PT.

PERTAMINA EP REGIONAL 4 ZONA 14

WELL, PRODUCTION & PROJECT DEPT.

INSPECTION & TEST PLAN (ITP) CIVIL

ISSUED FOR
A 29/05/2024 ETH ASM ATG DB/TIP BSA
REVIEW
BY CHECKED APPROVED CHECKED APPROVED
REV DATE DESCRIPTION
PT. BORNEO MITRA SINERGI PT.PERTAMINA EP
TOTAL OR PARTIAL REPRODUCTION AND/OR UTILIZATION OF THIS DOCUMENT ARE FORBIDDEN WITHOUT PRIOR
WRITTEN AUTHORIZATION OF PT PERTAMINA EP

PROJECT PEMBANGUNAN TANGKI WALIO PAPUA

FIELD
CO Number : 4710000731 SPMK No: 068/PPC90000/2024-S0
Document No:
Revision:
PEP-PTW-WLO-CV-PRO-001
A
 PT. PERTAMINA EP REGIONAL 4 ZONA 14
WELL, PRODUCTION & PROJECT DEPT.

TABEL LEMBAR REVISI

REVISI CATATAN HAL REVISI CATATAN

HAL
A B 0 A B 0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31 LAMPIRAN
32
33
34

PEP-PTW-WLO-CV-PRO-001_Rev A Page 2 of 6
 PT. PERTAMINA EP REGIONAL 4 ZONA 14
WELL, PRODUCTION & PROJECT DEPT.

DAFTAR ISI
ITP CIVIL .................................................................................................................................................................1
TABEL LEMBAR REVISI ........................................................................................................................................2
DAFTAR ISI .............................................................................................................................................................3
1. LATAR BELAKANG .......................................................................................................................................4
2. TUJUAN ...........................................................................................................................................................4
3. REFERENSI .....................................................................................................................................................5
4. INSPEKSI LEVEL ............................................................................................................................................6
5. LAMPIRAN ......................................................................................................................................................6

PEP-PTW-WLO-CV-PRO-001_Rev A Page 3 of 6
 PT. PERTAMINA EP REGIONAL 4 ZONA 14
WELL, PRODUCTION & PROJECT DEPT.

1. LATAR BELAKANG
Area Walio merupakan tempat dilakukan pengumpulan minyak dari SPU Linda sebelum di kirim
ke Petrogas Basin. Saat ini di area Walio memiliki 1 unit tangki dengan kapasitas volume Tangki
= 7700 bbls.

Gambar 1.1 Posisi Tangki Walio

2. TUJUAN
Dokumen prosdur ini bertujuan untuk mendeskripsikan Rencana inspeksi dan pengujian atau
Inspection and Test Plan (ITP)yang di persyaratkan dari tahap pengadaan, fabrikasi dan ereksi
untuk material Sipil pada Proyek Pembangunan Tanki Walio Papua Field.

PEP-PTW-WLO-CV-PRO-001_Rev A Page 4 of 6
 PT. PERTAMINA EP REGIONAL 4 ZONA 14
WELL, PRODUCTION & PROJECT DEPT.

3. REFERENSI
3.1. Code dan Standard
API 650 : Welded Steel Tanks for Oil Storage
API STD 663 : Tank Inspection, Repair, Alteration and Reconstruction
RKS : Rencana Kerja & Syarat-syarat Pembangunan Tangki Walio
Papua Field
BMS-EP14-PEP-001 : Prosedur Pelaksanaan Pekerjaan Fabrikasi, Assembly,
Erection Storage Tank
ACI 304 : Guide Measuring, Mixing, Transporting and Placing
Concrete
ACI 308 : Specification for Curing Concrete
ACI 347 : Guide to Formwork for Concrete
ACI JOIM-99 : Specification for Concrete Structure
ASTM C94 : Standard Specification for Ready-mixed Concrete
ASTM C143 : Test Method for Slump or Portland Cement
ASTM C150 : Standard Specification for Portland Cement
ASTM C33 : Standard Specification for Concrete Aggregates

3.2. Definisi dan Singkatan

OWNER : PT. PERTAMINA EP REGIONAL 4 ZONA 14
CONTRACTOR : PT. BORNEO MITRA SINERGI
VENDOR : Pihak yang terpilih sebagai penyuplai Jasa, Material, Alat dan
Inspector sesuai dengan Persyaratan Kontrak
PROJECT : PEMBANGUNAN TANGKI WALIO PAPUA FIELD
SKK MIGAS : Satuan Kerja Khusus Pelaksana Kegiatan Usaha Hulu
Minyak dan Gas Bumi
PEP14 : PT. PERTAMINA REGIONAL 4 ZONA 14
BMS : PT. BORNEO MITRA SINERGI

PEP-PTW-WLO-CV-PRO-001_Rev A Page 5 of 6
 PT. PERTAMINA EP REGIONAL 4 ZONA 14
WELL, PRODUCTION & PROJECT DEPT.

API : American Petroleum Institute

ACI : American Concrete Institute
ASTM : American Society for Testing and Materials
SNI : Standar Nasional Indonesia

4. INSPEKSI LEVEL
“M“ : Implementation (Persiapan dan Penyediaan Kelengkapan Inspeksi)
“A“ : Approval (Persetujuan kelengkapan inspeksi dan material yang di inspeksi)
“R“ : Review & Comment (Pemriksaan Dokumen dan report Inspeksi)

“SW“ : Spot Witness (Menyaksikan inspeksi secara acak dan tanpa pembitahuan
tertulis)
“W“ : Witness Point (Kontraktor akan memastikan waktu untuk Owner dapat
menyaksikan inspeksi yang akan di lakukan)
“H“ : Hold Point (Kontraktor berkewajiban untuk memberitahu Owner dengan jang
Ka waktu yang disepakati sebelum operasi sehingga dapat disksikan oleh
perwakilan owner. Kontraktor tidak boleh melanjutkan operasi pada titik Hold
point tersebut tanpa pesetujuan dari Owner)
“I” : Information (kontraktor menginformasikan pelaksanaan pekerjaan)

5. LAMPIRAN
5.1. ITP Civil Work

PEP-PTW-WLO-CV-PRO-001_Rev A Page 6 of 6
 INSPECTION & TEST PLAN ( ITP )

JOB No. : PROJECT NAME : PEMBANGUNAN TANGKI WALIO PAPUA FIELD

LOCATION : WALIO PUMP STATION - PEP Z14 DESCRIPTION : CIVIL WORK

LEGEND CLASSIFICATION
H - HOLD POINT ;
CONTRACTOR is not allowed to proceed with the test / inspection unless a written release is issued by the CONTRACTOR inspector

W - WITNESS ;
CONTRACTOR / OWNER intends to witness the test / inspection, however CONTRACTOR can proceed with the test / inspection
when the CONTRACTOR inspector is not present at the notified time:

SW - SPOT WITNESS ;
CONTRACTOR / OWNER intends to witness without the
when the CONTRACTOR inspector is not present at the notified time:

R - REVIEW
Review and approve the CONTRACTOR’s Inspection / Test Records and/or other CONTRACTOR’s documents

M - IMPLEMENTATION
Preparation for and execution of measurement, observation, examination / Testing include

A - APPROVAL
Approval of inspection document

OR - OFFICIAL REPORT

IR - INTERNAL REPORT

ABBREVIATIONS
AWS = American Welding Society PWHT = Post Weld Heat Treatment ASME = American Society Mechanical Engineers
CSA = Canadian Standard Association WQTR = Welder Qualification Test Record ASNT = American Societ Non Destructive Testing
WPS = Welding Procedure Specification Project Spec. = Project Specification ASTM = American Societ Testing of Material
PQR = Procedure Qualification Report N/A = Not Applicable API = American Petrolium Institute
NDE = Non Destructive Examination WQTR = Welder Qualification Test Record SNI = Standar Nasional Indonesia

NOTES
 Page 1 of 2

DOCUMENT NO
Inspection and Test Plan
PEP-PTW-WLO-CV-PRO-001
Civil Work BMS PEP
Rev Description Date BY CHK'D APP'D CHK'D APP'D
PT.PERTAMMINA EP - PT.BORNEO MITRA SINERGI A ISSUED FOR REVIEW 29-May-24 ETH ASM ATG DB/TIP BSA

Pembangunan Tangki Walio Papua Field

INSPECTION AND TEST PLAN

Applicable Spec./Code INSPECTION ACTIVITIES

NO ITEM ACTIVITIES ACCEPTANCE CRITERIA OTHER REPORT REMARK
/Standard/Procedure BMS PEP
S

0 MATERIAL RECEIVING INSPECTION

0.1 Sertifikat Raw Material Mill's Certificate Project Spec. & Proce. P SW IR

0.2 Visual and dimensional Inspection Brochure & Catalogue Project Spec. & Proce. P R/SW IR

1 EARTH WORK
1.1 Soil Investigation / Investigasi Jenis Tanah Project Spec. & Proce. Project Spec. & Proce. P R/SW OR
a Sondir Test / Tes Sondir

1.2 Excavation / Penggalian

a Investigasi fasilitas eksisting dalam tanah (Kabel, pipa, dan lain-lain) Project Spec. & Proce. Project Spec. & Proce. P R/W IR
b Relokasi / perlindungan fasilitas eksisting Project Spec. & Proce. Project Spec. & Proce. P R/W IR
c Metode Penggalian Approval Drawing Approval Drawing P R/W OR
d Elevasi dan kedalaman Penggalian Approval Drawing Approval Drawing P R/W OR
e Perlindungan dinding galian / shoring Approval Drawing Approval Drawing P R/W IR
f Dewatering Project Spec. & Proce. Project Spec. & Proce. P R/W IR
g Cleaning Are Penggalian Project Spec. & Proce. Project Spec. & Proce. P R/W IR

1,2 Backfill
a Cleaning (removal of trash, debrish, etc) Approval Drawing Approval Drawing P W IR

1,3 Disposal
a Disposal area location Project Spec. & Proce. Project Spec. & Proce. P W IR

2 CIVIL FOUNDATION/Pekerjaan Pondasi Sipil

2.1 Pemancangan
a Pengamanan area sekitar pancang Approval Drawing Approval Drawing P R IR
b Piling Setting Layout / penentuan layout pancang Approval Drawing Approval Drawing P R OR
c Penentuan Titik dan kedalaman pancang Approval Drawing Approval Drawing P R OR
d Penetration & Elevation Approval Drawing Approval Drawing P R OR
e Elevation of pile head cut off item pemancangan tambahkan1. Approval Drawing Approval Drawing P R OR
Kalendering
2.2 Reinforcing Bar work/Pembesian PEP-PTW-WLO-CV-DWG-004 ACI 308, ACI 347 P R/SW OR
a Surface cleaning
b Location, slope, size/ukuran, number/jumlah, cleaning and spacing/jarak
antar rebar
2.3 Fondation pilecap
A. Formwork ceklist (dimensi, kerataan , kerapatan , kesikuan, kestabilan , selimut beton,
support dan penopang
B. Reinforcing bar work Kebersihan (tidak ada sampah, lumpur , dan bahan material lain
yang mempengaruhi kualitas beton, Jarak, jumlah , ukuran )
c pouring concrete ( mutu beton , slump beton , kebersihan lantai kerja, stop cor , top
level pengecoran, jarak selimut beton, sambungan beton lama dan baru )

welding results inspection of pile

 Page 2 of 2
Formwork ceklist (dimensi, kerataan , kerapatan , kesikuan, pouring concrete ( mutu beton , slump beton , kebersihan lantai kerja, stop cor , top
kestabilan , selimut beton, support dan penopang level pengecoran, jarak selimut beton, sambungan beton lama dan baru )

INSPECTION AND TEST PLAN

Applicable Spec./Code INSPECTION ACTIVITIES

NO ITEM ACTIVITIES ACCEPTANCE CRITERIA OTHER REPORT REMARK
/Standard/Procedure BMS PEP
S
2.3 Concrete Work
a Cleanliness Inspection Project Spec. & Proce. Project Spec. & Proce. P R/SW IR
b Dimension & Levelness (Dimensi dan elevasi) Inspection Project Spec. & Proce. Project Spec. & Proce. P R/SW OR
c Orientation Mark Check Project Spec. & Proce. Project Spec. & Proce. P R/SW OR
d Formwork Project Spec. & Proce. Project Spec. & Proce. P R/SW OR

3 DOCUMENTATION Contract Document Project Spec. & Proce. P R OR

LEGEND:
"H" = HOLD POINT " W " = WITNESS INSPECTION " SW " = SPOT WITNESS
"A" = APPROVAL DOCUMENT " R " = REVIEW AND COMMENT
" I" = INFORMATION "M " =IMPLEMENTATION
IMPLEMENTATION

ITP untuk aspal ? ?

1. SNI 8135:2015
2. spek umum 2018 div 6
3. pembersihan , pengupasan,
pemadatan,pelapisan bawah ,
tackout/primecoat test ,
finishing)