PT.

INDOTECH CITRA SINERGI

GEAR REGISTER
Client : PT. ATLAS COPCO NUSANTARA Register No. :
Inspection Method : Visual Inspection
Condition : P: Pass O/S: Out of Service C: Condemend R: Repair or Replace N/S: Not Sighted
Contact : Mr. Slamet Endro
Inspector :
Date of Inspection : Next Inspection : Current Inspection Tag : Blue

No Description ID No. ID Tag SWL Location Inspection Date Item Condition

CHAIN SLING
1 Chain Sling 10mm x 1.45mtr, 2 legs assy TC 9150-2 5.5 ton Workshop
2 Chain Sling 7mm x 1.32mtr, 2 legs assy TC 9150-1 2.6 ton Workshop
3 Chain Sling 16mm x 6.59mtr, 2 legs assy AR 2028 13.8 ton Workshop
HARNESS & LANYARD
4 Harness, Skylotec 279172-005 - Workshop
5 Harness, KARAM 0938 - Workshop
6 Harness, KARAM 0936 - Workshop
7 Lanyard absorber double web 0151 - Workshop
8 Lanyard absorber double web 0152 - Workshop
WEBBING SLING
9 Webbing Sling, 2mtr, Spanset Unsee 2 ton Workshop
10 Webbing Sling, 2mtr, Webster Unsee 2 ton Workshop
11 Webbing Sling, 2mtr, Webster Unsee 2 ton Workshop
12 Webbing Sling, 1.5mtr, Titan 60/57 1 ton Workshop
13 Webbing Sling, 4mtr, Titan 16/10 2 ton Workshop
14 Webbing Sling, 5mtr 85/15 1 ton Workshop

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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No Description ID No. ID Tag SWL Location Inspection Date Item Condition

SHACKLE
15 Bow Shackle, Screw Pin, CE DY 91 8.5 ton Workshop
16 Bow Shackle, Screw Pin, Crosby 50B 3.25 ton Workshop
17 Bow Shackle, Screw Pin, Crosby 50C 3.25 ton Workshop
18 Bow Shackle, Screw Pin, Crosby 50B 3.25 ton Workshop
19 Bow Shackle, Screw Pin, Crosby 5LC 2 ton Workshop
20 Bow Shackle, Screw Pin, Crosby 5LC 2 ton Workshop
21 Bow Shackle, Screw Pin, Crosby 5NS 1 ton Workshop
22 Bow Shackle, Screw Pin, Crosby 2KD 1 ton Workshop
23 Bow Shackle, Screw Pin, Crosby 5BH 1 ton Workshop
EYE BOLT
24 Eye Bolt M16, Crosby 2HD - Workshop
25 Eye Bolt M16, Crosby 2HD - Workshop
26 Eye Bolt M16, Crosby 2HD - Workshop
27 Eye Bolt M16, Crosby 2LC - Workshop
28 Eye Bolt M12, BX 21 09/12 0.34 ton Workshop
29 Eye Bolt M12, CE - - Workshop
30 Eye Bolt M12, CE - - Workshop
31 Eye Bolt M12, CE - - Workshop
32 Eye Bolt M12, Crosby 2LE - Workshop
33 Eye Bolt M12, Crosby 2KI - Workshop
34 Eye Bolt M10, Crosby 2KF - Workshop
35 Eye Bolt ½" N-2 - Workshop
36 Eye Nut ⅜" C15 - Workshop
37 Eye Nut ⅜" C15 - Workshop
38 Eye Nut ⅜" C15 - Workshop
39 Eye Bolt M10, Crosby 2KF - Workshop
40 Eye Bolt M10, Crosby 2KF - Workshop
41 Eye Bolt M8, Crosby 2KC - Workshop

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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No Description ID No. ID Tag SWL Location Inspection Date Item Condition

42 Eye Bolt M8, Crosby 2KC - Workshop

43 Eye Bolt M8, Crosby 2KC - Workshop
44 Eye Bolt M8, Crosby 2KC - Workshop
45 Eye Bolt 3/4" 2PD - Workshop
46 Eye Bolt 3/4" 2PD - Workshop
47 Eye Bolt AR 9052 - Workshop
48 Eye Bolt AR 9051 - Workshop
LINK BRACKET
49 Link Bracket 493-3939 4082 kg Workshop
50 Link Bracket 493-3939 4082 kg Workshop
51 Link Bracket 493-3939 4082 kg Workshop
52 Link Bracket 493-3939 4082 kg Workshop

Balikpapan,
Inspected by ; Acknowledge by;

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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CITRA SINERGI
GEAR REGISTER

Current Inspection Tag : Blue

Remarks

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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 Remarks

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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 Remarks

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. ID No. Capacity Test Date Reason for Failing
( Description / Code ) Pass/Fail
1 Compressor Air CA-01 20-Jan-2017 p
2 Grinder 1 HG-01 20-Jan-2017 P
3 Bor Duduk BD-01 20-Jan-2017 P
4 C. Hose CH-01 20-Jan-2017 P
5 Hose Crimping HC-01 HC-01 P
6 Extension Cable 1 EC-01 20-Jan-2017 P
7 UPS 1 UPS-01 20-Jan-2017 P
8 CPU 1 CPU-01 20-Jan-2017 P
9 Desk Fan VCL-02 20-Jan-2017 P
10 Printer EXT-01 20-Jan-2017 P
11 UPS 2 EXT-02 20-Jan-2017 P
12 Extension Cable 2 EXT-03 20-Jan-2017 P
13 Printer 2 EXT-04 20-Jan-2017 F Non brass material conductor
14 Extension Cable 3 EXT-05 20-Jan-2017 P
15 Extension Cable 4 EXT-06 20-Jan-2017 P
16 Printer 3 EXT-07 20-Jan-2017 P
17 UPS 3 EXT-09 20-Jan-2017 P
18 Speaker 1 EXT-10 20-Jan-2017 P
19 Air Conditioner 1 EXT-11 20-Jan-2017 P
20 Extension Cable 5 EXT-12 20-Jan-2017 F Non brass material conductor

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Page 7 of 25
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. ID No. Capacity Test Date Reason for Failing
( Description / Code ) Pass/Fail
21 Extension Cable 6 EXT-13 20-Jan-2017 P
22 Air Conditioner 2 EXT-14 20-Jan-2017 P
23 Printer 4 EXT-15 20-Jan-2017 P
24 Television 1 EXT-16 20-Jan-2017 P
25 Power Server EXT-17 20-Jan-2017 P
20-Jan-2017 P

Balikpapan, 27 June 2016

Inspected by; Reviewed by;

ALFRED FRENGKI G. SUMARDI

Inspector Operation Manager

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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Telp. : +62-8115300340, Fax : +62-542-878631
PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
f Portable Electrical Equipment (Visual Inspection)

Action taken / Recommendation

Replaced carbon brush

Replaced carbon brush

Replaced pin plug with 3 pin plug

Replaced pin plug with 3 pin plug

Replaced

Replaced

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Page 9 of 25
Telp. : +62-8115300340, Fax : +62-542-878631
PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
f Portable Electrical Equipment (Visual Inspection)

Action taken / Recommendation

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Page 10 of 25
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. ID No. Capacity Test Date Reason for Failing
( Description / Code ) Pass/Fail
1 Turbo Washer BD-01 21-Jun-2016 P
2 Sand Blasting 01 FAN-01 21-Jun-2016 P
3 Gerinda Duduk WLD-01 21-Jun-2016 F Outer Insulation peeled
4 Gerinda Duduk 2 GRD-01 21-Jun-2016 P
5 Compressor Air GRD-02 375 wat 21-Jun-2016 P
6 WalL Fan PLMP-01 21-Jun-2016 F Disconnection of Cable Conductor
7 Extension Cable VCL-01 22-Jun-2016 P
8 Hand Drill HGN-01 2000 wat 22-Jun-2016 P
9 Angle Grinder KTL ELC-01 275 wat 22-Jun-2016 P
10 Angle Grinder EXT WS-02 22-Jun-2016 P
11 Extension Cable 7 EXT WS-13 22-Jun-2016 F Power Switch malfunction
12 Hydraulic Pump MB-01 22-Jun-2016 P
13 Regular Voltase SB-01 1500 wat 22-Jun-2016 P
14 Power Supply EXT WS-01 22-Jun-2016 P
15 Printer OPMP-01 750 wat 22-Jun-2016 F Electric Plug not atached
16 Electric Cabinet OPMP-02 750 wat 22-Jun-2016 P
17 Fan Wall OPMP-03 750 wat 22-Jun-2016 P
18 Vacumm Cleaner OPMP-04 750 wat 22-Jun-2016 P
19 Extension Cable 8 BR HTR-01 3800 VA 22-Jun-2016 P
20 Fan 01 HTRQ-01 22-Jun-2016 P
 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. ID No. Capacity Test Date Reason for Failing
( Description / Code ) Pass/Fail
21 Wall Fan 02 TRQ WCH-01 13 wat 22-Jun-2016 P
22 Extension Cable 9 PWFC-01 22-Jun-2016 P
23 Heat Gun SC-01 550 wat 22-Jun-2016 P
23-Jun-2016 F
23-Jun-2016 F
23-Jun-2016 F

Balikpapan, 27 June 2016

Inspected by; Reviewed by;

ALFRED FRENGKI G. SUMARDI

Inspector Operation Manager
T. INDOTECH CITRA SINERGI
INSPECTION REPORT
ortable Electrical Equipment (Visual Inspection)

Action taken

Replaced/Repaired

Repair

Replaced

Atached Electric Plug

T. INDOTECH CITRA SINERGI
INSPECTION REPORT
ortable Electrical Equipment (Visual Inspection)

Action taken
 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. Serial No. Capacity Test Date Reason for Failing
( Description / Code ) Pass/Fail

1 UPS Manf. by APC 3B1413X03712 650 VA, 390 Wat 13-Jul-2016 P

2 UPS Manf. by APC 3B1221X38288 1100 VA, 660 Wat 13-Jul-2016 P

Balikpapan, 13 July 2016

Inspected by; Reviewed by;

ALFRED FRENGKI G. SUMARDI

Inspector Operation Manager

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Page 15 of 25
Telp. : +62-8115300340, Fax : +62-542-878631
PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
f Portable Electrical Equipment (Visual Inspection)

Action taken / Recommendation

After Repair

After Repair

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Page 16 of 25
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 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. ID No. Capacity Test Date Reason for Failing Action taken
( Description / Code ) Pass/Fail
WAREHOUSE
1 Air Conditioner AC 01 11-Aug-2016 P
2 UPS Manf. by APC UPS 01 390 W 11-Aug-2016 P
3 UPS Manf. by APC UPS 02 390 W 11-Aug-2016 P
4 Printer Manf. by HP Printer 01 480 VA 11-Aug-2016 P
5 Printer Manf. by EPSON Printer 02 120 VA 11-Aug-2016 P
6 Cutting Wheel Manf. by BOSCH Cutting Wheel 01 2300 W 11-Aug-2016 P
7 Cutting Hose Manf. by Baldor Reliance Cutting Hose 01 3200 W 11-Aug-2016 P
8 UPS UPS 03 11-Aug-2016 P
9 Cutting Saw Manf. by BOSCH Cutting Saw 01 11-Aug-2016 P
MEETING ROOM 1st FLOOR
10 Extension Manf. by UTICON Extension 04 2500 W 15-Aug-2016 P
11 Extension Manf. by HINOHIKARI Extension 02 2900 VA 15-Aug-2016 P
RECEPTIONIST AREA
12 Monitor Manf. by DELL Monitor 01 15-Aug-2016 P
OFFICE 1st FLOOR
13 Coffe Maker Manf. by SAIKO Coffe Maker 01 15-Aug-2016 P
14 Dispenser Manf. by SANKEN Dispenser 01 530 W 15-Aug-2016 P
15 Refrigerator Manf. by SHARP Kulkas 01 15-Aug-2016 P
16 Foto Copy Machine Manf. by Develop Mesin Foto Copy 1680 VA 15-Aug-2016 P

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
INSPECTION REPORT
Testing of Portable Electrical Equipment (Visual Inspection)

Customer : PT. ATLAS COPCO NUSANTARA

Item Condition
No. ID No. Capacity Test Date Reason for Failing Action taken
( Description / Code ) Pass/Fail

Balikpapan, August 18 2016

Inspected by; Reviewed by;

ALFRED FRENGKI G. SUMARDI

Inspector Operation Manager

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
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Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - DB OFFICE 02

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - DB OFFICE 01

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - DB WORKSHOP

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - DB WAREHOUSE

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - MAIN DISTRIBUTION

Panel Door cannot closed

properly

Easy to burn stuff around

the Panel area.

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - DB WATER FACILITY

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631
 PT. INDOTECH CITRA SINERGI
PICTURES OF VISUAL INSPECTION
PANEL - DB AIR CONDITIONER

Jl. Asoka Raya Blok G5 No. 3A Pesona Country Balikpapan Baru, Balikpapan 76114
Telp. : +62-8115300340, Fax : +62-542-878631