JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No.

: SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
1 Pre-Inspection Meeting Attend - Minute of Meeting
2 TRANSFORMER
2.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.01 M W R
b. Foundation as per Civil Data Visual IFC Drawing - M W R
c. Check Name plate and Rating Visual IFC Drawing QI-E.01.01 M W SW
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.01 M W SW
2.2 Installation
a. Visual & dimensional Visual IFC Drawing QI-E.01.01 M W R
b. Seals of bushing Visual Engineering Spec. QI-E.01.01 M W R
c. Valves and pipe plugs Visual IFC Drawing QI-E.01.01 M W R
d. Cables, bells and connections Visual IFC Drawing QI-E.01.01 M W R
e. Sealing the terminal boxes Visual Engineering Spec. QI-E.01.01 M W R
f. Bolting and gaskets Visual IFC Drawing QI-E.01.01 M W R
g. Neutral connection (bolting, clamping, etc.) Visual IFC Drawing QI-E.01.01 M W R
h. Setting and Alignment Visual Engineering Spec. QI-E.01.01 M W R
i. Transformer oil level Visual Engineering Spec. QI-E.01.01 M W R
j. Equipment grounding connection Visual IFC Drawing QI-E.01.01 M W R
k. Check breathing device Visual Engineering Spec. QI-E.01.01 M W R
2.3 Testing
a. Insulation resistance measurement Test Engineering Spec. QI-E.02 M W SW
b. Inspect Dielectric strength of the insulation oil Test (sample) Engineering Spec. QI-E.07 M W SW
c. Inspect the Tap Changer and setting switch Setting/ Test Engineering Spec. QI-E.01.01 M W SW
d. Transformer function test Test Engineering Spec. QI-E.08 M W SW
e. Polarity & vector group test Test Engineering Spec. - M W SW
f. Impedance & load loss measurement Setting/ Test Engineering Spec. - M W SW
g. No load loss & exciting current measurement Test Engineering Spec. - M W SW

3 SWITCHGEAR / MOTOR CONTROL CENTER

3.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.02 M W R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
b. Foundation as per Civil Data Visual IFC Drawing - M W R
c. Check Name plate and Rating Visual IFC Drawing QI-E.01.02 M W R
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.02 M W R
3.2 Installation
a. Visual & dimensional Visual IFC Drawing QI-E.01.02 M W R
b. Board assembly and bolting Visual Engineering Spec. QI-E.01.02 M W R
c. Busbars bolted connection Visual IFC Drawing QI-E.01.02 M W R
d. Fuse ratings and gauge rings Visual IFC Drawing QI-E.01.02 M W R
e. Contact alignment of draw-out mechanism Visual Engineering Spec. QI-E.01.02 M W R
f. Cable glands, clamping and termination Visual IFC Drawing QI-E.01.02 M W R
g. Tag & wire number Visual IFC Drawing QI-E.01.02 M W R
h. Check grounding connections Visual IFC Drawing QI-E.01.02 M W R
i. Check rating and capacity of CT, PT Visual Engineering Spec. QI-E.01.02 M W R
j. The relays have complete final setting Visual IFC Drawing QI-E.01.02 M W R
3.3 Testing
a. Insulation resistance measurement Test Engineering Spec. QI-E.02 M W SW
b. Test anti-condensation heater Test Engineering Spec. QI-E.01.02 M W SW
c. PT's polarity & phase rotation Visual Engineering Spec. QI-E.11 M W SW
d. Inspect interlock & control correctly operate Test Engineering Spec. QI-E.08 M W SW
e. Test indicating and signaling lamps or devices Test Engineering Spec. QI-E.01.02 M W SW
f. Switchgear / MCC function test Test Engineering Spec. QI-E.08 M P SW
g. Earthing resistance measurement Test Engineering Spec. - M P P
4 DIESEL ENGINE GENERATOR
4.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.08 M R R
b. Foundation as per Civil Data Visual IFC Drawing M W R
c. Check Name plate and Rating Visual IFC Drawing QI-E.01.08 M W R
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.08 M W R
4.2 Installation
a. Visual & dimensional Visual IFC Drawing QI-E.01.08 M W R
b. Check bolting connection Visual IFC Drawing QI-E.01.08 M W R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
c. Check termination cable and wiring number Visual IFC Drawing QI-E.01.08 M W R
d. Check grounding connection Visual Engineering Spec. QI-E.01.08 M W R
e. Check fuel oil consumption Visual Engineering Spec. QI-E.01.08 M W R
f. Check lubricant system Visual Engineering Spec. QI-E.01.08 M W R
4.3 Testing
a. Insulation resistance test Test Engineering Spec. QI-E.02 M W SW
b. Inspect protection system Test Engineering Spec. QI-E.09 M W SW
c. Inspect sequence test Test Engineering Spec. QI-E.11 M W SW
d. Inspect operation / function test Test Engineering Spec. QI-E.08 M W SW
e. Automatic Synchronization & interlock test Test Engineering Spec. QI-E.08 M W SW
f. Load measurement Test Engineering Spec. By Vendor M W SW
5 CABLE INSTALLATION
5.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.04 M W R
b. Cable Trench/ Cable Trays accepted Visual IFC Drawing QI-E.01.15 M R R
c. Aboveground conduit accepted Visual IFC Drawing QI-E.01.16 M R R
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.04 M W W/R
5.2 Installation
a. Visual inspection during pulling cable Visual IFC Drawing QI-E.01.04 M R R
b. Check cable size and installation Visual IFC Drawing QI-E.01.04 M R R
c. Check cable route markers Visual IFC Drawing QI-E.01.04 M R R
d. Check cable end seal and cable gland Visual IFC Drawing QI-E.01.04 M R R
e. Check the cable protection Visual IFC Drawing QI-E.01.04 M R R
f. Check underground cable jointing Visual IFC Drawing QI-E.01.04 M R R
g. Check cable termination and connection Visual IFC Drawing QI-E.01.04 M R R
h. Check grounding connection Visual/ Test IFC Drawing QI-E.01.04 M R R
i. Check cable marker Visual IFC Drawing QI-E.01.04 M R R
5.3 Testing
a. Continuity test Test IFC Drawing QI-E.06 M R R
b. Insulation resistance measurement Test Engineering Spec. QI-E.02 M R R
c. High Voltage test (MV Cable) Test Engineering Spec. QI-E.03 M R R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT

6 GROUNDING SYSTEM
6.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.05 M R R
b. Cable Trench/ Excavation accepted Visual IFC Drawing QI-E.20 M W R
c. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.05 M W R
6.2 Installation
a. Visual inspection during pulling cable Visual IFC Drawing QI-E.01.05 M R R
b. Check cable size and installation Visual IFC Drawing QI-E.01.05 M R R
c. Check underground cable jointing Visual IFC Drawing QI-E.01.05 M R R
d. Check construction electrodes Visual IFC Drawing QI-E.01.05 M W R
e. Check cable clamp and layout Visual IFC Drawing QI-E.01.05 M W R
f. Check protective measurement Visual IFC Drawing QI-E.01.05 M W R
g. Check grounding connection Visual IFC Drawing QI-E.01.05 M W R
6.3 Testing
a. Grounding continuity test Test IFC Drawing QI-E.04 M W SW
b. Inspect resistance of each electrodes & grounding system Test Engineering Spec. QI-E.05 M W SW
c. Insulation Resistance Measurement Test Engineering Spec. QI-E.02 M W SW

7 LIGHTING AND RECEPTACLE INSTALLATION

7.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.06 M R R
b. Pulling cable accepted Visual IFC Drawing QI-E.01.04 M W R
c. Condition of material accepted Visual Engineering Spec. QI-E.01.06 M W R
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.06 M W R
7.2 Installation
a. Visual and dimensional Visual IFC Drawing QI-E.01.06 M R R
b. Inspect personal safety device Visual IFC Drawing QI-E.01.06 M W R
c. Check grounding connection Visual IFC Drawing QI-E.01.06 M W R
d. Check lighting fixture c/w accessories Visual IFC Drawing QI-E.01.06 M R R
e. Check receptacle c/w accessories Visual IFC Drawing QI-E.01.06 M W R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
f. Check the mounting system Visual IFC Drawing QI-E.01.06 M W R
7.3 Testing
a. Test operation and setting of time switches photoelectric. Setting / Test Engineering Spec. QI-E.01.06 P W SW
b. Continuity Test Test IFC Drawing QI-E.06 P W SW
c. Insulation resistance measurement Test Engineering Spec. QI-E.02 P W SW
d. Lighting circuit test Test Engineering Spec. QI-E.10 P W SW
e. Illumination quality check Test Engineering Spec. QI-E.18 P W SW
f. Inspect phase sequence of receptacle Test Engineering Spec. QI-E.11 P W SW

8 UNINTERRUPTED POWER SUPPLY (UPS) & BATTERY CHARGE

8.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.09 M W R
b. Foundation as per Civil Data Visual IFC Drawing - M W R
c. Name plate, rating and layout Visual IFC Drawing QI-E.01.09 M W SW
d. Check enclosure and safety device Visual Engineering Spec. QI-E.01.09 M W SW
e. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.09 M W SW
8.2 Installation
a. Visual & dimensional Visual IFC Drawing QI-E.01.09 M W SW
b. Check bolting connections Visual IFC Drawing QI-E.01.09 M W SW
c. Check termination and wiring number Visual IFC Drawing QI-E.01.09 M W SW
d. Check grounding connection Visual IFC Drawing QI-E.01.09 M W SW
e. Check battery rack installation Visual IFC Drawing QI-E.01.09 M W SW
f. Check the electrolyte Visual Engineering Spec. QI-E.01.09 M W SW
8.3 Testing
a. Battery
- Visual of Initial Record Visual IFC Drawing QI-E.01.09 M W SW
- Check of Initial Charge Record Visual IFC Drawing QI-E.01.09 M W SW
- Check of Initial Discharge Record Visual IFC Drawing QI-E.01.09 M W SW
- Charging test Test Engineering Spec. QI-E.17 M W SW
- Back up time measurement (normal load) Test Engineering Spec. QI-E.01.09 M W SW
b. Battery Charger
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
- Performance Test Test Engineering Spec. QI-E.17 M W SW
- Sequence and Alarm Test Test Engineering Spec. QI-E.08 M W SW
- Insulation Resistance Measurement Test Engineering Spec. QI-E.02 M W SW
- Noise Level Measurement Test Engineering Spec. QI-E.01.09 M W SW
c. Inverter
- Performance Test Test Engineering Spec. QI-E.17 M W SW
- Sequence and Alarm Test Test Engineering Spec. QI-E.08 M W SW
- Insulation Resistance Measurement Test Engineering Spec. QI-E.02 M W SW
- Noise Level Measurement Test Engineering Spec. QI-E.01.09 M W SW
d. Safety & Alarm Test Test Engineering Spec. M W SW
9 FIRE ALARM SYSTEM
9.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.10 M W R
b. Pulling cable accepted Visual IFC Drawing QI-E.01.04 M W SW
c. Condition of material accepted Visual Engineering Spec. QI-E.01.10 M W SW
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.10 M W SW
9.2 Installation
a. Visual and dimensional Visual IFC Drawing QI-E.01.10 M W SW
b. Inspect personal safety device Visual IFC Drawing QI-E.01.10 M W SW
c. Check board assembly and bolting Visual IFC Drawing QI-E.01.10 M W SW
d. Check the mounting system Visual IFC Drawing QI-E.01.10 M W SW
e. Check grounding connection Visual IFC Drawing QI-E.01.10 M W SW
f. Check termination and wiring number Visual IFC Drawing QI-E.01.10 M W SW
9.3 Testing
a. Continuity test Test IFC Drawing QI-E.06 M W SW
b. Insulation resistance measurement Test Engineering Spec. QI-E.02 M W SW
c. Test indicating signaling lamps and devices Test Engineering Spec. QI-E.01.10 M W SW
d. Operation test by manual and automatic Test Engineering Spec. QI-E.08 M W SW
e. Alarm system test Test Engineering Spec. QI-E.08 M W SW

10 LIGHTING PANEL
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
10.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.11 M W R
b. Foundation as per Civil Data/ Support accepted Visual IFC Drawing M W SW
c. Pulling cable accepted Visual IFC Drawing QI-E.01.04 M W SW
d. Check Name plate and Rating Visual IFC Drawing QI-E.01.11 M W SW
e. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.11 M W SW
10.2 Installation
a. Visual & dimensional Visual IFC Drawing QI-E.01.11 M W SW
b. Board assembly and bolting Visual IFC Drawing QI-E.01.11 M W SW
c. Busbars bolted connection Visual IFC Drawing QI-E.01.11 M W SW
d. Check Fuse and Circuit breaker ratings Visual IFC Drawing QI-E.01.11 M W SW
e. Contact alignment of draw-out mechanism Visual IFC Drawing QI-E.01.11 M W SW
f. Cable glands, clamping and installation Visual IFC Drawing QI-E.01.11 M W SW
g. Tag & wire number Visual IFC Drawing QI-E.01.11 M W SW
h. Check grounding connections Visual IFC Drawing QI-E.01.11 M W SW
i. Check termination and wiring number Visual IFC Drawing QI-E.01.11 M W SW
10.3 Testing
a. Continuity test Test IFC Drawing QI-E.06 M W SW
b. Insulation resistance measurement Test Engineering Spec. QI-E.02 M W SW
c. Phase sequence test Test Engineering Spec. QI-E.11 M W SW
d. Operation test Test Engineering Spec. QI-E.08 M W SW

11 CCTV
11.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.12 M W SW
b. Pulling cable accepted Visual IFC Drawing QI-E.01.04 M W SW
c. Condition of material accepted Visual Engineering Spec. QI-E.01.12 M W SW
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.12 M W SW
11.2 Installation
a. Visual and dimensional Visual IFC Drawing QI-E.01.12 M W SW
b. Inspect personal safety device Visual IFC Drawing QI-E.01.12 M W SW
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
c. Check board assembly and bolting Visual IFC Drawing QI-E.01.12 M W SW
d. Check the mounting system Visual IFC Drawing QI-E.01.12 M W SW
e. Check grounding connection Visual IFC Drawing QI-E.01.12 M W SW
f. Check termination and wiring number Visual IFC Drawing QI-E.01.12 M W SW
11.3 Testing
a. Continuity test Test IFC Drawing QI-E.06 M W SW
b. Insulation resistance measurement Test Engineering Spec. QI-E.02 M W SW
c. Operation test Test Engineering Spec. QI-E.08 M W SW

12 CABLE TRAY
12.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.15 M W R
b. Foundation as per Civil Data / Support accepted Visual IFC Drawing QI-E.01.15 M W SW
c. Check enclosure and safety device Visual IFC Drawing QI-E.01.15 M W SW
d. Condition and type of material accepted Visual Engineering Spec. QI-E.01.15 M W SW
12.2 Installation
a. Visual and dimensional inspection Visual IFC Drawing QI-E.01.15 M W SW
b. Check support of cable tray Visual IFC Drawing QI-E.01.15 M W SW
c. Alignment of cable tray Visual IFC Drawing QI-E.01.15 M W SW
d. Check installation of separator Visual IFC Drawing QI-E.01.15 M W SW
e. Check tightening bolt & nuts Visual IFC Drawing QI-E.01.15 M W SW
f. Check grounding connection Visual IFC Drawing QI-E.01.15 M W SW
g. Check completely of cover with clamp Visual IFC Drawing QI-E.01.15 M W SW

13 ABOVEGROUND CONDUIT
13.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.16 M W R
b. Support or bracket accepted Visual IFC Drawing QI-E.01.16 M W SW
c. Check enclosure and safety device Visual IFC Drawing QI-E.01.16 M W SW
d. Condition and type of material accepted Visual Engineering Spec. QI-E.01.16 M W SW
13.2 Installation
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
a. Visual and dimensional Visual IFC Drawing QI-E.01.16 M W SW
b. Check Support of conduit Visual IFC Drawing QI-E.01.16 M W SW
c. Alignment of conduit installation Visual IFC Drawing QI-E.01.16 M W SW
d. Check tightening bolt & nuts Visual IFC Drawing QI-E.01.16 M W SW
e. Make sure of conduit's clean and free damages Visual IFC Drawing QI-E.01.16 M W SW
f. Check bending radius of conduit Visual IFC Drawing QI-E.01.16 M W SW

14 PANEL DISTRIBUTION BOARD

14.1 Preparation
a. Location /Area Classification Visual IFC Drawing QI-E.01.18 M W R
b. Foundation as per Civil Data Visual IFC Drawing - M W SW
c. Check Name plate and Rating Visual IFC Drawing QI-E.01.18 M W SW
d. Tools / Equipment Tester Calibration/Review Engineering Spec. QI-E.01.18 M W SW
14.2 Installation
a. Visual & dimensional Visual IFC Drawing QI-E.01.18 M W SW
b. All MCB operational and correct rating. Visual Engineering Spec. QI-E.01.18 M W SW
c. All fuses correct rating. Visual IFC Drawing QI-E.01.18 M W SW
d. All terminal wiring completed and secure. Visual IFC Drawing QI-E.01.18 M W SW
e. All cable connected and glanded correctly. Visual Engineering Spec. QI-E.01.18 M W SW
f. Earthling connected and correct. Visual IFC Drawing QI-E.01.18 M W SW
g. All terminations secured. Visual Engineering Spec. QI-E.01.18 M W SW
h. All internal equipment labeled correctly. Visual Engineering Spec. QI-E.01.18 M W SW
i. Cable tags labeled correctly. Visual Engineering Spec. QI-E.01.18 M W SW
j. Installation Accepted. Visual Engineering Spec. QI-E.01.18 M W SW
k. Panel meter (voltage meter, ampere meter, frequency meter) Visual Engineering Spec. QI-E.01.18 M W SW
14.3 Testing
a. Insulation resistance measurement Test Engineering Spec. QI-E.02 M W SW
b. Test anti-condensation heater Test Engineering Spec. QI-E.01.18 M W SW
c. Phase sequence test Test Engineering Spec. QI-E.11 M W SW
d. Inspect interlock & control correctly operate Test Engineering Spec. QI-E.08 M W SW
e. Test indicating and signaling lamps or devices Test Engineering Spec. QI-E.01.18 M W SW
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 9 of 9

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev. M : Monitoring
H : Hold Point A : Approval
W : 100% Witness R : Review P : Perform / Prepare
ELECTRICAL 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik

Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
f. Operation / function test Test Engineering Spec. QI-E.08 M W SW

`
Prepared By, Checked/Reviewed By, Reviewed/Approved By, Reviewed/Approved By,
KWRK PMC PERTAGAS PJIT/MIGAS

Name : Date : Name : Date : Name : Date : Name : Date :

 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
1 Pre-Inspection Meeting Attend - Minute of Meeting
2 INSTALLATION INSPECTION
2.1 Preparation
a. Conform instrument with specification Review Engineering Spec. Data sheet R R R
2.2 Installation
a. Install instrument and termination Visual Instrument Connetion List QI-J09 / QI-J09a M W SW
2.3 Inspection
a. Check Tag.Number and Tag.Plate Visual Engineering Spec. QI-J09 / QI-J09a M W SW
b. Check process connection Visual Engineering Spec. QI-J09 / QI-J09a M W SW
c. Check Bolt and nut Visual Engineering Spec. QI-J09 / QI-J09a M W SW
d. Check cable entry Visual Engineering Spec. QI-J09 / QI-J09a M W SW
e. Check cable gland Visual Engineering Spec. QI-J09 / QI-J09a M W SW
f. Check Termination Visual Termination diagram QI-J09 / QI-J09a M W SW
g. Check Tubing Connection Visual Hook up QI-J09 / QI-J09a M W SW
h. Check gasket Visual Engineering Spec. QI-J09 / QI-J09a M W SW
i. Check Orientation Visual Engineering Spec. QI-J09 / QI-J09a M W SW
j. Check air supply Visual Engineering Spec. QI-J09 / QI-J09a M W SW
k. Conform with hook up Visual Hook up QI-J09 / QI-J09a M W SW
l. Check mounting/support Visual Engineering Spec. QI-J09 / QI-J09a M W SW
m. Check enclosure Visual Engineering Spec. QI-J09 / QI-J09a M W SW
n. Check power supply Visual Engineering Spec. QI-J09 / QI-J09a M W SW
o. Check flow direction Visual PID QI-J09 / QI-J09a M W SW

3 TEST AND INSPECTION FOR INSTRUMENT WIRING

3.1 Preparation
a. Material Conform to specification Review Engineering Spec. Data sheet R R R R
3.2 Installation
a. Pulling/dressing cable Visual Engineering Spec. QI-J18 M W SW R
b. Termination Visual Engineering Spec. QI-J09 M W SW R
c. Clamping and Supporting Visual Drawing QI-J12 M W SW R
d. Labelling of Cable Visual Drawing QI - J01, QI - J07, M W SW R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
e. Tightness of Compaction and Fastening Test Engineering Spec. QI-J12 M W SW R
3.3 Testing
a. Continuity Test Test Engineering Spec. QI-J-01 / QI-J01a M W W R
b. Megger Test Test Engineering Spec. QI-J-01 / QI-J01a M W W R

TEST PRESSURE/LEAKAGE AND INSPECTION FOR INSTRUMENT

4
PRESSURE PIPING
4.1 Preparation
a. Conform material to specification/data sheet Review Engineering Spec. Data sheet R R R R
4.2 Installation
a. Install instrument pressure piping Visual Engineering Spec. QI-J17 M W SW R
b. Space allowance for thermal expansion Visual Engineering Spec. QI - J17 M W SW R
c. Checking and Tighting all connection Visual Engineering Spec. QI-J17 M W SW R
4.3 Testing
a. Leak Test Test Engineering Spec. QI-J02 M W W R

5 TEST PRESSURE/LEAKAGE AND INSPECTION FOR AIR SUPPLY PIPING

5.1 Preparation
a. Conform material to specification Review Engineering Spec. Data sheet R R R R
5.2 Installation
a. Install instrument air supply piping Visual Engineering Spec. QI-J17 M W SW R
b. Hook-up drawing checking Visual Engineering Spec. QI-J17 M W SW R
c. Checking and Tighting all connection Visual Engineering Spec. QI-J17 M W SW R
5.3 Testing
a. Leak Test Test Engineering Spec. QI-J03 M W W R

TEST PRESSURE/LEAKAGE AND INSPECTION FOR INSTRUMENT AIR

6
TUBING
6.1 Preparation
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
a. Conform material to specification Review Engineering Spec. Data sheet R R R
6.2 Installation
a. Install instrument air tubing Visual Engineering Spec. QI-J17 M W SW
b. Hook-up drawing checking Visual Engineering Spec. QI-J17 M W SW
c. Checking all connection Visual Engineering Spec. QI-J17 M W SW
6.3 Testing
a. Leak Test Test Engineering Spec. QI-J03 M W W

CALIBRATION OF INSTRUMENT, CONTROL VALVES, PRESSURE

7
SAFETY VALVE, MOTOR OPERATION VALVE, ETC.
7.1 Preparation
a. Check specification data sheet and drawing Visual Data sheet QI-J05 / QI-J10 R R R R
b. Check instrument (control valves etc) Visual Engineering Spec. QI-J05 / QI-J10 M W SW R
c. Accessories equipment Visual Manual Book QI-J13 M W SW R
7.2 Testing
a. Stroke Test, Calibration PSV etc Test Engineering Spec., Data Sheet QI-J05 / QI-J10 M W W R

8 CALIBRATION OF FLOW PRESSURE, LEVEL, TEMPERATURE GAUGE

8.1 Preparation
a. Check specification and drawing Visual Data sheet R R R R
b. Check instrument Visual Engineering Spec. QI-J09 / QI-J09a M W SW R
c. Check test bench and tester Visual Manual Book QI-J09 / QI-J09a M W SW R
d. Check mill test report Visual Certificate - M R R R
8.2 Testing
QI-J04, QI-J11, QI-J14,
Calibration, Performance Test : hysteresis, press test, system level
a. Test Engineering Spec., Data Sheet QI-J15, QI-J16, QI- M W W R
functional test
J19

9 CALIBRATION OF FLOW PRESSURE, LEVEL, TEMPERATURE SWITCH

9.1 Preparation
a. Check specification and drawing Visual Data sheet R R R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
b. Check instrument Visual Engineering Spec. QI-J09 / QI-J09a M W R
c. Check test bench and tester Visual Manual Book QI-J09 / QI-J09a M W R
d. Check mill test report Visual Certificate - M R R R
9.2 Testing
QI-J04, QI-J11, QI-J14,
a. Calibration, Press Test, Performance test Test Engineering Spec., Data Sheet QI-J15, QI-J16, QI- M W R R
J19

CALIBRATION OF PRESSURE, LEVEL, TEMPERATURE, VIBRATION

10
TRANSMITTER
10.1 Preparation
a. Check specification and drawing Visual Data sheet R R R R
b. Check instrument Visual Engineering Spec. QI-J09 / QI-J09a M W SW R
c. Check test bench and tester Visual Manual Book QI-J09 / QI-J09a M W SW R
d. Check mill test report Visual Certificate - M R R R
10.2 Testing
QI-J04, QI-J11, QI-J14,
a. Calibration, Performance Test Test Engineering Spec., Data Sheet QI-J15, QI-J16, QI- M W W R
J19

SEQUENCE TEST INCLUDING SHUT DOWN SYSTEM & FIRE AND GAS
11
DECTECTOR SYSTEM
11.1 Preparation
a. Check termination Visual Engineering Spec. QI-J09, QI-J07 M W W R
QI-J04, QI-J11, QI-J14,
b. Check individual calibration report Visual Data Sheet QI-J15, QI-J16, QI- M R R R
J19
c. check interlock logic diagram Visual Data Sheet Logic Diagram - M R R R
d. I/O Check Test Data Sheet Logic Diagram - M R R R
e. Control/ alarm /trend Grouping chek Test Data Sheet Logic Diagram - M R R R
11.2 Test
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT

Engineering Spec., Interlook Logic

a. Sequence test, system shut down funcionally check Test QI-J08 M W W R
Diagram

FUNCTIONAL LOOP TEST INCLUDING ALARM/TRIP SETTING TEST

12
DATA & ACTION OF CONTROL VALVE
12.1 Preparation
a. Check termination Visual Engineering Spec. QI-J09, QI-J07 M W W R
QI-J04, QI-J11, QI-J14,
b. Check individual calibration report Visual Data Sheet QI-J15, QI-J16, QI- M R R R
J19
c. check loop diagram Visual Data Sheet Loop Diagram - M R R R
12.2 Test
Engineering Spec., Interlook Logic
a. Sequence test, Alarm circuit test, Switching device test Test QI-J06, QI-J06a M W W R
Diagram

INSPECTION FOR CABLE TRAY, CABLE DUCT AND CABLE LADDER

13
INSTALLATION
13.1 Preparation
a. Material Conform to specification Visual Engineering Spec. QI-J12 M R R
13.2 Installation
a. Install cable ladder, tray, cable duct Visual Lay Out of Instrument Cable Way QI-J12 M W R
b. Install jointing and support Visual Engineering Spec. QI-J12 M W R
13.3 Inspection
a. Finishing Visual Engineering Spec. QI-J12 M W R
b. Coating thickness/galvanis Visual Engineering Spec. QI-J12 M W R
c. Cable way Visual IFC Drawing QI-J12 M W R
d. Bolt and nut Visual Engineering Spec. QI-J12 M W R
e. Reducer Visual Engineering Spec. QI-J12 M W R
f. Jointing Visual Engineering Spec. QI-J12 M W R
g. Support and braces Visual IFC Drawing QI-J12 M W R
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
h. Covers Visual Engineering Spec. QI-J12 M W R
i Partitions Visual Engineering Spec. QI-J12 M W R
j. no conflict with piping layout Visual Engineering Spec. QI-J12 M W R
k. no conflict with other installation Visual Engineering Spec. QI-J12 M W R

14 EMERGENCY SHUTDOWN SYSTEM (ESD)

14.1 Preparation
a. Location /Area Classification Visual IFC Drawing Inspection Report R R R R
b. Check Name plate Visual IFC Drawing Inspection Report R R R R
c. Tools / Equipment Tester Calibration/Review Engineering Spec. Calibration Report M R R R
14.2 Installation
a. Visual & dimensional Visual IFC Drawing Inspection Report M W SW R
b. Board assembly and bolting Visual Engineering Spec. Inspection Report M W SW R
c. Fuse ratings and gauge rings Visual IFC Drawing Inspection Report M W SW R
d. Cable glands, clamping and termination Visual IFC Drawing Inspection Report M W SW R
e. Tag & wire number Visual IFC Drawing Inspection Report M W SW R
f. Check grounding connections Visual IFC Drawing Inspection Report M W SW R
14.3 Inspection
a. Wiring And Termination Test Engineering Spec. QI-J09 / QI-J09a M W W R
b. Site Acceptance Test Test Data sheet Vendor Report M W W W
QI-J04, QI-J11, QI-J14, W W
Other test as may be found necessary during design, erection and
c. Test Data sheet QI-J15, QI-J16, QI- M W
commissioning periods
J19

Prepared By, Checked/Reviewed By, Reviewed/Approved By, Reviewed/Approved By,

KWRK PMC PERTAGAS PJIT/MIGAS
 JASA PERANCANGAN PENGADAAN DAN KONSTRUKSI Contract No. : SP-203/PG0300/2014-SO
PEMBANGUNAN PIPA TRANSMISI GAS DARI Main Contractor : KWRK Date :
GRESIK - SEMARANG Project Owner : PERTAGAS Report No. :
Document No. : GRSM-00-QAC-PLAN-003 Page : 6 of 6

INSPECTION TEST PLAN (ITP)

Legend
Disciplin Rev.
H : Hold Point A : Approval M : Monitoring
W : 100% Witness R : Review P : Perform / Prepare
INSTRUMENT 0 SW : Spot/Random Witness V : Verification I : Information
KWRK : Konsorsium WIKA REBANA KELSRI PMC : Project Management Consultan PJIT : Perusahaan Jasa Inspeksi Teknik
Responsibility
No DESCRIPTION INSPECTION METHOD ACCEPTENCE CRITERIA VERIVIED DOCUMENT
KWRK PMC PTG PJIT
Name : Date : Name : Date : Name : Date : Name : Date :