SUPERVISION REPORT DOCUMENT ATTACHMENT
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1 DOCUMENT ATTACHMENT
2 COMPLETION CHECKLIST No. DESCRIPTION DOC NO. Completed REMARKS Completed Available 1 Supervision Report For Preparation Work PRO01 2 Supervision Report For Grounding Works PRO02 3 Supervision Report For Shelter Foundation PRO03 4 Supervision Report For Shelter Installation PRO04 5 Supervision For Mechanical Electrical PRO05 6 Supervision For PLN Connection PRO06 7 Supervision For Additional Work (If any) PRO07 These completion Reports has been thoroughly checked and verified by PT. PROTELINDO PT. CONSULTANT Engineer, Project Manager Engineer, Project Manager Site Supervisor, Project Manager Date :
3 Preparation Work Inspection : Preparation Work Date : 1. General e a. Written permission to enter site is available 2. Site Clearing a. Removal of tree and disposal b. Relocate / Demolish or Dispose of existing facilities c. Debris, Waste and Rubbish Removal has been took place prior foundation works 3. Site Preparation a Zero Level has been defined and marked properly (topographical survey) d. Site Lay-Out for Construction is already set based on site condition e. Batterboard setting is done suround the working area and using the proposed materials 4. Site Cleaning after Construction Completed has been properly carried out. 5. Reminder All additional works shall be identified at early stage and shall be approved by PROTELINDO 6. es PROTELINDO Field Supervisors Supervision Report 1 o f 1 PRO01
4 Shelter / Outdoor BTS Foundation Inspection : Shelter / Outdoor BTS Foundation Date: : 1. Shelter Foundation Excavation : Width : Meter Height : Meter Total Length : Meter Stone Masonry : Sand fill 5 cm thick : Quality of stone used : Bottom width : cm Mortar grade B ( 1 : 5 ) : Top Width : cm Total Height : cm Sandstone backfill : e 2. Concrete Plate Re-bar placement : x - direction ( top and bottom) : Ø mm - mm y - direction (top and bottom) : Ø mm - mm 3. Finishing Plastering quality : Brand/Type of paint : Paint used should be for outdoor/wheathershields : Quality of workmanship : 4. e : PROTELINDO Field Supervisors PT. SARANA ARTHA LESTAR Supervision Report 1 of 1 PRO003
5 Mechanical Electrical Inspection : Mechanical Electrical Date: : 1. Panel Box (PDB) a. Dimension : x x (cm) (Powder coated electro galvanized steel sheet) b. Cover condition - Indicator lamp with Fuse (red, yellow, green) (R,S,T) - PDB Lock - Labelling with white or Chrome-yellow latering engraved on plastic protection panel c. Approved manufacture : Caturmukti/Dawamiba/Westindo/Indromitra/Prastiwahyu 2. Equipment in AC-PDB (Approved manufacture : Caturmukti/Dawamiba/Westindo/Indromitra/ Prastiwahyu/Euroseat/Panca mitra) a. Input MCB A, Phase KA Pcs (Brand as standard) b. ELCB A, 1 phase, type S, ma Tripping Brand as standard ( Pcs) d. Phase failure Alarm Relay 220V, A, Brand as standard ( PCS) e. Output MCB A, Phase KA Brand as standard ( Pcs) f. Output MCB A, Phase KA Brand as standard ( Pcs) g. Output MCB A, Phase KA Brand as standard ( Pcs) h. Output MCB A, Phase KA Brand as standard ( Pcs) i. Surge Arestor, OBO type V20-C/3 (MOV) + NPE FS-SU (Spark Gap) or Phoenix Contact type VAL MS 230(MOV) + BE/FM (Spark Gap) j. Timer, Brand as standard, 24 Jam k. Magnetic Contactor 20A, 2 unit 3 Phase (Brand as standard) l. Thermostat, 3A, temperature range degree Celsius with NO/NC out put contact m. Output Contact : NO/NC n. Contact Current : 3A o. Internal ACPDB wiring should use 16mm or 25mm based on connection between components p. Neutral bar of size 200 x 15 x 3mm made of copper with silver plated with 6 micron thick q. Grounding bar of size 200 x 15 x 3mm made of copper silver plated with 6 micron thick r. PVC Cable duct of size 45 x 25mm s. Bolts & Nuts should be of stainless steel for mounting all the components t. Acrilite see through cover to protect from direct contact. u. Cable Gland- 36mm-1, 16mm-2 9. All down drops shall be in concealed conduit or surface conduit e Supervision Report 1 of 2 PRO005
6 Mechanical Electrical Inspection : Mechanical Electrical Date: : 10. e : CONSULTANT Supervision Report 2 of 2 PRO005
7 PLN Connection Inspection : PLN Connection Date : Site ID-Site Name : Reference Drawing No : 1. KWH Pole Position 2. KWH Pole Condition a. Hot Dipped Galvanized Pipe with dop b. Dia. 3", Length 5 Meter 3. KWH Box, Brand a. Dimension : x x (cm) b. Galvanized Unistalt Clamp & Canal c. Bolts, Nuts, Clamps Hot Dipped Galvanized d. Painting (Powder coated electro galvanized steel) f. KWH Box Door Condition g. Cleanness h. Key 4. KWH Meter a. Condition b. PLN Capacity : VA c. MCB Capacity A, 1 Phase KA Brand as standard ( Pcs) d. MCB Capacity A, 1 Phase KA Brand as standard ( Pcs) e. MCB Capacity A, 1 Phase KA Brand as standard ( Pcs) f. Terminal Block A, 3Phase, TR 60, 8 Unit as standard g. Lightning Arrester with capacity x KA (10/350 μs, spark gap technology), fully coordinated capability and grounded with BCC mm2 should be bonded to neutral and grounding bar h. Panel padlock, Brand i. BC mm2 j. Outdoor Type Flexible Pipe k. Anaconda Sealtite 5. COS 3 phase + neutral, interlock able for manual changeover to diesel generator 6. 3 Phase Socket for Genset 7. Grounding Measurement Value < 1 Ohm 8. Cable Power a. Type and Dimension: (Supreme/Kabelindo/Kabel Metal/Jembo) b. Laying cm underground c. Galvanized Pipe Dia inch d. Connected to COS Panel e. The color code follow PUIL Standard (R: Red, S: Yellow, T: Black, Neutral: Blue) 9. Bolts, Nuts and Clamps e Supervision Report 1 of 2 PRO006
8 PLN Connection Inspection : PLN Connection Date : Site ID-Site Name : Reference Drawing No : a. Hot Deep Galvanize 10. es PROTELINDO Field Supervisor Supervision Report 2 of 2 PRO006
9 Inspection : Grounding Works Date: : 1 Collection Bar in Control Box e a. Collection Bar, Steel Galvanis Bar : 300 mm x 100 mm x 8 mm having 2x9 zig-zag holes ø12 mm2, placed properly, using insulator and stainless steel bolt & nuts, acceptable? b. c. Connection Collection Bar to Perimeter is using BC 70 mm2, acceptable? Steel Galvanis Bar is installed to Control Box (600 mm x 600 mm x 550 mm) using insulator and stainless steel bolt & nuts, acceptable? d. All Connection is using cadweld 3. Grounding Measurement b. KWH Box Ω c. Internal Grounding Ring Ω ohm ohm e. External Graounding Bar Ω (M i I t t E th R i t t h ll b l th (1) Oh 12. es ohm PROTELINDO Field Supervisor Supervision report 1of 1 PR002
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