PS III

GROUP LEADER NAME

Halaman 1
 PT PAMAPERSADA NUSANTARA
MINING AND EARTHMOVING CONTRACTOR
PERIODICAL SERVICE FORM A
UNIT MODEL : HD785-7
Sheet 1a of 3
DATE :

CODE NUMBER : HOUR METER :

MECHANIC NAME :

250 500
NO EVERY 250 HOURS RISK REF. NO ACTIVITY VALUE STD
Inspection Follow up Inspection Follow up
Engine Running (Check Before Enter Workshop)

1 Foot brake (service brake) H BRK/0022-00 No move test at F2 min. 1570 rpm 3

2 Retarder brake H BRK/0022-00 No move test at F2 min. 1200 rpm 3

3 Emergency brake (secondary brake) H BRK/0022-00 No move test at F2 min. 1610 rpm 3

4 Parking brake H BRK/0022-00 No move test at F2 min. 1610 rpm 3

5 ASR switch L BRK/0052-00 Check function Active 0.5

6 ARSC switch L BRK/0056-00 Check function Active 0.5

7 AC controller L ACC/0046-00 Check function Good condition 1

8 Dump body positioner L HST/0018-00 Measuring voltage 4.26 V - 4.59 V 0.2

Measuring alternator
9 Alternator performance H ELE/0104-00 27.5 V - 29 V 1
voltage

10 Back alarm H ELE/0097-00 Check function Sound 0.2

Engine Stop (Check After Enter Workshop)

Condition & functional
11 Wiper H FRA/0019-00 Good condition 0.5
check

12 Emergency shut down H ELE/0041-00 Check function Active 0.5

13 Autolube controller L ACC/0030-00 Check function Good condition 4

Action : Action :
14 AC Filter (inner & outer) H ACC/0049-00 Cleaning Clean 10

15 Washer fluid L FRA/0022-00 Check level, add Between level 0.5

16 Radiator coolant color L ENG/0062-00 Check condition Light green 0.5

17 Coolant level H ENG/0001-00 Check level, add Between level 0.2

18 Battery condition L ELE/0001-00 Check load tester Good 5

Check condition,
19 Battery terminal & cable connection H ELE/0094-00 Good condition & tight 1
tightening

20 Battery electrolite level H ELE/0108-00 Check level, add Between level 10

21 Battery vent plug H ELE/0002-00 Cleaning Clean 10

Action : Action :
22 Brake cooling oil tank breather L POT/0043-00 Cleaning Clean 8

23 Grease pump H ACC/0048-00 Check function Active 0.5

24 Grease level L ACC/0029-00 Check level, add Between level 0.2

Action : Action :
25 Outer air cleaner element H ENG/0027-00 Cleaning Clean 15

Action : Action :
26 Cabin area H FRA/0026-00 Cleaning Clean 10

Check condition,
27 Dump body hinge pin (LH & RH) L ACC/0050-00 Good condition, Lubricated 2
Lub. 2 point
Check condition,
28 Rear suspenssion (LH & RH) L ACC/0050-00 Good condition, Lubricated 4
Lub. 4 point
Check condition,
29 Rear axle support (LH & RH) L ACC/0050-00 Good condition, Lubricated 8
Lub. 8 point
Check condition,
30 Hoist cylinder pin (LH & RH) L ACC/0050-00 Good condition, Lubricated 4
Lub. 4 point
Check condition,
31 Front suspenssion (LH & RH) L ACC/0050-00 Good condition, Lubricated 2
Lub. 2 point
Check condition,
32 Steering linkage (LH & RH) L ACC/0050-00 Good condition, Lubricated 6
Lub. 6 point
Check condition,
33 Exhaust brake control link (if equipped) L ACC/0050-00 Good condition, Lubricated 1
Lub. 1 point

EVERY 1000 HOURS REF. NO ACTIVITY VALUE STD 250 500

34 Air cleaner element assy H ENG/0027-00 Replace New part 10

Action : Action :

35 AC outer filter L ACC/0049-00 Replace New part

Action : Action :

EVERY 2000 HOURS REF. NO ACTIVITY VALUE STD 250 500

36 AC inner filter L ACC/0049-00 Replace New 10

Action : Action :

37 PDU cable connector & bolt mounting L ELE/0037-00 Visual check Good condition 15

38 Coolant level sensor L ENG/0013-00 Check function Good condition 20

39 Radiator cap H ENG/0015-00 Measure relief pressure Relief press 0,5 kg/cm2 15

Note :
Condition Inspection Follow Up RISK Group Leader Sign
Good cond V N/A H = HIGH, Must be closed, No backlog
2 columns Bad cond (Write the problem) (Write the action) L = LOW, May include in backlog Group Leader Name
N/A (if good)
Measure (Write the result)
(Write the action if bad)
1 column - Action: (Write the action)
 PT PAMAPERSADA NUSANTARA
MINING AND EARTHMOVING CONTRACTOR
PERIODICAL SERVICE FORM A
UNIT MODEL : HD785-7
Sheet 1b of 3
DATE :

CODE NUMBER : HOUR METER :

MECHANIC NAME :

750 1000
NO EVERY 250 HOURS RISK REF. NO ACTIVITY VALUE STD
Inspection Follow up Inspection Follow up
Engine Running (Check Before Enter Workshop)

1 Foot brake (service brake) H BRK/0022-00 No move test at F2 min. 1570 rpm 3

2 Retarder brake H BRK/0022-00 No move test at F2 min. 1200 rpm 3

3 Emergency brake (secondary brake) H BRK/0022-00 No move test at F2 min. 1610 rpm 3

4 Parking brake H BRK/0022-00 No move test at F2 min. 1610 rpm 3

5 ASR switch L BRK/0052-00 Check function Active 0.5

6 ARSC switch L BRK/0056-00 Check function Active 0.5

7 AC controller L ACC/0046-00 Check function Good condition 1

8 Dump body positioner L HST/0018-00 Measuring voltage 4.26 V - 4.59 V 0.2

Measuring alternator
9 Alternator performance H ELE/0104-00 27.5 V - 29 V 1
voltage

10 Back alarm H ELE/0097-00 Check function Sound 0.2

Engine Stop (Check After Enter Workshop)

Condition & functional
11 Wiper H FRA/0019-00 Good condition 0.5
check

12 Emergency shut down H ELE/0041-00 Check function Active 0.5

13 Autolube controller L ACC/0030-00 Check function Good condition 4

Action : Action :
14 AC Filter (inner & outer) H ACC/0049-00 Cleaning Clean 10

15 Washer fluid L FRA/0022-00 Check level, add Between level 0.5

16 Radiator coolant color L ENG/0062-00 Check condition Light green 0.5

17 Coolant level H ENG/0001-00 Check level, add Between level 0.2

18 Battery condition L ELE/0001-00 Check load tester Good 5

Check condition,
19 Battery terminal & cable connection H ELE/0094-00 Good condition & tight 1
tightening

20 Battery electrolite level H ELE/0108-00 Check level, add Between level 10

21 Battery vent plug H ELE/0002-00 Cleaning Clean 10

Action : Action :
22 Brake cooling oil tank breather L POT/0043-00 Cleaning Clean 8

23 Grease pump H ACC/0048-00 Check function Active 0.5

24 Grease level L ACC/0029-00 Check level, add Between level 0.2

Action : Action :
25 Outer air cleaner element H ENG/0027-00 Cleaning Clean 15

Action : Action :
26 Cabin area H FRA/0026-00 Cleaning Clean 10

Check condition,
27 Dump body hinge pin (LH & RH) L ACC/0050-00 Good condition, Lubricated 2
Lub. 2 point
Check condition,
28 Rear suspenssion (LH & RH) L ACC/0050-00 Good condition, Lubricated 4
Lub. 4 point
Check condition,
29 Rear axle support (LH & RH) L ACC/0050-00 Good condition, Lubricated 8
Lub. 8 point
Check condition,
30 Hoist cylinder pin (LH & RH) L ACC/0050-00 Good condition, Lubricated 4
Lub. 4 point
Check condition,
31 Front suspenssion (LH & RH) L ACC/0050-00 Good condition, Lubricated 2
Lub. 2 point
Check condition,
32 Steering linkage (LH & RH) L ACC/0050-00 Good condition, Lubricated 6
Lub. 6 point
Check condition,
33 Exhaust brake control link (if equipped) L ACC/0050-00 Good condition, Lubricated 1
Lub. 1 point

EVERY 1000 HOURS REF. NO ACTIVITY VALUE STD 750 1000

34 Air cleaner element assy H ENG/0027-00 Replace New part 10

Action : Action :

35 AC outer filter L ACC/0049-00 Replace New part

Action : Action :

EVERY 2000 HOURS REF. NO ACTIVITY VALUE STD 750 1000

36 AC inner filter L ACC/0049-00 Replace New 10

Action : Action :

37 PDU cable connector & bolt mounting L ELE/0037-00 Visual check Good condition 15

38 Coolant level sensor L ENG/0013-00 Check function Good condition 20

39 Radiator cap H ENG/0015-00 Measure relief pressure Relief press 0,5 kg/cm2 15

Note :
Condition Inspection Follow Up RISK Group Leader Sign
Good cond V N/A H = HIGH, Must be closed, No backlog
2 columns Bad cond (Write the problem) (Write the action) L = LOW, May include in backlog Group Leader Name
N/A (if good)
Measure (Write the result)
(Write the action if bad)
1 column - Action: (Write the action)
 PT PAMAPERSADA NUSANTARA
MINING AND EARTHMOVING CONTRACTOR
PERIODICAL SERVICE FORM B
UNIT MODEL : HD785-7
Sheet 2a of 3
DATE :

CODE NUMBER : HOUR METER :

MECHANIC NAME :

250 500
NO EVERY 250 HOURS RISK REF NO ACTIVITY VALUE STD
Inspection Follow up Inspection Follow up

1 Lock out switch H ELE/0010-00 Check function E/G can't start 0.5

2 Radiator fin L ENG/0007-00 Check and clean No clogged, dented 15

3 AC condensor fin L ACC/0045-00 Check and clean No clogged, dented 5

4 Engine oil level H ENG/0016-00 Check level, add Between level 1

Action : Action :
5 Engine oil H ENG/0063-00 Take oil sample 1 bottle 3

6 Starting motor terminal & cable connection L ELE/0016-00 Check & clean Thight, clean 0.5

Action : Action :
7 Engine breather hose H - Cleaning Clean 5

8 Alternator terminal & cable connection L ELE/0014-00 Check torque & clean Tight & clean 0.5

9 Alternator v-belt H ELE/0029-00 Check condition No cut, crack 3

10 Alternator v-belt tension H ELE/0029-00 Measure & adjust Deflection 10 - 15 mm/ 6 Kg 1

11 AC compressor v-belt H ACC 0038-00 Check condition No cut, crack 0.5

12 AC compressor v-belt tension H ACC 0038-00 Measure & adjust Deflection 10 - 15 mm/ 6 Kg 1

13 Magnetic coil of AC compressor clutch L ACC 0043-00 Measure resistance Standart: ±15 Ohm 4

low side 100 Psi (e/g stop), or

1.5-2 bar (e/g run)
14 Compressor AC refrigerant H ACC 0041-00 Check pressure 10
High side 100 Psi (e/g stop), or
12-17 bar (e/g run)

15 Fire supression nozzle L ACC 0009-00 Visual check Good condition & complete 1

Good condition & clamp

16 Fire supression tube & clamp (LOP only) H ACC/0028-00 Check condition 1
complete

17 Water separator (LH & RH) L ENG/0064-00 Visual check No water 2

18 Hydraulic oil level H HST 0001-00 Check level, add Between level 0.5

Action : Action :
19 Hydraulic tank breather H HST 0009-00 Cleaning Clean 5

Action : Action :
20 Fuel Tank H ENG/0064-00 Drain sludge No sludge 0.5

Does not slip

21 AC compressor clutch H ACC 0042-00 Check function 3
(starting switch ON)

EVERY 500 HOURS REF NO ACTIVITY VALUE STD 250 500

Action : (only for ADRO) Action :
22 Fuel prefilter cartridge H ENG/0066-00 Replace New 15

Action : Action :
23 Engine oil H ENG/0019-00 Replace New 15

Action : Action :
24 Engine oil filter H - Replace New 10

EVERY 1000 HOURS REF NO ACTIVITY VALUE STD 250 500

Action : Action :
25 Hydraulic oil strainer H HST/0021-00 Cleaning Clean 15

26 Starting motor bolt mounting H ELE/0109-00 Check & tighten Complete & tight 1

Action : Action :
27 Fuel main filter cartridge H ENG/0065-00 Replace New 10

28 Alternator bolt mounting H ELE 0096-00 Check & tighten Complete & tight 5

EVERY 2000 HOURS REF NO ACTIVITY VALUE STD 250 500

Measure circumferential
29 Damper output shaft L POT 0002-00 ≤ 15 mm 2
play

30 Hydraulic return filter H HST 0013-00 Replace New 15

Action : Action :

Action : Action :
31 Receiver driyer L ACC/0051-00 Replace New 10

Axial play:
0.08 - 0.13 mm
32 Turbocharger end play L ENG 0029-00 Check condition 240
Radial play:
0.43 - 0.63 mm

33 LOTO & emergency shutdown seal & connector L ELE/0010-00 Check condition Good condition 15

34 Suspenssion lock pin L UNC 0008-00 Check & retorque Torque 25 - 31.5 Kgm 20

EVERY 4000 HOURS REF NO ACTIVITY VALUE STD 250 500

35 Engine ground cable L ELE 0022-00 Check & cleaning Tight & clean 20

36 Hydraulic oil H - Replace New 60

Action : Action :

Note :
Condition Inspection Follow Up RISK Group Leader Sign
Good cond V N/A H = HIGH, Must be closed, No backlog
2 columns Bad cond (Write the problem) (Write the action)
L = LOW, May include in backlog Group Leader Name
N/A (if good)
Measure (Write the result)
(Write the action if bad)
1 column - Action: (W rite the action)
 PT PAMAPERSADA NUSANTARA
MINING AND EARTHMOVING CONTRACTOR
PERIODICAL SERVICE FORM B
UNIT MODEL : HD785-7
Sheet 2b of 3
DATE :

CODE NUMBER : HOUR METER :

MECHANIC NAME :

750 1000
NO EVERY 250 HOURS RISK REF NO ACTIVITY VALUE STD
Inspection Follow up Inspection Follow up

1 Lock out switch H ELE 0010-00 Check function E/G can't start 0.5

2 Radiator fin L ENG 0007-00 Check and clean No clogged, dented 15

3 AC condensor fin L ACC 0045-00 Check and clean No clogged, dented 5

4 Engine oil level H ENG 0016-00 Check level, add Between level 1

Action : Action :
5 Engine oil H ENG/0063-00 Take oil sample 1 bottle 3

6 Starting motor terminal & cable connection L ELE 0016-00 Check & clean Thight, clean 0.5

Action : Action :
7 Engine breather hose H - Cleaning Clean 5

8 Alternator terminal & cable connection L ELE 0014-00 Check torque & clean Tight & clean 0.5

9 Alternator v-belt H ELE 0029-00 Check condition No cut, crack 3

10 Alternator v-belt tension H ELE 0029-00 Measure & adjust Deflection 10 - 15 mm/ 6 Kg 1

11 AC compressor v-belt H ACC 0038-00 Check condition No cut, crack 0.5

12 AC compressor v-belt tension H ACC 0038-00 Measure & adjust Deflection 10 - 15 mm/ 6 Kg 1

13 Magnetic coil of AC compressor clutch L ACC 0043-00 Measure resistance Standart: ±15 Ohm 4

low side 100 Psi (e/g stop), or

1.5-2 bar (e/g run)
14 Compressor AC refrigerant H ACC 0041-00 Check pressure 10
High side 100 Psi (e/g stop), or
12-17 bar (e/g run)

15 Fire supression nozzle L ACC 0009-00 Visual check Good condition & complete 1

Good condition & clamp

16 Fire supression tube & clamp (LOP only) H ACC/0028-00 Check condition 1
complete

17 Water separator (LH & RH) L ENG/0064-00 Visual check No water 2

18 Hydraulic oil level H HST 0001-00 Check level, add Between level 0.5

Action : Action :
19 Hydraulic tank breather H HST 0009-00 Cleaning Clean 5

Action : Action :
20 Fuel Tank H ENG/0064-00 Drain sludge No sludge 0.5

Does not slip

21 AC compressor clutch H ACC 0042-00 Check function 3
(starting switch ON)

EVERY 500 HOURS REF NO ACTIVITY VALUE STD 750 1000

Action : (only for ADRO) Action :
22 Fuel prefilter cartridge H ENG/0066-00 Replace New 15

Action : Action :
23 Engine oil H ENG/0019-00 Replace New 15

Action : Action :
24 Engine oil filter H - Replace New 10

EVERY 1000 HOURS REF NO ACTIVITY VALUE STD 750 1000

Action : Action :
25 Hydraulic oil strainer H HST/0021-00 Cleaning Clean 15

26 Starting motor bolt mounting H ELE/0109-00 Check & tighten Complete & tight 1

Action : Action :
27 Fuel main filter cartridge H ENG/0065-00 Replace New 10

28 Alternator bolt mounting H ELE 0096-00 Check & tighten Complete & tight 5

EVERY 2000 HOURS REF NO ACTIVITY VALUE STD 750 1000

Measure circumferential
29 Damper output shaft L POT 0002-00 ≤ 15 mm 2
play

30 Hydraulic return filter H HST 0013-00 Replace New 15

Action : Action :

Action : Action :
31 Receiver driyer L ACC/0051-00 Replace New 10

Axial play:
0.08 - 0.13 mm
32 Turbocharger end play L ENG 0029-00 Check condition 240
Radial play:
0.43 - 0.63 mm

33 LOTO & emergency shutdown seal & connector L ELE/0010-00 Check condition Good condition 15

34 Suspenssion lock pin L UNC 0008-00 Check & retorque Torque 25 - 31.5 Kgm 20

EVERY 4000 HOURS REF NO ACTIVITY VALUE STD 750 1000

35 Engine ground cable L ELE 0022-00 Check & cleaning Tight & clean 20

36 Hydraulic oil H - Replace New 60

Action : Action :

Note :
Condition Inspection Follow Up RISK Group Leader Sign
Good cond V N/A
2 columns Bad cond (W rite the problem) (Write the action)
H = HIGH, Must be closed, No backlog
N/A (if good) L = LOW, May include in backlog Group Leader Name
Measure (W rite the result)
(Write the action if bad)
1 column - Action: (Write the action)
 PT PAMAPERSADA NUSANTARA
MINING AND EARTHMOVING CONTRACTOR
PERIODICAL SERVICE FORM C
UNIT MODEL : HD785-7
Sheet 3a of 3
DATE :

CODE NUMBER : HOUR METER :

MECHANIC NAME :

250 500
NO EVERY 250 HOURS RISK REF NO ACTIVITY VALUE STD
Inspection Follow up Inspection Follow up

1 Final drive oil level LH H POT/0040-00 Check level, add Level 4

2 Final drive oil level RH H POT/0040-00 Check level, add Level 4

3 Differential oil level H POT/0036-00 Check level, add Level 3

Action : Action :
4 Differential breather H POT/0035-00 Cleaning Clean 5

5 Rear suspension LH L UNC/0004-00 Check & adjust level No leak, between level 2

6 Rear suspension RH L UNC/0004-00 Check & adjust level No leak, between level 2

7 Transmission / brake cooling oil level H POT/0010-00 Check level, add Between level 1

8 Brake cooling clamp, piping & hose L - Visual check Clamp complete, no leak 5

Good condition & clamp

9 EPC Harness L HST/0007-00 Visual check 2
complete
Action : Action :
10 Transmission breather H POT/0043-00 Cleaning Clean 8

11 Brake piping & clamp L BRK/0004-00 Visual check Clamp complete, no leak 5

12 Brake oil level H BRK/0005-00 Check level, add Between level 1

13 Front suspension LH L UNC/0004-00 Check & adjust level No leak, between level 2

14 Front suspension RH L UNC/0004-00 Check & adjust level No leak, between level 2

EVERY 500 HOURS REF NO ACTIVITY VALUE STD 250 500

Action : (only for ADRO)
15 Fuel L - Flushing 3x circulation 100

Action : Action :
16 Transmission oil H - Take oil sample 1 bottle 5

Action : Action :
17 Transmission oil filter H POT 0/15-00 Replace New 15

Action : Action :
18 Differential oil L - Flushing 3x circulation 119

Action : Action :
19 Final drive oil (LH & RH) L - Flushing 3x circulation 106

20 Transmission oil L BRK/0006-00 Flushing 3x circulation 92

Action : Action :
21 Hydraulic oil L HST/0004-00 Flushing 3X circulation 31

Check condition,
22 Drive shaft area H ACC/0050-00 Good condition, Lubricated 4
Lub. 4 point

EVERY 1000 HOURS REF NO ACTIVITY VALUE STD 250 500

23 Final drive oil (LH & RH) H - Take oil sample 2 Bottle 5
Action : Action :

24 Final drive magnetic plug L - Check particles Rating A,B,C or X 5

25 Differential oil H - Take oil sample 1 bottle 5

Action : Action :

26 Rear Brake Disc Wear (LH & RH) H BRK/0043-00 Check groove Permissible wear 5

27 Front Brake Disc Wear (LH & RH) H BRK/0043-00 Check groove Permissible wear 5

28 Brake oil (subtank) H BRK/0006-00 Replace New 10

Action : Action :

29 Brake oil filter element H BRK/0007-00 Replace New 15

Action : Action :

30 Transmission oil (6000 hrs with flushing) H POT/0013-00 Replace New 30

Action : Action :

Action : Action :
31 Transmission Strainers L POT/0041-00 Cleaning Clean 20

32 Transmission / brake cooling oil filter H POT/0015-00 Replace New 15

Action : Action :

33 Bracket mounting back alarm L ELE/0046-00 Check condition Good condition 2

Check condition,
34 Tensioner & fan pulley H ACC/0050-00 Good condition, Lubricated 3
Lub. 3 point
Check condition,
35 Transmission mount H ACC/0050-00 Good condition, Lubricated 1
Lub. 1 point
Check condition,
36 Automatic suspenssion (LH & RH) H ACC/0050-00 Good condition, Lubricated 2
Lub. 2 point

EVERY 2000 HOURS REF NO ACTIVITY VALUE STD 250 500

37 Differential Oil (6000 hrs with flushing) H POT/0033-00 Replace New 30

Action : Action :

38 Final Drive Oil (6000 hrs with flushing) H POT/0042-00 Replace New 30
Action : Action :

Note :
Condition Inspection Follow Up RISK Group Leader Sign
Good cond V N/A
2 columns Bad cond (Write the problem) (Write the action) H = HIGH, Must be closed, No backlog
N/A (if good) L = LOW, May include in backlog Group Leader Name
Measure (Write the result)
(Write the action if bad)
1 column - Action: (W rite the action)
 PT PAMAPERSADA NUSANTARA
MINING AND EARTHMOVING CONTRACTOR
PERIODICAL SERVICE FORM C
UNIT MODEL : HD785-7
Sheet 3b of 3
DATE :

CODE NUMBER : HOUR METER :

MECHANIC NAME :

750 1000
NO EVERY 250 HOURS RISK REF NO ACTIVITY VALUE STD
Inspection Follow up Inspection Follow up

1 Final drive oil level LH H POT/0040-00 Check level, add Level 4

2 Final drive oil level RH H POT/0040-00 Check level, add Level 4

3 Differential oil level H POT 0036-00 Check level, add Level 3

Action : Action :
4 Differential breather H POT 0035-00 Cleaning Clean 5

5 Rear suspension LH L UNC 0004-00 Check & adjust level No leak, between level 2

6 Rear suspension RH L UNC 0004-00 Check & adjust level No leak, between level 2

7 Transmission / brake cooling oil level H POT 0010-00 Check level, add Between level 1

8 Brake cooling clamp, piping & hose L - Visual check Clamp complete, no leak 5

Good condition & clamp

9 EPC Harness L HST 0007-00 Visual check 2
complete
Action : Action :
10 Transmission breather H POT/0043-00 Cleaning Clean 8

11 Brake piping & clamp L BRK 0004-00 Visual check Clamp complete, no leak 5

12 Brake oil level H BRK 0005-00 Check level, add Between level 1

13 Front suspension LH L UNC 0004-00 Check & adjust level No leak, between level 2

14 Front suspension RH L UNC 0004-00 Check & adjust level No leak, between level 2

EVERY 500 HOURS REF NO ACTIVITY VALUE STD 750 1000

Action : (only for ADRO)
15 Fuel L - Flushing 3x circulation 100

Action : Action :
16 Transmission oil H - Take oil sample 1 bottle 5

Action : Action :
17 Transmission oil filter H POT 0015-00 Replace New 15

Action : Action :
18 Differential oil L - Flushing 3x circulation 119

Action : Action :
19 Final drive oil (LH & RH) L - Flushing 3x circulation 106

20 Transmission oil L BRK 0006-00 Flushing 3x circulation 92

Action : Action :
21 Hydraulic oil L HST 0004-00 Flushing 3X circulation 31

Check condition,
22 Drive shaft area H ACC/0050-00 Good condition, Lubricated 4
Lub. 4 point

EVERY 1000 HOURS REF NO ACTIVITY VALUE STD 750 1000

23 Final drive oil (LH & RH) H - Take oil sample 2 Bottle 5
Action : Action :

24 Final drive magnetic plug L - Check particles Rating A,B,C or X 5

25 Differential oil H - Take oil sample 1 bottle 5

Action : Action :

26 Rear Brake Disc Wear (LH & RH) H BRK 0043-00 Check groove Permissible wear 5

27 Front Brake Disc Wear (LH & RH) H BRK 0043-00 Check groove Permissible wear 5

28 Brake oil (subtank) H BRK 0006-00 Replace New 10

Action : Action :

29 Brake oil filter element H BRK 0007-00 Replace New 15

Action : Action :

30 Transmission oil (6000 hrs with flushing) H POT 0013-00 Replace New 30
Action : Action :

Action : Action :
31 Transmission Strainers L POT/0041-00 Cleaning Clean 20

32 Transmission / brake cooling oil filter H POT 0015-00 Replace New 15

Action : Action :

33 Bracket mounting back alarm L ELE 0046-00 Check condition Good condition 2

Check condition,
34 Tensioner & fan pulley H ACC/0050-00 Good condition, Lubricated 3
Lub. 3 point
Check condition,
35 Transmission mount H ACC/0050-00 Good condition, Lubricated 1
Lub. 1 point
Check condition,
36 Automatic suspenssion (LH & RH) H ACC/0050-00 Good condition, Lubricated 2
Lub. 2 point

EVERY 2000 HOURS REF NO ACTIVITY VALUE STD 750 1000

37 Differential Oil (6000 hrs with flushing) H POT 0033-00 Replace New 30
Action : Action :

38 Final Drive Oil (6000 hrs with flushing) H POT/0042-00 Replace New 30
Action : Action :

Note :
Condition Inspection Follow Up RISK Group Leader Sign
Good cond V N/A
H = HIGH, Must be closed, No backlog
2 columns Bad cond (Write the problem) (Write the action)
L = LOW, May include in backlog Group Leader Name
N/A (if good)
Measure (Write the result)
(Write the action if bad)
1 column - Action: (W rite the action)
 PT. PAMAPERSADA
NUSANTARA TCMM/PLT/F-010
MINING CONTRACTOR BRCB
PAMA

FORM MONITORING IMPROVEMENT

CODE NUMBER : DATE :

0 HM :

NO ACTIVITY IMPROVEMENT STD PS I remark PS II remark PS III remark PS IV remark

INTERVAL 250 HOURS

1 STARTING MOTOR CHECKER (HD ONLY) 10
2 CLEAN AIR FILTER WITH AIR CLEANER TOOLS 15
3 CLEANING CABIN 10
4 WASHING BEFORE & AFTER PS 20
5 FLUSHING FUEL 15
BEFORE = TON BEFORE = TON BEFORE = TON BEFORE = TON
AFTER = TON AFTER = TON AFTER = TON AFTER = TON
6 CALIBRATION PLM (HD ONLY) 10

7 CLEAR PLM (HD465 ONLY) 10

8 FLUSHING FINAL DRIVE (HD ONLY) 15
9 FLUSHING DIFFERENTIAL (HD ONLY) 15

INTERVAL 500 HOURS

10 FLUSHING HYDRAULIC 15

INTERVAL 1000 HOURS

11 COOLANT TESTER 5

INTERVAL 2000 HOURS

12 RADIATOR CAP TESTER 10

V = VISUAL CHECK (GOOD COND.) X = GOOD AFTER REPAIR/ADJUST/CLEANING/REPLACE/CHANGE/

X = BAD COND./RUSAK NA = NOT APPLICABLE
 PT PAMAPERSADA NUSANTARA
PLANT DIVISION
PLANT DEPT
Filtakleen Inspection Form
UNIT MODEL : KOMATSU HD785-7

CODE NUMBER : DATE :

0 HOUR METER :

EVERY 250 HOURS ACTIVITY KETERANGAN PS I PS II PS III PS IV

1 ELEMEN BYPASS (ITEM NO. 2) DIGANTI SC : 369710

DATANG DENGAN
2 LID O-RING (ITEM NO. 4) DIGANTI
FILTER ELEMENT

DATANG DENGAN
3 LARGE O-RING (ITEM NO. 5) DIGANTI
FILTER ELEMENT

TORQUE PENGENCANGAN NUT,

5 SAAT MEMASANG ELEMEN (ITEM DITORQUE TORQUE = 3,5 Kg.m
NO. 17)

KONDISI HOSE DAN INSTALLASI

CHECK,
6 LAIN ( APAKAH ADA KEBOCORAN
DIGANTI
ATAU KERUSAKAN LAIN NYA)

HIDUPKAN ENGINE
SELAMA 5 MENIT,
FUNGSI BYPASS FILTER PASTIKAN BAHWA SUHU
7 CHECK
FILTAKLEEN FILTAKLEEN
MENINGKAT (MENJADI
PANAS)

EVERY 500 HOURS ACTIVITY KETERANGAN PS I PS II PS III PS IV

BERSIHKAN ORIFICE DARI SEMPROT DENGAN AIR

7 CLEAN
FILTAKLEEN SETIAP 500 JAM COMPRESSOR

EVERY 2000 HOURS ACTIVITY KETERANGAN PS I PS II PS III PS IV

SC INLET : 1795392
SC OUTLET : 1795400
HOSE INLET (ITEM NO.13) & HOSE
7 REPLACE
OUTLET (ITEM NO. 14) PASTIKAN HOSE
TERPASANG
POLYGUARD

MECHANIC

GROUP LEADER SIGN

 PT PAMAPERSADA NUSANTARA
DISTRICT BRCB ELECTRICAL INSPECTION CHECK SHEET
EAST KALIMANTAN UNIT MODEL HD785-7
TANGGAL
START
STOP
HOUR METER
CODE NUMBER :
CHECK BY
EVERY 250 HOURS ACTIVITY STD REMARK PS I PS II PS III PS IV PIC
1 Emergency Stop Check Condition & Function 1 S/C 584607
2 Lock Out Check Condition & Function 1 S/C 387662
Check Condition, Level & PH 10 Baterry GS
3 Battery Check Voltage (E/G Stop) 2 Min 23 Volt
Check Voltage (E/G Start) 3 Min 19 Volt
4 Fuses Check Condition & Function 2 Part List
5 Alarm Buzzer Check Condition & Function 1
6 Horn Check Condition & Function 1 S/C 69625
7 Cabin Lamp Check Condition & Function 1
8 Combination Switch Check Condition & Function 2
9 Back Alarm Check Condition & Function 1 S/C 506766

MEKANIK E
10 Monitor Panel Lamps Check Condition & Function 1 S/C 36939
11 Starting Motor Check Condition & Function 2 Small Comp.
12 AC Check Condition & Function 1
Check Condition & Function 2 Small Comp.
13 Alternator
Check Voltage (EG Running) 2 Min 26 Volt
14 Rotary Lamp Check Condition & Function 1 S/C 578211
15 Payload Lamps Check Condition & Function 2 S/C 34629
17 Head Lamps Check Condition & Function 2 S/C 143685
18 Turn Lamps Check Condition & Function 2 S/C 34629
19 Clearance Lamps Check Condition & Function 2 P/N 421-06-13310
20 Fog Lamps Check Condition & Function 2 S/C 143685
21 Side / Tire Lamps Check Condition & Function 2 S/C 143685
22 Reverse Lamps Check Condition & Function 2 P/N 500-X24F35PIB
23 Rear Lamps Combination Check Condition & Function 3 S/C 34637 & 36939
EVERY 500 HOURS ACTIVITY STD REMARK PS II PS IV PIC
24 Emergency Stop Check Condition inner part 10 S/C 584607
25 Lock Out Check Condition inner part 10 S/C 387662
26 Head Lamp Bulbs Check & Replace 10 S/C 143685
27 Turn Lamp Bulbs Check & Replace 10 S/C 34629
28 Clearance Lamp Bulbs Check & Replace 10 P/N 421-06-13310
29 Side / Tire Lamp Bulbs Check & Replace 10 S/C 143685
30 Reverse Lamp Bulb Check & Replace 10
EVERY 1000 HOURS ACTIVITY STD REMARK PS IV PIC
31 Cabin Harness Check Condition 2 monitoring
32 E/G Alternator Harness Check Condition 2 monitoring
33 Front RH Harness Check Condition 2 monitoring
34 Front LH Harness Check Condition 2 monitoring

MEKANIK E
35 Side RH Harness Check Condition 2 monitoring
36 Side LH Harness Check Condition 2 monitoring
37 Rear Centre Harness Check Condition 2 monitoring
38 Transmission Harness Check Condition 2 monitoring
39 Fire Supression Harness Check Condition 2 monitoring
40 Auto Lubrication Harness Check Condition 2 monitoring
41 Radio Communication Harness Check Condition 2 monitoring
EVERY 2000 HOURS ACTIVITY STD REMARK PS IV PIC
42 Cabin Lamp Bulb Check & Replace 5
43 Panel Lamp Bulbs Check & Replace 10 S/C 36939
44 Rotary Lamp Bulb Check & Replace 5 S/C 578211
45 Payload Lamp Bulbs Check & Replace 10 S/C 34629
46 Head Lamp Bulbs Check & Replace 10 S/C 143685 MEKANIK E
47 Turn Lamp Bulbs Check & Replace 10 S/C 34629
48 Clearance Lamp Bulbs Check & Replace 10 P/N 421-06-13310
49 Fog Lamp Bulbs Check & Replace 10 S/C 143685
50 Side / Tire Lamp Bulbs Check & Replace 10 S/C 143685
51 Reverse Lamp Bulb Check & Replace 10
52 Rear Lamp Comb. Bulb Check & Replace 10 S/C 34637 & 36939
 PAMAPERSADA NUSANTARA AIR CONDITIONING CHECK SHEET
BRCB- EAST KALIMANTAN UNIT MODEL : ALL MODEL

UNIT NUMBER : TANGGAL

AC PRODUCT : START TIME

COMPRESSOR MODEL : FINISH TIME

COMPRESSOR NO : HOURMETER

NO ITEM TO BE CHECK CHECK POINT PS I REMARKS PS II REMARKS PS III REMARKS PS IV REMARKS

EVERY 250 HOURS

1 AC OVER ALL CONTROLER & FUNCTION CHECK & ADJUST

2 V BELT COMPRESSOR CHECK & ADJUST

3 BRACKET & ADJUSTER COMPRESSOR CHECK & TIGHTEN

4 SAFETY COVER V BELT CHECK & TIGHTEN

5 COMPRESSOR AC :

- PULLEY COMPRESSOR CHECK CONDITION

- MAGNETIC CLUTCH CHECK FUNCTION

- BODY & COVER (FR & RR) CHECK LEAKING

- SEAL SHAFT COMPRESSOR CHECK LEAKING

- LOW & HIGH PORT CHECK LEAKING

- LOW & HIGH VALVE CAP CHECK CONDITION

6 WIRING & CONNECTION CHECK CONDITION

7 HOSE, PITTING & CONNECTION CHECK CONDITION

8 REFRIGERANT & OIL COMPRESSOR CHECK & ADD

- RESULT LOW PRESS :

- RESULT HIGH PRESS :

9 CONDENSOR :

- FIN & CORE CHECK & CLEAN

- MOTOR ( JIKA DILENGKAPI ) CHECK FUNCTION

10 RECEIVER DRYER CHECK LEAKING

11 DUCT & GRILE CHECK CONDITION

12 ELEMEN VENTILASI (OUTER) CHECK & CLEAN

13 ELEMEN AR CONDITIONER (INNER) CHECK & CLEAN

14 BEARING PULLEY COMPRESSOR CHECK & CLEAN

EVERY 500 HOURS

1 HOSE COMPRESOR TO CONDENSOR CHECK CONDITION

2 HOSE CONDESOR TO AIR DRYER CHECK CONDITION

3 HOSE RECEIVER DRYER TO EVAPORATOR CHECK CONDITION

4 HOSE EVAPORATOR TO COMPRESOR CHECK CONDITION

EVERY 1000 HOURS

1 ELEMEN VENTILASI ( OUTER ) REPLACE

2 ELEMEN AIR CONDITIONER ( INNER ) REPLACE

EVERY 2000 HOURS

1 V BELT COMPRESSOR CHECK & REPLACE

2 RECEIVER DRYER REPLACE

3 REFRIGERANT & OIL COMPRESSOR REPLACE

EVERY 8000 HOURS

1 COMPRESSOR ASSY REPLACE

2 MAGNETIC CLUTCH REPLACE

3 HOSE COMPRESOR TO CONDENSOR REPLACE

4 HOSE CONDESOR TO AIR DRYER REPLACE

5 HOSE RECEIVER DRYER TO EVAPORATOR REPLACE

6 HOSE EVAPORATOR TO COMPRESOR REPLACE

V KONDISI BAIK & STANDARD X KONDISI RUSAK X KONDISI SUDAH DIPERBAIKI

KOLOM REMARK DIISI ACTION YANG DILAKUKAN/HASIL DARI PENGUKURAN

SIGNATURE
MECHANIC AC
NAME