GATE VALVE CHECK REPORT

Date of Check :
Ship Name :
Owner :
Project Code :

Status
No. Valve Specification Material Position/System Qty.
Service/Replace

Inspection Item
Visual Inspection Advance Inspection
Part Name Remarks Part Name Remarks
¨ All Bolt/Nut ¨ Stem
¨ Handwheel ¨ Gland Packing
¨ Body ¨ Bonnet Bushing
¨ Yoke ¨ Gate/Disc
¨ Yoke Sleeve ¨ Seat Ring
¨ Bonnet ¨ Guide Ribs
¨ Others _________________ ¨ Others _________________

Recommendation :

Prepared by, Checked by, Acknowledged by,

PT. Dharma Sentosa Marindo PT. Dharma Sentosa Marindo
_____________________ _____________________ _____________________
Mechanic Project Incharge Owner / Master / Chief Engineer
 LAPORAN PEMERIKSAAN GATE VALVE
Tanggal :
Nama Kapal :
Pemilik Kapal :
Kode Proyek :

Status
No. Spesifikasi Valve Material Posisi / Sistem Pipe Jumlah
Servis/Ganti Baru

Bagian yang Diperiksa

Pemeriksaan Visual Pemeriksaan Lanjutan
Nama Bagian Keterangan Nama Bagian Keterangan
¨ Mur/Baut ¨ Stem
¨ Handwheel ¨ Gland Packing
¨ Body ¨ Bonnet Bushing
¨ Yoke ¨ Gate/Disc
¨ Yoke Sleeve ¨ Seat Ring
¨ Bonnet ¨ Guide Ribs
¨ Lain-lain _________________ ¨ Lain-lain _________________

Rekomendasi :

Dibuat oleh, Diperiksa oleh, Diketahui oleh,

PT. Dharma Sentosa Marindo PT. Dharma Sentosa Marindo
_____________________ _____________________ _____________________
Mechanic Project Incharge Owner / Master / Chief Engineer
ti Baru