INSPECTION AND TEST PLAN (RENCANA UJI DAN RIKSA)

RE-CERTIFICATION (SERTIFIKASI ULANG)

For Ecalator and or Escavator (untuk Eskalator / Eskavator)

Dibuat / Dipersiapkan Oleh ; Diverifikasi Oleh ; Diverifikasi dan disetujui Oleh ;

Cahyo Putra Darmawan Wing Wiryawan Suwarto

Distrik manager AK3 EE No. Reg.:………. NIP :
PT. Global Insurance Indonesia PT. DEPRIWANGGA DISNAKER
 INSPECTION AND TEST PLAN RE CERTIFICATION (RENCANA UJI DAN RIKSA SERTIFIKASI ULANG)

Project : RECERTIFICATION (UJI ULANG SERTIFIKASI)

Location :
Owner : PT. Global Insurance Indonesia
Third Party : PT. Depriwangga

AR : Approval Required M : Monitoring V : Verification

A : Actual Inspection R : Review of Document 1 : 100%
W : Witness Inspection T/C : Test Certification Required 2 : 10%
S : Operation Surveillance/Provide H : Hold Point
INSPECTION LEVEL
NO. ACTIVITY REFERENCE DOCUMENT VERIFIED DOCUMENT ACCEPTANCE CRITERIA
OWNER PJK3 DISNAKER
1. DOCUMENT REVIEW
Previous Inspection Report & - Inspection Procedure - Design and calculation, Fabrication, - Inspection Procedure S R1 R2
1.
Disnaker Certificate - Applicable Code, Standard, Installation & Inspection - Applicable Code, Standard,
Procedure Inspection, Test Specification & Regulation Procedure & Document Specification & Regulation
2. S R1 R2
Electrical, Mechanichal, Equipments support - Owner Spec - NDT Procedure - Owner Approval as build
Certificate , calibrasi Material/ Equipments - UU No. 1 th. 1970 - Manufacturer Data rrecord
3. S R1 R2
MDR and SOP - Permenaker no. 6 th. 2017 Repair & History Record
- Final Inspection Report
4. Repair & History Maintenance Report S R1 R2

A S R1
5. Documents Control Report

2. PHYSICAL / VISUAL INSPECTION

- Inspection Procedure - Inspection Procedure - Inspection Procedure S V W/M
1. Structural Building ,Component
- Applicable Code, Standard, - Inspection Report - Applicable Code, Standard,
Specification & Regulation Specification & Regulation
2. Mechanical & Electrical Components S V W/M
- Owner Spec - Owner Approval as build
- UU No. 1 th. 1970
3. Power driven S V W/M
- Permenaker no. 6 th. 2017

4. Control Panel S V W/M

5 Wiring S V W/M

6 Step. Cabin S V W/M

7 Safety Devices S V W/M

8 PVI Overall Comment S/AR V W/M

 INSPECTION AND TEST PLAN RE CERTIFICATION (RENCANA UJI DAN RIKSA SERTIFIKASI ULANG)

Project : RECERTIFICATION (UJI ULANG SERTIFIKASI)

Location :
Owner : PT. Global Insurance Indonesia
Third Party : PT. Depriwangga

AR : Approval Required M : Monitoring V : Verification

A : Actual Inspection R : Review of Document 1 : 100%
W : Witness Inspection T/C : Test Certification Required 2 : 10%
S : Operation Surveillance/Provide H : Hold Point
INSPECTION LEVEL
NO. ACTIVITY REFERENCE DOCUMENT VERIFIED DOCUMENT ACCEPTANCE CRITERIA
OWNER PJK3 DISNAKER
3. FUNCTIONAL TESTING
Functional Testing Procedure - Inspection Procedure - Inspection Procedure - Inspection Procedure S/AR R1 R2
1.
- Applicable Code, Standard, - Functional Testing Procedure - Applicable Code, Standard,
Functional Testing Execution Specification & Regulation - Inspection Report Specification & Regulation
2. S H W/M
- Owner Spec
Post Functional Testing Inspection - UU No. 1 th. 1970
3. S V W/M
- Permenaker no. 6 th. 2017
Functional Testing Release Note
4. S/AR AR R2

4. LOAD TESTING
- Inspection Procedure - Inspection Procedure - Inspection Procedure S AR R/V
1. Load Testing Procedure/Sequence - Applicable Code, Standard, - Load Testing Procedure - Applicable Code, Standard,
Specification & Regulation - Inspection Report Specification & Regulation S
2. Load Testing Execution H H
- Owner Spec ( before, prior, after
- UU No. 1 th. 1970 Load Test Report )
3. Post Inspection of Load Testing S V H
- Permenaker no. 6 th. 2017

4. Load Testing Release Note S/AR AR H/AR

5. REPORTING
- Inspection Procedure - Inspection Report - Inspection Report S V/AR V/AR
1. Final Inspection Report
- Applicable Code, Standard, - Inspection Certificate - Applicable Code, Standard,
Specification & Regulation - New Load Chart & Table Specification & Regulation
2. Inspection Certificate - V/AR V/AR
- Owner Spec - Any Recommendations
- UU No. 1 th. 1970
3. Report Handling to DISNAKER S - V/AR
- Permenaker no. 6 th. 2017

4. DISNAKER Operating Permit - - S/AR