Derrick/Mast Inspection Certificate: (API Recommended Practice 4G - 3 Edition 2004 - Sect 9.0)

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DERRICK/MAST INSPECTION

CERTIFICATE
(API Recommended Practice 4G – 3rd Edition 2004 - sect 9.0)

CLIENT DETAILS
INSPECTION Derrick Services (UK) Limited
CLIENT NAME:
PT. Daya Alam Tehnik Inti AUTHORITY
CLIENT
ADDDRESS: PT. Daya Alam Tehnik Inti PURPOSE OF To certify compliance of :
(Aurum Building, 2nd. Floor; Derrick:
CERTIFICATE Mast: X
Jl. Ampera Raya 37 Cilandak; 1)
In accordance with API 4G – 3rd Edition 2004
Jakarta, Indonesia) “Recommended Practice for Use and
Procedures for Inspection, Maintenance, and
Repair of Drilling and Well Servicing Structures.

INSPECTION February 2012


DATE
INSPECTOR Lee Allen
NAME
RIG/INSTALLATION DETAILS
RIG/INST. NAME: Rig 231 NAMEPLATE NOV
DETAILS:-
OEM NAME;
DHW-136-N22
LOCATION: Indonesia
SERIAL NO, ETC. 600,000lbs (10 lines)

DECLARATION

We hereby certify that an:

API 4G Category III Derrick/Mast Inspection


API 4G Category IV Derrick/Mast Inspection X
Dropped Object Survey

has been carried out on the above named equipment in accordance with the terms and conditions of the clients
1).
Purchase Order documents and the referred standards, codes, and specifications To the best of our knowledge
and belief the derrick/mast complies in all respects with the applicable requirements of API 4G subject to
2)
satisfactory implementation of any findings and recommendations set out in documents listed below .

OUTSTANDING WORK
2)
DSL Inspection Document No: 2821-API-01 - API cat IV Mast Visual Inspection Report
2821-API-02 - API cat IV Substructure Visual Inspection Report
2821-API-03 - Recommendation Report
If no Outstanding Work state NONE
“NONE”

NEXT INSPECTION
We recommend that the derrick/mast referenced hereon is subject to further periodic inspections at intervals of not
more than two (2) years as per stated frequency for API 4G CATEGORY III Inspections.
Inspection 1) Next API 4G Cat III 2) Next API 4G Cat IV
Date/s Due Date: February 2014 Due Date: February 2017
For and on behalf of Derrick Services (UK) Limited

Name: Craig Stear Title: Inspections Coordinator

Signature: Date: 04/05/2012

Form No QA 271 Rev 4


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Derrick Services (UK) Limited
Falcongate House, Faraday Road, Harfreys Industrial Estate, Great Yarmouth; Norfolk, NR31 0NF – United Kingdom
Tel: +44(0)1493 669141 Fax: +44(0)1493 668409

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