CENTRAL JAVA 2X1000 MW CFPP PROJECT Doe No : RFI-SSP/MES-CIP/16/08-044 Date: August 01,2016 REQUEST FOR INSPECTION MES Mr. K Tanaka Central Java Project |centlement, We would like to have your presence on commencement work according to the following schedules Data & Time Place / Area Work item, Remark | canguras 1 Lowland Power block Visual Check Prior Backfill (05) (layer 2nd) (follow drawing attached ) Result JAccepted [Jrejectea eispecton eaued [ie [re [Comments : PT. SSP. MES/ SUMITOMO int Name Evtan 1 AGRA |CENTRAL JAVA 2x1000 MW CFPP PROJECT 1-60.03 | seu Doc. No, Page Jrissowcscrnneoes ‘Subject : VISUAL CHECK PRIOR BACKFILL Project Central Java Location Client MES Reference Drawing ITEM TO CHECK RESULT Project No. : 1607-SD peer Groce dy _C ancl tose) DATE & SIGN REMARKS Yes ___NA [Cutting Grass, accepted we ahs d [Quality of cleaning before backfil, accepted wt Quality of backfill material, accepted Print Name SignaturefF Ele Hen oon sence + aT fo tate le sme BowneCENTRAL JAVA 2x1000 MW @. a FIELD INSPECTION REPORT ‘SSP WSPECTIONTYPET acwal eLavATION Pe, 0S Laven t cpp1or gpceru Later 20>) REF. DWG.Nox ance / Griteria lancainspecreo: Dr D&C ARYA Ute nee /Criteria = ; Taal 1086 HAA ELEVATION ri ee - a Deviation REMARI ‘ACTUAL | _ DESIGN ® 6b09. 08 |__| Ys 937177 999 x- 367998 994_ Te 9237109. 529 Prepared & checked by [check & Confirmed by JWanessed by RewraarcA by - PT. SSP, lpr.ssP PT.Mes ane] SUN mek ea frame: SUAVE TOR TE 9237196 344 launo: _egrnn _!¥/n/ Pb postin: LC. Cro -