RFA Beton

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PT.

CITRA KARSA DINAMIKA


No. Dok. : Reff. No : RFA-009/CSA/CKD-KCS-FF/2022 Day :
Date . Ref : Issued Re-Issued-1 Re-Issued-3 Date :
NO. PO : Re-Issued-2 Re-Issued-4 Page : 1

REQUEST FOR APPROVAL MATERIAL


Fire Sprinkler System Factory & Office Plant Project
FUNCTION :

: Civil : Mechanical : Landscape

: Structure : Electrical : …………………………

: Architecture : Plumbing

(1) CONTRACT REQUEST TITLE :

SUBJECT ATTACHED REFERENCE

: Material set : Sample set : Drawing

: Shop Drawing set : Catalogue set : As Built Drawing

: Typical Detail set : Technical Data set

TITLE : Ready Mix Concrete

(2) ATTN : Submitted by Checked by


PT. Citra Karsa Dinamika PT. Skemanusa Consultama Teknik
For Review / Approve See Note Authorized Signature : Authorized Signature :
(Site Engineer)
Acknowledge Please Clarify

NOTE : ……...………………………………………….. (…........................) (…........................)


…………………………………………………… Date/ Time : ………............ Date/ Time : ………............
……………………………………………………

(3) Owner Result / Comment Approved by


PT. Kimberly Clark Softex
Work may Proceed Clarified Signature :
(Project Manager)
Work may Proceed as Noted Acknowledge

Make Corrections as Noted & Resubmit


……………………………….
Not Approved Date/ Time :
………………..………………
NOTE : ……...…………………………………………..
…………………………………………………… * Distribution : 3 Original Signed Copies
…………………………………………………… (1 for Contractor, 1 for Consultant, 1 for Owner)

Checked By : Document By : Doc. Date :

(Engineering) (Doc. Control)

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