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Scaffolding Request & Modification Form

This document is a scaffolding modification request form for the Tangguh Expansion Project. It requests scaffolding support from CSTS Scaffolding including the type of scaffolding needed, approximate dimensions, estimated volume, required trades, and estimated man-hours. The form must be filled out and signed by the requestor and approved by CSTS personnel. It provides requirements for advance submission of 24 hours for minor or 72 hours for major scaffolding modifications.

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M. Adam Arizal
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253 views1 page

Scaffolding Request & Modification Form

This document is a scaffolding modification request form for the Tangguh Expansion Project. It requests scaffolding support from CSTS Scaffolding including the type of scaffolding needed, approximate dimensions, estimated volume, required trades, and estimated man-hours. The form must be filled out and signed by the requestor and approved by CSTS personnel. It provides requirements for advance submission of 24 hours for minor or 72 hours for major scaffolding modifications.

Uploaded by

M. Adam Arizal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TANGGUH EXPENSION PROJECT

CSTS SCAFFOLDING REQUEST FORM

SCAFFOLDING MODIFICATION REQUEST AND MANPOWER

Request No. : (Requestor ref. no.)


Section 1. Scaffold Request (Fill by Requestor and approved by CSTS Person In Charge) (CSTS ref. no.)

Subcontractor Name* * Discipline(s) requested for the Scaffolder support :


Subcontractor Requestor Name * Select discipline(s) requesting the Scaffolder supports.
Requestor Tel no. / Radio Channel * 1.
Email address * 2.
Date Requested * 3.
Scaffolder Required Date * 4.
Duration Scaffolders Required * 5.
Location of the Scaffolders to be utilized * Details of the Requirement if stated Others in above column:

Scaffolding drawing, marked up / details drawing (Plot Plan,


Scaffolding Plan/Detail Attached * equipment, structure drawings etc…) to be attached by Requestor

Signature *
Accepted by CSTS Area Leader / Discipline
If a S.I raised for the
In charge : (CSTS Signature) Site Instruction No.: scaffolding works

Name :
Date :

Section 2. Scaffolding Modification and Man-hours details

Scaffolding Type to be Modify : Independent Tower Birdcage Suspended Cantilever Mobile Hard Barrier
(Scaffolding Subcontractor to tick related
scaffolding requirement) Other (pls Specify) :

Item Length Width Height Total Scaffold Volume 3 2


Approximate Dimensions (m) : * Unit (M /M /M)
no. (in meter) (in meter) (in meter) / Lift required Estimation
(To be fill by requestor as per their site requirement)

Item Numbers Estimate


Trades TOTAL
no. Require Man-hours
0
0
0
0
0
0
Grand TOTAL : 0 Man-hours

CSTS Verification & Comment :

Subcontractor Scaffolding Group Acceptance: CSTS Scaffolding Group Acceptance and Approval:

Name Name
Company Signature
Signature Date
Date

Notes : Submission of Scaffolding request are as below ;

1. Minimum of 24 hours for MINOR Modification requirement.

2. Minimum of 72 hours for MAJOR Modification requirement.

3. This Request must be submit to CSTS Scaffolding Group after all required columns above filled and signed/approved by related parties.

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