MANTAN PRIMA PERSADA
Contractor & Mining
KPP Developer
(QA7 & QA1) MACHINE INSPECTION REPORT
MACHINE WHEN INSPECTED
MODEL CODE NUMBER DATE HOUR METER
KSB19
COMP NO ITEM TO BE CHECK CHECK POINT
1 Radiator core & Fin,cap,strainer and pressure valve Dirty,leak,clogged,damage
2 Water level sensor Mulfunction (Check condition @ 4000 HR)
SAFETY TANK
RADIATOR &
3 Safety tank level Clogged,crack,cap lost,mulfunction
4 Water Pump,Corrossion filter and valve Leak,mulfunction
5 Hose and pipe connection Leak,crack,loose,deformation
6 Fan balde,Puly,V-belt and tension pully Loose,damage,worn out,
7 Water temp.sensor and cable Damage,lost,mulfunction,disconnection
1 Lubrication oil Leveland plug connection
2 Lub.oil piping and hoses Leak,loose,crack,deformation
3 Air cleaner,rubber and connection Clogged,crack,cap lost,deformation
4 Exh.manifold,mufler,mounting bolt and temp.sensor Leak,loose,crack,deformation
5 Turbocharger,clamp and mounting bolt Leak,loose,crack,unusual noise
6 Cyl.head,return fuel line,rocker arm cover Leak,loose,unusual noise
ENGINE
7 Cyl.Block,Oil cooler,front seal,oil pressure sensor Leak,crack
8 Oil filter,bracket,piping and hoses Leak,loost,damage,deformasion
9 Fuel filter,fuel line,fuel tank,water sparator & breather Leak,loost,damage,deformasion
10 Fuel Pump,coupling and mounting bolt Leak,crack,loose,lost,
Unusual noise,leaking,Low power,Black
11 Running Test
smoke,
12 Water temperature Over heat,over cool
13 Exhaust smoke and temperatur Excess color (black,blue,white) and too High
1 Battery electrolit Level,deterioration
2 Battery,clamp and cable connection Low current,loose,crack,dirty
ELECTRICAL
3 Battery relay,St.motor,Alternator,St.Switch Damage,mulfunction
SYSTEM
4 Gauge,pannel lamp,fuse,relay and wiring connection Damage,loose,mulfunction
5 Lock Off switch and wiring Function and connection
6 Service meter Damage,mulfunction
7 Warning lamp,working lamp,turn lamp,brake lamp,Rotary lamp Damage,mulfunction
1 Grease lubricating Level,deterioration
AUTOLUBE
2 Botle,Pump and mounting bolt Leak,Clogged,crack,loose
3 Piping,hoses,distributor and mounting bolt Leak,Clogged,crack,loose
4 Setting timer Over,low,mulfunction
MANTAN PRIMA PERSADA
Contractor & Mining
KPP Developer
(QA7 & QA1) MACHINE INSPECTION REPORT
MACHINE WHEN INSPECTED
MODEL CODE NUMBER DATE HOUR METER
KSB19
COMP NO ITEM TO BE CHECK CHECK POINT
1 Breather bare, shaft pump Clogged,crack,cap lost,deformation
2 Intake & exhaust vacuum Leak,loose,crack,deformation
3 Lube oil and grease leak main pump Leak,crack,loose,deformation
4 Water leaks for main pump Leak,loose,crack,deformation
5 Hose bolts tightness loose,lost,deformation
ATTACHMENT
6 Vacuum gauge Damage,mulfunction
7 Gland Packing Leak,crack
8 Butterfly valve leaks Leak,crack,loose,deformation
9 Main pump bearing, Vacuum pump bearing, lost,crack,unusual noise
10 Krundiment valve Leak,crack,loose,deformation
11 Non return valve Leak,crack,loose,deformation
12 Guarding Crack, lost
Mechanic comment :
V : Good Condition
Notes :
Approved by, Inspect
X : Bad Condition
( ) (
NA: Not Aplicable G.Leader Me
Form No. S.2.2.030/FRM
Rev : 00
ECTION REPORT
CONDITION WATER PUMP
QA 7 QA 1 REMARKS
Form No. S.2.2.030/FRM
Rev : 00
ECTION REPORT
CONDITION WATER PUMP
QA 7 QA 1 REMARKS
Inspected QA 7 by, Inspected QA 1 by,
( ) ( )
Mechanic Mechanic
Page 1 / 6
PT PAMAPERSADA NUSANTARA Form No. S.2.2.030/FRM
MINING CONTRACTOR
MANTAN PRIMA PERSADA
Contractor & Mining Rev : 00
KPP
Developer
PERIODICAL SERVICE FORM
WATER PUMP
ENGINE MODEL :
CODE NUMBER : KSB19
PS I PS II PS III PS IV PIC
WORK ORDER NUMBER
HOUR METER
SERVICE
Mechanic
DATE
START TIME
FINISH TIME
MAN POWER QTY PS
START TIME ALL ACTIVITIES
ACTIVITIES
LEAD TIME
WASHING UNIT (HOUR)
Mechanic
SERVICE TIME (HOUR)
WASHING AFTER SERVICE (HOUR)
FINISH TIME ALL ACTIVITIES (RFU TIME)
Mec.
PAP ENGINE OIL (QTY BOTTLE)
FILLED BY GROUP LEADER PS I PS II PS III PS IV PIC
TOTAL DOWN TIME (HOUR)
GL
MANHOUR PS (HOUR)
FINAL CHECK (dilakukan setelah PS) ACTIVITY PS I PS II PS III PS IV PIC
1 WALK AROUND CHECK RECHECK
2 OIL LEVEL RECHECK
3 FILTERS TIGHTNESS & LEAKAGE RECHECK
4 OIL & FUEL CAP TIGHTNESS RECHECK
5 DRAIN PLUG TIGHTNESS & LEAKAGE RECHECK
6 BACKLOG REPAIR QUALITY RECHECK
7 WATERCOOLANT LEVEL RECHECK GROUP LEADER
8 PANEL, WARNING LAMP & BUZZER RECHECK
9 START ENGINE, CHECK NOISE RECHECK
10 WORKLAMP, SIGNAL LAMP RECHECK
11 WORK EQUIPMENT FUNCTION RECHECK
12 OIL/WATER/FUEL LEAKAGE RECHECK
NAME
SIGN
Page 2 / 6
Form No. S.2.2.030/FRM
KALIMANTAN PRIMA PERSADA
Contractor & Mining Rev : 00
KPP
Developer
PERIODICAL SERVICE FORM
WATER PUMP
DnD200
HM
CODE NUMBER : KSB19 Mech.
EVERY 250 HOURS ACTIVITY STD PS I PS II PS III PS IV PIC
1 ENGINE OIL CHANGE 30
2 OIL FILTER REPLACE 15
3 FUEL FILTER REPLACE 15
4 RADIATOR COOLANT CHECK BY C/TESTER 5
5 AIR CLEANER CHECK / CLEAN 15
6 DUST INDICATOR CHECK 3
7 EXHAUST SYSTEM LEAKAGE AND CLAMP BOLTS CHECK 5
8 ENGINE RUBBER MOUNTING BOLTS CHECK 5
9 FAN BELT TENSION INSPECT & ADJUST 5
10 ALTERNATOR V-BELT INSPECT & ADJUST 5
11 RUBBER COUPLING MAIN PUMP CHECK / REPLACE 10
12 CLUTCH VACUUM PUMP CHECK / REPLACE 15
13 BELT VACUUM PUMP INSPECT & ADJUST 10
14 VACUUM PUMP MOUNTING FOR TIGHTNESS CHECK & RETIGHTEN 10
MECHANIC
15 BARE SHAFT PUMP LUBRICATE 5
16 NON RETURN VALVE CHECK CONDITION 5
17 DRIVE COUPLING CHECK CONDITION 5
18 VACUM TANK PROBES (VACTRONIC & WATERLOSS) CHECK/CLEAN 10
ELECTRICAL
STARTING & CHARGING SYSTEM
19 STARTING MOTOR CHECK 5
20 BATTERY ELECTROLYTE CHECK / REFILL 3
21 BATTERY TERMINAL CLEAN & CHECK 3
22 ALTERNATOR CHECK / REPLACE 5
23 WIRING HARNESS, MONITOR PANEL, VACTRONIC MODUL CHECK & REPAIR 10
24 COIL & CLUTCH VACUUM PUMP CHECK & REPAIR 5
25 CABLE PROBE CHECK & REPAIR 5
26 ROTARY LAMP CHECK 3
27 WORK LAMP CHECK & REPLACE 5
28 LOCK OUT CHECK 3
29 EMERGENCY STOP CHECK 3
EVERY 500 HOURS ACTIVITY STD PS II PS IV PIC
ENGINE
FUEL SYSTEM
30 FUEL LINE LEAKS AS PIPING,HOSES,FUEL TANK CHECK & REPAIR 10
AIR INTAKE & EXHAUST SYSTEM
31 AIR LINE FOR CLAMP & HOSE CHECK / REPAIR 10
32 TURBOCHARGER CHECK & REPLACE 10
33 AIR INTAKE & EXHAUST FOR LEAKS CHECK / REPAIR 10
34 MUFFLER BRACKET & CLAMP CHECK & RETORQUE 10
COOLING SYSTEM
MECHANIC
35 WATER LINE FOR HOSE, PIPE & CLAMP CHECK/REPLACE 10
36 RADIATOR CORE CHECK/CLEAN 10
37 RADIATOR MOUNTING FOR TIGHTNESS CHECK 10
38 FAN HUB CHECK & LUBRICATE 5
39 WATER PUMP CHECK / REPLACE 15
LUBRICATING SYSTEM
40 OIL LEAKS OF CYLINDER HEAD COVER CHECK & REPAIR 5
ATTACHMENT
41 BREATHER BARE SHAFT PUMP CHECK & REPLACE 5
42 MAIN WATER PUMP LEAKS CHECK & REPAIR 10
43 INTAKE & EXHAUST VACUUM CHECK & REPAIR 5
44 LUBRICATE OIL, GREASE LEAKS FOR MAIN PUMP CHECK & REPAIR 10
5.22
START
STOP
V Kotak checkmark sebagai tanda bahwa recheck telah dilakukan untuk critical item Page 3 / 6
MANTAN PRIMA PERSADA
Contractor & Mining
KPP Developer
PERIODICAL
WATER PUM
DnD200
INSPECTION REPORT CODE NUM
Part Number No.
No HM Problem Description Component Part Description No. Figure
Required Index
Form No. S.2.2.030/FRM
Rev : 00
RIODICAL SERVICE FORM
TER PUMP
D200
DE NUMBER : KSB19
Inspection Plan Repair Plan Repair Status
Qty
Date Date Duration (Hour) (BL/Close)
Page 4 / 6
Form No. S.2.2.030/FRM
MANTAN PRIMA PERSADA
Contractor & Mining Rev : 00
KPP
Developer
PERIODICAL SERVICE FORM
WATER PUMP
DnD200
HM
CODE NUMBER : KSB19 Mech.
EVERY 1000 HOURS ACTIVITY STD PS I PS II PS III PS IV PIC
1 ALL BOLTS HOSES TIGHTNESS CHECK & RETORQUE 5
2 VACUUM GAUGE CHECK & REPLACE 3
3 VACUUM PUMP OIL CHANGE 20
4 GLAND PACKING CHECK & REPLACE 15
5 BUTTERFLY VALVE LEAKS CHECK & REPAIR 15
6 BARE SHAFT PUMP (IMPELLER,WEAR PLATE) CHECK CONDITION 15
7 VACTRONIC CONTROL CHECK CONDITION 5
8 AUTO SHUTDOWN CHECK FUNCTION 3
EVERY 2000 HOURS ACTIVITY STD PS IV PIC
ENGINE
9 WATER COOLANT CHANGE 20
10 AIR CLEANER REPLACE 15
MECHANIC
ATTACHMENT
11 BEARING MAIN PUMP NOISE VISUAL CHECK 3
12 BEARING VACUUM PUMP NOISE VISUAL CHECK 3
13 KRUNDIMENT VALVE CLEAN 15
14 NON RETURN VALVE CHECK / REPLACE 10
2.45
START
STOP
V Kotak checkmark sebagai tanda bahwa recheck telah dilakukan untuk critical item
Page 5 / 6
MANTAN PRIMA PERSADA
Contractor & Mining
KPP Developer
PERIODICAL
WATER PUM
DnD200
INSPECTION REPORT CODE NUM
Part Number No.
No HM Problem Description Component Part Description No. Figure
Required Index
Form No. S.2.2.030/FRM
Rev : 00
RIODICAL SERVICE FORM
TER PUMP
D200
DE NUMBER : DnD200
Inspection Plan Repair Plan Repair Status
Qty
Date Date Duration (Hour) (BL/Close)
Page 6 / 6
