"
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/7/2024 SR No#: ___SOUTH/DDY/195
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/7/2024 SR No#: ___SOUTH/DDY/0196
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 3B - 24 N & P_3B
Piping - 14 Install conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 3B - 24 N & P_3B - 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
24/7/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding RSS
Check During welding RSS
Check After welding RSS
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/7/2024 SR No#: ___SOUTH/DDY/0196
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/7/2024 SR No#: ___SOUTH/DDY/0197
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 01 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 01 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
25/7/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Conductor Pipe 14 "
Check During welding Conductor Pipe 14 "
Check After welding Conductor Pipe 14 "
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/7/2024 SR No#: ___SOUTH/DDY/0197
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/7/2024 SR No#: ___SOUTH/DDY/198
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6" and jumper line 4"
Check During welding Flow line Ø 6" and jumper line 4"
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/7/2024 SR No#: ___SOUTH/DDY/198
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 25/7/2024 SR No#: ___SOUTH/DDY/199
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6 F -
91 PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6F - 91 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
25/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install spool HOTTAP 4"
Check During welding install spool HOTTAP 4"
Check After welding install spool HOTTAP 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 25/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 25/7/2024 SR No#: ___SOUTH/DDY/199
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/7/2024 SR No#: ___SOUTH/DDY/200
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
26/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground 4"
Check before welding under ground 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/7/2024 SR No#: ___SOUTH/DDY/200
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 26/7/2024 SR No#: ___SOUTH/DDY/201
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
26/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6" and jumper line 4"
Check During welding Flow line Ø 6" and jumper line 4"
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 26/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 26/7/2024 SR No#: ___SOUTH/DDY/201
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/7/2024 SR No#: ___SOUTH/DDY/202
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line 4"
Check during welding flow line 4"
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/7/2024 SR No#: ___SOUTH/DDY/202
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/7/2024 SR No#: ___SOUTH/DDY/203
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
27/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 6"
Check During welding Flow line Ø 6"
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/7/2024 SR No#: ___SOUTH/DDY/203
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/7/2024 SR No#: ___SOUTH/DDY/204
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 16
Ø 4 " & 6" PT. ADK
Piping PT. ADK
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
29/7/2024 E ✘
O
Fabrication and install Flow line 4" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number √ 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line 4"
Check during welding wing line 4"
Pigging U/ G and flow line 4"
Hydrotest all pipe 4"
POP
Number of items inspected 26 Number of Items accepted 26
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/7/2024 SR No#: ___SOUTH/DDY/204
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/7/2024 SR No#: ___SOUTH/DDY/205
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/7/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Pigging Flow line 6"
Hydrotest flow line 6" , manyfold & line tester 4"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/7/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/7/2024 SR No#: ___SOUTH/DDY/205
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 1/8/2024 SR No#: ___SOUTH/DDY/206
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Welder test PT. RDP at BLK pekan baru
Piping PT. RDP
M
C W A E
FI T HI
P ✘ D R P
Location : Pekan baru C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
1/8/2024 E ✘
O
Welder test S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Welder test √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Welder test PT. RDP
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 1/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 1/8/2024 SR No#: ___SOUTH/DDY/206
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/8/2024 SR No#: ___SOUTH/DDY/207
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
2/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under groung Ø 4" and power pole 12 "
Check During welding Under groung Ø 4" and power pole 12 "
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/8/2024 SR No#: ___SOUTH/DDY/207
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/8/2024 SR No#: ___SOUTH/DDY/208
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
4/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding power pole 12 "
Check During welding power pole 12 "
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/8/2024 SR No#: ___SOUTH/DDY/208
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/8/2024 SR No#: ___SOUTH/DDY/209
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
5/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Install valve 6"
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/8/2024 SR No#: ___SOUTH/DDY/209
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/8/2024 SR No#: ___SOUTH/DDY/210
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitor re POP
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/8/2024 SR No#: ___SOUTH/DDY/210
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/8/2024 SR No#: ___SOUTH/DDY/211
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Site com for loc 4A - 25 ( RTP ) PT. V - BRI
Piping PT. V - BRI
M
C W A E
FI T HI
P ✘ D R P
Location : Area 4A - 25 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
6/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Site KOM √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Site KOM
Number of items inspected 7 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/8/2024 SR No#: ___SOUTH/DDY/211
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/8/2024 SR No#: ___SOUTH/DDY/211
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
9/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 4"
Check During welding Flow line Ø 4"
Number of items inspected 14 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/8/2024 SR No#: ___SOUTH/DDY/211
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/8/2024 SR No#: ___SOUTH/DDY/212
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground and Jumper line Ø 4"
Check During welding Under ground and Jumper line Ø 4"
Check After welding Under ground and Jumper line Ø 4"
Number of items inspected 18 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/8/2024 SR No#: ___SOUTH/DDY/212
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/8/2024 SR No#: ___SOUTH/DDY/0213
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Fabrikasi Pipe bundle, Mobilisasi Bundling ke Junk
Piping Yard PT. HKM PT. HKM
M
C W A E
FI T HI
Location : 7 Yard P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
10/8/2024 ✘ E
O
Fab Bundle S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Pipe bundle
Check During welding Pipe bundle
Number of items inspected 8 Number of Items accepted 8
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/8/2024 SR No#: ___SOUTH/DDY/0213
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/8/2024 SR No#: ___SOUTH/DDY/214
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Shoot Radiography √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground and Jumper line Ø 4"
Check During welding Under ground and Jumper line Ø 4"
Check After welding Under ground and Jumper line Ø 4"
Number of items inspected 19 Number of Items accepted 19
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/8/2024 SR No#: ___SOUTH/DDY/214
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 13/8/2024 SR No#: ___SOUTH/DDY/215
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
13/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Tie - In line tester Ø 4"
Check During welding Tie - In line tester Ø 4"
Hydrotest U/ G Ø 4"
Number of items inspected 22 Number of Items accepted 22
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 13/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 13/8/2024 SR No#: ___SOUTH/DDY/215
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 14/8/2024 SR No#: ___SOUTH/DDY/216
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
14/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
hot tap √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding jumper line Ø 4"
Check During welding jumper line Ø 4"
Pigging Piping 4"
HOT TAP
Number of items inspected 15 Number of Items accepted 15
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 14/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 14/8/2024 SR No#: ___SOUTH/DDY/216
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/8/2024 SR No#: ___SOUTH/DDY/216
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 6B -
36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check √
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Hydrotest U/ G Ø 4"
Number of items inspected 17 Number of Items accepted 17
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/8/2024 SR No#: ___SOUTH/DDY/216
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/8/2024 SR No#: ___SOUTH/DDY/217
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punchlist PT. ADK MD for loc P_ 16
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 16 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6 " S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch list No finding
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/8/2024 SR No#: ___SOUTH/DDY/217
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/8/2024 SR No#: ___SOUTH/DDY/217
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Punchlist PT. ADK MD for loc P_2D - 32 N Ø 4 "
PT. ADK ( RTP )
Piping PT. ADK MD
M
C W A E
FI T HI
P ✘ D R P
Location : Area 2 D - 32 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punch list No finding
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/8/2024 SR No#: ___SOUTH/DDY/217
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 15/8/2024 SR No#: ___SOUTH/DDY/219
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 7 E -
81 NS Ø 4 " & 6" PT. BKP ( RTP)
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7E - 81 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
15/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR 3. Pressurized as per steps √
Alignment and straightness 4. Holding time as per procedure √
Root Opening meet with WPS/PQR 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Hydrotest U/ G Ø 4"
Pigging flow line 4", U/G 4" & Flow line 6"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 15/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 15/8/2024 SR No#: ___SOUTH/DDY/219
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/8/2024 SR No#: ___SOUTH/DDY/220
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Puchlist ''Relocation and New Facility for new
wells P_ 6B - 36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist no finding
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/8/2024 SR No#: ___SOUTH/DDY/220
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 16/8/2024 SR No#: ___SOUTH/DDY/220
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Puchlist ''Relocation and New Facility for new
wells P_ 6B - 36N Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
16/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist no finding
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 16/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 16/8/2024 SR No#: ___SOUTH/DDY/220
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 19/8/2024 SR No#: ___SOUTH/DDY/222
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3D -
73 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 73 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
19/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Monitor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitoring
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 19/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 19/8/2024 SR No#: ___SOUTH/DDY/222
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 20/8/2024 SR No#: ___SOUTH/DDY/223
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 7 E -
81 NS Ø 4 " & 6" PT. BKP ( RTP)
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 7E - 81 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
20/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check During welding wing line Ø 4"
Review film Radiography. Before POP
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 20/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 20/8/2024 SR No#: ___SOUTH/DDY/223
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/8/2024 SR No#: ___SOUTH/DDY/224
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 05 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 05 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
21/8/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Install conductor pipe
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/8/2024 SR No#: ___SOUTH/DDY/224
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 21/8/2024 SR No#: ___SOUTH/DDY/225
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 11
Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 11 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
21/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
During welding install power pole 8"
Number of items inspected 8 Number of Items accepted 7
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 21/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 21/8/2024 SR No#: ___SOUTH/DDY/225
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 22/8/2024 SR No#: ___SOUTH/DDY/226
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
22/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Veryfication Material
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 22/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 22/8/2024 SR No#: ___SOUTH/DDY/226
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/8/2024 SR No#: ___SOUTH/DDY/227
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Wall thickness for HOT TAP √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Wall thickness line production 8"
Number of items inspected 2 Number of Items accepted 2
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/8/2024 SR No#: ___SOUTH/DDY/227
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 23/8/2024 SR No#: ___SOUTH/DDY/228
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Punchlist Relocation and New Facility for new
wells P_3D - 91 N Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3D - 91 N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
23/8/2024 E ✘
O
Fabrication and install Flow line 4" & 6" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts √
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List √
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Punchlist
Number of items inspected 3 Number of Items accepted 2
FINDING / NON COMPLY WORK:
Bolting pipe flow line near blind flange and Tie - In 6" ( short )
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Re Install bolting ( Change to Bolting )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 23/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 23/8/2024 SR No#: ___SOUTH/DDY/228
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/8/2024 SR No#: ___SOUTH/DDY/229
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 05 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 05 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
24/8/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Monitoring
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/8/2024 SR No#: ___SOUTH/DDY/229
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/8/2024 SR No#: ___SOUTH/DDY/230
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 05 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 05 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
24/8/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) Intallation
Approved WPS / PQR available Install Gasket and Bolt-nuts
Approved ITP available and implemented Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Monitoring √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitoring
Number of items inspected 1 Number of Items accepted 1
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/8/2024 SR No#: ___SOUTH/DDY/230
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 24/8/2024 SR No#: ___SOUTH/DDY/231
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4D -
16 Ø 4 " PT. BKP ( RTP )
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
24/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding jumper line Ø 4"
Check During welding jumper line Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 24/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 24/8/2024 SR No#: ___SOUTH/DDY/231
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 27/8/2024 SR No#: ___SOUTH/DDY/232
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
27/8/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
monitoring Pilling riq structure 8"
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 27/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 27/8/2024 SR No#: ___SOUTH/DDY/232
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 28/8/2024 SR No#: ___SOUTH/DDY/233
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4D -
16 Ø 4 " PT. BKP ( RTP )
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
28/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding wing line Ø 4"
Check During welding wing line Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 28/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 28/8/2024 SR No#: ___SOUTH/DDY/233
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/8/2024 SR No#: ___SOUTH/DDY/233
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE M
DATE C C
COMPLETED WORK S
E Y N
29/8/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
monitoring Pilling riq structure 8"
Number of items inspected 5 Number of Items accepted 5
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/8/2024 SR No#: ___SOUTH/DDY/233
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 29/8/2024 SR No#: ___SOUTH/DDY/234
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4D -
16 Ø 4 " PT. BKP ( RTP )
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
29/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding u/g Ø 4"
Check During welding u/g Ø 4"
Number of items inspected 14 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 29/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 29/8/2024 SR No#: ___SOUTH/DDY/234
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/8/2024 SR No#: ___SOUTH/DDY/235
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4D -
16 Ø 4 " PT. BKP ( RTP )
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding u/g Ø 4"
Check During welding u/g Ø 4"
Pigging U/G 4"
Number of items inspected 15 Number of Items accepted 13
FINDING / NON COMPLY WORK:
repair film radiography wimg line and U/G summary 3 joint ( defect Porosity )
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
re welding joint repair ( Close ) tgl 31-8-24
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/8/2024 SR No#: ___SOUTH/DDY/235
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 30/8/2024 SR No#: ___SOUTH/DDY/236
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4A -
51 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 51 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
30/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding power pole Ø 8"
Check During welding power pole Ø 8"
Number of items inspected 13 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 30/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 30/8/2024 SR No#: ___SOUTH/DDY/236
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 31/8/2024 SR No#: ___SOUTH/DDY/237
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4D -
16 Ø 4 " PT. BKP ( RTP )
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 6B - 36N C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
31/8/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts √
Approved ITP available and implemented √ Install anti seize coumpound √
Certified Welders √ All bolts extend completely through their nuts √
Materials Handling and Storage √ Line Check √
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package √
Joints Fit Up Review Calibration tools and equipments √
Tranfer Head Number 1. Warning sign and barricade √
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly √
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps √
Alignment and straightness √ 4. Holding time as per procedure √
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps √
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering √
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Wing line Ø 4"
Check During welding Wing line Ø 4"
Check After welding Wing line Ø 4"
Install all Bolting 4"
Hydrotest all piping 4 "
Number of items inspected 32 Number of Items accepted 32
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 31/8/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 31/8/2024 SR No#: ___SOUTH/DDY/237
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/9/2024 SR No#: ___SOUTH/DDY/238
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 4A -
51 Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 4A - 51 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
2/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding install power pole Ø 8"
Check During welding Install power pole Ø 8"
Number of items inspected 13 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/9/2024 SR No#: ___SOUTH/DDY/238
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 2/9/2024 SR No#: ___SOUTH/DDY/239
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
2/9/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 11 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 2/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 2/9/2024 SR No#: ___SOUTH/DDY/239
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/9/2024 SR No#: ___SOUTH/DDY/240
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
3/9/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Fab RSS
Check During welding Fab RSS
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/9/2024 SR No#: ___SOUTH/DDY/240
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 3/9/2024 SR No#: ___SOUTH/DDY/241
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
3/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding jumper line Ø 4"
Check During welding jumper line Ø 4"
Number of items inspected 14 Number of Items accepted 13
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 3/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 3/9/2024 SR No#: ___SOUTH/DDY/241
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/9/2024 SR No#: ___SOUTH/DDY/242
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
4/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 4"
Check During welding Flow line Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/9/2024 SR No#: ___SOUTH/DDY/242
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 4/9/2024 SR No#: ___SOUTH/DDY/243
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
4/9/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install RSS
Check During welding Install RSS
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 4/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 4/9/2024 SR No#: ___SOUTH/DDY/243
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/9/2024 SR No#: ___SOUTH/DDY/244
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
5/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Flow line Ø 4"
Check During welding Flow line Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/9/2024 SR No#: ___SOUTH/DDY/244
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 5/9/2024 SR No#: ___SOUTH/DDY/245
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
5/9/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install RSS
Check During welding Install RSS
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 5/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 5/9/2024 SR No#: ___SOUTH/DDY/245
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/9/2024 SR No#: ___SOUTH/DDY/246
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
6/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Road crossing Ø 4"
Check During welding Road crossing Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/9/2024 SR No#: ___SOUTH/DDY/246
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 6/9/2024 SR No#: ___SOUTH/DDY/247
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
6/9/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install RSS
Check During welding Install RSS
Number of items inspected 12 Number of Items accepted 11
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 6/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 6/9/2024 SR No#: ___SOUTH/DDY/247
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/9/2024 SR No#: ___SOUTH/DDY/248
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells 7E - 43
Ø 4 " PT. BKP ( RTP)
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area 7E - 43 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
7/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4"
Check During welding Under ground Ø 4"
Check After welding Under ground Ø 4"
Number of items inspected 18 Number of Items accepted 18
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/9/2024 SR No#: ___SOUTH/DDY/248
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 7/9/2024 SR No#: ___SOUTH/DDY/249
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
Road and Location for new wells P_ 14 Install
Piping conductor pipe PT. RDW PT. RDW
M
C W A E
FI T HI
Location : Minas P_ 14 P D R P
C C S
DESCRIPTION OF JOB INSPECTED : ISSUE MDATE C C
COMPLETED WORK S
E Y N
7/9/2024 ✘ E
O
Install RSS & Conductor pipe S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
AWS D1.1; PHR-PIM-SPC-103541
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number √ 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Install RSS
Check During welding Install RSS
Number of items inspected 12 Number of Items accepted 12
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 7/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 7/9/2024 SR No#: ___SOUTH/DDY/249
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 8/9/2024 SR No#: ___SOUTH/DDY/250
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells 7E - 43
Ø 4 " PT. BKP ( RTP)
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area 7E - 43 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
8/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect √ Punch-list
Wide & High of welding surface √ Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack ) √
High / Low (if any) √ Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films √
Review Defect based on Standard √
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding Under ground Ø 4"
Check During welding Under ground Ø 4"
Check After welding Under ground Ø 4"
Number of items inspected 20 Number of Items accepted 19
FINDING / NON COMPLY WORK:
repair film radiography U/G summary joint ( defect Porosity )
CORRECTIVE ACTION :
re welding joint repair ( Close ) tgl 8-9-24
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 8/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 8/9/2024 SR No#: ___SOUTH/DDY/250
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/9/2024 SR No#: ___SOUTH/DDY/251
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding under ground Ø 4"
Check During welding under ground Ø 4"
Number of items inspected 14 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/9/2024 SR No#: ___SOUTH/DDY/251
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 9/9/2024 SR No#: ___SOUTH/DDY/252
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 05
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 05 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
9/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Monitoring
Number of items inspected 4 Number of Items accepted 4
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 9/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 9/9/2024 SR No#: ___SOUTH/DDY/252
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/9/2024 SR No#: ___SOUTH/DDY/253
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
10/9/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging √
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check Pigging Under ground 4"
Number of items inspected 2 Number of Items accepted 1
FINDING / NON COMPLY WORK:
pigging stuck (Finding insert pipe under ground 4" there is wood with dimension 5 X 7 ) length 1 meter
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Re pigging result OK closes 10 - 09 24
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/9/2024 SR No#: ___SOUTH/DDY/253
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 10/9/2024 SR No#: ___SOUTH/DDY/254
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 05
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 05 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
10/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage Line Check
Welding consumable (E-7018) put in dryer and plug in
Welding machine is good condition Hydrotesting
Install wind sheild properly Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR 3. Pressurized as per steps
Alignment and straightness 4. Holding time as per procedure
Root Opening meet with WPS/PQR 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Wall thickness √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Wall thickness pipe existing for spot HOT TAP
Number of items inspected 6 Number of Items accepted 6
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
N/A
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 10/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 10/9/2024 SR No#: ___SOUTH/DDY/254
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/9/2024 SR No#: ___SOUTH/DDY/255
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 14
Ø 4 " PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 14 C C S
M C C S
DESCRIPTION OF JOB INSPECTED : ISSUE DATE E COMPLETED WORK
Y
N
11/9/2024 E ✘
O
Fabrication and install Flow line 4" S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding flow line Ø 4"
Check During welding flow line Ø 4"
Number of items inspected 15 Number of Items accepted 13
FINDING / NON COMPLY WORK:
NO install wind shield properly during welding
Wrap Vacpac electrode 7018 leaking
CORRECTIVE ACTION :
Install wind shield properly during welding ( closes ) 11-09-2024
Change Vacpac electrode 7018 not leaking ( Vacum )
EPCM-SM-QAC-FRM-CORP-9002 rev 1
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/9/2024 SR No#: ___SOUTH/DDY/255
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 11/9/2024 SR No#: ___SOUTH/DDY/256
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
11/9/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding after repair welding NDT ( radiography ) U/G Ø 4"
Check During welding after repair welding NDT ( radiography ) U/G Ø 4"
Number of items inspected 15 Number of Items accepted 13
FINDING / NON COMPLY WORK:
NO install wind shield properly during welding
Wrap Vacpac electrode 7018 leaking
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
Install wind shield properly during welding ( closes ) 11-09-2024
Change Vacpac electrode 7018 not leaking ( Vacum )
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 11/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 11/9/2024 SR No#: ___SOUTH/DDY/256
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : _ 12/9/2024 SR No#: ___SOUTH/DDY/257
SURVEILLANCE REPORT
Page __ of __
DISCIPLINE : WR NO : Project Name : Contractor PROJECT AREA :
NORT ✘ SOUTH
H
'Relocation and New Facility for new wells P_ 3B -
24 N & 3B - 14 Ø 4 " & 6" PT. BKP
Piping PT. BKP
M
C W A E
FI T HI
P ✘ D R P
Location : Area P_ 3B - 24 N & 3B - 14 C C S
M C C S
ISSUE DATE E COMPLETED WORK
DESCRIPTION OF JOB INSPECTED : Y
N
12/9/2024 E ✘
O
Fabrication and install Flow line 4" & 6" . S
INSPECTION CHECKLIST, SPECIFICATION, OR DRAWING USED AS REFERENCE:
ASME B31.4; API 1104; AWS D1.1; PHR-PPL-SPC-101800; PHR-PIM-SPC-103541,PHR - PP- SC-GG-001
INSPECTION CHECKLIST:
Preparation Y N N/A Y N N/A
Drawing (latest revision) √ Intallation
Approved WPS / PQR available √ Install Gasket and Bolt-nuts
Approved ITP available and implemented √ Install anti seize coumpound
Certified Welders √ All bolts extend completely through their nuts
Materials Handling and Storage √ Line Check
Welding consumable (E-7018) put in dryer and plug in √
Welding machine is good condition √ Hydrotesting
Install wind sheild properly √ Pipe Internal cleaning by Pigging
Review Test Package
Joints Fit Up Review Calibration tools and equipments
Tranfer Head Number 1. Warning sign and barricade
Cutting and Edge Preparation √ 2. Bolt Completely and tightening properly
Bevelling meet with WPS/PQR √ 3. Pressurized as per steps
Alignment and straightness √ 4. Holding time as per procedure
Root Opening meet with WPS/PQR √ 5. Release pressure as per steps
Cleanliness (free from oil, grease, scale, paint) √ 6. De-watering
Welding Under Ground Piping
Ampere and Voltage meet with WPS/PQR √ Placement of pipe in Trench
Back Fill Trench
Visual Inspection of Weldments
Surface Under Cut / Other Defect Punch-list
Wide & High of welding surface Finals Inspection and Punch List
Surface Cleaning (Slag, Spatters & Tack )
High / Low (if any) Others
Weld Repair (if any visual failed) QC contractor √
Review RT Film
Review Quality of Films
Review Defect based on Standard
OBSERVATION :
Check welder qualification
Check welding electrode
Check before welding after repair welding NDT ( radiography ) U/G Ø 4"
Check During welding after repair welding NDT ( radiography ) U/G Ø 4"
Number of items inspected 15 Number of Items accepted 14
FINDING / NON COMPLY WORK:
N/A
CORRECTIVE ACTION :
EPCM-SM-QAC-FRM-CORP-9002 rev 1
N/A
CORRECTIVE ACTION VERIFIED AND CLOSED BY:
Inspector: ____ Doddy Irwansyah # 202208015 Date: ____ 12/9/2024 Signature: _____________________
Person Notified of Deficiency:
Name: _____________________ Date: _____________________ Signature: _____________________
Reviewed by PBP - QAQC Lead:
Name: _____________________ Date: _____________________ Signature: _____________________
EPCM-SM-QAC-FRM-CORP-9002 rev 1
PT. Prosys Bangun Persada Quality Management System
Contract Number: SPHR00106A
Date : __ 12/9/2024 SR No#: ___SOUTH/DDY/257
Page __ of __
SURVEILLANCE PHOTOS
EPCM-SM-QAC-FRM-CORP-9002 rev 1
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