COMMISSIONING and START-UP REQUEST

To : PT. ATLAS COPCO INDONESIA Date : __ /__/ ____

Attn : Syafrul Syafaat
Phone : +62(0)21 7801008 Ext. 202
Mobile : +62(0)811 910 2344
Email : syafrul syafaat@id.atlascopco.com

1. Requester Information

Company Name :
Site Address :
Phone :
Contact Person :
Mobile :
Email :

We herewith aware that date of commissioning and start-up shall be requested in advance on 5 (five)
working days.
Dengan ini kami mengetahui bahwa permintaan commissioning dan start-up harus disampaikan 5(lima)
hari kerja sebelum tanggal commissioning dan start-up.

We herewith request you to commission and start-up the below listed equipment at your earliest
convenience, preferably ……………… . (date) ….………….. (time) ……………..
Dengan ini kami kami mohon dilakukan commissioning dan start-up atas peralatan tersebut dibawah ini
pada …………………………………….…. (tanggal) ……………(pukul) …….……….

2. Equipment’s model and identity

No. Model Qty. Serial Number

1.

2.

3.

4.

5.

6.
3. To be completed by Requester

Dilengkapi oleh Pembeli / Pelanggan

1. Mechanical Installation

a) Piping Installation, Gosh Neck Applied (Picture shall be attached) Yes No

b) Any Ducting Installation (Picture shall be attached) Yes No

c) Collector Drain Installed (Picture shall be attached ) Yes No

d) Minimum Free Area to be reserved = _______________________

(Consult Instruction Book depends on Machine Type)

2. Electrical Installation

a) Supply Cable Size =________________________

(Consult Instruction Book depends on Machine Type)

b) MCB Setting =________________________

(Consult Instruction Book depends on Machine Type)

3. Documents

a) Atlascopco Instruction Books has delivered along the equipment ? Yes No

b) Atlas Copco Sparepart List has delivered along the equipment? Yes No
4. Conditions

Above questionnaires has been truly completed and is in accordance with the site condition
Pernyataan diatas telah dilengkapi sesuai dengan keadaan dilapangan yang sebenarnya

Any incorrect data stated in this request form which may lead onto un-readiness of equipment’s to be
commissioning and started-up, the cost occurred shall be borne by Requester/ Customer as Atlas Copco
will apply Do & Charge invoices.
Apabila data yang di sampaikan pada pernyataan di atas tidak sesuai dan mengakibatkan equipment
tidak siap untuk di commissioning dan start-up, biaya yang di timbulkan akan menjadi tanggung jawab
pelanggan dan Atlas Copco akan mengaplikasikan Do & Charge tagihan.

Name : Signed and stamped

Position :
Date :