NO:PSS/DOC/2022/TBPST0010 ANCAR, SAMUDERA SHIPYARD DOCKING nie a TB. PANCARAN 311 PT, PANCARAN SAMUDERA TRANSPORT2 PT. PANCARAN SAMUDERA SHIPYARD ICARAN nN get Oe: Mente Sut sonreleepe Geary se ANOS 1 Boulevard Keopa Going td Nov art 6 Tel. s82 2129988704 Foe 162 2 29305782 SURAT KETERANGAN DOCKING Nomor: TRPSTOTO/SKD-PANCARAN 311/PS5I/2022 ‘Beysama surat ni menerangkan bah ‘Nama Kapal PANCARAN 311 emi / Over PT, PANCARAN SAMUDERA TRASPORT senis TUG BOAT Cass 8K ‘Ukuran Utama Keapal Panjang (LOA) 25 Meter “Tinggi (0) 375 Meter Lebar (8) 8 Meter GRTINRT 2 Gt Telah menjalani docking epair dgalangan kapal mk PT Pancaran Samucera Shipyard, sebega! Berkut apa! Masuk Galangan 20 Novernber 2021 Kapal Nai Dock 24 Novernber 2021 pal Torun Dock 18 Januar 2022 Kapa Selesai Pekerjaan Kapal Keluar Galengan Domitian kami sampoikan, dengan segele hormat atas perhatian dan kebjaksanaznnya kami ucapkan teria kasih oa 48 < PANeAt aT anion! SUKRE RAS URYARD Head of hipyareBS PT. PANCARAN SAMUDERA SHIPYARD PANCARAN Pee CoO it fie: Merra sou senrekrape Goteg D> 1 Bot og eg tar ap SSSTOT FO 22123885782 none BERITA ACARA (KAPAL SELESAIPERBAKAN) Pada har in, Seas tanga Delapan Solos Bulan Januar Tahun Ove Ribu Ove Puun Ova (18 Janvari 2022) yang bertandatangan dawah in Nama ‘ANDR! SUKMA RAMADHAN ebatan Head of Shipyard Perusahaan PT. Pancaran Samusera Shipyard Dalam alin bectindak untuk dan atas nama PT. Pancaran Samudera Shipyard ‘untuk selaniutnya dsebut YARD Nama ZAINUL ARIFIN aban ‘Owner Representative Perusahesn PT Pancaren Samadera Transport [alam haf berindak untuk can ats nama PT. Pancaran Samudera Transport, vang selanjinyadisebut OWNER REPRESENTATIVE ‘Dengan ini menyatakan dengan sebenarnya, batwa YARD telah menyerankan 1 (satu) unt kapel kepada OWNER REPRESENTATIVE, yang tela selesa deksanskan semua perbakanfdockg repair dengan dat-cata sebagai beret Nama Kapa PANCARAN 311 Type Tus BOAT Ukutan Panjang (LOA) 285 Meter Lebar i) 8 Mater ‘nga (0) 375 Meter GRIN 27 Gr Mesin 2% 1000 HP OWNER REPRESENTATIVE tian menerima ponyerahan 1 (eat) unt kapal dar YARD, yang telah selesaldaksanekan semus perbakanicocking pak eeeuaikesepekatan dalam repalet Demian beta acara ini buat dengan sebenamya untuk dapat dpergunakan sebognimana mestnys. yaro PT. PANCARAN 4S SHPYARD ‘OWNER REPRESENTATIVE PT. PANCARAN SAMUDERA TRASPORT = OpAN@ARAN como2 PT. PANCARAN SAMUDERA SHIPYARD PANCARAN Aco 0, Lf al rtp Elmar rt ce 1. BoutvoréKlopo Going Ad No Lento 6 Tap 62 21292857 BERITA ACARA (SERAH TERIMA DOCUMENT ) Pada hain, Seasa tanggal Delapan Belas Buin Januari Tahun Dua Ribu Dua Puluh Dua (18 Janae 2022) telah diserantermakan document berupa Docking Report TUG BOAT PANCARAN 311 ( Crginal)sebanyak 1 Rangkap [Nomor: TEPSTOTO/SKO-PANCARAN 31/PSSI2022 ‘Yang Manyerahian Nama ERLANGGA PANDU BRAMASTYA sebotan Project Officer Perusahaan PT Pancaran Semudera Shipyard Yang Menerima Nama ZAINUL ARIFIN sabetan (Owner Representative Perusahaan PT Pancaran Samudera Transport Document telah diserahterimakan dengan kondisi bak dan langkap. ‘Demiktah benta aca ni sbuat dengan sebenernya untuk dapat cipargunakan sebageimana mestny YARD ‘OWNER REPRESENTATIVE PT, PANCARAN "YARD PT. PANCARAN SAMUDERA TRASPORT CARAN ARS ZaINUL ARE Projet Ofieer ‘Owner Representative Page-62 PT. PANCARAN SAMUDERA SHIPYARD PANCARAN np 20, ly tel eanegus natn Tat bree 1 tera Ketpa Gad iAa Na 3 Lato 6 Tel BERITA ACARA {(SERAH TERIMA TUG BOAT PANCARAN S11 ) Pada har ni, Seloeatanggal Delapan Blas Bulan Januar Tahun Oue Ribu Dua Pulsh Dus (18 Januar 2022) yang beriandatangan dawah int 4 Name ERLANGGA PANDU BRAMASTYA baton Projet Officer Pereschaan PT. Pancaran SamuderaShipyars ‘Daler hain bertndak untuk an atas nama PT. Pancaran Samudera Sioyar, ‘untuk seaniunva disebut YARD 2 Nama ZAINUL ARIFIN “aban Ovmer Represertatve Perusaheen PT. Pancaran Samudera Trangport alam hal ini bertndak untuk den atas nama PT. Panceran Samudera Transport, ‘yang selanjtnya disebut OWNER REPRESENTATIVE Denn in menyatakan dengan sebenarnya, banwa YARD telah menyerahkan 1 (eat) unt kepa kepada OWNER REPRESENTATIVE, ‘yang tlh sles dioksanakan semua perbakan!Socking pai dengan data-aatasebaga bert 3 ‘Nama Kapal PANCARANS1 Type Tus BOAT karan Panjang (LOA) 285 Meter Lebar @) a Meter Tinga (0) 375 Mater GRIN 207 GT Meer 2x 1000 HP: ‘OWNER REPRESENTATIVE telah menorima penyerahan 1 (eats) un kapal drt YARD yang telah eoloca dakaanakan semua perbikan / ‘docking par dgalangan PT Pancaran Samusera Shipyard sesuai Ketepakatan dalam repr iat ‘cap Kons Kapa 1 Lambung Hu ond bak (solosa pengecatan ) 2 Sie Snal ond bak colosai pengecatan ) 53 Deck eternal ond bak (seeea pengocatan ) 4 Satan Propuel Longkap (Konda Bak) 5 Sete Hema LLengkap (Kona Bak) 6 Bolder Lengkap (Koni Sak) 7 Ze Anode Konda bars (42 pce) 8 Ban Daprah Lengkapsekeling Tug Boat (© Winch Jonghar Lengkap ( Konds! Bak & Bisa doperaskan ) Demian bers acara in buat dengan sebenamya untuk dapat dpegunekan eebagaimana mestnya2 PT. PANCARAN SAMUDERA SHIPYARD Fc 3 1. toe Gogo R20, tow Kul Kuta Kertanegra, Kelmanton Tm, ndoneso DANGARAN ned Ofee: Menra ot entre etope Cong ROE Seo 4 bowevard Kelp Gading A3 No. nto 6 ep. +6221 79385781 Fox +62 21 29385782 Sater > BERITA ACARA {FINAL INSPEKSI ) Pada hatin, Selasa tanggel Delapan Selas Bulan Januar! Tahun Dua Ribu Dua Puluh Dua (18 Januari 2022) Tela diakukan final inspeks!bersame pada TUG BOAT PANCARAN 311 antara pitak ower yang dvakli oleh Bp. ZAINUL ARIFIN dan pihak yard yang di wakll oleh Bp. ERLANGGA PANOU BRAMASTYA ‘Owner menyatakan bahwe pekerjaen perbalkan sudan selesal ot akan sesual dengan Ist pekerjaan yang ot ‘sepakati antara pihak galangan PT. PANCARAN SAMUDERA SHIPYARD dan pihak onner PT. PANCARAN SAMUDERA TRASPORT an kapal TUG BOAT PANCARAN 311 cinyatakanlayak untuk dloperasikan DDemikian beritaacara ini dbust dengan sebenamya untuk depat dipergunakan sebagsimana mestnya vyarD OWNER REPRESENTATIVE PT. PANCARAN Sat > PT. PANCARAN SAMUDERA TRASPORT (ARD ‘ZAINUL ARI ‘OMeae ‘Owner Representative Projet= EANCARAN a - 1 boulevard Reign Godin (83. Lan 6 ep, 28221 23355781 FO *62 21 29385782 2 PT. PANCARAN SAMUDERA SHIPYARD tr BERITA ACARA (Cleaning Void Tank ) ‘Selasa tanggal Delapan Belas Bulan Januari Tahun Oua Ribu Dua Puluh Dua (18 Januari 2022) Teiah selesaiclaksanakan pekerjean cleaning pada Chain Locker & Engine Room kapal TUG BOAT PANCARAN 311 Sotelah di lakukan pengecekan olsh ovmer representative, maka area Chain Locker dan Engine Room dinyatakan bersh DDemikian beritaacara ini dbuat dengan sebenamya untuk depat dipergurakan sebagaimana mestinya YARD ‘OWNER REPRESENTATIVE PT. PANCARAN SAYIDERA SHIPYARD PT, PANCARAN SAMUDERA TRASPORT sea BARA! Proj ERA SHIPYARD=" . ,,| DXVAdIHS VYAGNINVS NVEVONVa “Ld = (vauW ONILY1d3u) NOISNYdxa TISHS 290579 | ayog | __ANOGSNVEL VUSONAVE NVEVONVE "Ld ano Cees -lvosonL aL THERVEVONVE Taare wez'e © WH atte we: qWa waIsDI0d wvez a1 wg'@z WOT NOISNAWIG S1dIONIEd (sw revouncnascs (IR amnerno auvomurEswm TVAGIHS VaIONWS NVEWONVA “Id =aaa a SIRE 7 is RANSON ag Baa | aesse a vet yes tamara ‘TRIN REIT 9 HN ‘paraRTIRRRR Tm a NRT — aR RR OR arse ie ‘soneLk ie TJ T Felelld| 3] sls | me ware aS TTA EI Se pT IIT Sen ap MART ATOR lelelale|aus paras Toa aa a ane ‘Bie Bi seP a mE oa pen naar | ‘SMLHinoote sateg | T | RET ae T PTR RE ge 2 98 ¢ Tra Tag mCaBTOT ka wieswoae lal oR sald Swe awa 2 = 39) son 39) somBiSie) ee zie | | sige on gtotay Bao Be er TOG) Tag) am 39 Bony one) aR HRT a TAS) ‘aN | ‘os naae ua TBE RG eB S| TGERRPITIAW BDE ro 7 7 J ela el sl el el wal eel | lz|_ 2 ol es mRR URN a BUSS ATS RE SH HOTS TREAT RRIS ab SATIRE) a armeniaoar oes ramos uo wa wy Soro) ep> pr Pancaran Samudera Shipyard REQUISITION for INSPECTION PANCABAN 0 saptienniv i armweratitmeni i nen and ACCEPTANCE FORM or TB PANCARAN SIT REFERENCE REQUEST No. IR/TOPSTODIO/OOL lcuent PT. PANCARAN SAMUDERA TRANSPORT PROIECT CODE Jcuass a) INSPECTION/TEST DATE: @-Dec-21 lcaTecory ANCHOR & ANCHOR CHAIN INSPECTION/TESTTIME — : 09,00-10,00 PROJECT No, [REQUEST TO Dep Quality Contrat SECTION ‘aaTaC by lbesicnaTion ITEM TOBE INSPECTED "ANCHOR & ANCHOR CHAIN Description Reff. Drawing No. 1. Clearence Anchor Weight (2) 2. Clearence Anchor Chain Diameter (1) Please arrange for inspection/test to be performed on the following TICK F APPLICABLE DESCRIPTION RESULT [INCOMING MATERIAL INSPECTION TRANSFERING HEAT / BATCH NUMBER JT-uP /WELO PREPARATION JAR TEST/ VACUUM TEST / HOSE TEST/ HYDRO TEST*_ [sua BLASTING & PAINTING Measurement Check ‘ACCEPTED. Inspection Result Comments / Recommendation + Laporan Terlampir * Choose the appropriate requirement PT. Pancaran Samudera Shipyard APPROVED BY REQUESTOR (QC:INSPECTOR PLANNER ‘OWNER REPS DATE 4Dee-2 ‘eDec ad SIGNATURE Z (J NAME: ERLANGGA ‘ABDUL IINAN TMRIQBAL RAHMAN ZAINUL ARIFIN2 PT Pancaran Samudera Shipyard REQUISITION for INSPECTION ANGABAN —t=rcati tangata and ACCEPTANCE FORM Sr TR PANCARAN aT REFERENCE REQUEST Wo, > TRITBPSTOOIO/002 cunt FT PANCARAN SAMUDERA TRANSPORT PROIECT CODE cuass x INSPECTION/TESTDATE 30-Nov-2021 lcatecony PROPULSION SYSTEM INSPECTION/TESTTIME — : 99,00:10.00 PROIECTN, REQUESTTO Dep OualityContral SECTION ‘CALOC By DESIGNATION TENA TORE INSPECTED PROPUISION STEM Description elf. Orawing No. 1. Cearence Rudder Stock ower Bearing / Bottom Pinte (2) 2 Clearence Rudder Stock Neck Bearing (2) |3. Clearence Propeller Shaft AFT (2) |4. Clearence Propeller Shaft FWD (2) Please arrange for inspection test to be performed on the following TICK IF APPLICABLE DESCRIPTION Res incon MATERA STON [TRANSFERING HEAT / BATCH NUMBER <7 sani Fre / wen oaePaeaTion i 7 lBACK GAUGING INSPECTION rt nae iC /ISUAL | WELDING IP a [NON OESTRUCTVETESTNOM: RT, PU, > | JMSUAL/ ANAL WSPECTION STRUCTURE)” aa E Ie Test vacuum Ts 7 WYORO TEsT* aie [vSUAL BASTING & PAINTING (ToteaRence cnec: ‘ACCEPTED inspection Result Comments / Recommendation = Laporan Clearance terlampie * Choose the appropriate requirement DATE 30-Nov-21, 30-Nov-21 TT I T Tee a a diB PT Pancaran Samudera Shipyard REQUISITION for INSPECTION PANCABAN steak it enaeprtatmtan ut nn and ACCEPTANCE FORM SH Te PANCARAN 31 REFERENCE REQUEST No, + 1RVTBPSTOOIO7003 [cuenr 07. PANCARAN SAMUDERA TRANSPORT PROJECT CODE : Icuass ex! INSPECTION/TESTDATE —; 28-Dec-21 lcaTeGorY GENERAL OUTFITTING INSPECTION/TEST TIME 910.00-11.00 PROJECT No. REQUEST TO Dai ‘Conttal SECTION > QAZOC by DESIGNATION ITEM TOBE INSPECTED Description Reff. Drawing No. 1. Hand Railing (Bridge deck, Top deck) 2. Stay Bulwarks Main Deck 3. Eyolug for Tyre Fender |4. Mud Box for Chain Locker Please arrange for inspection/tst tobe performed onthe following TICK IF APPLICABLE DESCRIPTION ReSUT Income ware RANSFERING HEAT /axTeH Wi 3 / WELD PREPARATION [asus rua. nsron(sucrURe)* Jn Test vACUUNITEST/ wos Test HYORO TEST omens spec Inspection Result Comments / Recommendation Crack pada araca bulwarks ~Ketok sag /kerak las * choose the appropriate requirement PT. Pancaran Samudera Shipyard APPROVED BY REQUESTOR ‘OCANSPECTOR PIANNER ‘OWNER REPS DATE 28-Dec2i, 28:Dec-2 ; a eo | Wl NAME ERLANGGA P. TABDULJIHAN TMIQBAL RACHMAN ZAINULARIFIN SIGNATUREs S PT Pancaran Samudera Shipyard REQUISITION for INSPECTION EARS AION toa ceeatton tutta keranepnacatiantn Tir ndaneda and ACCEPTANCE FORM (sai TB PANCARAN 3H REFERENCE REQUESTNo, > 1R/TBPSTOOIO/00a lcuent PT, PANCARAN SAMUDERA TRANSPORT PROJECT CODE ciass Ki INSPECTION/TEST DATE 27-Dec-2021 |caTecory HULL STRUCTURE INSPECTION/TESTTIME — : 16.00-17.00 PROJECT No. REQUEST TO Dep.Quallty Control ‘SECTION ALOE By DESIGNATION, [TEM TOBE INSPECTED: Description Reff. Drawing No. |. REPLATED AREA AT KEEL AREA AFT. 2, REPLATED AREA AT FRESH WATER TANK AFT. (PS) 3. DOUBLING BOTTOM AREA AT STEERING GEAR COMPT. (SB) |4. REWELDING AT HAWSE PIPE (PS) Please arrange for inspection/test to be performed on the following : TICK IF APPLICABLE [DESCRIPTION RESUTT [Income MATERIAL RSPECTION TRANSFERING HEAT / BATCH NUMBER JasckcaucinsinsrecTion [sua weionic mension GrUCTURES [MSUAL FINAL INSPECTION (sTRUCTURE}* [VACUUM TEST * [omens (ro spect inspection Result Comments / Recommendation -Undercut pada pengelasan doubling dan dikil plat Pin hole pada botton AFT ps = Laporan vacuum test terlampir * Choose the appropriate requirement tea nae od OTT aU oC TO SEATS STS DATE 27-Dec-21, 27-Dec-2i L stonarne a ( A | NAME ERLANGGA P.. ‘ABDULIIHAN MIGBAL RACHMAN, ‘ZAINUL ARIFINZ —_erancaran Samnudera Shipyard PANCARAN — ‘Ltorcntion ti tixarenepraainan Ti: once REQUISITION for INSPECTION and ACCEPTANCE FORM sai TB PANCARAN SEI REFERENCE REQUEST No. IR/TBPSTOOI0/005 lcuent {PT PANCARAN SAMUDERA TRANSPORT PROJECT CODE Jc.ass, xt INSPECTION/TEST DATE: 2Jan-2022 JCATEGORY ——:_—PIPING SvSTEM INSPECTION/TEST TIME: 09.00-11.00 PROJECT No, : REQUEST TO Dep. Quality Control SECTION @azac By DESIGNATION [TEN TOBE INSPECTED Description 1. INLET M/E & A/E (PS & 8) 2. OVERBOARD M/E & AVE (PS & SB) 3. INLET & OVERBOARD COOLING GEARBOX (PS & $8) Is. ows sysreM 6. FRESH WATER DISTRIBUTION PIPE 7. BYPASS GENERAL SERVICE Reff, Drawing No, Please arrange for inspection/test to be performed on the following TCKIF APPLICABLE DESCRIPTION RESUT INCOMING MarEmAL naPECTON TRANSFERING HEAT /aaTCn NUMBER z is Inv. / WELD PREPARATION 7 “ACCEPTED eACK GAUGING SPECT [WSuAL/ WELDING iNspccTON ferRUCTURE)P ACCEPTED INON DESTRUCTIVE TESTINOT): RT, MPI PT UT, = JISUAL / FINAL INSPECTION (sTRUCTURE}® Jan TesT/ VACUUNW TEST / HOSE TEST/ HYORO TEST* lorens(rospectyy inspection Result Comments / Recommendation Welding overall oke * Choose the appropriate requirement PT Pancaran Sarmudera Shipyard ‘APPROVED BY REQUESTOR ‘OCINSPECTOR OWNER REPS OWERREPS DATE 2an-22 Pan-22. sarin La a NAME ERLANGGAP. ‘ABDULIAAN MUIQBAL RACHIMAN ZAINUL ARIFINa PT Pancaran Samudera Shipyard REQUISITION for INSPECTION PANCARAN tos coattoa tau mt teanepeataimantan Tm none and ACCEPTANCE FORM [sar TB PANCARAN 31 REFERENCE REQUESTNo. = 1IR/TBPST0010/005 Icuent PT. PANCARAN SAMUDERA TRANSPORT PROJECT CODE cuass 2 aK! INSPECTION/TEST DATE —: 3.Jan-2022 ICATEGORY PROPULSION SYSTEM INSPECTION/TESTTIME = 09.00-10.00 PROJECT No. REQUEST TO Dep Quality Control SECTION ‘aaTac By DESIGNATION TEN TOBE INSPECTED Description Roff. Drawing No. 1. SHAFT DEFLECTION P5/SB 2. NDT SHAFT AND PROPELLER PS/SB 3. BALNCING PROPELLER PS/SB Please arrange for inspection/test tobe performed onthe following TICK F APPLICABLE DESCRIPTION aur IRON MATERIAL ETON anf Hear/ arch NUMER nr-u / wEvo Preanarion AEX GAUGING iSPECTIN [VISUAL / WELDING INSPECTION {STRUCTURE}* v Now DESTRUCTIVE TST NOM: RMF. UT. * ‘ACCEPTED [VISUAL / FINAL INSPECTION (STRUCTURE)* [AIR TEST/ VACUUM TEST / HOSE TEST/ HYDRO TEST * MEASUREMENT CHECK (SHAFT DELECTION P5/58 AND BALNGING PROPELLER PS/S8 ‘ACCEPTED [inspection Result Comments / Recommendation -Laporan Shaft deflection and Blancing terlampit = Report on PT. PINTEK * choose the appropriate requirement PT, Pancaran Samudera Shipyard PPROVED BY REQUESTOR ‘QC INSPECTOR OWNER REPS OumneR ners . ees cf] tue NAME ERLANGGAP. ‘ABDULIINAN. MLIQBAL RAHMAN ZAINULARIFIN= PT Pancaran Samudera Shipyard REQUISITION for INSPECTION PANCARAN Jeers iv acinar oes and ACCEPTANCE FORM SHIP TB PANCARAN 311 REFERENCE REQUEST No, > IR/TBPSTOOI07007 lcuent PT, PANCARAN SAMUDERA TRANSPORT PROJECT CODE cuss °x) INSPECTION/TESTDATE 15-Dec-2021 lcaTecoRy PIPING system INSPECTION/TESTTIME — 15.00-1 PROJECT No, REQUEST TO Dep. Quality Control SECTION ‘aaac By DesicnaTion TEM TOBE INSPECTED Description 1. UII KEKEDAPAN VALVE Reff. Drawing No. Please arrange for inspection/test to be performed on the following. TICK IF APPLICABLE DESCRIPTION ReSuT inoue MATERA PESTON eansFERING HEAT /arcH NUMBER |e we paemanarion pace Gavin mspection ~ [VISUAL / WELDING INSPECTION (STRUCTURE}* NON DESTRUCTIVE TEST NOT) mT, [sua WAL sPéTON srBUCTURE)> HYDRO TEST (am) [OTHERS (Toc) “ACCEPTED inspection Result Comments / Recommendation ~Tidak ada kebocoran * Choose the appropriate requirement a iS (bpsPT Pancaran Samudera Shipyard os Gaga Lo as ttl Kertanegareaineta Tn indonesia =e ICABAN REQUISITION for INSPECTION and ACCEPTANCE FORM SHIP Ta PANCARAN 311 REFERENCE REQUEST No, 1R/TBPSTO010/008 Icuenr PT. PANCARAN SAMUDERA TRANSPORT PROJECT CODE Iciass. 2 BK INSPECTION/TEST DATE: 27-Dec-2021, lcarecory PROPULSION SYSTEM INSPECTION/TESTTIME —:15.00- 7,00 PROJECT No, REQUEST TO Dep Quality Control ‘SECTION © @azac By DESIGNATION fe TOBE InsPECTED: Description Reff. Drawing No. 1. CONTACT FITT 5/58 Please arrange for inspection/test to be performed on the following DESCRIPTION. RESULT TICK IF APPLICABLE. cova waTeRIA WPETION RaNSFERING HEAT / BATCH NUWBER JFo-uP/WeLo pranarion — ence caucins mspecron DING INSECTON (STRUCTURE? JETIVE TEST (NOT T, MP, PT, > JMSuAL IMAL NSPECTON(TRUCTURE}® HYDRO TEST * | 8 BAR) oe lorwERs contacter) ‘ACCEPTED inspection Result Comments / Recommendation Laporan terlampir meme | age (dlBa PT Pancaran Samudera Shipyard REQUISITION for INSPECTION PANCABAN otsunt in ut etneprtsnana tse and ACCEPTANCE FORM oT © TBPANCARAN3i1 REFERENCE REQUEST No. > IR/TBPSTOOIO/009 lcuent DT PANCARAN SAMUDERA TRANSPORT PROJECT CODE lcuass an INSPECTION/TEST DATE: 6-Dec-2021 lcaTeGoRY BLASTING INSPECTION/TEST TIME —: 99.00 LT PROIECT No, [REQUEST TO ‘Dep.Quality Control ‘SECTION aazac lav DESIGNATION TEM TOBE INSPECTED ‘BLASTING Description: Reff. Drawing No. |- BLASTING UNDERWATER. BLASTING TOPSIDE & EXTERNAL BULWARK Please arrange forinspection/test to be performed on the folowing “TICK IF APPLICABLE DESCRIPTION. RESUTT [COMING WATERALINSPEGTION [TRANSFERING HEAT / BATCH NUMBE J-uP/ weLo PReraramion JNON DESTRUCTIVE EST NOTE: AT, MPLPTUT, = Visual FINAL NSPECTION STRUCTURE | vistiaL BLASTING section Result Comments / Recommendation Founded some flash rust/rusty area and area need to grinding on minor area, {QC fully advice to do repair and re inspect is required. Re inspection and final inspection has conducted together Owner rep's, as the result is satisfying, * Choose the appropriate requirement I Pancaran Semudera Shipyard APPROVED EY REQUESTOR ‘OCANSPECTOR PLANNER Owen REPS DATE —= | -| (i | NAME. ERLANGGA WARYU MALHAKIM | ___ MIJQBAL RACHMAN ZAINULARIEIN2 PT Pancaran Samudera Shipyard REQUISITION for INSPECTION PANCABAN o/c ov ets emeattatnTnseons and ACCEPTANCE FORM Sa TE PANCARAN ST REFERENCE REQUEST No. > IR/TBPSTOOIO/OI0 icuent PT. PANCARAN SAMUDERA TRANSPORT PROJECT CODE. cuss 8K INSPECTION/TEST DATE = 6-Dec-2021 IcaTEGORY PRINTING INSPECTION/TEST TIME: 99.00 1T PROIECT No. REQUESTTO Dep Quality Control SECTION ‘aazac By DESIGNATION [TEM TOBE WSPECTED. PAINTING [Description Reff. Drawing No. - PAINTING UNDERWATER - PAINTING TOPSIDE & EXTERNAL BULWARK Please arrange forinspection/test to be performed on the folowing : TICK APPLICABLE DESCRIPTION RESULT C 1 ——— sean [cone WATERAL INSPECTION [TRANSFERING HEAT / BATCH NUMBER Jr-ur/weLo PREPARATION — Jsxcx Gauci nsPECTON [sua weLoins msPecTON (sTRUCTURE)” INON DESTRUCTIVE TEST (NDT): AT, MPL PT, UT, > _ [sua (rina insrecTion(sraucruRE)* lan rest/v sua. pan inspection Result Comments / Recommendation Founded some miss coat, low DFT, paint sagging & water matk on minor area, {fully advice to do repair and re inspect is required Re inspection and final inspection has conducted together Owner reps, as he result satisfying. * Choose the appropriate requirement It= LEAK TEST PAN REPORT Date [29 Desember 20m LO onter cove renerna score oF CO ewe wera EE] excxcnmns Jexmmnarion 7] eooerrer LE] eraneowei umrem zo1so [=] sun 1 suce wera cm on CO omer: leacresr To emcresr EE] anresr lOwnER PT. PANCARAN SAMUDERA TRANSPORT Date of Inspection = 729 DESENBER 2021 Jourraceconoiron EY] weiss EE] crounoruuew Jsmceorenm — FX] arenwerono FE] arrenironcsrane lweionsenccess O} craw BO om CO omer, DO omer: CO omens a wevoeaer TO omen: OI vcun rest ) , > PREPAREDBY, ‘cHECRED SY rd “RSDUL THAN ‘ERUNGGAF ZAROC ART QC inspector Project Oficer ‘OwnerB VACUUM TEST = (oad T_PANCARUN SAVUDERA TRANSPORT — [Locator DRYDOSK, PANCARAN [Pret TE PANCARAN ST? Dee No toenail FIT CENTERE Date Dasara ET ‘VACUUM TESTeS VACUUM TEST = lower T-PANCARAN GAMUDERA TRANSPORT —[[acabon DRVBOR PANCARAN Proper Ta PANCARANSTT Bos = mrcmnneahe frat ENTS oa i Desenbe VACUUM TEST VACUUM TESTLeak Test How Time lPRessURE Co arrest 60 MENIT 6 Bar ‘STARBOARD TD Wororest a LEAK TEST eet CANSABAN REPORT = “a. PANGARATT Sanna re 1 omer « ) pa eow. sian ERLANGA, ZANUL REN. OC espe Projet Oc ooBaas MAIN CODE | 5S | = VESSEL TB. PANCARAN 311 PANCARAN ARTICLE RUDDER SHAFT CLEARANCE NO. ORDER CONDITION: BEFORE REPAIR JNSPECTION 59. Nov-2021 unit : STARBOARD & PORT SIDE DATE C 7 C mem grater Sock: 1250 Max clearance: 325 mm (Bk) omens neocnesemes 1 FL OTTO PRITLE @ Bottom Pintle: 115 mm | ! i te, Maxclearence: 5.18 mm (BKi) | aston | l | PORTSIDE STARBOARDSIDE | RUDDER STOCK BOTTOM PINTLE RUDDER STOCK BOTTOM PINTLE | FP FP, FP FP 3 15 25 12 PS | $5 | Ps se | | Ps se | Ps $B | De 125 | 68 | a7] (48 25 | 42 | 35 05, a7 05 a 7 oy rg we REVIEW BY, INSPECTED BY, VERIFIED BY, Ea PRODEMPOMicen a AHIPYtON AR. oti SRE| BS MAIN CODE = VESSEL TB. PANCARAN 311 PANCARAN JARTICLE RUDDER SHAFT CLEARANCE NO. ORDER CONDITION: AFTER REPAIR NSPECTION 1 jan-2022 UNIT : STARBOARD & PORT SIDE. DATE | 7 rm) SS : a © Rudder Stock: 125 mm ee | Max clearance: 3.25 mm (Bk!) 3 porese( | \eanacane | ox pesans NE | j ores i sorromenmne a a> ee ec i i a Max clearance: 5.15 mm (Bk) 1) Se | I | TLD corronrnnce | PORTSIDE ‘STARBOARDSIDE | RUDDER STOCK BOTTOM PINTLE RUDDER STOCK BOTTOM PINTLE FP FP 15 18 0 18 | (ps. | 8B | PS | $B | | PS | SB | PS | $8 o7 a) os | [0s 15 | 05 05 ho | | | 05 03 2 0 AE > P P ' REVIEW BY, INSPECTED BY, VERIFIED BY, | aa - ae N PRODELPoPticeR L |== IMAIN CODE : | = VESSEL ‘TB, PANCARAN 311 PANCARAN JARTICLE CLEARANCE SHAFT PROPELLER |No. oRDER CONDITION: BEFORE REPAIR Paes 30-Nov-21 luni STARBOARD & PORT SIDE | | | V | — | PORTSIDE STARBOARDSIDE Shaft = 178 mm @ Shaft = 178mm | AFTER FORWARD AFTER FORWARD | Top Top Top Top } 2: 3 34 | | [es | sp | Ps | se | | ps | se | Ps | $B | [os os [14 | [aa 22 [09 18 | | | | | 0 05 vs 7 | Bottom Bottom Bottom | [eax Clearance 4.78 mm Max Clearance: 4.78 mm | | | REVIEW BY, INSPECTED BY, VERIFIED BY, |_jnon | PROJECT OFFICER iL “OWNER SURVEYOR23 MAIN CODE = ]VESSEL TB. PANCARAN 311 PANCARAN JARTICLE ——: CLEARANCE SHAFT PROPELLER NO. ORDER CONDITION AFTER REPAIR Seem 11-Jan-22 UNIT : STARBOARD & PORT SIDE | PORTSIDE STARBOARDSIDE @ Shaft = 178 mm G Shak = 178mm AFTER FORWARD AFTER FORWARD Top. Top Top Top | 15. 12 1 2 | Les. se | Ps | sa | | ps | sp | Ps 8B | [os os | 1 o7 | [45 | 06 | 06 1 0 05 0 0 Bottom Bottom Bottom Bottom Max Ciearance :4.78 mm IMax Clearance : 478 mm REVIEW BY, INSPECTED BY, VERIFIED BY,zs MAIN CODE a VESSEL ‘TB PANCARAN 311 PANCARAN JARTICLE SHAFT DEFLECTION NO, ORDER CONDITION: AFTER REPAIR ee 03 JANUAR 2022. {UNIT STARBOARD & PORT SIDE AMOLEROTATON ug ee aoe ea ‘0 “fF ‘ m5 Ae ater “6k eof wl = ROLLER BEARING ROLLER BEARING PORTSIDE STARBOARD SIDE ANGLE DIAL “ANGLE DIAL ROTATION | 1 2 3 4 5 6 ROTATION | 1 2 3 4 5 6 o 0 oO 0 0 0 0 o 0 0 0 0 0 0 45° +0,21| +0,46 | -0,06 | +0,05] +0,20] +0,20, co 0,08 | +0,18] +0,04] -0,15 | -0,30 | -0,11 90° 40,06 | +0,60] -0,05 | +0,10] 40,17] +0,18) 90" 0,01] 40,21] +0 | +0,09] -0,40 | -0,11 135" -0,49 | +0,19] 40,06} +0,16] -0,19 138" 0,01 | +0,26} -0,02 | +0,05] -0,32 | -0,09 180" 0,50] -0,09 | -0,06 | +0,15] -0,35 180" 0,09 | +0,32| -0,50 | -0,40 225" +045 | 40,55] -0,16 | +0,20] -0,36 225° 0,05 | +0,20| 0,17 | -0,22 270" 40,36] +0,60] -0,21 | -0,50 | -0,34 270" 0,02 | +0,05) 0,22 | -0,33 35" 40,10] +0,22| -0,12| -0,07 | -0,20 315" 0 [009 oO [016 Remark REVIEW BY, INSPECTED BY, VERIFIED BY, Tat PROD HPfcee ee,PANCARAN SAMUDERA SHIPYARD MAIN CODE VESSEL TB PANCARAN 311. JARTICLE BALANCING PROPELLER NO. ORDER CONDITION: AFTER REPAIR eee SJan-22 UNIT STARBOARD & PORTSIDE DATE ( \ PORT SIDE STARBOARD SIDE ROTATED RESULT ROTATED RESULT [Blade 1 in bottom BALANCE, Bade 1 in bottom BALANCE, [Blade 1 & 2 parallel inbottom | BALANCE [Blade 1 & 2 parallel in bottom | BALANCE [Blade 2in bottom BALANCE, Blade 2in bottom BALANCE [Blade 2 & 3 parallel in bottom | BALANCE Blade 2 & 3 parallel inbottom | BALANCE Bade 3 in botiom BALANCE Blade 3in bottom BALANCE, [Bade 3 & 24paralelin bottom | BALANCE Bade 3 & 24paratel in bottom | BALANCE Blade 4 in bottom BALANCE Blade 4 in botiom BALANCE REVIEW BY, INSPECTED BY, VERIFIED BY, erOse Fd i of SOR ORea a MAIN CODE in a ail VESSEL TB. PANCARAN 311 | SAUDER” ARAN ARTICLE ©: CONTACT FIT TAIL SHAFT |No. ORDER CONDITION: DOCKING REPAIR eee 2-Deo-2t unit : STARBOARD & PORT SIDE | portsie| A | B | c IstaRBoaRO] A | B | Cc Fwo | wa] wa | 80% Fwo | NA | NA | 60% | art | ase | | NA art | 90% | = | NA | | Remark REVIEW ge INSPECTED BY, VERIFIED BY, ca ee fatMAIN CODE Za> a VESSEL TB. PANCARAN 311 | PANCARAN [oar | SAMUDERA SHIPYARD a CHAIN MEASUREMENT NO. ORDER CONDITION: DOCKING REPAIR INSPECT ISPECTION 4 60-91 UNIT STARBOARD & PORT SIDE DATE B oo | —u4 | COMMON LINK | RANTAI JANGKAR | KIRI KANAN, | ‘SEGEL 1 2 3 | KETERANGAN | 1 2 3__| KETERANGAN | A 21.00 [7.50 | 1850 20.00_[ 778.00 [79.00 {a 3 | 2200] 21.00 | 1900 Bak 1800 | 1940 [1960] eAk Rata’ 21.50 2125 18.75 19.50 18.70 19.30 A 21.20 21.40 21.00 19.50 20.00 18.40, a [8 [2140 [2450 _[ 2000 Bak 7930_| 2050 | 1950 Bak Rata? 21.30 245 20.50 19.40 20.25 18.95 A 20.00 20.75 20.60 18.75, 19.60 19.50, ja B 2060 [21.10 [21.50 Bak 7670 | 7980 [1980 Baik | Rata’ 20.30 20.93 21.05 18.73 19.70 19.65 A 20.90 21.00 20.50 19.50 18.50 18.50 B 20.50, 20.00 19.50 Bak 18.00 18.50 19.40 Bak | Rat#_[ 7070 | 7050 | 2000 18.75_| 18.50 | 1895 | 19.5 25 2 20.4 205 19.3 || v. (raters [21 | i95 Baik 25 | 215 | 195 aK 19.125 21.25 19.75 20.45, a 194 | Remark : Over all masih memenuhiaturan dari aturan BKI 16.00 mm UKURAN STD WEAR LIMIT | 2 mm) 12% | 19.36 mm| | | 12% INSPECTED BY, VERIFIED BY, PROJECT OFFICER “OWNER SURVEYOR42 PT. PANCARAN SAMUDERA SHIPYARD Per BLASTING AND PAINTING INSPECTION REPORT PANCARAN SAMNOENA SHPARD [Poject Name — [TS PANCARAN S17 Repo No perso i component sar at Prec ae ‘Surface Preparation /Cleenina_|[ V ] BLASTING. {_Jpower-Tooung (_Jnvoro yermng [Sanaa Caring [saz [Types ofAbresve [Sica Sana Press -O- Fim Mion [rea inepecied [UNDERWATER (00% [COMPLETED ——] [sonster (ea inspected BATS o% [sist Prone saxon [saa Proms |(Ataon Press -O- Fim) Ataen Press - - Fi) Attach Press -© - Fi ) [Campiston of Cesring Date TRIO Hime ooo TA PAINTING ‘Coal Prd Coat Tito Pant wenstaaurer JOTUN PANT [ype errant JOTAWASTIC 807A featch No. (A) @ pevooss.1 | 26706007 [Type of Thinner JOTUN THINNER NOT7 [ston No i772 [DP Crar Temp c7RH wel we 79% | [Sutace Temp 30 [sin Dae Tine ‘raat | co owiTA [Wer /DFT Wirone 75 inspected by ‘GG Pant Rep And One Rep [Reman : [This ie to cary thatthe sbove Rems have been inspected and accepted by the Paint Representatives [coMPANY PrP PAINT REPRESENTATIVE ‘OWNER REPRESENTATIVE For [sionaTuRE ; 7| INANE WASTU MAL RAKING ZORTRFLT AR NUL ARTE [DATE2 PANCARAN EahADERA SPARS PT. PANCARAN SAMUDERA SHIPYARD BLASTING AND PAINTING INSPECTION REPORT [Proje Name — [TS PANGARAN'STT [RepaitNe eae Date, rertzrenet [Component ant Nez Project Surface reparation Clearing _|['V ] BLASTING. (_Jrower-rooinc CJ nore sernve [Standard of Caring [sazo [Types of Abrasve [Sica Sana ess -0- Fim Micrometer 0 [ea inspecied fTOPSibE (G03)7 COMPLETED [Bomar [ea inspected BATE % tes Prom [saa Prone Bias rote tach Press -O- Fim) tach ress -O- Fim) |Atack Press -O- Fim) (Campiaion of Caaning ate TaRBEOAT tine —=0a D0 WTA PAINTING Tei Goat Prdcoat Bra Goat Paint Manutociurer JOTUN PANT Hype of Paint JOTAMASTIC 80 AL Beteh No (a) ® 2610088-1 2570600-1 [Type of Thinner JOTUN THINNER NO 17 Batch No, BIST [DP C/A TemperR wo] a6 79% [ [Surace Temp © 3S [Sano Tine yerzneat | OacoWiTA [Wer 7 DFT Merone Te nspectec by a ‘GG Pant Rap And Owner Rep [Remarks : [This isto cortty that the above tes have boon inspected and accepted by the Paint Representatives coma 7 PANT REPRESENTATIVE | — OWNER REPRESENTATIVE SIGNATURE biel Ina WEE ZOCRFTA ZANICARER ATEBS — PANCARAN EAADERA SARS PT. PANCARAN SAMUDERA SHIPYARD BLASTING AND PAINTING INSPECTION REPORT ars RRENONT apa aa csp Bae Pea oat — ‘Surface Preparation /Cesnina [LV] BLASTING (Cleower rooune (_Jworoverins aa a saa SE a pena ER OEE RT ROTATE a 2 ee ss oe a peace eee oe acres Baresi a coer — fr a — PANTING ia — ica Paani a # eam aaa paae wa a oe Soe a ae JOP Ci Air Temp CY RH% 25°C Exod 79% a Sata ie ae | Serre os aie Seana fons: sotceeaan ace tot neetieeinn aistacre ature — = FART ERESETATE | San RATE [SIGNATURE : _ ra TaN ee ee2 PT. PANCARAN SAMUDERA SHIPYARD BLASTING AND PAINTING INSPECTION REPORT PANCARAN EXADERA Se ARS [Pigject Name —[T8 PANCARANSTI Repeat Rema picasa Date [oscow20z2 ae ri NEE Projet Wo ‘Surface Preperation /Cleening HAND CLEANING {power rooune (| nynro ernie Sanda Cesnrg pes ol Asie Sica Sand Pres 0- Fin Meron [ea nected [UNDERWATER 1005) 7 COMPLETED [eorster [ve repecied Bre w Bast Prone sas Fae areca |‘AtacnPress-0- Fim) |cAtacn Press -0- Fim) | AtachPres-0-Fim) (Competon of ean ie OT ne oo PAINTING acest Tra Goat atom Paremartecirer JOTUN FANT, [pe oF Pane ‘SAFEGUARD UN'ES, PLUM sch a Heaao10-4 22073 7 [ype of Tanner SOTON THINNER 17 7 sch to Z Tarver De cr ar Temp CIR we [wwe 7H a [suace Ter c 3e 7 [Sat Ose Tre aaa TooowmTa | 7 WET DFT Nene z 75 inspect Pai Rep Ard Oo Rap [Remar This to cry that the above ts have Ben inspected and accepted by the Pant Represetatves [CONANT PrPSS PAINT REPRE SENTATE (OWNER RPRESENTATIVE sronaruRe i ae WARY RC RA ZOLGELT A NOL ARR DATE4 PT. PANCARAN SAMUDERA SHIPYARD > BLASTING AND PAINTING INSPECTION REPORT PANCARAN DANGABAN (Project Narre [TE PANCARANTSTT [Report No) naman paeahes Be aa aa Was Pea Ses Popaeton Seow [TV Luaumcsaamas —— (_lenwen-ranune Too rms socscreag re sea ee ee ———— eer ea neaieas 7 a oreo Saree (atscrPee-0-Fim) [haan Prw-0-Fm) Pascoe -0-Fin) |[Compietion of Cleaning [Date OaroTr2022 [Time = 43.00 WiTA PARTING ate ae aia [iesarrar Z SARTRE 7 pacino.) | 7 ee | eee [ips Time 7 SRT ae ee Seon Top Z Sree ae [oe saeartone 7 =e 7 or mo Tae] aro [ner 7or ce Z a ; immer Spates inom —— [Ti is to cet that he above toms have been inspected en acepted by the Pant Representatives [CoueAN FIRS, PAINT REBRESENTATWE ‘WINER REGPRSENTATIVE IsionaruRe Nam WARYU WAL HART Zotar LA NOL ARN [DATE= PT. PANCARAN SAMUDERA SHIPYARD BLASTING AND PAINTING INSPECTION REPORT PANCARAN Eada oeAS [Project Name [TH PANCARANSIT ReportN Ee ate rio [Component lident No Project No Suace Prepareson!Ceanra [[V] anpeieauinc —_[_]poweR-ToouNG (1) worosertine [Sadar Coan yes of ave [ies Sond ree 0 Fin Merrie [ves hepectes |WHEATER DECK & WT BULVIARK (00%) seemiler [ves pected Bare oe ele rota last Prote [Sastre Ata ress-O- Fm) ((AéacnPree-O- Fim {‘Atacn Press-O- Fim) corp oT ean Date OTROS lime SOOT PAINTING Tato rd Coat atom Pane anatase JOTUN PANT [pe ofPare {IOTARKPUTOPCOAT, GREEN 5; esch No. ® TWwosoroeat_[—_assore-t [ype of Tanner JOTUN THINNER 10 esten No, 7 arabe 7 I CrAr Temp G7 RFE Z ae [so om Butace Temp ¢ Z Eg P [sa Date Tine Tipe Towa | 7 Wer DFT eons oH LZ Inspects by ‘GE-Pa Rep And Owner Rep Remar ets to corty tat te sbove tems have been inspected and accepted bythe Pant Representatives [COMPANY PpSE PANT REPRESENTATIVE OAR REPAERENTATNE JSIGNATURE For, aE ARTO KARE ZRF ZNO ARER bareBs PANCARAN EAKNDERK SHEARS, PT. PANCARAN SAMUDERA SHIPYARD. BLASTING AND PAINTING INSPECTION REPORT Fajea ans TSPNCARANT prs sae Bae Spee jeempenenn ident. No. 7 [Project No Sarees Popontn Coss [[V] wunpeisauina ——__/eaweRTooUNG (Tironosersie Sar ome Tiss asta ae [eesnaeses Sener ATE TORR COMPLETED = ferns ooes ae Serre pana aro |catach Press -O Fim ) | atac Press-0 -Fam | atacn Press -©- Fim ) Complete of Gearing [aie ownranee [ine Tana wita PAINTING TeiCoat Pd Coat Fed Coat [Pare Manufacturer Z TOTON PANT [Type of Paint 7 "AF WAK GUARD, DARK RED [asic No. © 7 72660254 Hype of Thinner {OTN THNNERT ten no. 25620151 [DP C/A Temp C7RHG 2 Surface Temp © [Ser Date Tine anew Tao WaT [wet DFT Marans {G6 Paint Rep And Owner Rap inspected by Remarks: Thi ito cetly thatthe above toms have been inspected acl accepted by te Pat Represetatives (coMPANY 75 PANT REPRERENTATNE ‘OWNER RERRESENTATIVE [sionarure Far (RANE Wario MRL AAR ZOLTAR INC ARTE [parePANITARAMNM SAMUDERK SHIPSARD BLASTING & PAINTING PROGRES TB PANCARAN 311 Beoce Indico ‘Fouling3 DFT checked2 Overiow ater completed pst spletionThis is to Certify that the Supply of TBT-Free Selfpolishing Antifouling to this ship is compliant with IMO’s AFS Convention* ‘Supplied to: PT. PANCARAN SAMUDERA TRANSPORT Vessel name TB. PANCARAN 311 Date of supply 04 JANUARY, 2022 Als Ce adopted 11.10.2002‘This is to certify that Date of issue 04 January, 2022 “TB. PANCARAN 311” was coated on the underwater area with TBT-free Self-Polishing Anti Fouling Self- Polishing system !n compliance with the IMO Antifouling Systems Convention of 2001 (AFS/CONF/26) This certify is limited to the area which the antifouling system applied at dry docking at PT. Pancaran Samudera Shipyard, January 2022. The product is manufactured by Jotun Coatings and contains the following active ingredients SeaForce | Shield, D Red Dicopper Oxide (CAS Number 1317-39-1) Zineb (CAS Number 12122-67-7) Safeguard Universal ES, Plum(2.comp. primer) was applied to seal off any possibleexisting TBT-antifouling TSS Support — Marine Coatings Indonesia Jotun Coatings ‘This certificate does not replace the "Certificate of Compliance* issued by the proper authorityPT. JOTUN INDONESIA No, Senttkat Persetukian : 00088 20.7P01168 Na. af prove Cerificate Lembar Pengukuhan Endorsement Sheot - esas ry He ' 7 me Pemeriksaan periodik (16 Juli 2022 s/d 16 Jul 2023) | Tanggal Perel suretoace (16 bly 2022 wll 16-oy 2023) | Dawe No, Laporan: | Report no | Surveyor CCatatan : Sertfizat akan dtangguhkan secara otomatis ka tidak: dikukubkan dalam rentang waktu yang telah ditetapan diatas None Tae erate wil be anomaly suspended ant ended win ie spec ome pari above F323082018 Rev Page?f Lampiran 1 Annex to Sertifikat Persetujuan Tipe Type Approval Certificate 1966 aoe No, Serikat :00089.20.1P01168 No. Persetuyan : 00363TA20 ofeenteae sono Deskripsi Produk of Pret Bespin Seaforce Shields alin Fee self poshing,tydrlysing anifiouling pain with active contents as mention below Cuprous Oxide CAS No. 1317-391 Zineb (GAS No. 12122-6777 ‘The product avaiable in various colours. Kondisi Persetujuan ‘Const or Agora 1. This approval is solely connected to the control of harmful of Anti Fouling System as required by approval standard applied. The approval is not includes. any evaluation of corrosion protective porlermance, toxicity, contamination, Pollution, or fre technical properties 2. Consideraton is tobe paid to the manufacturing recommendation concerning coating application, 3. Individual product certification i not required. Dokumentaci Persetujus ‘Azra Dosmstaton 1. BKI Assessment Report No. 01168-TP/C1/2020 2 Technical Data Shest and Material Safely Data Shoot for Sealorce Shield 3. Type approval test report no. LT- 0-20-0453 conducted by Unit Laboratorium Jase Periguian, Kalibrasi, dan Sertifkasi — Institut Pertanian Bogor recognized by BK, Penandaan Produk Maing of Prost ‘The folowing items are tobe cleerly marked on the paint container labels or other suitable places. Product name . Manufacture’s name or trace mark Manufacture’ production address Type of Anti Fouling System Storage instruction Production date Batch number BT'S approval rumber : 00363TA20 emeriksaan periodik Fanadea! Sorento, For retention ofthe approval, a BK! Surveyor shall conduct periocical surveillance to verily that approved quality system, etc of the manufacturing works are maintained satisfactory ‘The main scope ofthe periodical suveiance will normaly include + Verifeation of the manufacturers production and quality system with regard to ensure continued consistent production cof the Type Approved products at the manufactures premises, + Review ofthe approval documentation and that this is sill used as basis for the production = Review of possible changes to te properties of he product Verification ofthe product marking, Fsza.9s.20rmev3 saves 214394sisere shar ersere avon aeew eros een shone ior uo is c | ote Ee voor rezoin3 OL 200 SIVOWITSIO ISS1 TWN ‘'seuopul - okogoINS OL TAALS VAVPNVIG NYMVNNO ‘Ld