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Non-Conformance Report Notification

Originator: Date: 22/11/2022


Agus Prasetya
(Bureau Veritas Indonesia)
On behalf Pure Data Centers
To: Contract title: JKT01 – TATA TFO
Yoga Purnomo – TATA Project Manager
Ronald B – TATA Dy. Project Manager
Contract No:
Nurul Putra – Project HSE Manager
Laurensius Lamech – TATA Corporate HSE Contractor: PT. TATA MULIA
Manager NUSANTARA INDAH
Copied to: Notification No:
Chris Yates – PDC William Strachan – PDC JKT01-NCR-HSEW-004-2022
Lyndon Davies – PDC Lendy Prabowo – PDC
Graeme Munro – PDC Mark Holden – PDC
Akhil Kattali – PDC Serasi Purba – LSI PM
James Teegan – PDC Ben McGeachie – T&T
A Non-conformance, as follows, has been identified:
Title: Unsafe Lifting Practice and RAMS did not cover the scope of work.
Describe: The lifting activity of Temporary pump on Upper roof area found not following the standard
lifting procedures. The similar lifting frame was spotted before and site instruction was given to stop the
further use. However, the contractor approved submitted RAMS not covering the lifting and installation of
the pump.
1. Submitted RMAS not covering the actual work scope of lifting.
2. There was no design and calculation for lifting frame.
3. There was no work permit obtained or lifting plan submitted.
4. Lashing belts are used for lifting instead of standard lifting slings.
5. All the PJK3 certifications of the lifting gears to be available on site.

Within these unsafe finding with Breach Indonesia regulation (PERMEN No. 8/2020, KEPMEN No.
174/1986 & PERMENAKER ESDM No. 18/2018).

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Name: Agus Prasetya
Date: 22/11/2022

The following Corrective Action is proposed by Contractor:

The date proposed for completion of the Corrective Action is:

--/--/ --
Name:
Date:

The Corrective Action described is accepted/accepted with comments/rejected (details as


appropriate)

Signed BVI / Consultant

Name Date:

The actions described above have been carried out to the satisfaction of the Employer
/Consultant Team

Signed Pure DC / Employer

Name Date:

Signed PT. LSI / Project Manager

Name Date:

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