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INSTRUCTION OF MINISTER OF MANPOWER

NUMBER: INS. 11/M/BW/1997

REGARDING

SUPERVISION OF WORK SAFETY AND HEALTH

SPECIAL FOR FIRE PROTECTION

MINISTER OF MANPOWER

Considering:

a.

that Fire incidents that occur lately show high number of incidents with financial loss and victims, which are not a little,

b.

that the duties on establishment/building and supervision of work safety and heat including fire prevention at workplace that are the responsibilities of the department of Manpower in accordance with Law No I not 1970 are have not worked run at they should have been.

c.

that for the purposes it is necessary to issue the realization of works Safety and health establishment and Supervision of fire prevention at workplace.

In view of:

1.

Law No. 1 of 1970 regarding work Safety;

2.

Regulation of the Minister of Manpower No. Per-14 /Men/ 1980 regarding Conditions for Installing and Maintaining Light Fire Extinguisher;

3.

Regulation

of

the

Minister

of

Manpower No. Per -

 

02/Men/1983 regarding it Installation of automatic Fire

Alarms;

 

4.

Regulation of the Minister of Manpower No. Per- 04/Men/1988 regarding the Validity of National Standard SNI – 225 Regulation of Indonesian Electricity Installation at workplace;

5.

Regulation of Minister of Manpower No. Per-02/Men/1989 regarding the Supervision of the Installation of Lightening Conductors;

6.

EE Special Regulation concerning work Safety and health conditions where flammable material are processed, stored or finished;

7.

K Special Regulation concerning work safety conditions where explosive materials are processed, stored, or finished.

PT. ERM INDONESIA

INSTRUCTED

TO:

HEADS OF REGIONAL OFFICES OF THE DEPARTMENT OF MANPOWER ALL OVER INDONESIA

1.

Carry out coordination with related Institutions/ Services to improve efforts in implementing work safety norms in fire prevention areas, among others:

- the implementation of work safety and health conditions for permit mechanism of building license, IPB, HO and so on;

- establishment/extension/training in fire hazard prevention;

- Inspection/investigation/analysis of fire cases.

2.

Improve inspection intensively at workplaces with high fire hazard protection potencies by assigning supervisors; particularly those have attended Specialist Training for fire prevention.

3.

Carry out inspections in the installation of fire protection equipment in building construction project.

4.

Carry out this instruction with full responsibilities in accordance with the prevailing stipulations and technical guidelines attached. Report the implementation to the Minister.

Promulgated in Jakarta

On 21 October 1991

On behalf on the Minister of Manpower

Director General of Industrial relationship Building and Supervision

MOHD. SYAUFII SYAMSUDIN

NIP. 160008975

Copies are forwarded to:

1. Minister of Manpower

2. The Secretary General of the Department of Manpower

3. The Inspector General of the Department of Manpower

4. Governors all over Indonesia.

PT. ERM INDONESIA

Appendix

:

INSTRUCTION OF THE MINISTER OF MANPOWER

No.

:

INS. 11 /M/BW/1997

Date

:

21 October 1997

GUIDELINES FOR TECHNICAL SUPERVISIONS OF FIRE PROTECTION SYSTEM

I. GENERAL GUIDELINES

Work safety conditions related to fire protection have clearly been outlined in Law No. 1 of 1970, among others:

- to prevent, reduce, extinguish fire;

- provisions of roads for escaping;

- the control of smoke, flame, and gas;

- to carry out training for all workers.

Formulation mentioned above with technical approaches can be classifies as follows:

1. Preventive actions so fire does not take place by eliminating or controlling various energy forms used should be prioritized on statically prominent problems causing fire.

2. Actions to reduce the seriousness level of financial loss and number of victims can be done by localizing and compartment so fire, smoke, and gas do not spread to other parts.

3. Provisions of equipment/fire protection installation such as detection system/fire alarm and light fire extinguishers, hydrants, sprinklers, or special installation that are sophisticated and self-supporting through planning, installation, and maintenance according to standard stipulations.

4. The availability of roads for escaping that are safe, fast and sufficient in accordance with the number of people and building construction shape.

5. Formation of emergency response organization to prevent if fire hazard take places.

Construction and supervision tasks for work safety for fire prevention area as the explanation above must be carried out professionally by supervising officials and by cooperating closely and harmoniously with related institutions/services.

PT. ERM INDONESIA

II.

PLANNING OF FIRE PROTECTION SYSTEM

1.

Every plan for a workplace must consider conditions and stipulations for fire protection effort, both active and passive protections.

- A passive fire protection is a technical design for a workplace to restrict or block the spreads of flame, heat, smoke, and gas both vertically and horizontally by adjusting the distance between buildings, installing fire- proof wall dividers, closing every opening with fire-proof media or with certain mechanism;

- An active fire protection is the implementation of a suitable and sophisticated system design or detection installation, alarm and fire extinguishers at a workplace in a building, so it is self-sufficient for its infrastructure to combat fire hazard.

2.

Planning of fire protection installation must refer to prevailing regulations and standards and is made by an individual or corporate body that has obtained approval.

3.

A supervising official that has been appointed as a supervising specialist in fire protection are has the duty to inspect planning file for fire protection system and the authority to stipulate conditions for alteration or repair considered necessary.

4.

Planning file system is made in triplicate and after being examined and authorized by the supervisor is then sent to the Director of PNKK to be published for its legalization/approval for the planning blueprint mentioned.

III.

INSTALLATION OF FIRE PROTECTION SYSTEM

1.

The implementations of fire protection installation must be in accordance with the planned blueprint that has been approved and carried out by appointed installation.

2.

All installation equipment installed must be in accordance with approved technical specification.

3.

After the installation work is completed, local inspection and testing must be carried which is attended by all parties involved, among others:

- Contractor

- Planner (consultant)

- Owner (employer)

- Manager (building manager)

- Manpower Supervising Official (Fire Protection Specialist).

PT. ERM INDONESIA

4.

After the entire inspection and testing are completely carried out, evaluation is done together. Manpower supervisor provides comments and conditions considered necessary based on the findings when inspection and testing were carried out.

5.

As built drawing must be made completely together with the Official Report regarding the result of inspection and testing, sent to the Director of PNLL to be issued for legalization.

6.

Owner, manager, contractor is responsible to comply with conditions determined by the Director of PNKK in accordance with the agreement made in the contract.

IV.

INSPECTION AND TESTING

1.

Dwelling classification

Dwelling type classification will determine the technical conditions for fire protection system that must be applied.

2.

Ignition Sources

Notice any potency that can become a trigger source of fire and notice whether the safety device required is suitable, when the latest inspection is, and whether the conditions given have been implemented.

3.

Flammable/explosive materials

Notice the types of materials being processed, finished, or stored. Recognize their physical and chemical properties, whether they contain flammable or explosive potencies. Notice whether there is a work safety procedure or it is carried out properly.

4.

Compartment

Notice the conditions of workplace environment concerning the spreads of fire, heat, and smoke and whether or not there are efforts to control them.

5.

Emergency exits

Notice the evacuation lanes, emergency exits stairs, whether or not there are barriers that can obstruct, whether there are directional signals, emergency lights, and the distance to the exits is not more than 36 m for low risk, 30 m for medium risk, and 24 m for high risk.

PT. ERM INDONESIA

6.

Light Fire Extinguisher

Check whether light fire extinguishers match the types and are sufficient in quantity, whether the location is easily seen and reached as well as easily fetched. Also check the effective period of the extinguishing materials as well as the trial period of their tubes.

7. Alarm installation

a. Check whether it has approval and technical documents such as installation drawing, catalogue, and maintenance guidelines;

b. Check the latest inspection result, whether the conditions previously given have been implemented;

c. Check the indicators on the control panel, whether it is in stand by position or not;

d. Carry out testing on equipment function on the panel, whether or not all equipment and indicators work properly, and zone alarm signaling has been installed;

e. Carry out test on the function of operation system by activating manual buttons and detectors in every alarm zone while synchronizing the drawing with its implementation. Watch closely the local alarm indication confirmation and the indication on the panel whether they function in accordance with their zone numbers. Also watch closely whether the loudness of alarm sound can be heard (laudable) at the furthest distance at that zone;

f. Conduct test on open circuit by opening the resistor in the last detector circuit.

g. Record all irregularities found.

8. Hydrant and Sprinkler Installation

a) Check whether it has approval, technical documents, such as installation drawing, catalogue, and maintenance guidelines;

b) Check the result of the latest inspection, whether the conditions previously given have been implemented;

c) Check the indicator on the panel control whether it is in stand by position;

d) Check the pump room and record technical data of the pump, activator, and the available equipment, control panel, and so on;

e) Check the water supply system whether it can guarantee the water requirement for extinguishing operation in time in accordance with certain standard time;

f) Carry out test on pump operation by opening test shell provided in the pump room and watch closely t6he pump pressure;

PT. ERM INDONESIA

The steps in testing the pump are as follows:

1)

Record the pressure at stand by position;

2)

Record the pump pressure at spur run position;

3)

Close the test-shell and record the pump pressure at spur stop position;

4)

Reopen the test-shell until the main pump operates and record its pressure;

5)

Monitor for a certain time the operation pressure of the main pump and record it.

6)

Closer again the test-shell and let the main pump run. Record the pressure and monitor whether the safety valve work or not;

7)

Test the spare pump. Record its start and operational pressure as the steps taken in testing the main pump.

g) Pump Evaluation

Hydrant pump must have a minimum pressure of 4.5 kg/Cm 2 and a minimum flow of 500 US GPM. Match the pump specification based on the catalogue with the result of try-out.

Check the pump control circuit, among others:

1)

The electric capacity supply must be pulled from the supply side in the main panel by using its own switch;

2)

Conductor cable used must be fire-proof type cable or it may be permitted to use other cable provided it is installed in spiral pipe;

3)

It is forbidden to have other load on the installation circuit of the fire extinguisher unrelated to the pump operation needs;

4)

The safety device of a pump circuit must have the characteristics to be capable of being supplied with 125% of its current full load continuously and at 600% open full load not less than 20 seconds but not more than 50 seconds;

5)

Between the motor and the control circuit, it is not allowed to install safety device for extra load.

h) Hydrant operational testing

1)

Open the closest hydrants point to the pump. Measure to the right of the spraying opening with pivot pipe and record the pressure on the manometer in the pump room;

2)

Open the second hydrant point, that is the furthest one and the first testing point leave open. Measure the pressure at the spraying opening and manometer pressure in the pump room;

PT. ERM INDONESIA

3) Open the third hydrant point, that is the middle one and let the first and second points open. Measure the pressures at the spraying openings and on the manometer in the pump room.

i) Evaluation of Operational Testing

The conditions required are that the heaviest pressure is not more than 7 kg/Cm 2 and the pressure at the furthest point is not less than 4.5 kg/Cm 2.

9. Special Installation

Certain objects sometimes require special fire protection system with certain media that are adjusted to the concerned object characteristics. The evaluation criteria for special installation must refer to the prevailing standard and technical specification of the equipment from the manufacturer.

Promulgated in: J A K A R T A

On : 21 October 1999

On

MANPOWER

Director General of

THE ESTABLISHMENT OF INDUSTRIAL RELATIONSHIP AND MANPOWER DIVISION

behalf

of

the

MINISTER

OF

Signed

MOHD. SYAUFII SYAMSUDDIN

NIP. 160008975

PT. ERM INDONESIA

SYSTEMATIC LEGALIZATION FOR FIRE PROTECTION SYSTEM USE (At Central)

CONTRACTOR/OWNER SUBMISSION OF APPLICATION LETTER (63-K FORM) - DESCRIPTION OF CRITERIA DESIGN - PLANNING BLUEPRINT
CONTRACTOR/OWNER
SUBMISSION OF APPLICATION LETTER (63-K FORM)
- DESCRIPTION OF CRITERIA DESIGN
- PLANNING BLUEPRINT
- TECHNICAL SPECIFICATION
REGIONAL/LOCAL OFFICE TO BE EXAMINED
NO
COMPLY WITH CONDITIONS?
YES

DIRECTOR OF PNKK

LEGALIZATION OF PLAN DRAWING (64-K FORM) REGIONAL/LOCAL OFFICE SUPERVISING OFFICIAL INSTALLATION BY CONTRACTOR
LEGALIZATION OF PLAN DRAWING (64-K FORM)
REGIONAL/LOCAL OFFICE
SUPERVISING OFFICIAL
INSTALLATION BY CONTRACTOR
SUBMISSION OF USE PERMIT ( 65-K FORM)
COMMISSIONING/TESTING AND INSPECTION
- CONTRACTOR
- DESIGNER/ CONSULTANT
- OWNER/ EMPLOYER
- MANAGER
- SUPERVISING OFFICIAL
EVALUATION/ REPORT ( 66-K FORM)
NO
COMPLY WITH CONDITIONS?
REGIONAL OFFICE LEGALIZATION FOR TEMPORARY USE ( 67-K FORM) CENTRAL OFFICE/ DIRECTOR OF PNKK
REGIONAL OFFICE
LEGALIZATION FOR
TEMPORARY USE ( 67-K FORM)
CENTRAL OFFICE/ DIRECTOR OF PNKK

LEGALIZATION FOR PERMANENT USE (68-K FORM)

PT. ERM INDONESIA

63 K FORM

APPLICATION FOR LEGALIZATION/CERTIFICATION

FIRE PROTECTION INSTALLATION

No. …………………….

Based on Law No. 1 of 1970 and Instruction of the Minister of Manpower No. Inst. 11/M/BW/1997, we herewith submit a legalization/certification application for the installation of fire protection.

Applicant Name : ………………………………………………………………. Position : ………………………………………………………………. Institution/company : ………………………………………………………………. Address : ………………………………………………………………. Phone ………………………… Fax ………………………

General Data

Building name

:

……………………………………………………………….

Type of business/activity :

……………………………………………………………….

Address : ………………………………………………………………. ………………………………………………………………. Owner : ………………………………………………………………. Manager : ……………………………………………………………….

Organizer’s name

Types of installations : ( ) Alarm installation

……………………………………………………………….

:

(

) Hydrant installation

(

) Sprinkler installation

( ) Special installation *) Please specify ……………………………………………… Consultant : ………………………………………………………………. Address : ………………………………………………………………. Phone ……………………… Fax …………………………. Contractor : ………………………………………………………………. Address : ……………………………………………………………….

Implementation schedule :

Explanation

:

Phone ……………………………. Fax …………………… ………………………………………………………………. Details of design criteria, plan drawing, and technical specification is attached.

To:

The Director of PNKK Directorate General of the Binawas Jl. Jend. Gatot Subroto Kav 51 Jakarta

………., …………………………………… Applicant,

Revenue stamps

Rp.2000

10

PT. ERM INDONESIA

64-K FORM

DEPARTMENT OF MANPOWER OF THE REPUBLIC OF INDONESIA

DIRECTORATE GENERAL OF THE ESTABLISHMENT OF INDUSTRIAL

RELATIONSHIP AND SUPERVISION OF MANPOWER

LEGALIZATION OF PLAN DRAWING OF

FIRE PROTECTION INSTALLATION

No. …………….…

The Director General of the Establishment of Industrial Relationship and Manpower Supervision:

Read

:

The application letter (63-K form) from:

 

No:

Date :

Considering:

1.

Law No. 1 of 1970 concerning Work safety;

 

2. Regulation of the Minister of Manpower No. Per- 04/Men/1980 regarding conditions on the installation and maintenance of light fire extinguisher;

3. Regulation of the Minister of Manpower No. Per- 02/Men/1983 regarding the installation of automatic fire alarm;

4. Regulation of the Minister of Manpower No. Per- 04/Men/1988 regarding the validation of Indonesian National Standard SNI-225-1987 concerning General Regulations on the installation of Indonesian electricity of 1987 (PUIL-1987) at workplaces.

 

DECIDED

To Legalize

:

Planned Drawing for the installation of the fire protection installation Building name : …………………………………………… Address : …………………………………………… … Organizer : ……………………………………………

Explanation

:

Fire protection installations planned constitute:

(

)

Light fire extinguishers

(

) Hydrant installation

(

) Sprinkler installation

(

) ………………………………………………………………

Designer

:

…………………………………………….

Address

:

……………………………………………

Contractor

:

……………………………………………

Address

:

……………………………………………

PT. ERM INDONESIA

64-K FORM

Other requirements that: - The execution of fire protection installation must meet the approved drawing.

- After installation the owner must report to Manpower Dept Officer to be conducted an examination and testing.

On Behalf Of The Directorate General Of The Establishment of Industrial Relationship and Supervision of Work Safety and Health Norms

NIP.

PT. ERM INDONESIA

65-K FORM

APPLICATION FOR LEGALIZATION/CERTIFICATION

FIRE PROTECTION INSTALLATION

No. …………………

Based on Law No. 1 of 1970 and Instruction of the Minister of Manpower No. Inst. 11/M/BW/1997, the person who signs below Name : ………………………………………………………………. Position : ………………………………………………………………. Institution/company : ………………………………………………………………. Address : ………………………………………………………………. Phone ………………………… Fax ………………………

Herewith submit an application for certification of Fire Protection Installation installed at:

Building name

:

……………………………………………………………….

Address

:

Owner Manager Organizer’s name

………………………………………………………………. ………………………………………………………………. : ………………………………………………………………. :

……………………………………………………………….

:

:

Types of installations

………………………………………………………………. ( ) Alarm installation

(

) Hydrant installation

(

) Sprinkler installation

(

) Special installation *) Please specify …………………………………………

Drawing Legalization

:

No. :

Date:

Consultant

:

Address

:

:

:

………………………………………………………………. ………………………………………………………………. Phone ……………………… Fax …………………………

Contractor

Address

………………………………………………………………. ……………………………………………………………….

Implementation schedule :

Phone ……………………………. Fax …………………… ……………………………………………………………….

Explanation

:

Enclosed

 

-

As built drawing

 

-

Official

Report

on

the

result

of

internal

 

inspection/testing

 

…………………

,

………………………

 

To:

The Applicant, Director of PNKK Dir.Gen. of the Binawas Jl. Jend. Gatot Subroto Kav 51 Jakarta

Revenue stamps Rp.2000

PT. ERM INDONESIA

65-K FORM

Official Report Form Sample

No:

OFFICIAL REPORT OF INSPECTION/TESTING OF FIRE

Sheet quantity:

Date:

Sheet No.:

PROJECT

 

LOCATION

 

CONTRACTOR

 

On

date

,

I;

Name:

Position:

Institution:

Witnessed by parties signing this official report, it has been carried out:

 

Results:

Note:

Thus this official report is properly made

 

Name

Position/Occupation

Signature

PT. ERM INDONESIA

66-K FORM

No.:

REPORT ON THE INSPECTION AND TESTING OF FIRE PROTECTION

No. of KLUI:

Date:

I. GENERAL DATA

1. Building name

:

……….

2. Type of activity/business

:

……….

3. Address

:

 

….

4. Owner

:

5. Manager

:

6. Name of organizer

:

II. BUILDING DATA

1. Land area

:

m 2

2. Building area

:

meter

3. Building Construction

:

-

Main structure

:

-

Floor structure

:

-

Outside wall

:

-

Inside wall (isolation)

:

-

Ceiling frame

:

-

Ceiling cover

:

-

Roof frame

:

-

Roof cover

:

4. Building height

:

………………………………

meter

5. Number of stories

:

6. Floor area

:

………………………………

m2

7. Build in (year)

:

8. Fire protection equipment

8.1. Light fire extinguisher

(

)

8.2. Automatic fire alarm installation

(

)

8.3. Hydrant installation

(

)

8.4. Sprinkler installation

(

)

8.5. Specific installation*)

(

)

8.6. Evacuation infrastructure

(

)

9. Description of room/working unit

No. Work unit Location PT. ERM INDONESIA
No.
Work unit
Location
PT.
ERM INDONESIA
SPECIFICATION OF AUTOMATIC FIRE ALARM INSTALLATION 66-K(A) Form

SPECIFICATION OF AUTOMATIC FIRE ALARM INSTALLATION

66-K(A) Form

No.

Equipment

Trade-Mark/Model

Quantity

Unit

Condition

1.

Control panel

       

2.

Enunciator

       

3.

Heat detector

       

4.

Smoke detector

       

5.

Flame detector

       

6.

Gas detector

       

7.

Manual knob

       

8.

Bell alarm

       

9.

Alarm light signal

       

Note:

PT. ERM INDONESIA

DATA OF ALARM INSTALLATION

Detector Alarm Location Zone No. TPM Fl. Sw. STATUS*) ROR Fixed Sample Bell Lamp. (1)
Detector
Alarm
Location
Zone No.
TPM
Fl. Sw.
STATUS*)
ROR
Fixed
Sample
Bell
Lamp.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
PT.
ERM INDONESIA

RESULT OF INSPECTION AND TESTING OF INSTALLATION

No.

Inspection /Testing

Result

Conditions

1.

Function of panel operation

 

2.

Alarm Test

 

3.

Foult Test

 

4.

General Alarm;

 

AC Interconnection, LIFT, PRESS FAN, etc.

Inspected and tested on

 
 

Name

 

Position

Signature

PT. ERM INDONESIA

SPECIFICATION OF DETECTION AND AUTOMATIC FIRE ALARM INSTALLATION (INTEGRATED SYSTEM) 66-K(IS) Form

SPECIFICATION OF DETECTION AND AUTOMATIC FIRE ALARM INSTALLATION (INTEGRATED SYSTEM)

66-K(IS) Form

Extinguishing Media Application System Room No. Protected Room Single Total Flooding Volume Media Type Quantity
Extinguishing Media
Application System
Room
No.
Protected Room
Single
Total Flooding
Volume
Media Type
Quantity
Detection /
Extinguisher/
Cross Zone
Local Protection
RESULT OF INSPECTION AND TESTING
Inspected and tested on
Name
Position
Signature
PT.
ERM INDONESIA
SPECIFICATION OF HYDRANT INSTALLATION 66-K(IS) Form

SPECIFICATION OF HYDRANT INSTALLATION

66-K(IS) Form

No.

Concerning

Specification

Status

Explanation

1.

Water standard source

     

2.

Ground reservoir

     

3.

Gravitation Tank

     

4.

Siamese connection

     

5.

Spur pump

Q:

US

GPM

   

H:

Meter

Start Auto./Man :

 

Kg/Cm Stop Auto./Man :

2

 

Kg/Cm

2

6.

Main pump

Q:

US

GPM

   

H:

Meter

Start Auto./Man :

 
 

Kg/Cm

2

Stop Auto./Man :

 

Kg/Cm

2

7.

Spare pump

Q:

US

GPM

   

H:

Meter

Start Auto./Man :

 

Kg/Cm Stop Auto./Man :

2

 

Kg/Cm

2

8.

Priming tank

     

9.

Wind vessel

Capacity:

Litter

   
 

:

Kg/Cm 2

:

Kg/Cm 2

10.

Pressure relief valve

     

11.

Test valve

     

12.

Open electricity indicator

     

13.

Sucking pipe

     

14.

Main distributing pipe

     

15.

Upright pipe

     

16.

Yard hydrant

     

17.

Building hydrant

     

18.

Hose reel

     

Note:

PT. ERM INDONESIA

DATA ON THE INSTALLATION HYDRANT EQUIPMENT

Quantity of Hydrant equipment In door No. Location Out door Status Landing valve 2.5 “
Quantity of Hydrant equipment
In door
No.
Location
Out door
Status
Landing valve
2.5 “
1.5”
1”
HP
HM
SC
Note:
PT.
ERM INDONESIA

RESULTS OF EXPERIMENT ON HYDRANT PUMP UNIT

No.

Pump

 

Start

Stop

Explanation

     

Automatic/Manual

Automatic/Manual

 

1.

Spur pump

Kg/Cm 2

Kg/Cm 2

     

Automatic/Manual

Automatic/Manual

 

2.

Main pump

Kg/Cm 2

Kg/Cm 2

     

Automatic/Manual

Automatic/Manual

 

3.

Spare pump

Kg/Cm 2

Kg/Cm 2

     

Automatic/Manual

Automatic/Manual

 

4.

Diesel pump

Kg/Cm 2

Kg/Cm 2

 

RESULTS OF HYDRANT OPERATIONAL EXPERIMENT

No.

Experiment

Pressure

Status

 

Explanation

1.

Stand by

     

2.

1 point of hydrant

     

3.

2 point of hydrant

     

4.

3 point of hydrant

     

Inspected and tested on

Name

Position

Signature

PT. ERM INDONESIA

SPECIFICATION OF SPRINKLER INSTALLATION 66-K(SP) Form

SPECIFICATION OF SPRINKLER INSTALLATION

66-K(SP) Form

No.

Concerning

 

Specification

Explanation

1.

Water standard source

   

2.

Ground reservoir

   

3.

Gravitation tank

   

4.

Siamese connection

   

5.

Spur pump (Electric)

Q:

US GPM

 

H:

Meter

Start Auto./Man :

Kg/Cm 2 Stop Auto./Man :

 

Kg/Cm 2

6.

Main pump

Q:

US GPM

 

H:

Meter

Start Auto./Man :

Kg/Cm 2 Stop Auto./Man :

 

Kg/Cm 2

7.

Spare pump

Q:

US GPM

 

H:

Meter

Start Auto./Man :

 

Kg/Cm 2

Stop Auto./Man :

 

Kg/Cm 2

8.

Priming tank

Capacity:

Litter

 

9.

Wind vessel

Q

:

Litter

 
 

: Kg/Cm 2

: Kg/Cm 2

10.

Pressure relief valve

   

11.

Test valve

   

12.

Open electricity indicator

   

13.

Gong Alarm

   

14.

Sucking pipe

   

15.

Main pipeline

   

16.

Upright pipe

   

17.

Divider

   

18.

Service pipe

   

19.

Head

   

Note:

PT. ERM INDONESIA

DATA ON SPRINKLER EQUIPMENT INSTALLATION

Quantity of sprinkler equipment Location Note 1) 2) 3) 4)
Quantity of sprinkler equipment
Location
Note
1)
2)
3)
4)

RESULT OF THE INSPECTION AND TESTING OF SPRINKLER PUMP

No.

Pump

Start

Stop

Explanation

1.

Spur pump

Automatic/Manual

Automatic/Manual

 

Kg/Cm 2

Kg/Cm 2

2.

Main pump

Automatic/Manual

Automatic/Manual

 

Kg/Cm 2

Kg/Cm 2

3.

Spare pump

Automatic/Manual

Automatic/Manual

 

Kg/Cm 2

Kg/Cm 2

4.

Diesel pump

Automatic/Manual

Automatic/Manual

 

Kg/Cm 2

Kg/Cm 2

Inspected and tested on

Name

Position

Signature

PT. ERM INDONESIA

RECOMMENDATION ON INSPECTION AND TESTING OF FIRE PROTECTION INSTALLATION

No.

Concerning/Location

Condition/Finding

Suggestions

Thus the results of inspection and recommendation for perfecting means of fire protection have been discussed with those signing this report for further consideration.

Compiled in

on

Name

Position

Signature

PT. ERM INDONESIA

67-K FORM

DEPARTMENT OF MANPOWER OF THE REPUBLIC OF INDONESIA REGIONAL OFFICE IN PROVINCE: ………………………

TEMPORARY LEGALIZATION INSTALLATION OF FIRE PROTECTION

The Head of Regional office of the Department of Manpower in Province

Reading

:

Application letter (Form 65-K) of :

 

No.:

Date:

Considering

:

1. Law No. 1 of 1970, regarding work safety; 2. Regulation of the Minister of Manpower No. Per- 04/Men/1980, regarding condition for installation and maintenance of light fire extinguisher; 3. Regulation of the Minister of Manpower No. Per- 02/Men/1983, regarding the installation of automatic fire alarm; 4. Regulation of the Minister of Manpower No. Per- 04/Men/1988, regarding the validity of national standard SNI-225-1987 concerning general regulation on electric installation in Indonesia 1987 (PUIL-1987) at workplace

In View of

:

1. Legalization of plan design for the fire protection installation

 

No.:

Date:

2. Report of inspection and testing result (Form 66-K)

No.:

Date:

 

DECIDED

To Stipulate

:

Legalize the use of fire protection installation at:

Building :

Address :

Name of organizer:

System of fire protection installation include:

(

)

Fire Extinguisher;

(

)

Manual/automatic alarm installation;

(

)

Hydrant;

(

)

Sprinkler;

(

)

Designer :

Address :

Contractor :

Address :

PT. ERM INDONESIA

With stipulations:

67-K FORM

1. Must implement the condition stipulated in the inspection sheet.

2. The legalization valid for 3 months since the date of promulgation while waiting for furthers decision.

,

Department Of Manpower

Regional Office of Province …….

NIP.

Head,

PT. ERM INDONESIA