MAINTENANCE RECORD FM-ME-9.

1-04/02-005

Unit Name : Centrifugal Pump Gunakan APD yang dipersyaratkan ( )

Unit No. : Multiple Bersihkan Tools & area sebelum dan sesudah pekerjaan ( )
Area : All area Pembuatan Permit To Work (PTW) ( )
Periode : Lakukan LOTO atau Barikade area jika perlu (Y/ N)

C Check condition / Test / Cleaning / Tightening Mengetahui Mengetahui Dikerjakan oleh

GL Greasing / Lubrication / Adding
R Repair / Change part / Service
Ex External service / Legislation test / Calibration

PM Number No. Items 3 Bln 12 Bln Standard C GL R Nilai Ukur Remark

FM-ME-9.1-04/02-005
1 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor ST….....
Strainer √ Tdk tersumbat TR….....
Pressure indicator √ berfungsi
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
2 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor RS…....
Strainer √ Tdk tersumbat ST….....
Pressure indicator √ berfungsi TR….....
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
3 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor RS…....
Strainer √ Tdk tersumbat ST….....
Pressure indicator √ berfungsi TR….....
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
4 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor RS…....
Strainer √ Tdk tersumbat ST….....
Pressure indicator √ berfungsi TR….....
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
5 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor RS…....
Strainer √ Tdk tersumbat ST….....
Pressure indicator √ berfungsi TR….....
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
6 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor RS…....
Strainer √ Tdk tersumbat ST….....
Pressure indicator √ berfungsi TR….....
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
7 Centrifugal Pump :
Motor unit √ √ Berfungsi R….......
Cables and connections √ Tdk terkelupas, tdk kendor S….......
Box terminal √ Tdk pecah T….......
Push button / switch control √ Berfungsi
Mechanical seal, bearing, gasket and coupling √ √ Bersih, Tidak sobek/ bocor RS…....
Strainer √ Tdk tersumbat ST….....
Pressure indicator √ berfungsi TR….....
Impeler, Housing, Shaft √ Bersih Tidak rusak/ Aus
Packing/gasket √ Bersih, Tidak sobek/ bocor

Note : √ = Ok X = Tidak Ok O = Sudah direpair

Note :